What on call used to mean
“I was surprised when the emergency doctor at Cityside Hospital said he was going to call you to discuss my case,” Farmer Carr said when I saw him today. “I figured you’d be asleep at that hour.”
I smiled as I recalled the cell phone call that had come in at 9:30 the night I had sent him back to the hospital for a reassessment.
“No, I was sitting in my camping recliner in the tack room in our horse barn, writing on my iPad and listening to the barn animals chewing their hay.”
I saw his eyes soften. He no longer had a hundred head of cattle, but he was still Farmer Carr, and he loved animals.
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Source: Kevin, M.D. - Medical Weblog - March 28, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/a-country-doctor" rel="tag" > A Country Doctor, MD < /a > Tags: Physician Hospital Source Type: blogs
The emergency department and “access” to care
The redefinition of a potentially functioning medical system in which each individual is able to utilize financially non-prohibitive care into a disjointed balkanized realm of income-based insurance tribes is aided by the protean definitions of the political buzzword “access.” Access to medical care does not entail the ability to reliably obtain medical care much as medical insurance reform is not, in point of fact, healthcare reform. Regardless, the conflation of one’s potential ability to access a broken system with the delivery of a reliably accessible holistic system is never more evident than in the discussi...
Source: Kevin, M.D. - Medical Weblog - March 28, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/william-f-paolo" rel="tag" > William F. Paolo, MD < /a > Tags: Policy Emergency Source Type: blogs
What can doctors learn from La La Land?
Last week I finally got around to watching La La Land. As a fan of musicals, I had wanted to see it for quite some time, and before I stepped into the theater, I didn’t know what it was about nor what kinds of reviews it had been getting. Spoiler alert: Don’t read on if you haven’t seen it and intend to watch it (and I’ve never told anybody before not to read my blog, but the movie is so good, please watch it before you read this!).
Very rarely would I use the word “masterpiece” to describe a movie, but La La Land would be it. The storyline involves two main characters, brilliantly played by Ryan Goslin...
Source: Kevin, M.D. - Medical Weblog - March 28, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/suneel-dhand" rel="tag" > Suneel Dhand, MD < /a > Tags: Physician Primary care Source Type: blogs
How social media powers physician advocacy
This week is Physicians Week, and this is one in a series of interviews with members of the physician community that are bringing a variety of ideas and networks together in order to improve the relationships between physicians and between physicians and their patients.
Dr. Marion Mass is a pediatrician in Philadelphia and a board member of a physician advocacy group, a large physicians-only network that started as a group on Facebook. Dr. Mass joined the group when it was still just a Facebook group — now it’s a major network of thousands that have done major work like cracking national health care town halls ...
Source: Kevin, M.D. - Medical Weblog - March 28, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/marion-mass" rel="tag" > Marion Mass, MD < /a > Tags: Physician Health reform Source Type: blogs
This doctor gives his cell number out to patients. He explains why.
Contrary to what my wife and colleagues think, it is not all about me. Well yes, I do get lonely sitting at my desk late at night, when my wife is busy, and the long-ago-moved-away kids are not available, and there is nothing running on NASCAR. Nonetheless, it is not really about my needs. I am talking, of course, about why I give patients my cell phone number.
It is printed on my card, and I emphasize it during office visits.
“If you need me, call.”
I remind them that when you are lying on the floor with crushing chest pain, the correct number is 911. PLEASE, do not leave life and death messages on my voice mail...
Source: Kevin, M.D. - Medical Weblog - March 27, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/james-c-salwitz" rel="tag" > James C. Salwitz, MD < /a > Tags: Physician Cancer Source Type: blogs
3 myths about a single-payer system and why it ’s doomed to fail
It sounds great, almost too good to be true: Coverage for all with lower costs, a broad choice of providers, and minimal paperwork.
The problem is that it won’t work.
For more than half a century, advocates for a government-run, single-payer approach to health care coverage have touted its potential. With debate over the Affordable Care Act heating up by the day, progressives, both at the state and federal levels are now pushing anew to move to some form of this system. Most recently, the California Legislature introduced a bill to accomplish this, although without any details of how it would work.
On the surface, the a...
Source: Kevin, M.D. - Medical Weblog - March 27, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/robert-pearl" rel="tag" > Robert Pearl, MD < /a > Tags: Policy Health reform Source Type: blogs
Going with our gut, not guidelines
His voice was gruff and his expression surly.
“I don’t want any more medications.”
His face was indented by deep clefts, remnants of eight decades of life hard lived. His tone was commanding and certain. I knew that he was fond of me, but I could feel his patience slipping. He neither asked about nor accepted his diagnosis of heart failure. I could tell him till I was blue (or he was for that matter) in the face that his low ejection fraction portended a poor prognosis, and national guidelines suggested both a beta blocker and defibrillator placement.
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Your patients are rating you onl...
Source: Kevin, M.D. - Medical Weblog - March 27, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/jordan-grumet" rel="tag" > Jordan Grumet, MD < /a > Tags: Physician Primary care Source Type: blogs
Meet the doctor who started a physician advocacy group
This week is Physicians Week, and this is one in a series of interviews with members of the physician community that are bringing a variety of ideas and networks together in order to improve the relationships between physicians and between physicians and their patients.
Dr. Kim Jackson founded a large network of physicians and future physicians that started as a group on Facebook. As patients lamented increasing costs in health coverage and less time with their physicians, doctors became burdened, and this political advocacy group was founded as a way to help deal with the issues.
How did this physician advocacy group come...
Source: Kevin, M.D. - Medical Weblog - March 27, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/kim-jackson" rel="tag" > Kim Jackson, MD < /a > Tags: Physician Health reform Source Type: blogs
My cold hands met their match
Despite living in Michigan for over 30 years, my cold hands disclose my Southern California origin. As a physician, these cold hands have touched many lives. For my pregnant patients, they usually sigh with relief as I touch their bellies, the coolness of my hands offering them respite from the inferno growing inside them. They smile when I tell them I can feel their baby squirming and how it is laying inside them. And I smile inside that I have the privilege to touch them and their baby.
My gynecology patients, even though I warn them, jump in surprise at how cold my hands truly are. Those past menopause, in the midst of ...
Source: Kevin, M.D. - Medical Weblog - March 27, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/andrea-eisenberg" rel="tag" > Andrea Eisenberg, MD < /a > Tags: Physician OB/GYN Source Type: blogs
Watch who you call “paternalistic”: A physician takes exception to the New York Times
My husband and I, both anesthesiologists, enjoy our Sunday mornings together — coffee, the New York Times, a leisurely breakfast. No rush to arrive in the operating room before many people are even awake.
Today, though, seeing reporter Jan Hoffman’s front-page article in the Times — “Staying Awake for Your Surgery?” — was enough to take the sparkle out of the sugar. Her article on how much better it is to be awake than asleep for surgery reminded me why I left a plum job as a reporter for the Wall Street Journal to go to medical school — because reporters have to do a quick, superficial job of co...
Source: Kevin, M.D. - Medical Weblog - March 27, 2017 Category: Journals (General) Authors: Kevin Tags: Uncategorized Source Type: blogs
Digital tools should not adversely affect the doctor-patient relationship
I did a second stint on a talk radio a few weeks ago which I really enjoyed. The callers represent a genuine, down-to-earth view of the reality of connected health adoption. The first time around, most callers were cautionary, raising concerns about data security and wondering about physician endorsement. This time the theme that spontaneously emerged was one of people telling stories from the heart, about loved ones who have benefited from connected health. That was uplifting for me.
As the hour came to a close, the last caller, a physician, voiced a concern I’ve heard from the medical community before. He sugge...
Source: Kevin, M.D. - Medical Weblog - March 27, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/joseph-kvedar" rel="tag" > Joseph Kvedar, MD < /a > Tags: Tech Mobile health Source Type: blogs
10 signs to know when to quit your job
Attention all nurses, nurse practitioners, physician assistants, midwives, doctors and anyone else in health care: Here are the top 10 warning signs that it is time to quit your job. The first three are mine. The rest are from colleagues. If you recognize anything on this list, please quit your job.
10. You feel nauseated when you see your clinic logo. You alter your commute to avoid streets with your clinic’s billboard.
9. Discouraged by the general despair among clinic staff, you try to be joyful. Then you’re reprimanded by the clinic manager for being “excessively happy.”
8. You dream of leaving medicine to work...
Source: Kevin, M.D. - Medical Weblog - March 26, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/pamela-wible" rel="tag" > Pamela Wible, MD < /a > Tags: Physician Primary care Source Type: blogs
The problem with price transparency
Transparency — including price, quality, and effectiveness of medical services– is a vital component to lowering costs and improving outcomes. However, it is imperative transparency go hand-in-hand with financial incentives for patients and consumers; otherwise, the quest will be in vain. The single best way of reducing costs while not worsening health outcomes is to redistribute resources from less cost-effective health services to more cost-effective ones. Americans are extremely uncomfortable with the idea of making decisions based on cost, but we must become fluent in the language of cost and more com...
Source: Kevin, M.D. - Medical Weblog - March 26, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/niran-s-al-agba" rel="tag" > Niran S. Al-Agba, MD < /a > Tags: Physician Primary care Source Type: blogs
How politicians mislead their constituents on health care
When Louisiana resident Andrea Mongler wrote to her senator, Bill Cassidy, in support of the Affordable Care Act, she wasn’t surprised to get an email back detailing the law’s faults. Cassidy, a Republican who is also a physician, has been a vocal critic.
“Obamacare” he wrote in January, “does not lower costs or improve quality, but rather it raises taxes and allows a presidentially handpicked ‘Health Landing Pages Choices Commissioner’ to determine what coverage and treatments are available to you.”
There’s one problem with Cassidy’s ominous-sounding assertion: It’s false.
The Affordable Care Act, c...
Source: Kevin, M.D. - Medical Weblog - March 26, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/charles-ornstein" rel="tag" > Charles Ornstein < /a > Tags: Policy Health reform Source Type: blogs
The one person that sustains this emergency physician
When I go to work, I take a lot of things with me. Everyone has their ritual, right? I take my backpack with my computer inside. I take my phone. I take charging cords, the true modern lifeline. I take lunch. I carry a pen, flashlight and pocket knife.
On a more abstract level, I take the wonderful education I received as a medical student and resident, coupled with my years of experience as a physician. I take my drug-store +2 diopter glasses, not only to read and suture but equally important, to look venerable and wise.
But I take something else. It’s certainly as important as all of the other stuff, if not more so in ...
Source: Kevin, M.D. - Medical Weblog - March 26, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/edwin-leap" rel="tag" > Edwin Leap, MD < /a > Tags: Physician Emergency Source Type: blogs
