What does it mean to be a progressive doctor?
A curious post popped up on my Facebook feed recently: “Another doctor running for office!” A picture of an attractive family was nestled below that exclamation, asking to show your support (in the form of dollars) for this doctor running as a Democrat for the House of Representatives. It had that sense of enthusiasm that implied I was obligated to be excited, but instead came off more like Jeb Bush’s perfunctory, “Please clap.” It joined a growing number of posts supporting physician candidates in the “Progressive Doctors” Facebook group (of which I happen to be a member).
Physici...
Source: Kevin, M.D. - Medical Weblog - September 15, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/surafel-tsega" rel="tag" > Surafel Tsega, MD < /a > Tags: Policy Public Health & Washington Watch Source Type: blogs
Physicians: Use your voice to make the difference
This article originally appeared in the Hospital Leader.
Image credit: Shutterstock.com
Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - August 28, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/vineet-arora" rel="tag" > Vineet Arora, MD < /a > Tags: Physician OB/GYN Public Health & Policy Washington Watch Source Type: blogs
Should only infectious disease specialists be allowed to prescribe antibiotics?
The WHO’s recent announcement of multi-drug resistant strains of gonorrhea raises the specter of a worldwide SuperClap Attack that even the Avengers couldn’t foil. It also comes as yet another ominous reminder of the perils of rampant and indiscriminate antibiotic use.
There’s plenty of blame to spread around. True, here in the U.S., consumers can’t buy antibiotics over the counter, but that hasn’t kept physicians and other providers from over-prescribing them with a casual “more-is-more,” “just-in-case” philosophy. As an internist colleague once warned me, facetiously, with furrowed brow, “We’re seei...
Source: Kevin, M.D. - Medical Weblog - August 9, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/craig-bowron" rel="tag" > Craig Bowron, MD < /a > Tags: Meds Hospital Hospitalist Infectious disease Medications Source Type: blogs
The sad direction of hospital care
My 74-year old obese, poorly controlled diabetic patient with high blood pressure, high cholesterol, coronary artery disease, asthma, obstructive sleep apnea has been difficult to motivate to improve his lifestyle and his health. He is bright, sweet and caring but just not very disciplined.
At each office visit, we review his medications, review his dietary habits and go through the check list of check-ups for diabetic complications including regular ophthalmology exams and podiatric exams to prevent diabetic retinopathy and foot skin breakdown and infection. His spouse is always present, and we discuss seeing his endocrin...
Source: Kevin, M.D. - Medical Weblog - August 8, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/steven-reznick" rel="tag" > Steven Reznick, MD < /a > Tags: Physician Diabetes Emergency Hospital Hospitalist Infectious disease Source Type: blogs
Make the patient feel like the absolute center of your world
Several years ago, when I was working as a hospital physician in Florida, a patient’s wife said something that has always stuck with me. The service was very busy on that day, and I was doing my best to get through everybody in a timely manner. I was with a patient whose wife was at the bedside, beside herself with worry. I was focused on the main presenting complaint, but it was clear that the wife had a couple of questions that needed answering.
I stood up after spending a few minutes with them, and my body language clearly signaled that I needed to move on, despite the fact that I was still intending to answer her que...
Source: Kevin, M.D. - Medical Weblog - August 6, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/suneel-dhand" rel="tag" > Suneel Dhand, MD < /a > Tags: Physician Hospital Hospitalist Patients Source Type: blogs
I left medicine to become an entrepreneur
I have wanted to be a pediatrician since I was eight years old. Growing up, my favorite book was the large medical encyclopedia that sat on the bookshelf in our den. My life has been planned around that singular goal, each step predetermined and in a very specific order. I have thoroughly enjoyed practicing medicine over the last 17 years — first as a primary care pediatrician, then for the last 13 years as a pediatric hospitalist. If anyone had told me I would leave clinical medicine to be an entrepreneur I would have laughed in disbelief. But on July 1, 2017, that is exactly what I did.
How did I get here? I had no des...
Source: Kevin, M.D. - Medical Weblog - July 25, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/nicole-rochester" rel="tag" > Nicole Rochester, MD < /a > Tags: Tech Mobile health Source Type: blogs
What it ’s like to be a doctor in the heroin capitol of the U.S.
I am a practicing hospitalist physician in Dayton, Ohio. Dayton has emerged in the last year as the city with the highest per capita death rate from opioid overdoses. When we measure the number of deaths here we talk about how many there are per day, not per week or month. We have been inundated with heroin and other products laced with fentanyl or carfentanil. Every other drug, including marijuana, is laced with an opiate in this city. Dealers stand on street corners and throw baggies of heroin into passing cars who have the windows open — free of charge — to get new customers hooked. A routine dose of Narcan ...
Source: Kevin, M.D. - Medical Weblog - July 19, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/jenny-hartsock" rel="tag" > Jenny Hartsock, MD < /a > Tags: Physician Medications Source Type: blogs
Important considerations in how we use advanced care planning documentation
There have been recent discussions in the lay media about a growing trend of litigation cases focused not on the “right to live,” but rather on the “right to die.” These cases have involved patients who received aggressive treatment, despite having documentation of their wishes not to receive such aggressive treatment. Although unsettling, it is not surprising that this issue has arisen, given the national conversations about the exorbitant cost of care at the end of life in the U.S., and the frequency with which patients do not receive end of life care that is concordant with their wishes. These conversations have...
Source: Kevin, M.D. - Medical Weblog - July 17, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/danielle-scheurer" rel="tag" > Danielle Scheurer, MD < /a > Tags: Physician Hospital Hospitalist Palliative care Source Type: blogs
Hospitalist comanagement improved outcomes
(Source: Notes from Dr. RW)
Source: Notes from Dr. RW - July 14, 2017 Category: Internal Medicine Tags: hospital medicine Source Type: blogs
Pain Medication for Older Patients Must be Carefully Chosen and Closely Monitored
Dear Carol: My dad has Alzheimer’s. Recently, he had a bad fall and needed to be hospitalized. Dad was given Dilaudid for pain, but the drug affected his dementia so badly that I begged them to take him off of it. The hospitalist agreed, and they found something else for the pain, but he still hasn’t improved. It’s been two weeks and Dad's dementia is off the charts. The staff said that he may still improve, but that we must remember that Alzheimer’s is a progressive disease so he may simply be getting worse because of the disease. This change was so sudden that I can’t buy this thinking. Is there anything ...
Source: Minding Our Elders - July 9, 2017 Category: Geriatrics Authors: Carol Bradley Bursack Source Type: blogs
Losing our clinical focus: hospitalists as throughput facilitators
(Source: Notes from Dr. RW)
Source: Notes from Dr. RW - June 30, 2017 Category: Internal Medicine Tags: hospital medicine Source Type: blogs
Quality is this physician ’s religion
My hospitalist medical group consists of as great collection of atheists, agnostics, and skeptics as you will ever find. But we all agree that quality is our religion. We believe to our last breath that patient care is sacred and an invaluable gift. And so, as with all faith, there is no halfway. You believe, or you stand around scratching your head asking what those other fools are worshipping. Just so with quality; there is no 50 percent attempt. You either believe that providing the best quality care is what you devoted your life to, or you are left adding up check boxes in the EMR to calculate your “quali...
Source: Kevin, M.D. - Medical Weblog - June 23, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/kjell-benson" rel="tag" > Kjell Benson, MD < /a > Tags: Physician Hospital Source Type: blogs
Editorial Board Q & A: Grace Huang, MD
This article sits right in the wheelhouse of Academic Medicine, the journal, because it targets a universal problem in academic medicine the sector. Organizational buy-in is challenging as a science, and frameworks like this provide a roadmap for leaders wanting to institute change.
Ericsson KA. Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Acad Med. 2004 Oct;79(10 Suppl):S70-81. Professor Ericsson recently came to speak with us at Harvard Medical School, and it gave me a new perspective on the critical value of practice and feedback. No serious athlet...
Source: Academic Medicine Blog - June 19, 2017 Category: Universities & Medical Training Authors: Guest Author Tags: Editorial Board Q & A Featured faculty development medical education mentorship professionalism Source Type: blogs
The last patient of the day gets the least care
He entered the hospital on Monday morning with a list of patients running through his mind. From the time he received a sign out of 22 patients from his colleague on Sunday evening, he was planning his workday. It was a ritual of his to pray and sleep early on Sunday night to prepare him for what lie ahead. What lied ahead was a busy week of inpatient medicine — also known as hospital medicine. He was a hospitalist. He loved what he did. He worked hard to understand his patients as individuals and did his best to understand the diseases that ruthlessly and mercilessly afflicted them.
With time, effort and dedication, he ...
Source: Kevin, M.D. - Medical Weblog - June 13, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/anonymous" rel="tag" > Anonymous < /a > Tags: Physician Primary care Source Type: blogs
Troponin: what the hospitalist needs to know
(Source: Notes from Dr. RW)
Source: Notes from Dr. RW - June 13, 2017 Category: Internal Medicine Tags: cardiovascular hospital medicine Source Type: blogs
