A guest column by the American Medical Association, exclusive to KevinMD.com.

This week, I’m joining hundreds of physicians and medical students in Washington, DC during the American Medical Association’s National Advocacy Conference to talk to our federal lawmakers about an end to what has become an annual chore of stopping drastic scheduled Medicare physician payment cuts to preserve access to health care for seniors and military families. This year, a 27 percent cut is scheduled to hit physicians who treat Medicare and TRICARE patients on March 1. Congress must come together to end this yearly routine once and for all by permanently repealing the broken Medicare physician payment formula.

Read the rest of AMA: Advocating for Medicare, military and fiscal responsibility on KevinMD.com.

Category: Policy | Tags: Health reform, Medicare | No comment

This series is brought to you by MedPage Today.

1. Obama Budget: No Big Dollars for Health. President Obama’s proposed 2013 budget includes a slight increase for the Department of Health and Human Services (HHS) — but it’s coming at a time when his Republican adversaries are calling for budget cuts, not increases.

2. Air Pollution Tied to Stroke, Cognitive Slide. Airborne pollution can have serious consequences for the brain and the heart even at typical levels of exposure.

3. No Age Limit on Benefits of Eating Well. Older people who eat properly are likely to live longer.

Category: News | Tags: | No comment

I have decided to spam for public health.

Phone calls, text messaging, and even apps have been shown to help improve health and sustain behavior change, even in people suffering from profound mental illness. But when it comes to using these tools for public health, there are two problems. The first is that each message (whether via phone call or text) costs money. The second is that it’s quite hard to use those platforms for blasting messages to a whole population.

Read the rest of Using Twitter to deliver health improvement messages on KevinMD.com.

Category: Social media | Tags: Primary care, Twitter | 3 comments

Does your medical practice allow anybody to post links and comments on your Facebook page?

The short answer is yes. We do. Why? Because we think allowing patient to post links and commenting on our practice’s Facebook page helps us achieve these four things:

1. It encourages communication.
2. It allows us to address issues that we would otherwise have a hard time addressing.
3. Other patients will benefit by reading the discussions.
4. We get an opportunity to show how we handle different situations.

Read the rest of Addressing comments on your medical practice’s Facebook page on KevinMD.com.

Category: Social media | Tags: Facebook, Pediatrics | No comment

I’ve only had to declare death a couple of times. Once in a three-year-old and once in an adult. In each case the heart had stopped beating. Death was clear.

Brain death is tougher to cope with, both clinically and psychologically. I imagine it would make anyone want to say, at some point, “Are you sure? Are you really sure? How do you know? How can you be sure?” Some times when brainstem function is gone and seems clearly irretrievable, there remains a good, strong heartbeat. Strong. Vital signs vigorous.

Read the rest of Why an anesthesiologist would be needed for organ donation on KevinMD.com.

Category: Physician | Tags: Specialist, Surgery | 3 comments

Billionaire Teddy Forstmann had been diagnosed with a serious form of brain cancer.  There’s a tragic twist to the story: according to Fox Business News, Forstmann believes that for more than a year, he had been misdiagnosed with meningitis.

ABC News wonders, “How could such a misfortune befall a billionaire —- a man able to afford the best doctors, best technology and the most sophisticated diagnostic tests?”

They’re missing the point.  Misdiagnosis happens with shocking regularity – as much as 44% of the time, depending on the illness.

Read the rest of 5 ways to avoid a misdiagnosis on KevinMD.com.

Category: Physician | Tags: Malpractice, Neurology | 2 comments

This series is brought to you by MedPage Today.

1. Biomarkers May Help Heart Failure Risk Prediction. In older adults, echocardiographic variables and levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) improved heart failure risk stratification compared with a clinical risk score alone.

2. Progress Cited in War Against Trans Fats. The campaign against trans fats appears to be producing results, according to a CDC report detailing a drop in serum levels nationally.

3. Frequent Moves as Kid Take Toll Later. Frequent relocation during childhood had a significant association with poor health, poor health behaviors, and psychological distress in adolescence and adulthood.

Category: News | Tags: | No comment

One of the things I have come to really enjoy and appreciate is the opportunity to interview the subjects of my articles and multimedia pieces. In a way, being a reporter reminds me a lot of being a physician-in-training – both roles require me to go into a room, learn an individual’s story inside out, and present the learned information for a further goal.

In my Public Issues Reporting class, the journalism students practiced interviewing techniques not too far off from the interviewing skills I learned through Stanford’s Practice of Medicine course. Both classes emphasized empathy towards the subject. Both courses taught the art of extracting information through carefully worded questions. Similarly, the theme of “Keep asking open-ended questions to draw out more information from the subject!” appeared in both courses. The topic of dealing with sensitive information in an emotional environment was also discussed. My professor told us that his personal rule for interviewing subjects involved with a tragedy is to try three times; if the subject still refuses, then reporters should respect the interviewee’s wishes.

Read the rest of Reporters and doctors are more similar than you think on KevinMD.com.

Category: Education | Tags: Mainstream media, Medical school, Patients | 1 comment

One of the things I love about family medicine is that I get to care for people of all ages. I almost went into pediatrics, but the time I spend with older adults was too valuable to give up.  Our elders have such great stories and knowledge to impart – it’s an honor to participate in their lives and share their experience.

Since I first realized in residency training that Medicare didn’t cover preventive care, I’ve been frustrated with trying to focus on maintaining the health of my patients instead of just responding to one health crisis after the next.  I never understood how Medicare would pay for a patient’s heart attack but not cover a screening blood test to check cholesterol before the heart attack so we could have a chance to prevent it.

Read the rest of Benefits of the Medicare Adult Wellness Visit on KevinMD.com.

Category: Physician | Tags: Medicare, Primary care | 1 comment

No one wants to die. Even people who want to go to heaven don’t want to die to get there. And yet death is the destination we all share. No one has ever escaped it. And that is as it should be, because death is very likely the single best invention of life. It is life’s change agent. It clears out the old to make way for the new.
-Steve Jobs, in his 2005 speech to the graduating class at Stanford University

We’re uncomfortable with death in this country.  That’s my conclusion as a hospital chaplain who has worked with numerous patients and family members facing life-threatening illnesses or injuries.   In my experience, people generally accept that “death is the destination we all share,” as the late Steve Jobs put it, but the thought of our own particular death or the death of a loved one unsettles us.  And so we defend ourselves against the specter of death by denying its existence, trusting superstitiously that if we never speak its name, death will leave us alone.  (For example: I’ve heard many terminally ill patients ask:  “I wonder if I’m dying?” only to have a family member quickly cut them off with:  “Don’t talk like that!  You’re going to be just fine.”)

Read the rest of How to get ready for death on KevinMD.com.

Category: Patient | Tags: Palliative care, Patients | 5 comments