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More Unvaccinated Children Cause Public Health Fears To Increase

Dr. Robert Sears’ The Vaccine Book, is, as Dr. Rahul Parikh puts it, “a nightmare for pediatricians like me.”

In a piece from Salon, Dr. Parikh brings his issues to the author. The controversy of the book is the so-called “alternative vaccine schedule,” which, as vaccine developer Paul Offit puts it:

…is “misrepresentation of vaccine science” that “misinforms parents trying to make the right decision for their children” in the Journal of Pediatrics. And yet, as a pediatrician myself, I have seen an increasing number of caring, reasonable parents hold it up like a bible in my practice (and that of my colleagues).

This post, however,  isn’t about the vaccine controversy — I’ll leave you to read Dr. Parikh’s excellent piece for yourself.

What I found interesting was a passage discussing the public health fears stemming from an increasing number of unvaccinated children. Read more »

*This blog post was originally published at KevinMD.com*

Are Social Networks Compatible Or Competitive?

The BlogWorld Panel - Kerri Sparling, Kevin Pho, and Bryan VartabedianI was in Las Vegas, but it wasn’t all just spending quality time with blogging buddies.  There was work to do — we were there for the Social Health track of BlogWorld & New Media Expo 2010 to help inform others about the discussions taking place in the medical blogosphere, and the power of these communities. 

The panel that I was participating on was Social Networks & The Medical Blogosphere:  Compatible or Competitive, with fellow panelists Kevin Pho and Bryan Vartabedian (see photo) moderated by the fabulous Kim McAllister. The big question was: “Are these social networking technologies helping or hurting the blogosphere?”

We, as a panel, gave this a lot of thought as we prepared for our discussion, and we ultimately settled on the answer of “Well…both.” Read more »

*This blog post was originally published at Six Until Me.*

Too Much Data: Can It Overwhelm Doctors And Harm Patients?

One of the supposed strengths of electronic medical records is better tracking of test data. In theory, when using more sophisticated digital systems, doctors can better follow the mountains of test results that they encounter daily.

But a recent study, as written in the WSJ Health Blog, says otherwise. Apparently, a study performed in 2007 found:

VA doctors failed to acknowledge receipt of 368 electronically transmitted alerts about abnormal imaging tests, or one third of the total, during the study period. In 4% of the cases, imaging-test results hadn’t been followed up on four weeks after the test was done. Another study, published in March in the American Journal of Medicine, showed only 10.2% of abnormal lab test results were unacknowledged, but timely follow-up was lacking in 6.8% of cases.

Consider that the VA has what is considered the pinnacle of electronic systems — their unified, VistA program that permeates all their hospitals and clinics. Apparently the problem is one of alert overload:

Hardeep Singh, chief of the health policy and quality program at the Houston VA’s health and policy research center, led both studies. He tells the Health Blog that doctors now receive so many electronic alerts and reminders — as many as 50 each day — that the important ones can get lost in the shuffle.

This is not unlike the alarm fatigue issue that I recently wrote about. Too much data — whether it is written or on the screen — can overwhelm physicians and potentially place patients at harm. Curating test results by prioritizing abnormals will really be the true power of electronic test reporting.

*This blog post was originally published at KevinMD.com*

Should Doctors Work Weekends?

Peter Orszag wants doctors to work weekends. The former director of the White House Office of Management and Budget wrote as much in this past weekend’s New York Times:

Doctors, like most people, don’t love to work weekends, and they probably don’t enjoy being evaluated against their peers. But their industry can no longer afford to protect them from the inevitable. Imagine a drugstore open only five days a week, or a television network that didn’t measure its ratings. Improving the quality of health care and reducing its cost will require that doctors make many changes — but working weekends and consenting to quality management are two clear ones.

And he’s right, to a point.

I’ve pointed to studies showing that mortality rises on the weekends, in part due to skeleton staffs that hospitals employ on Saturday and Sunday. And, since Mr. Orszag is an economist, the cost factor is noted. Tests that get pushed off until Monday cost the health system serious dollars. The problem I have is that Mr. Orszag, like most health reformers, offers doctors little incentive in return. Read more »

*This blog post was originally published at KevinMD.com*

Dating An American Medical Student? Some Financial Advice

The average medical school debt today, according to the Association of American Medical Colleges, is $156,456.

The United States is the only country in the world were future doctors have to bear such a financial burden of their education. That places significant strain on any relationship involving an American medical student.

Recently, there was an interesting piece in the New York Times discussing this very issue. The article profiled a female medical student who had amassed $250,000 of school debt:

Still, if she and [her boyfriend] Mr. Kogler are going to move in together and get engaged, she wants their financial arrangements to be clear and fair. But how do you define fair when you’re bringing a quarter of a million dollars in debt to a relationship?

Indeed. It’s an issue that’s rarely discussed, yet frequently encountered by medical students. With that degree of debt, there is little room for flexibility should one’s future plans change. You have to continue working to pay off the loan. Read more »

*This blog post was originally published at KevinMD.com*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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