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Doctor To Patient: “Do You Text And Drive?”

It’s time to ask patients whether they text and drive. An important perspective piece from the New England Journal of Medicine urges doctors to include that question during preventive health exams. The data surrounding texting and driving is grim:

Although there are many possible distractions for drivers, more than 275 million Americans own cell phones, and 81% of them talk on those phones while driving. The adverse consequences have reached epidemic proportions. Current data suggest that each year, at least 1.6 million traffic accidents (28% of all crashes) in the United States are caused by drivers talking on cell phones or texting. Talking on the phone causes many more accidents than texting, simply because millions more drivers talk than text; moreover, using a hands-free device does not make talking on the phone any safer.

The author of the piece, Amy Ship from Boston’s Beth Israel Deaconess Hospital, says that doctors should update traditional preventive questions to keep up with the times.  The simple question, “Do you text while you drive?” is a way to start this important conversation. Read more »

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

A Clinic For Diarrhea And International “Travelers?”

Diarrhea ClinicI’m not sure what country this photo was snapped in, but the clinic owners were smart enough to help international travelers seek care for traveler’s diarrhea. There’s no beating around the bush on this one. If you’re in this waiting room staring at strangers, they’re all going to know why you’re there.

Diarrhea Clinic — that’s simple brilliance. That doctor needs to be hired by the ACP and SHM and ABIM to help us answer questions like “What is an internist?” and “What is a hospitalist?” For these doctors, everyone knows exactly what he does — no questions necessary.

*This blog post was originally published at The Happy Hospitalist*

Microbiology And The “Cooties” Epidemic

Remember “cooties” in grade school? You know, the germs or disease that girls gave boys or boys gave girls in grade school if they touched? Well, it seems they’re becoming an epidemic. Thank goodness someone checked for “cooties” on the Stanley Cup:

The NHL champion Blackhawks’ beloved trophy stopped by the Chicago Tribune newsroom, and so we took the opportunity to do something the Cup’s keeper said had never been done: We swabbed it for germs. We sent the samples to the Chicago lab EMSL Analytical, which found very little general bacteria and no signs of staph, salmonella or E. coli. “It’s surprisingly clean,” lab manager Nancy McDonald said. Just 400 counts of general bacteria were found, she said. By comparison, a desk in an office typically has more than 10,000.

No staph species detected? Hmmm. I think there was a sampling error…

-WesMusings of a cardiologist and cardiac electrophysiologist.

*This blog post was originally published at Dr. Wes*

Science And The Pain Scale

Every day in the emergency department I am confronted by pain. In fact, the treatment of pain is one of the most important skills emergency physicians, indeed all physicians, possess.

For instance, I recently cared for a child with sickle cell disease who was having a pain crisis which involved severe leg pain. His life is one of frequent, intense pain. I gently, and repeatedly, treated his pain with morphine until he had relief. I see hip fractures; all broken bones hurt. I am thrilled to alleviate that discomfort.  Pain is one of the things I can fix, if only temporarily. It makes me happy to see the relaxed face of a man or woman with a kidney stone or migraine, who suddenly smiles and says “thanks!”

But pain is also the source of so much subterfuge. Emergency department are full of individuals who use controlled substances for recreation. I know because they have pain that is entirely unverifiable. They have terrible right flank pain with no gall-bladder, no pancreatitis, no kidney stone (documented by CT), no pneumonia or rash. They have nothing to cause the pain. And yet, dose after dose of narcotic later, snoring in their ER stretcher, they look up at me with hazy eyes and say, thickly, “Cann I gettt somethinn elsss for paaiin…it hurtssss so…bad. zzzz.  Itzzz a tennn.”

So I began to wonder about science and the pain scale. Read more »

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

Healthcare, Finance, And Poverty: Fault Lines Intersected

Solutions to problems are generally sought from within the problems themselves. Two recent examples are healthcare and finance. In both cases, the solutions are believed to be better-structured and regulated systems. In blogs, articles and speeches, I have stressed that — while there are myriad ways that healthcare can be improved — the real solutions to high healthcare spending lie outside of healthcare.

Poverty and its associated manifestations are at the core of the healthcare spending crisis. The high costs of caring for the poor will continue to overwhelm the system, no matter how it’s structured and improved. Rather than looking for solutions through changes in process and regulation, the major solutions to healthcare’s excessive spending reside in areas such as K-12 education, neighborhood safety, and the creation of jobs that can lift low-income families from the cycle of poverty.

Simply stated, the U.S. does not and will not have the resources to provide equitable care for those among us who confront inequitable circumstances in every other aspect of their lives. Read more »

*This blog post was originally published at PHYSICIANS and HEALTH CARE REFORM Commentaries and Controversies*

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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