A neurologist grapples with aducanumab

We Search It For You January 26, 2022 No Comments

A neurologist grapples with aducanumab

I have been following the controversy surrounding the approval of the new Alzheimer’s drug aducanumab with great interest.  Until a year and a half ago, I worked as a neurologist in an adult general neurology clinic.   Many of my patients had dementia.  While I thoroughly enjoyed seeing these patients and their family members, I often felt helpless when treating them.  When I left clinical practice to explore a non-clinical career in the pharmaceutical industry, I envisioned helping patients with neurological conditions by bringing much-needed drugs to market.  Drugs like aducanumab. Aducanumab is the first disease-modifying drug approved for Alzheimer’s disease (AD) and the first AD medication to be approved in nearly two decades.  This should be exciting.  Instead, I find aducanumab’s approval both confusing and worrisome.  Simply stated, the drug has significant side effects, and it is unclear whether it has meaningful clinical benefit.  Despite the eleven-person neurological advisory board […]

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the quest for positive reviews [PODCAST]

We Search It For You January 26, 2022 No Comments

the quest for positive reviews [PODCAST]

“Studies show that those physicians with negative online reviews were more often scored poorly due to non-physician specific causes. In my career, I’ve read comments from patients that said they were not satisfied with their provider because they didn’t like the color of the walls in the exam room. Another mentioned that tea wasn’t offered in the waiting room, just coffee. Surveys are not necessarily bad, but they have changed the way we interact with patients. Doctors are now feeling pressured to provide care patients don’t need because of fears of bad patient satisfaction scores or negative reviews online. This causes more stress on health care professionals. In a national study, 78 percent of clinicians said patient satisfaction scores moderately or severely affected their job satisfaction negatively, and 28 percent said the scores made them consider quitting.” Peter Valenzuela is a family physician and author of Doc-Related: A Physician’s Guide to Fixing […]

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5 science-backed strategies an allergist-mom is using to protect her family’s health

We Search It For You January 25, 2022 No Comments

5 science-backed strategies an allergist-mom is using to protect her family’s health

Like most parents, my children are my world. I would do anything to protect them and keep them healthy. It is Darwinian. Instinctual. Most of us get by with a combination of sage advice from generations past interspersed with a “know better do better” approach. Personally and professionally, I encountered this duality pretty quickly. In March 2016, my husband and I hopped on a plane to Los Angeles with our 4-month-old daughter with the purpose of both visiting grandparents and attending the American Academy of Allergy, Asthma and Immunology meeting. A few months prior, the LEAP (Learning Early About Peanut Allergy) trial was published. The old paradigm of avoiding potentially allergenic foods was tossed aside as new data emerged. As this data was extensively discussed, debated, and expanded upon during that meeting, you better bet that as soon as Charlotte could sit up, she was the poster child for early […]

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Lessons in caring too much from a fictional physician [PODCAST]

We Search It For You January 25, 2022 No Comments

Lessons in caring too much from a fictional physician [PODCAST]

“All the faceless young men who are brought to his operating table, prepped and draped, broken and bleeding, are finding their experience of war bears little resemblance to their reveries of war. They should have known better. At corner taverns in Chicago, Albuquerque, and Murphysboro, there were tired veterans with scars and limps; men with faded names of regiments or slogans like “Semper Fi” tattooed on their biceps; men with creased faces and shuttered eyes, who quietly nursed schooners of beer while they watched the Sox or the Dodgers on the TV behind the bar; men who had been to places like Bastogne and Peleliu and the Chosin Reservoir. They, too, once had reveries. Carelessly fingering an old scar or slowly twisting a worn ring, they might have explained some things to these un-blooded young men, things forever indecipherable to those who have never worn the uniform, who have never […]

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Publicity and sharing our experiences are our best tools against legal injustice

We Search It For You January 24, 2022 No Comments

Publicity and sharing our experiences are our best tools against legal injustice

An excerpt from Rheum for Improvement: The Evolution of a Health-Care Advocate. Their expert witness, “Dr. Z,” was simply a hired gun willing to do their bidding for a price. He had completed only one year of a rotating internship in family practice in the 1960s. He had not done a residency and had no rheumatology training. He had not seen a patient in 14 years and made his living providing “expert testimony.” Had this been an actual malpractice lawsuit, he would have been disqualified from testifying based on the Act 13 mandates in Pennsylvania that were passed in 2002. As noted in Chapter 3, this ruling decreed that any expert who testifies must have training in the same area as the defendant and must be in active practice or recently retired. Dr. Z met neither of these criteria. That did not stop the state board of medicine from using […]

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A physician’s self-care song [PODCAST]

We Search It For You January 24, 2022 No Comments

A physician’s self-care song [PODCAST]

“No matter what, your healing work matters. No one should tell you otherwise, and nothing can change that, not even a shortcoming. You provide healing in a way no one else can. Care for yourself, and you can be the healer you truly wish to be.” J. C. Sue is a family medicine resident. He shares his story and discusses his KevinMD article, “Self-care should now be your plan.” Reflect and earn 1.0 AMA PRA Category 1 CME for this episode. Did you enjoy today’s episode? Please click here to leave a review for The Podcast by KevinMD. Subscribe on your favorite podcast app to get notified when a new episode comes out! Do you know someone who might enjoy this episode? Share this episode to anyone who wants to hear health care stories filled with information, insight, and inspiration. Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of […]

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The status quo is failing people with opioid use disorder

We Search It For You January 23, 2022 No Comments

The status quo is failing people with opioid use disorder

As we anticipated the release of new CDC data on overdose deaths, those of us who specialize in substance use disorders braced for grim statistics, but this milestone was still shocking: over 100,000 lives lost to overdoses in one year, the great majority from opioids. Overdose deaths began outpacing traffic fatalities in the United States in 2013, but 2.5 times as many people died from an overdose as a car crash in 2020. It’s a number that could fill some of our largest stadiums, entirely populate a mid-sized city, and is the equivalent of 270 people dying each day, one every 5 minutes. To add insult to injury, there are highly effective treatments to treat opioid use disorder (OUD), but the majority of people who need them cannot access them. An estimated 80 percent of people with OUD do not access any treatment in a given year, and of those […]

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a KevinMD panel discussion [PODCAST]

We Search It For You January 23, 2022 No Comments

a KevinMD panel discussion [PODCAST]

Welcome to a special episode of The Podcast by KevinMD. In this 60-minute episode, I partner with DrFirst, a pioneer in health IT for over 20 years. We bring together physicians with different backgrounds to explore information overload and physician burnout. Dr. Sameer Badlani is chief digital officer, M. Health Fairview, a major health system in Minnesota. He is also adjunct faculty at Carnegie Mellon University. Dr. Colin Banas is chief medical officer, DrFirst. He was an internal medicine hospitalist and served as the chief medical information officer for VCU Health System in Richmond, VA. They share their stories and discuss the following questions: Based on your roles as physicians and as leaders in health IT, what are your insights into what is contributing to clinician burnout? How did you look at it differently when you became a tech leader? Did your perspectives change? Does tech sometimes contribute to burnout? […]

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a tale of 2 physicians

We Search It For You January 22, 2022 No Comments

a tale of 2 physicians

Remember in Jurassic Park when Ian Malcolm describes Chaos Theory to Ellie Satler, watching a drop of water roll down her hand? It might roll to one side or the other based on any number of differences in the hair on her hand, subcutaneous blood flow, imperfections in her skin, all tiny variations in a complex system, affecting the outcome. The scene came to mind last week when in 24 hours, my teen daughter and I had our worst doctor visit ever, followed by one of the best. Through the lenses of a fellow physician, concerned mother, and patient, I saw two physicians whose development in the complex world of medicine have had very different outcomes. We saw firsthand how moral injury to physicians, described by Drs. Talbot and Dean appears in different guises. First, we had a follow-up with a late-career pediatric cardiologist in a Big City “not for […]

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Coal mining culture and the opioid crisis [PODCAST]

We Search It For You January 22, 2022 No Comments

Coal mining culture and the opioid crisis [PODCAST]

“For me, my own personal stories of opioid patients come to mind, including one who keyed my car when I stopped prescribing his opioid after an acute injury. I think of some local opioid overdose deaths in my community. I would love to hear what other doctors and clinicians have to say about these issues, like the ‘not responsible’ verdict and the Sackler family running away liability-free and still worth billions of dollars. Does anybody feel like the opioid companies were pushy in the ‘90s and 2000s? Were they in the right? Is the California ruling in line with the common good? Are our prescribing practices under scrutiny? What runs through our heads right now, doctors? I would love to know.” Rebecca Thaxton is a family physician. She shares her story and discusses her KevinMD article, “The people vs. opioid pharma: Pharma wins again.” Reflect and earn 1.0 AMA PRA Category […]

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