Interim Physicians Blog

Dr. Ken's Corner: landmark report addresses physician burnout

Posted by Ken Teufel M.D. on Nov 20, 2019 12:17:45 PM

It's not the doctor's fault – blame the system! That's the underlying message in the landmark report released October 23, 2019 by the prestigious National Academy of Medicine. "You can't just teach doctors meditation, yoga, and self-care. We need big, fundamental changes," said Christine Cassel, M.D., professor of medicine at University of California at San Francisco and co-chair of the committee of experts who wrote the report. "What this report is saying is that this is a systemic problem that requires systemic solutions." It's time to stop blaming the victim.

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Topics: Physician Burnout, Dr. Ken's Corner

Dr. Ken's Corner: surgeons can achieve pain control with fewer opioids

Posted by Ken Teufel M.D. on Oct 24, 2019 9:45:25 AM

Surgeons are finding that they can prescribe fewer pain-killing opioids after surgical procedures and still achieve effective pain relief. "In the months after new guidelines went into place [in Michigan], the number of opioid pills being prescribed to surgery patients fell by one-third overall, yet there was no change in patients' satisfaction with their pain control." The findings were published in the August 15 issue of the New England Journal of Medicine. "This isn't just about reducing opioid use," said lead researcher Dr. Jocelyn Vu. "It's also about giving patients the best care for their pain.”

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Topics: Dr. Ken's Corner

Dr. Ken's Corner: new standards for surgical care of the elderly

Posted by Ken Teufel M.D. on Sep 24, 2019 3:25:09 PM

More than 40 percent of inpatient operations and 33 percent of outpatient procedures are performed on older adults each year in the United States. And that number is expected to mushroom as the boomer population ages (per a July 2019 article from AARP). To improve the surgical experience for patients 75 and older, the American College of Surgeons has released 30 patient-centered standards of care. It's called the Geriatric Surgery Verification (GSV) Program. It was developed over a four-year period with input from over 50 stakeholders, including hospitals, patients, and providers.

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Topics: Dr. Ken's Corner

Dr. Ken's Corner: are patients harmed when residents work fewer hours?

Posted by Ken Teufel M.D. on Sep 4, 2019 1:01:31 PM

When work hours for residents in training were capped at 80 hours per week, two questions came up:

  1. Will residents have enough time to learn everything they need to know?
  2. Will the residents' future patients suffer as a consequence?
A recent study appears to have answered these questions.

The study's investigators faced persistent "speculation that physicians completing residency today have less robust clinical experience before entering unsupervised practice compared with pre-reform residency cohorts" (per July 2019 BMJ research.) They assumed, however, that "it might also be possible that residents who are less fatigued consolidate their knowledge better and have equivalent or greater clinical competency both during and after residency."

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Topics: Dr. Ken's Corner, Residents in Training

Dr. Ken's Corner: prescription drug marketing faces criticism

Posted by Ken Teufel M.D. on Jul 24, 2019 3:33:56 PM

Only two countries worldwide allow direct-to-consumer (DTC) advertising of prescription drugs: The United States and New Zealand. Over 20 years (1997 to 2016) DTC prescription drug advertising in the U.S. increased from $1.3 billion to $6 billion "with a shift toward advertising high-cost biologics and cancer immunotherapy" (JAMA Network, January 1/8, 2019). According to the JAMA-published study, pharmaceutical companies bombarded the American consumer with 4.6 million ads in 2016. This includes 663,000 TV commercials (compared to 72,000 in 1997). The authors' conclusions: "Despite the increase in marketing over 20 years, regulatory oversight remains limited."

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Topics: Dr. Ken's Corner

Dr. Ken's Corner: competency of older doctors being questioned

Posted by Ken Teufel M.D. on May 23, 2019 5:16:21 PM

Instead of retiring at age 65, many doctors choose to continue practicing medicine well into their 70s and 80s. A national trend to test the competency of these older physicians appears to be gaining momentum, especially among some of the nation's largest hospital systems. Hospitals report growing concern that the mental and physical skills of some of their older physicians have deteriorated to the point of putting patient safety at risk. Paying special attention to "weeding out" impaired physicians once they have reached a certain age is proving to be a sensitive issue, to say the least.

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Topics: Dr. Ken's Corner, Physician Retirement