Summer 2018

TIMELY CARE – A PMH STORY

The patient was an older gentleman who had been declining in health and vigor. A blood count on Friday showed there was significant anemia. The cause of anemia was not clear.

Dr. Kelly called the gentleman and reviewed the findings, offering to either address this problem in the hospital or at the office. As there were no acute symptoms and the patient lived nearby with his wife, he felt safe at home. Dr. Kelly asked him to start oral treatment for the anemia and return to the office on Monday.

That Saturday, Dr. Kelly sent a brief text message to a hematology colleague about the patient and asked if he would be able to see the patient early in the coming week. Records were faxed to the hematologist’s office.

On Monday the patient came to Dr. Kelly’s office and the findings were reviewed with him and his wife. He was feeling weak. The hematologist’s office had already contacted the patient and told him that he could be seen at 2 p.m. that same day. Appropriate studies were completed and the patient was seen. The correct diagnosis was made and treatment was already underway.

We live in a place where we can get care when we need it and in a manner that we prefer. While sitting in the waiting room the next morning, the patient overheard a conversation: “Isn’t it nice to have a doctor that you can see so quickly?” The day before, his wife had exclaimed, “Thank God we don’t live in Canada!”

This is a story about the care all physicians want to give their patients and the kind of care that patients want to get from their doctor – even in Canada. PMH delivers the opportunity, time, training and experience to organize such care, in a manner preferred by PMH subscribers.

Robert H. Kelly, MD, FACP

IT’S THE PATIENT, NOT THE MRI THAT MATTERS

A study was done of 67 individuals who had never had back problems or sciatica. In The Journal of Bone and Joint Surgery study, three neurologists reviewed each MRI. Volunteers were recruited through advertising, mostly younger than 60 years of age.

Robert H. Kelly, MD FACP

FEED A COLD, STARVE A FEVER

An experiment on mice was done at Yale University. Researchers asked: is there benefit to feeding or not feeding animals infected with virus or infected with bacteria? Half of the mice were infected with bacteria, half with virus. Each group was then divided into two groups: one given food via a tube into the animal’s stomach, and the other given no food, only water. Appetite was poor in both groups, especially in the bacteria infected group. In the bacterial group given nutrition none lived: 0% survived. In the fasting group 40% survived. In the viral group given artificial feeding: none died, 100% survival. But in the fasting virus infected group there were deaths.

Robert H. Kelly, MD, FACP

COFFEE, TEA AND OTHER POPULAR BEVERAGES

We have written recently about the safety of tea. Tea and coffee are among popular caffeinated beverages. The coffee shop and the teapot are icons of western society.

Allan R. Kelly, MD, FACP

OVERDOSE DEATHS AND THE OPIATE CRISIS

Because of the rapid increase in the number of Americans dying from opiates and renewed caution about opiate use, doctors are trying to learn how this trouble came about. In a recent Annals of Internal Medicine, researchers from National Institutes of Health analyzed opiate deaths in 2015 and 2016.

Allan R. Kelly, M.D. FACP

PMH QUOTATIONS

“Doctors who want shift work, who see the relationship with their patients as an arms’ length transaction, who value their private time more than their patients’ comfort, will thrive in today’s world of medicine. But those doctors … have settled for less”

Joseph Mambu, M.D., (2017)

“It is my own practice to avoid drugs as much as possible, and I more frequently find it more difficult to persuade people to abstain from using drugs than to induce them to take drugs…. It is a very narrow and unjust view of the practice of medicine to suppose it to consist altogether in the use of powerful drugs or drugs of any kind. Far from it.”

James Jackson, M.D., (1856)

Guest Editors

Hannah Nguyen, MS-2
Texas College of Osteopathic Medicine

Christina Kelly
University of Texas at Austin