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It’s time for more doctors to practice mindfulness. Here’s how.

Physician

November 4, 2015

A few summers ago during a week-long vacation, I started playing a mind game. In the mornings, I would sit outside on a comfortable deck chair, surrounded by the shrill call of cicadas, and gaze across the lawn into the trees. After getting settled, I would close my eyes and bring my body to complete stillness except for the rhythmic rise and fall of my chest with each breath.

Then I’d …

EHRs need to get out of the way of both patients and physicians

David Mann, MD

Health Technology

November 4, 2015

Dr. Lisa Rosenbaum has an excellent piece in the NEJM entitled “Transitional Chaos or Enduring Harm? The EHR and the Disruption of Medicine.” In essence a review of Dr. Robert Wachter’s book, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age, it deals with the ever increasing intrusion of the digital-industrial medical complex on the practice of medicine. Bottom line: Electronic health records …

The controversy over Theranos misses the larger point

Vamsi Aribindi, MD

Conditions and Diseases

November 3, 2015

Theranos is a Silicon Valley start-up dedicated to revolutionizing (some would say disrupting) the medical blood testing industry. The claim to fame of the company was to use a single drop of blood from a finger stick to run hundreds of tests. This premise led to a $9 billion valuation and rock-star status for it’s founder, Elizabeth Holmes; and was recently threatened by a Wall Street …

The first time I pronounced someone dead

Chrisse Henneberg, MD

Physician

November 3, 2015

It’s easy to get lost in the hospital. I’m only an intern, and already I know it like the hallways of my old high school, every doorway, and doorknob. But overnight, as I float between the floors and the units, answering pages, I quickly lose track of where I am, what time it is, what day it is.

I am vaguely aware that I’m on the fifth floor, the top floor …

The new mammogram guidelines emphasize that screening is a personal decision

John Schumann, MD

Conditions and Diseases

November 3, 2015

The big story recently is that the American Cancer Society issued an updated guideline recommending that women undergo mammography less frequently than before.

This announcement was denounced on both “sides” of the perennial debate. Those in the “mammograms save lives” camp are outraged that a scientific society dedicated to cancer prevention and treatment would issue a proclamation that seems to run counter to the notion that “early detection saves lives.”

Those …

Credulity and skepticism exist in a dynamic balance

Steven Reidbord, MD

Physician

November 3, 2015

As we grow into adulthood, each of us develops a personal comfort zone located on the continuum between paranoia and gullibility. A few of us are highly suspicious by nature, a few are unwitting dupes; most of us are in between. Mental health professionals are no exception, and it shows in our work. Is a request for tranquilizers or stimulants legitimate, or are we abetting a substance abuser? When told of horrific past abuse, do we believe every word, …

5 ways radiologists can reduce unnecessary tests

Dr. Saurabh Jha

Physician

November 2, 2015

The Lown Institute advocates rational use of medical resources. This is a noble goal and worthy of the attention of radiologists. It was recently RightCare Action Week: Here are five simple things any radiologist can do that week, and the following weeks. This will improve patient care by avoiding unnecessary tests.

1. Speak to the referring clinician, at least sometimes, if not often, perhaps twice a day. The conversation need not …

Physicians suffer the personal toll of corporate medicine

Rose Kumar, MD

Physician

November 2, 2015

I am a board certified internist. I am Stanford trained and have been practice for nearly 25 years. I have a very busy practice. I love my patients. To help, heal and to love them every day is a daily gift. I want to help them make sense of their suffering, to help awaken and empower them and help them gain health. I have also been a lifelong seeker. I …

#ILookLikeASurgeon, not an imposter

Dzifa S. Kpodzo, MD

Physician

November 2, 2015

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Born to a family of scientists — my father an engineer and my mother an oral surgeon — I was given a clear message that I could do anything. Case in point: At age nine when I declared my career goal of being “president of the world” nobody batted an eyelash. Their unwavering confidence followed me through college at UC Berkeley and …

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#ILookLikeASurgeon, not an imposter

An emergency physician goes to the ER, and is shocked at the care she receives

Karen Shackelford, MD

Physician

November 2, 2015

I have lately been discussing the state of health care with a lot of doctors. I’m a doctor, and I’m also a consumer of health care services.

Imagine my surprise when I visited a local ER on a three day weekend, hoping to get some advice from someone who might be able to use the panoply of diagnostic tools available in the ED to help me mitigate the pain of a …

Motivate smokers to quit before surgery. It could save lives.

David O. Warner, MD

Conditions and Diseases

November 1, 2015

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

Physicians who care for surgical patients witness the devastating consequences of cigarette smoking almost every day. For example, smoking increases the risk of acute complications such as pneumonia and wound infections, and adds to the burden of smoking-related diseases such as heart disease. As …

If you don’t advocate for women, I don’t trust you with patients

Anonymous

Medical Education

November 1, 2015

I started medical school recently. Before it started, I told myself (and everybody else) that I would feel like a kid in a candy shop when I was here. I’d get to try different specialties and figure out which one I want to do out of everything that excited me. It really is kind of like that, don’t get me wrong. But I’m also confused and disheartened.

I had a different …

A physician’s open letter to Medicare patients

Rebekah Bernard, MD

Physician

November 1, 2015

Dear patients,

This is a hard letter to write, but it is important that you know about a major change that is coming for both of us in 2017, just a short year away.

As you recall, last year I left a large hospital group practice and opened my own office, and I want to thank you for your faithfulness in following me to my new location. With the newfound freedom of …

What a Muslim medical student thinks of Dr. Ben Carson’s words

Cherie Fathy

Medical Education

November 1, 2015

I wonder how I would’ve felt if Ben Carson had run for president back when I was a kid. At that age, I was wholly inspired (and terribly intimidated) by doctors. They knew everything! They were the coolest people ever! Nowadays, I’m in medical school where I’ve learned that doctors definitely learn a lot, but we’re not the coolest ever, and we are certainly not filled with innate knowledge on …

Physician assisted suicide is our moral indicator

Stephen Kamelgarn, MD

Physician

October 31, 2015

On September 12, 2015, the California Legislature passed a controversial bill legalizing physician-assisted suicide. California would become the fifth state to allow doctors to prescribe lethal medication to terminally ill patients who request it, after Oregon, Washington, Vermont and Montana. During the debate over the passage of the bill, everybody weighed in: patient’s rights advocates, dying patients and their advocates, religious groups. The one group that I didn’t hear about …

A heartfelt thank you to my patients

Kathleen McFadden

Medical Education

October 31, 2015

To be a third year medical student is to enter a world that few understand. The pressure of constant evaluation, the stress of doing well in the field which you want to enter, and the fear of making a mistake often haunt the very long days and night which characterize the most physically exhausting year of medical school.

Yet quite frequently as I move through this year I find myself feeling …

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A heartfelt thank you to my patients

Share our stories and let the world know that health is primary

Jay W. Lee, MD, MPH

Physician

October 31, 2015

The U.S. health care system is under intense pressure to change from volume to value. Primary care physicians must become the leaders our health system needs us to be: finding solutions to the problems that continue to plague this system. Costs continue to rise, access to physicians is quite limited in many locations, care often remains fragmented, and quality is uneven. To provide excellent care across the country and ensure …

Test your medicine knowledge: 48-year-old woman with type 2 diabetes mellitus

mksap

Conditions and Diseases

October 31, 2015

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 48-year-old woman is evaluated during a follow-up visit. She has a 5-year history of type 2 diabetes mellitus. She has no other significant medical history. Medications are atorvastatin, metformin, and a multivitamin. She works as a mail carrier and has a walking route that takes 3 hours each day. She consumes a diet high …

An episode of low-value care delivered to my father

Victor Lee, MD

Physician

October 30, 2015

My father recently visited his internist with complaints of vague chest symptoms and was referred to a cardiologist who recommended coronary CT, ultrasonography, and angiography. A cardiac workup would seem to be a reasonable course of action given that he has a history of coronary artery disease (CAD) with prior angioplasty.

However, upon further exploration, I felt that his chest symptoms were due to stress and were not of cardiac origin. …

A cancer patient who had bad luck with clinical trials

Nathan A. Pennell, MD, PhD

Conditions and Diseases

October 30, 2015

I am superstitious, and I freely admit it. I don’t use the word “cure” with patients until the 5-year scan has come and gone cleanly. I don’t celebrate the scans showing tumor response until I see them myself and make sure I am not mixing up the new scan with the old. And one of my most closely held superstitions …

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