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The core of the scientific process is how we ultimately serve our patients

Medical Education

October 20, 2015

A few weekends ago, I saw a patient with bloated shins at our school’s free clinic, and I marked in my notes that she exhibited “peripheral edema,” an esoteric phrase that means little to those outside of the medical community. That experience only highlighted the tendency in medicine to inflate common bodily functions into opaque medical jargon. Its use can be frustrating for patients who are trying to understand their …

What did a surgeon think of the television show, Code Black?

Skeptical Scalpel, MD

Physician

October 19, 2015

A new television series called Code Black debuted on CBS. The show’s name supposedly means the emergency department has too many patients and not enough staff. In my over 40 years in medicine, I’ve seen many busy, understaffed EDs but never heard anyone call it a Code Black.

There is the usual array of standard medical characters — the inexperienced new residents on their first day at work, the savvy nurses, …

Are new cancer drugs really worth their price?

Peter Ubel, MD

Medications

October 19, 2015

Cancer drugs have become increasingly expensive in recent years. No one blinks anymore when a new lung cancer or colon cancer treatment comes to market priced at more than $100,000 per patient. In part, we don’t blink because we have simply gotten used to such prices — the shock has worn off.

Moreover, many of these new treatments are targeted therapies that only work for patients whose cancers express specific mutations, …

This epic EHR video may save our relationship with patients #LetDoctorsBeDoctors

Zubin Damania, MD

Health Technology

October 19, 2015

I have a love-hate relationship with the electronic health record (EHR).

To be precise, it’s 90 percent hate, 6 percent love. The missing 4 percent? That would be the percentage of time spent on the phone with tech support trying to figure out which order set I have to use to input percentages.

I’ve been in practice long enough to straddle the transition from paper … to even more paper (thanks EHR, you’re the …

What if ICD-10 was a joke created by a 13-year-old boy?

Roy Benaroch, MD

Physician

October 19, 2015

It turns out that the entire transition to the new ICD10 code set was just a joke perpetrated by a 13-year-old boy.

“I mean, who would take it seriously?” said RancheroBoy, using his screen name from MedicalCoders.com. He agreed to speak with us only on the condition that we not use his real name.

Hospitals and physicians’ offices nationwide were required to transition to the ICD10 code set for all diagnostic reporting …

A medical student’s psychiatric hospitalization

Anonymous

Medical Education

October 19, 2015

“You work here?!”

I nodded, a hint of a smile revealing my bemusement at his incredulity.

“Well … probably not after this.”

The other patients in the psych waiting area of the ER nodded in agreement. In my newly issued brown scrubs, stripped of my belongings, I was no longer a research coordinator at a top hospital, but rather one of them. And sadly, they believed being one of them meant you couldn’t …

Why are medical bills full of mistakes?

Janice Boughton, MD

Physician

October 18, 2015

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Within the last two days, I received a bill for my glasses and read a post by a friend ranting about medical billing mistakes. This is a huge problem that is so common that it could be considered the norm. It is ridiculously expensive and could probably be fixed.

My exposure to medical bills has been through patients who show them to me, …

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Why are medical bills full of mistakes?

Readmission penalties: Medicare’s ingenious move

Hans Duvefelt, MD

Health Policy

October 18, 2015

A long, long time ago, hospitals existed to admit patients when they were sick, treat them with medicines or surgery and good nursing care, and discharge them after they became well.

Hospital care was at one time a charity, which evolved into a nonprofit service, before it became a very big business.

In olden days, nonprofit hospitals charged patients straightforward fees for their services. Then, when you were just a young whippersnapper …

Moms after cancer are a new demographic

Don S. Dizon, MD

Conditions and Diseases

October 18, 2015

One afternoon, I was seated in front of my computer working when a ping came through, notifying me of a message delivered on Twitter. I stopped what I was doing and scrolled through Twitter and then checked my message. It was from someone I had never met in real life (“IRL,” in social media), though I felt we had …

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Moms after cancer are a new demographic

5 tips for physicians to achieve financial freedom

James M. Dahle, MD

Physician Finance

October 18, 2015

In the ten years since I graduated from residency, I have noticed an interesting correlation between burnout and finances among my physician colleagues: The more secure we are financially, the more we enjoy our work. However, physicians working long clinic hours and moonlighting 15 times a month as a hospitalist in order to make alimony payments, boat payments, mortgage payments, or all …

Defunding Planned Parenthood will deny poor women access to basic health care

Vincent DeGennaro, Jr., MD, MPH

Physician

October 17, 2015

Micheline came to Project Medishare’s women’s health center in Port-au-Prince as many of my patients do — with advanced cancer. At only 46 years old, she still had two young daughters and a family that needed her income selling clothing on the street. Micheline has cervical cancer, a disease that literally takes years to form and grow, is easily detected with simple tests, and is entirely preventable.

We initially launched the …

Why cancer outcomes to vary by socioeconomic status

Margaret Wacker, MD

Physician

October 17, 2015

Even though I have had health insurance continuously since finishing training, I found the costs of illness significant. So that the costs of care cancelled my income for working nearly half a year. No wonder so many people have gone bankrupt due to health care expenditures. This was a major impetus for health care reform and the Affordable Care Act.

Fortunately for me, my savings and those left me by my …

Is the end of football coming? This doctor says it can’t come fast enough.

Jeffrey Parks, MD

Conditions and Diseases

October 17, 2015

Evan Murray was a 17-year-old high school senior, honor student, and three-sport athlete who died recently as a direct result of injuries sustained playing quarterback for his school football team. On the last play of his life, he got drilled by a defender with a clean hit to the midsection. He gathered himself, rose, and walked off the field on his own. Shortly thereafter, however, he collapsed on the sideline …

Test your medicine knowledge: 48-year-old woman with fatigue

mksap

Conditions and Diseases

October 17, 2015

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

A 48-year-old woman is evaluated for fatigue and intermittent abdominal discomfort of 2 months’ duration and occasional dark urine. Medical and family histories are unremarkable. Her only medication is an oral contraceptive pill.

On physical examination, temperature is 37.2 °C (99.0 °F), blood pressure is 125/74 mm Hg, pulse rate is 68/min, and respiration rate is …

Lab coats and scrubs don’t make the physician

Edwin Leap, MD

Physician

October 16, 2015

I was working at a small hospital when I heard the nurses talking about a new rule. The rule was that the only people who could wear lab coats would be physicians and administrators. It made me laugh a little. I’ve hated lab coats since medical school.

I currently sport what a family medicine resident told me was the ER mullet: khakis and polo shirt. (Who knew?) I find it much …

Learning to become a doctor is like panning for gold. Here’s how.

Jessica Sallstrom

Medical Education

October 16, 2015

Throughout most days of clinic rotations, I envision myself panning for gold. Just like I pretended to do as a young child. I am standing in a river that courses through a mountainside somewhere in West Virginia. It is a warm August afternoon; I roll up the pant legs of my overalls and wade into the water, which is just cold enough for you to keep noticing it. As each …

Why did she want to become a doctor? Read her personal statement.

Jennifer Chevinsky, MD

Medical Education

October 16, 2015

Alright, here you go future medical school applicants. Here it is. My personal statement for medical school, written four years ago.

***

Strolling down busy, student-filled Rue Mouffetard, I was surprised to turn around and see my friend’s swollen eye as he ran off; he had been punched in the face. Thirty seconds later, his cousin was attacked and pushed against a car. Initially confused and terrified, I sprinted across the narrow …

When doctors stalk their patients

Kunmi Sobowale, MD

Health Technology

October 16, 2015

I peeked. Several months ago, I met a 60-year-old woman with shortness of breath. Her hospital stay was a whirlwind. She had lost weight, and a test detected her stool had blood in it. This was an ominous sign. Within a few hours, she underwent a colonoscopy that revealed she had colon cancer. The colorectal surgery team whisked her away from my general medicine team. I soon left that hospital for …

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When doctors stalk their patients

Our training, ourselves: The impact of defunding Planned Parenthood

Kira Neel and Jennifer Tsai

Physician

October 15, 2015

Approximately one in three women under the age of 45 have had an abortion.

Approximately one in three women under the age of 45 have a tattoo.

Think about your community. How many tattoo parlors can you think of? How many can you easily access?

How many abortion clinics can you think of? How many can you easily access?

A cursory, ten-second search for “tattoo” yielded more than 40 results within a 5-mile …

Primary care doctors love their work. It’s time for America to love them back.

T. R. Reid

Health Policy

October 15, 2015

“I love my job.”

Throughout the year 2015, a national campaign called Health is Primary has held seminars with primary care doctors around the country. The point was to remind Americans of a basic truth about health care: Primary care physicians are the lynchpin of any health care system. In every country, more emphasis on primary care leads to better health outcomes at lower cost.

I got to be the moderator for …

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