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OTC Lipitor? Why Pfizer made the right decision for the wrong reason.

Ira Nash, MD

Medications

August 15, 2015

There were several news stories recently that reported that Pfizer had abandoned its efforts to have its Lipitor brand of atorvastatin made available over the counter (OTC), without a prescription. I was never a big fan of OTC statins, but I was struck by the reason that Pfizer put out:

The study did not meet its primary objectives of demonstrating patient compliance with the direction to check their low-density lipoprotein cholesterol …

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OTC Lipitor? Why Pfizer made the right decision for the wrong reason.

What does a doctor look like?

Lara Devgan, MD, MPH

Physician

August 15, 2015

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As a plastic surgeon, I am interested in how people look. Whether I am piecing together a fractured face or reconstructing a cancer-scarred breast, I am focused on appearance, symmetry, contour, and lines. I am always thinking about how our bodies are the physical manifestations of who we are.

What I am never thinking about is how that sentiment applies to me.

An intern …

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What does a doctor look like?

What is the diagnosis in this woman with an enlarging neck mass?

mksap

Conditions and Diseases

August 15, 2015

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

A 78-year-old woman is evaluated for a rapidly enlarging neck mass that has been present for 4 weeks and is associated with neck discomfort, dysphagia, and hoarseness. The patient has had Hashimoto thyroiditis and hypothyroidism since age 24 years and has been taking levothyroxine since that time.

Physical examination reveals an older woman …

Ain’t the way to die: The stories that this physician will never forget

Zubin Damania, MD

Physician

August 14, 2015

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Like so many other medical professionals, I felt voiceless in the face of a gargantuan health care non-system built to do things to people, rather than for people. But after a decade of hospital practice, my “cry for help” looked slightly different than the typical midlife crisis: It involved the creation of a somewhat ridiculous blue-scrubbed rapping doctor alter ego. “ZDoggMD” could …

Please, don’t eat your placenta. Here’s why.

Jennifer Gunter, MD

Conditions and Diseases

August 14, 2015

Every few news cycles placenta-eating seems to make the rounds. I’ve already seen it a couple of times this year, so I figured the Internet is trying to tell me something.

Some women, but mostly those who recommend and/or prepare placenta for them, think that ingesting placenta can cure/help postpartum depression and possibly a host of other postpartum ills and issues. Some …

This is how one physician became a happy doctor

Pamela Wible, MD

Physician

August 14, 2015

I was a physician employee, many times for many hospitals and clinics. I’d stay a year or two, but eventually I’d quit. Then, in 2005, I opened an ideal clinic designed by my patients. Ten years later, I still love private practice. Why? I’m finally practicing medicine the way I had always imagined.

When I decided to open a private practice, I was …

What happens when moral physicians stand up to power

Richard Gunderman, MD, PhD

Health Policy

August 14, 2015

Dr. Melos is a gastroenterologist in solo practice in a medium-sized Midwestern city. One day she hears a knock on her door. When she answers, she finds two representatives of Athenian Health System, who request a few minutes of her time. She invites them to take a seat in her office.

After exchanging pleasantries, the visitors get down to business. They extend Dr. Melos an …

The Hunger Games of health care is here. Who will be our Katniss?

Regina Druz, MD

Health Policy

August 13, 2015

“Doctor, the patient is complaining,” said my secretary in a hush-hush voice. “She has been waiting for 30 minutes.”

“She” had an appointment for later in the afternoon but phoned our office about 2 hours before the scheduled time, and requested to come earlier. No emergency. No acute complaints. We always try to accommodate, and pushed to “squeeze” her in. The earlier time, …

When doctors win, patients are the ones that sometimes lose

Jordan Grumet, MD

Physician

August 13, 2015

Like two ships passing in the night, we sidled up to each other at the nursing station on the hospital telemetry ward. I had already been home, ate with the kids, and returned, while he hadn’t left floors all day. We typed away at our computer stations, and chatted from time to time.

After we exchanged common pleasantries, we jumped into local politics. …

Health care could use someone like Donald Trump. Wait, what?

Suneel Dhand, MD

Health Policy

August 13, 2015

He’s loud, brash and audacious. He’s been a celebrity for decades, a well-known businessman and reality TV star. And anyone who is even remotely following the news at the moment knows he’s also dominating headlines with his presidential run. I’m going to pause here to say that I’m not going to get into the politics of anything he has said — no …

This is why the humanities are important in medicine

Nasir Malim, MD, MPH

Medical Education

August 12, 2015

As a medical student having completed my undergraduate major in the humanities, I often receive the question, “Why did you choose to do that?” The underlying thought behind asking why I would choose a major in the humanities while holding the intention to later attend medical school is that medicine is especially distinct from the humanities (and specifically African-American studies in my case). The sciences are just a whole other …

Doctors are playing a very difficult game of changing rules

Emily Gibson, MD

Physician

August 12, 2015

“The chief difficulty Alice found at first was in managing her flamingo: She succeeded in getting its body tucked away, comfortably enough, under her arm, with its legs hanging down, but generally, just as she had got its neck nicely straightened out, and was going to give the hedgehog a blow with its head, it would twist itself round and look up …

Cerner beats Epic in the DoD sweepstakes. What does that mean for the rest of us?

Margalit Gur-Arie

Health Technology

August 12, 2015

The health information technology (HIT) world has been hit by a watershed event like no other. The Department of Defense (DoD), widely respected for its indiscriminate generosity to contractors, has awarded the most coveted prize in recent HIT memory: the Defense Healthcare Management Systems Modernization (DHMSM) contract. And the winner is … Leidos, the contractor formerly known as SAIC. A couple of years ago, when the race for …

Physician journalists also should put patients first

Kevin R. Campbell, MD

Physician

August 12, 2015

As a physician journalist I find myself in a very fortunate and quite unique position: I am able to reach vast numbers of Americans on a daily basis and provide them with credible (and hopefully impactful) news on health and wellness. Medical journalism is similar to the practice of medicine in that we must put the patient first. Just as physicians provide patients …

Slowly, slowly

Christy Duan

Physician

August 11, 2015

“What is the meaning of life?”

A perfectly reasonable question, albeit a strange one considering that I was in the third grade, it was recess time, and I was having a philosophical conversation about death with a grasshopper I had just caught.

Ever since I could remember, I was fascinated by death. But my life was characterized more by loss than by death. When I was three, there were no funeral processions …

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Slowly, slowly

The real cost of MOC is stunning

Tara F. Bishop, MD, MPH

Physician

August 11, 2015

In the past few years there has been tremendous criticism of the American Board of Internal Medicine’s (ABIM’s) maintenance of certification (MOC) program. The MOC program was significantly expanded in 2014 and required doctors to get 100 MOC points every 5 years and do at least one MOC activity every 2 years. These requirements also came with increased fees for the MOC program and increased failure rates for the recertification …

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The real cost of MOC is stunning

How Medicare benefits doctors: A complicated history

Bob Doherty

Health Policy

August 11, 2015

Fifty years ago, President Lyndon Baines Johnson signed Medicare (and Medicaid) into law. Medicare’s relationship with physicians since then can best be described as a complicated one.

First, recall that Medicare became law notwithstanding the American Medical Association’s fierce opposition to it. Three years prior to its enactment, AMA President Ed Annis warned that, “We doctors fear that the American …

When women speak: Is there a gender bias in medicine?

Lara Devgan, MD, MPH

Physician

August 11, 2015

I have given a number of medical talks over the years — reports on my research, reviews of surgical topics, mentoring speeches, and grand rounds, among others. I prepare for these talks extensively but tend to speak extemporaneously to engage better with my audience. I’m pleased to say that, in general, I have received good feedback. Several times, however, I have been …

What happens when the best medicine has to offer can’t be offered to everyone?

Taimur Safder, MD, MPH

Physician

August 10, 2015

“We have an admission.”

The dreaded four words for most interns on a day you are swamped with discharges while trying to get your post rounds orders in.

“Hypertensive emergency and possible osteomyelitis of the foot,” my senior informed me with a few other details as we made our way to the emergency department. Mr. Rodriguez was a very pleasant middle-aged gentleman, with graying hair and a goatee. I introduced myself, explained …

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