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The transition from medical student to teacher

Medical Education

May 17, 2015

In just under two months, I will be making two big transitions as I begin life as a resident. The first and obvious change is from student to doctor. The second doesn’t get the same spotlight, but might be just as important: from student to teacher.

Residents play a vital role in medical student teaching. With medical training like an apprenticeship, it is the residents with whom third-year medical students often …

It’s time to study the economic impact of new drugs

Ramesh Nathan, MD

Medications

May 17, 2015

I recently was invited to participate in a research study, looking at the economic impact of a new drug for the treatment of Clostridium difficile infection. The new drug, called fidaxomicin, has been available for a few years and has proven efficacy in thousands of patients but is generally very expensive. The study will follow patients after their hospitalization and delve into analyzing the monetary costs associated with the medicine, …

Knowledge and power: The fallacy that leads to a distrust of medicine

Ron Cheung, MD, PhD

Physician

May 17, 2015

Some time ago, I engaged in a debate with a proponent of GMO labeling. His main point was that the information provided by labeling would allow consumers to make better decisions about what they eat. He went so far as to condense his argument into three simple words: “Knowledge is power.”

What my opponent failed to mention is that the truth of this statement is conditional. Knowledge can be powerful, but …

Casual Fridays don’t have a place in medicine

Greg Smith, MD

Physician

May 16, 2015

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A disclaimer before I even get started on this post.

Some of you who know me or work with me will think that by writing this post I am talking about you or even attacking you. I am not. If you’re especially sensitive, don’t read any further.

I am simply writing something that has been kicking around in my head for a long …

Honoring the impact of even the smallest, briefest lives

Cortney Davis, ARNP

Conditions and Diseases

May 16, 2015

It was a Wednesday in late spring, 1972. I was a nursing student in my final months of training, eagerly awaiting graduation.

When I arrived on the maternity ward that morning, my nursing instructor told me that I’d be caring for a baby, only hours old, with special needs.

I thought she’d send me to the neonatal ICU. Instead, to my surprise, she motioned toward the linen closet, its doors closed tight.

“The …

Getting congratulated on hand washing. Really?

Michael Kirsch, MD

Physician

May 16, 2015

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Everyone likes to be recognized for a special achievement or accomplishment. Every career has special awards and commendations for everything. While there’s no reward that matches cold hard cash, many of these honorable mentions have no tangible value whatsoever. Pull into a fast food parking lot and you may see a parking space designated with a sign proclaiming, employee of the …

Guts on the bed: A surgeon talks postoperative evisceration

Hope Amantine, MD

Physician

May 16, 2015

We spend a lot of time in medicine in education. Pursuing medicine as a career requires embracing learning for a lifetime, because there is always something new, always something different, new approaches, new medications, new discoveries — we want what’s best for our patients, and you can’t deliver on that promise unless you know what’s out there.

As a consequence, we spend time trying to organize information, categorize it, study it, …

Business ethics are no match for medical ethics

Steven Reidbord, MD

Physician

May 15, 2015

Compared to most others in society, physicians endorse, and are held to, higher ethical standards. (To illustrate, here are ethical codes from the AMA and the World Medical Association.)

High standards apply to professionals in other fields as well, especially fiduciaries such as attorneys, accountants, school teachers, and judges. But standards of medical ethics may be among the most stringent. We put patient welfare first, and anything that interferes with this …

Dr. Oz shouldn’t be fired. And here’s why.

Dr. Saurabh Jha

Physician

May 15, 2015

If I could invite four people for dinner, alive or dead, they would be Mark Twain, William Shackleton, Christopher Hitchens and Homer Simpson (Bart’s dad). If Mehmet Oz turned up with a bag of Garcinia cambogia, I would excuse myself.

Few things drive me to the abyss more reliably than the banality of status updates on Facebook and the monotony of health …

5 ways the Affordable Care Act improved health care

Robert Pearl, MD

Health Policy

May 15, 2015

In October, 2013, at the launch of the Affordable Care Act, I predicted that the health insurance exchanges about to go into effect would grow in popularity and improve the health insurance marketplace, then so imperfect.

Twenty months later, the exchanges are proving effective in reducing the number of uninsured and are beginning to provide the information people need to make an informed selection about which plan is best …

Eliminating hypothyroidism from iodine deficiency

Christopher Johnson, MD

Conditions and Diseases

May 15, 2015

One of the words we don’t use anymore is cretin; it’s long been a derogatory slur rather than a precise description of something. But a century ago cretinism actually meant a specific thing: a person, generally a child, who was severely damaged by a lack of thyroid hormone during early development, particularly fetal development. Now we call the condition congenital hypothyroidism. A few cases still exist, which is why we …

When did primary care physicians stop becoming doctors?

Jordan Grumet, MD

Physician

May 15, 2015

We both agreed that it was unfortunate.

I sat on Paul’s living room couch with a computer perched on my lap as he recounted the events of the last few weeks. His business flight was interrupted by severe spasms of cough and high fever. He called me upon landing, and based on my advice, went to a local urgent care center. After …

She took Zofran and her son had a heart defect. Here’s why she’s not suing.

Jennifer Gunter, MD

Conditions and Diseases

May 15, 2015

I suffered from extreme nausea during my pregnancy; I had triplets, and I’m pretty sure I had a triple dose. I never threw up, but you know how your mouth salivates the moment right before you vomit, that sensation that sends you running to the bathroom? I had that. All. Day. Long. For four weeks.

By day four or five I was …

Value and quality are fuzzy concepts. Here’s why.

Robert Centor, MD

Health Policy

May 14, 2015

Now that we no longer have to worry about the SGR, we have a new worry. The law consolidates several measurement tools into one big tool. CMS has declared that it wants to pay for value. The law provides a blueprint for paying for value. The underlying assumption of this approach is that we can define and measure value through measuring quality components.

Can we define health care value through measurement? …

The time I realized I kicked cancer’s ass

Stacey Gordon

Patient

May 14, 2015

The harder the conflict, the more glorious the triumph. What we obtain too cheap, we esteem too lightly; it is dearness only that gives everything its value. I love the man that can smile in trouble, that can gather strength from distress and grow.
― Thomas Paine

Dear my oncologist,

This year was my 11th anniversary as a breast cancer survivor. For the past 6 …

How do you know if cancer treatment worked?

Anne Katz, RN, PhD

Conditions and Diseases

May 14, 2015

The patient was a young looking 74-year-old woman, accompanied by her husband. She was not exactly sure why she was seeing me and nodded as I explained that I see all women with anal or rectal cancer who are being treated with radiation therapy. I explained that we recommend that these patients use vaginal dilators to improve elasticity after …

Mathematics is the new science of medicine

Jack Cochran, MD, Charles Kenney, Paul Grundy, MD, and John Merenich, MD

Health Technology

May 14, 2015

The progression of science in medicine has been as remarkable as it is relentless. From alchemy, chants, purges, and leeches, medicine has progressed to a deep understanding of human form and function through biology, anatomy, and physiology.

Microbiology and pathology revealed details and causes of diseases while chemistry and pharmacology opened the doors for advanced diagnostic testing and a variety of therapies. Physics added more diagnostic capabilities and additional options for …

Editing the genes of human embryos: A line that should not be crossed

Ruth Macklin, PhD

Conditions and Diseases

May 14, 2015

In my work as a bioethicist, I have very rarely taken an “absolutist” position regarding the use of a biomedical technology. But when I read an article titled “Chinese Scientists Edit Genes of Human Embryos, Raising Concerns,” my reaction was that this should not be done. I am not alone.

The technique mentioned enables genes to be altered in every cell …

This doctor didn’t support Vivek Murthy. And it’s not because of what you think.

Suneel Dhand, MD

Health Policy

May 13, 2015

Recently, the new surgeon general of the United States, Vivek Murthy, was officially sworn in by Vice President Joe Biden. Congratulations to him, it’s quite an achievement at the relatively young age of 37. Nobody can doubt the hard work, intelligence and passion that must have gone into reaching such a height.

His nomination was first put forward at the end of 2013, and he faced something of an uphill political …

Tax tips for doctors and young physician families

Bruce Roscher, CPA

Physician Finance

May 13, 2015

Although the time of year when everyone has their list of tax questions has just passed, tax questions are appropriate all year. It’s best to be prepared at tax preparation time, so much less stress is created. Tax time can be especially stressful for younger taxpayers who are going through life changes, or earning substantially higher income for the first time.

Young physician families are an excellent example of this type …