Dr. Wes has written passionately against MOC: ABIM Pleads for Mercy.
But perhaps we should ask first: Why MOC at all?
Contrary to years of propaganda promoted through pseudo-science and journal article citations on the ABIM’s website, might MOC have really been created because the ABIM’s consolidated fund balance dropped 43.2% from $54,009,086 on June 30. 2001 to $30,691,329 by June 30, 2013 while the Standard and Poors 500 index increased 37.7% …
In order to interpret the world, we tell ourselves stories. All day long. About everything. That guy in the grocery store who clipped your heels with his cart? A jerk. The car that cut you off at that intersection? A jerk. A little old lady stopping in the middle of the aisle at the grocery store? Senile.
It is automatic, it takes no effort, and it is completely egocentric. It is …
It’s important that we get our stories right
Let’s talk about vaccine ingredients. I am reading less about vaccines causing autism (we all know that theory is utter nonsense, right?) and more about vague concerns regarding the chemicals in vaccines. To begin with, we are surrounded by chemicals. Water (H2O), caffeine (C8H10N4O2), sugar (C12H22O11) are all chemicals. But perhaps it is the unfamiliar ingredients that people find intimidating.
Let’s tackle the ingredients in the measles, mumps, rubella and varicella (MMRV) vaccine …
Don’t be scared: Let’s see what’s really in vaccines
Medicaid expansion “is one of the biggest milestones in health care reform,” according to the Obamacare Facts website. The goal was to provide insurance coverage to low-income Americans, specifically the uninsured. The major problem with Medicaid is low reimbursement. “Due to low payouts, many doctors don’t take Medicaid, and the quality of care tends to be poor,” admits the website. The solution was to raise the amount doctors get paid under …
How Medicaid’s bait and switch fooled doctors
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 60-year-old man is evaluated as a new patient. He was diagnosed with type 2 diabetes mellitus during a health insurance evaluation 6 months ago. At that time, metformin was initiated. Medical history is otherwise unremarkable.
On physical examination, blood pressure is 145/94 mm Hg; other vital signs are normal. BMI is 29. …
MKSAP: 60-year-old man with type 2 diabetes mellitus
Have you ever tied your shoes and found that the bow unraveled and you almost tripped over your own laces? Learning to tie your shoes is a life skills task that you learned as a toddler unless you were trained on Velcro straps! You performed the task of tying your shoes nearly every day of your life believing that you were …
What physicians can learn from tying their shoes
My last patient, Joyce, a 45-year-old single mother of four with high blood pressure and diabetes, is late. She was in the emergency department last week with dizziness and blurred vision, a blood sugar of 345 and a blood pressure of 190/110.
Her last office visit was a month ago, when weighing in at 222, she joked that she wished she could pull those numbers at the casino’s slot machines. She …
Food insecurity is an undiagnosed medical problem
Once an alcoholic, always an alcoholic.
This is one of the main tenets of Alcoholics Anonymous, and it serves to encourage its members to commit to absolute abstinence. It is also a belief, I have come to realize, held by the many medical residents I have encountered.
When an alcoholic patient is admitted to the hospital, it is no secret that he (or she) is an alcoholic. This is because it feels …
An alcoholic patient, and his effect on a medical student
Every year 300 to 400 physicians commit suicide. More than 10 percent of doctors are thought to have depression, a frequent precursor to suicide. Rates of depression and suicide
Does medical student debt lead to suicide?
The medical condition provocatively called exploding head syndrome, or EHS, brings back the disturbingly graphic images of the 1981 sci-fi horror flick Scanners where the main character blew up people’s heads with the power of telekinesis. Fortunately, as ominous as exploding head syndrome sounds, no skulls have actually exploded, and the condition is reassuringly non-life threatening. For the people who experience the symptoms of EHS, however, the ordeal can be …
Exploding head syndrome: Is it really terrifying?
Measles Makes an Unwelcome Visit to Disneyland
Health Alert after Disneyland linked to measles outbreak
Mickey, Minnie and measles for nine Disneyland tourists
The headlines from January 7th and 8th told an increasingly serious story about America’s vaccine civil war — a story that was to explode in the weeks ahead. We’ve come to expect that kind of story to be uncovered by a major news network with expertly trained, …
2015’s biggest health story was broken by a doctor, not a reporter
A few weeks ago Bill Maher made a number of critical remarks about medicine and physicians. I sent Mr. Maher the following response in an effort to address his comments. I am sharing this with you in hopes that other physicians will also speak out in defense of our profession.
Dear Mr. Maher,
Let me start by saying that I have been a …
Bill Maher criticizes doctors: A physician responds
Three years ago I received some of the best news of my life — that I have dopa-responsive dystonia. (Yes, a neuromuscular disorder was welcome news.) Painful, life-interrupting muscle contractions had made the dystonia diagnosis likely several years before, despite poor response to standard treatments, and I was fighting through graduate school: trying to compensate for medication-induced memory problems, increasing need to work from bed, and a disappearing social life. …
A domperidone dilemma: A patient’s perspective on ordering from Canada
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The next step in our …
Where is the waste in health care?
I read with interest the recent article written by Dr. Rourke Stay, “What ESPN doesn’t tell you about MRI in professional athletes,” and couldn’t agree more. The bigger issue, however, is what ESPN may leave out of broadcasts about sports injuries. Prominent figures on the air often espouse their knowledge with enough charisma to convince even the most doubting fan that their opinion is more than just an armchair …
Consult experts in sports medicine when discussing players’ injuries
To most physicians my illness is a routine incident in their rounds, while for me it’s the crisis of my life. I would feel better if I had a doctor who at least perceived this incongruity.
– Anatole Broyard
For medical students to treat illnesses of all kinds, we must first fill our brains with thousands of facts, everything from anatomy, to physiology, to microbiology, and biochemistry. We essentially become robots, pounding …
Are we sacrificing our humanism in medicine?
In medical school, I was taught to keep my distance. To remember that the patient is the one with the disease. I was told to protect my heart, to be a little cynical, a little deprecatory, to keep a separation between me and the patient. Because they can hurt you.
For 18 years, I met people on what was arguably the worst …
Stop trying to be God. Be human.
Please choose one:
The three words blink in front of me on the computer screen.
Please choose one:
Patient is-
☐Male ☐Female
I click FEMALE.
I watch as the auto-template feature fills in the paragraph for me based on my choices.
Patient #879302045
Patient is: 38-year-old female status post motor vehicle accident. Please acknowledge you have reviewed her allergies, medications, and past medical history.
I click YES.
Have you counseled her about smoking cessation?
I click NO.
A little, animated icon of a …
I am sorry that you are in the hospital. You are feeling ill. The noises are loud, people are walking in and out of rooms, and you aren’t sure of what to expect. You are probably nervous. This whole situation is a disturbance to your life. You would rather be at home — I can understand that. Few people want to …
Dear patient: Apologies from your medical student
This morning, a friend of mine posted an article on Facebook that was titled, “Dear anti-vax parents, we’re not mad at you. Sincerely, your doctor.” She had captioned it, “Maybe when all the vitriol and anger and judgment dies down, maybe we can start having conversations like this, instead.”
The funny thing is that I had posted the exact same …
As a mother, I’m angry at vaccine refusers. As a physician, I’m scared.
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