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The measles outbreak: Let’s look at the bigger picture

Conditions and Diseases

February 21, 2015

As the measles outbreak gathers worrisome steam in parallel to the explosion of passionate rants both pro and anti-vaccination, I find myself wondering; what is this really about? Rather than get bogged down in the myriad of issues on either side- though at the outset I will say that as a pediatrician I unequivocally recommend vaccination; I will aim to look at the bigger picture.

Is this issue really about trying …

A tale of two strep throats: Retail clinic vs. PCP

Leslie Kernisan, MD, MPH

Conditions and Diseases

February 21, 2015

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Six years ago, just after arriving in Baltimore for a winter conference, I fell sick with fever and a bad sore throat.

After a night of feeling awful, I went looking for help. I found it at a Minute Clinic in a CVS near the hotel. I was seen right away by a friendly NP, who did a rapid strep test …

Let’s break the association of palliative care as hospice

Don S. Dizon, MD

Physician

February 21, 2015

Mom. Dad.

Happy. Sad.

Friend. Trust.

I remember playing this game. A friend would say one thing, and then I would say the first thing that came to my mind. For some reason, it would pass the time. I remember how some words would spark an emotion or a memory. Sometimes happy, sometimes not so happy. But, playing that game was one of …

When should parents be vaccinated against measles?

Natasha Burgert, MD

Conditions and Diseases

February 20, 2015

“Nervous.”

I’ve heard that word a lot lately. It keeps falling from the mouths of my families in clinic, landing on the floor with a silent thud.

I mean, we have a right to be. We should be. It is one of the most infectious diseases on the planet, today about 400 people worldwide will have died of it, and the number of infected people in the U.S. is climbing.

Do you want a doctor or a demotivated test-taking machine?

Shirie Leng, MD

Medical Education

February 20, 2015

Last week, my best friend took the recertification exam in anesthesia, the so-called MOCA exam. Like a good doobie, she paid her $2,100, paid her nanny extra so she could study, took a day off in which she missed the funeral of a friend’s husband, and took the test. Wow, she must be the most awesome, most well-read, most skilled, most …

I am proud of our society. We provide care to everyone.

Michael Joel Pottash, MD, MPH

Physician

February 20, 2015

She is always a difficult admission. The long chart review. The vague complaints. The entitled attitude. The misdirection. These are expected. As is the cake at her bedside after a diabetic crisis. The two-liter soda after an emergent fluid dialysis. The urine toxicology was positive for cocaine. The staff knows her well. I know her well. I give her the attention, kindness and empathy that I give to every patient. …

No, you don’t need a vagina facial

Jennifer Gunter, MD

Conditions and Diseases

February 20, 2015

I saw this little news item from Shape Magazine about “vagina facials.”

First of all, the post means vulva. The vagina is inside and the vulva is the outside (where your underwear touches your skin). The vestibule is in between.

This what Shape Magazine had to say about it:

Created by Lisa Palmer, the facial came about after she “looked downstairs” and realized her …

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No, you don’t need a vagina facial

How to make a great first impression with patients

Edward Leigh

Patient

February 20, 2015

You don’t have a second chance to make a great first impression.

If twenty random numbers were read aloud, most people would remember the first few numbers and the last few numbers. We tend to remember beginnings and endings. It is the same with patients; they tend to recall what they hear at the beginning and …

Does Tamiflu work and what are the side effects?

Janice Boughton, MD

Medications

February 20, 2015

The flu season has really gotten into gear now with 46 of our 50 states reporting widespread influenza activity as of January 3, 2015. Influenza is a virus that infects the respiratory tract, causing sore throat, runny nose, fever, and cough. Rarely people with the flu will have nausea, vomiting and diarrhea, but this is not “stomach flu” which is a term some of us use to describe any one …

The power of expensive placebos

Albert Fuchs, MD

Medications

February 19, 2015

The power of placebos has long been known. People who believe that they are taking an effective drug frequently feel better. In fact, prior to the discovery of penicillin, it is likely that the placebo effect accounted for much of the benefit of medical care.

A study published in the journal Neurology makes an interesting connection between the magnitude of the placebo effect and the medication’s perceived price.

The study enrolled 12 …

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The power of expensive placebos

How the advent of propofol changed the meaning of the term “sedation”

Karen S. Sibert, MD

Medications

February 19, 2015

“Twilight! She has to have twilight,” insisted the adult daughter of my frail, 85-year-old patient. “She can’t have general anesthesia. She hasn’t been cleared for general anesthesia!”

We were in the preoperative area of my hospital, where my patient — brightly alert, with a colorful headband and bright red lipstick — was about to undergo surgery. Her skin had broken down on both legs due to poor circulation in her veins, …

Driving advice from a trauma surgeon

Jamie Coleman, MD

Conditions and Diseases

February 19, 2015

No one ever wants to meet me. Well, at least inside of a hospital. If you are meeting me in a hospital, it is likely because you have been stabbed, shot, assaulted, or in a car accident. Although the only advice I have about avoiding the first three mechanisms of injury is to stay away from “two dudes” and not try to sell …

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Driving advice from a trauma surgeon

The misguided case against the annual physical

David L. Katz, MD

Physician

February 19, 2015

Recently in the New York Times, Dr. Ezekiel Emanuel suggested that this year’s resolution might be to abandon the ritual of your annual physical. The title of his column, perhaps chosen by an editor to maximize glibness and thus provocation was: “Skip Your Annual Physical.”

But permit me to suggest you don’t commit to that just yet. The annual physical exam warrants some more examination, a defense to follow its prosecution.

Dr. …

Want to know why your doctor is late? Read this.

Sanaz Majd, MD

Physician

February 19, 2015

One of my biggest pet peeves in life is tardiness. I hate it when other people are late. It’s as if they are not respecting my time. But you know what? I hate being late myself even more. In fact, I cringe at the thought. Conscientious, successful people are on time.

Always.

So you can imagine that nothing irks me more than being …

Giving test results directly to patients: What’s missing is context

Kathryn A. Hughes, MD

Physician

February 19, 2015

I do not think that word means what you think it means.
– Inigo Montoya, The Princess Bride

Stick to Facts, sir! … In this life, we want nothing but Facts, sir: nothing but Facts!
– Charles Dickens, Hard Times

“Information without context isn’t transparency” flashed across my Twitter feed. So now I am thinking about context, and communicating context, in medical care.

This quote, from Heather Pierce, JD, MPH, Director of Science Policy and Regulatory …

Should we give more Tamiflu for influenza? A look at the evidence.

Kenneth Lin, MD

Medications

February 18, 2015

As the Centers for Disease Control and Prevention (CDC) reported that people who received this season’s influenza vaccine were only 23 percent less likely to be diagnosed with influenza than unvaccinated persons, CDC director Tom Frieden was publicly urging high-risk patients and their physicians to use antiviral medications to prevent complications and disease transmission:

People who are sick with flu, if they’re very sick in the hospital or if they have …

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Should we give more Tamiflu for influenza? A look at the evidence.

So what’s the big deal about measles?

Chad Hayes, MD

Conditions and Diseases

February 18, 2015

In a recent post (“Dear Anti-Vax Parents: We’re Not Mad At You”), I wrote about the critical need for better education and communication between doctors and vaccine-hesitant parents. It was far more popular than I would have imagined, and I appreciate all of you who shared it. And in the spirit of providing reliable information about vaccine-preventable illnesses, I wanted to take the time to write about why measles matters.

The measles vaccine …

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So what’s the big deal about measles?

What we can learn from cardiology-related malpractice claims

Sandeep Mangalmurti, MD, JD

Physician

February 18, 2015

In anticipation of American Heart Month, an examination of the liability risks faced by cardiologists was recently undertaken by The Doctors Company, the nation’s largest physician-owned medical malpractice insurer. This analysis of 429 closed cardiology claims from 2007 to 2013 revealed that the most common patient allegations against cardiologists and other clinicians were diagnostic errors, followed closely by procedural or surgical mishaps. This data is of particular interest to cardiologists, …

3 ways parents quash the kindness in their kids

Claire McCarthy, MD

Physician

February 18, 2015

The other day, I read about some really cool research that suggests that little kids are naturally altruistic.

It got me thinking: What is it we do that stops them from being that way? Because, let’s face it, not all big kids — and definitely not all grownups — are kind and look out for others.

Felix Warneken, a Harvard researcher, studies the evolutionary …

Improve teamwork with better selection of medical trainees

Joshua Liao, MD

Medical Education

February 18, 2015

Amid the many ongoing changes to health care, it’s clear that better teamwork is needed in American medicine. Calls for stronger interdisciplinary collaboration have permeated position statements and policies, and organizations have begun redesigning care processes to include novel team-based approaches. Emerging data continue to affirm that strong teamwork and communication can increase the value of care.

Of the many efforts to improve teamwork, however, one potential area for significant improvement …