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What does a pain physician think about the movie, Cake?

Conditions and Diseases

February 10, 2015

I saw the movie Cake tonight. I felt it was my duty. I am, after all, a pain specialist.

I’d read that it was gritty, honest, and accurate, and that Jennifer Aniston was very convincing. I found all that to be true.

It’s the show’s first weekend in Louisville theatres, and the crowd at this 5:30 p.m. showing was decidedly mature, reverently attentive, and noticeably equipped with more walkers and canes than …

The wrong people are leading the charge for health care quality

Rocky Bilhartz, MD

Health Policy

February 10, 2015

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Recently, the Department of Health and Human Services (HHS) announced an ambitious goal to have 85 percent of payments made to doctors linked to clinical quality measures within the next two years. HHS believes that incentives should be weighted almost entirely toward quality of care instead of volume of care. I guess if you’re a patient, you could ask yourself the …

In times of stress, remember who is behind the mask

Dr. Artaza Gilani

Physician

February 10, 2015

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As clinicians, we often forget or become desensitized to the image that society has of medicine and doctors. Alongside teachers and scientists, we are seen to be among the most trustworthy of professionals, yet our morale is low, with almost 50 percent describing it as “low” or “very low.” You can imagine, then, why I often describe medicine as a forest: …

What ESPN doesn’t tell you about MRI in professional athletes

Rourke Stay, MD

Physician

February 9, 2015

I have to admit, I’ve been excited to see radiology slowly infiltrate into the mainstream of sports. Fifteen years ago, it was rare for the public to know when an athlete had an MRI. Now I hear people in the coffee shop saying:

“Man did you see Derrick Rose go down last night?”

“Yeah, we’ll just have to see what the MRI shows.”

In …

The practice of medicine is becoming a numbers game

David Mokotoff, MD

Physician

February 9, 2015

We all accept that we can’t vote until we are 18 and can’t order alcohol — at least legally — until we are 21. We know that if we speed 60 mph in a 45 mph zone, we risk a traffic ticket or accident. We get used to these numbers and pretty much know the risks if we break them. However, the practice of medicine is becoming more and more …

If mechanics were paid like doctors

Chad Hayes, MD

Physician

February 9, 2015

My friend, Trent, is an auto mechanic. When he was growing up, he loved to work on old cars. He rebuilt his first one when he was fourteen — and drove it for 11 years. He loved finding problems and figuring out how to fix them. He never cared about getting rich; his goal was to make a decent living doing …

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If mechanics were paid like doctors

The medical community and complicity: Our role in the Eric Garner case

Jacob Rosenberg

Medical Education

February 9, 2015

On Thursday January 15, over one hundred Stanford Medical School graduate and medical students gathered to commemorate MLK day and remember the lives of Mike Brown and Eric Garner. On a white board that proclaimed “Black Lives Matter,” attendees wrote their thoughts. On the board, I wrote “Keep the conversation going,” and in that effort I’d like to examine one …

7 secrets to keep loyal patients for life

Pamela Wible, MD

Physician

February 9, 2015

Loyal patients are the lifeblood of a medical clinic. And devoted patients are worth their weight in gold. It’s a lot easier to care for an established patient that lots of one-timers who never return. Beyond ease of workflow, the economic benefits are fabulous. A loyal patient panel will stay with you (and pay you) through sickness and in health …

Stop clinging to tradition in medicine

Edwin Leap, MD

Physician

February 8, 2015

Walking around the ER in Tiny Community Hospital, I had a few realizations. In medicine, we hold onto some things very tightly. We love tradition; we love the known. We don’t always know why, but we choose “the devil we know,” almost every time, no matter how pointy his horns.

For instance: “No cell phones.” First of all, has anyone ever seen a cell phone interrupt anything we do? No? Neither have …

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Stop clinging to tradition in medicine

The fight against MOC: The spark that unites physicians

Jordan Grumet, MD

Medical Education

February 8, 2015

Physicians are docile. We are programmed to put the greater good above our own. We train mercilessly, work tirelessly, and bend faithfully at the alter of those we have vowed to heal. This is our birthright. This is the covenant we signed in our own blood when we took our healing oath. Decry us as they will, no one becomes a …

Sitting is a major health risk. But don’t panic.

David L. Katz, MD

Conditions and Diseases

February 8, 2015

The big medical news recently was that sitting hours a day is taking years from our lives, whether we exercise or not. We have heard similar things before, so the now reiterated message is: Yes, we are sitting on a major health risk. Sitting is the major health risk! The new study, a meta-analysis in the Annals of Internal Medicine, purportedly adds precision to the estimate of risk.

There …

The bacteria that almost killed my grandmother

Natalia Birgisson

Conditions and Diseases

February 8, 2015

“Hefur þú lært um Staphylococcus aureus?” I almost don’t recognize the bacteria name because my grandmother pronounces it differently in Icelandic.

“Já–” I’m about to translate my microbiology flashcard for her when she interrupts, her hands busy kneading the cookie dough and her eyes on my little sister near the oven.

That’s the bacteria that almost killed her eleven years ago, she tells me. I can hear her words building up. This …

When the seemingly simple becomes complex

Chiduzie Madubata, MD

Physician

February 7, 2015

In medicine, the seemingly simple questions become the complex ones.

“How’s it going?”

It is a question that is frequently asked whenever we encounter friends and acquaintances. In a given day, we ask this question many times out of courtesy and we expect to hear short, affirmative answers, such as “Things are good,” or “It’s OK” as we continue to walk to where we need to go since we are pressed for …

Why rural hospitals are fighting a losing battle

Robert Pearl, MD

Health Policy

February 7, 2015

Rural hospitals are fighting for their lives. Over the past five years, more than 40 rural facilities have closed their doors due to lack of funding. And because the majority of their funds come fromMedicare and Medicaid — two government programs facing potential cutbacks in 2015 — many rural hospitals may be fighting a losing battle.

Understandably, small-town residents fear hospital closures or downsizing may leave them vulnerable when serious illness strikes. …

The 7 stages of grief when you’re called for an admission

GomerBlog

Physician

February 7, 2015

The Rübler-Koss model or 7 stages of grief is a series of emotional stages an admitting provider experiences when faced with an impending admission. The 7 stages are best remembered by the acronym DABDDAH, which stands for denial, anger, bargaining (or blocking), deflection (or delaying), depression, acceptance, and …

Family medicine doesn’t have to be a dying profession

Mark Tomasulo, DO

Physician

February 7, 2015

When I entered the profession of being a family doctor, like many aspiring physicians, I had a more altruistic vision of what it would be like. However, the reality of that picture over the last 10-years has resulted in frustration, disappointment, and, above all, the realization that health care has changed for the worse. It has become unaffordable for the masses and institutionalized for the benefit of corporate America, not …

MKSAP: 72-year-old man with dyspnea at rest

mksap

Conditions and Diseases

February 7, 2015

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

A 72-year-old man is evaluated for dyspnea at rest. He has end-stage COPD and is on a home hospice program. He has weight loss, reduced functional capacity, and muscle atrophy. His medications are ipratropium, salmeterol, fluticasone, albuterol as needed, and prednisone. He is uncomfortable, with chronic air hunger that has gradually increased …

Advances in hepatitis C treatment. Why aren’t they being used?

Nezam H. Afdhal, MD

Conditions and Diseases

February 7, 2015

The really incredible advances in the treatment of hepatitis C bring to life several relevant questions as we move forward into 2015. First, who should be treating hepatitis C patients (primary care providers, gastroenterologists, infectious disease specialists)? Second, can we really afford to use these new treatments? I recently discussed this topic with my GI and hepatology colleagues in AGA Perspectives, the bi-monthly opinion magazine of the American …

Touching a life on the other side of the world

Bhupesh Vasisht, MD

Physician

February 6, 2015

In 2012, in a remote town of San Jose, on the southern part of Occidental Mindoro province in the Philippines, I met a little boy and his desperate, but courageous mother. The boy was just a few months past his first birthday. He was born with a facial congenital defect known as bilateral cleft lip, so commonly seen in …

4 things we should be teaching in medical school, but aren’t

Alexandra S. Brown, MD

Medical Education

February 6, 2015

For many years, I taught a sizable chunk of our local medical school’s second-year pathology course. I was always energized by the students’ enthusiasm and desire to learn more about medicine. On the other hand, I remembered feeling their same frustrations regarding the lack of fundamental practice skills included in today’s medical school curriculum.

In fact, at our university, a group of students started a business in medicine interest group, where …