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Solving the problem of medical student debt

Adam Rapp

Medical Education

February 3, 2015

Dr. Richard Gunderman published an article that shared the story of Melissa Chen, a 35-year-old radiology resident in her final year at the University of Texas San Antonio. While her road to medical school was somewhat unconventional (it is great story, I highly suggest reading it), Chen is not your typical medical school student — one whom has persistently endured a rather standard, run-of-the-mill path through graduate school and …

Pay for a doctor and get a plumber instead

Jordan Grumet, MD

Physician

February 3, 2015

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It seems everywhere you look in health care today; some consultant is telling you that “less” is actually “more.” Less care leads to more quality. Less expense brings better outcomes. Nurse practitioners with less training are more cost effective. Fewer work hours for residents builds a safer hospital environment.

Never in our entire history have we gotten so much for so little.

Arshya …

A patient reminds a doctor: How unpredictable life is

Don S. Dizon, MD

Physician

February 2, 2015

I am looking out of my window on a cold and cloudy Boston afternoon and find myself pondering about life: How unpredictable it is, and how one minute can hold no assurance for what happens after. Before I left for vacation, I saw Joan.* She has been under my care for a number of years, living with and thriving despite …

The sad, tragic road to meaningful use

Rocky Bilhartz, MD

Health Technology

February 2, 2015

Meaningful. Having a serious, important, or useful quality.

You know this word because you want it to define your life. Nearly all of us, at some point, will seek a more meaningful existence. Most wish our jobs were that way too.

Meaningless. Having no purpose or reason. Ouch. We don’t want anything to do with that. Meaningless makes us question what in the …

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The sad, tragic road to meaningful use

The financial sinkhole of health insurance complexity

James G. Kahn, MD, MPH

Health Policy

February 2, 2015

We all know that the U.S. system of paying for health care is tremendously complex and inefficient: a multitude of insurers, thousands of insurance plans, innumerable medical bills, countless incorrect and denied claims.

But just how much do we waste on this administrative morass?

I led a research team that recently reviewed all the available evidence and published our findings. The resulting numbers are staggering.

Compared with countries that have a single health …

Mobile health: Just because we can do it doesn’t mean we should

Michael Kirsch, MD

Health Technology

February 2, 2015

I just deposited a check into my bank account by photographing the check with my iPhone and zapping it through cyberspace. I realize this is ho hum to the under 35 crowd. Soon, there won’t be any paper checks as the entire transaction will occur electronically. As a member of the over 35 crowd (plus 20 years), I am wowed by this process. I remember being astonished when my kids …

Why getting your yearly flu shot matters, even if it’s not 100 percent effective

Chris Carroll, MD and Deep Ramachandran, MD

Medications

February 2, 2015

There’s been a lot in the press lately about the flu shot not being effective this year. This provides an excellent opportunity to educate about what the flu vaccine is and why it is important.

First, a review of basic biology and immunology. Antigens are proteins on the surface of organisms that trigger an immune response. Recognition of these antigens is how your body …

Dear anti-vax parents: It’s not your fault

Chad Hayes, MD

Physician

February 2, 2015

Dear anti-vax parents,

In the wake of the Disneyland measles outbreak, there’s been a lot of heated talk about parents who choose not to vaccinate their children. It seems like the medical community is now protesting even louder than the anti-vax groups were a couple years ago. But I want to take a moment and apologize for the harsh tone some of …

Psychiatry is devalued: And patients suffer because of it

Natalie Wilcox

Conditions and Diseases

February 1, 2015

This past week I spoke with a patient who noted that since his wife’s death six months ago, he had lost 40 pounds, slept a maximum of four hours nightly, and stopped enjoying activities he used to take pleasure in. He found it difficult to concentrate at work, and getting out of bed each morning was described as his greatest struggle. While relaying this story, the man was on the …

How to build a great hospitalist team

Sowmya Kanikkannan, MD

Physician

February 1, 2015

Ever since we are children, our parents and society teach us how to play together with others. What we don’t realize is that this lays the groundwork for developing important teamwork skills — the same skills that enable success and positive outcomes in the workplace. My own experiences in hospital medicine practice throughout the last decade continue to increase my appreciation for these seemingly simple yet invaluable techniques.

Like many young …

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How to build a great hospitalist team

How to talk to your patients about alternative medicine

Mel Borins, MD

Medications

February 1, 2015

A woman told me she saw her physician recently and, when she told him all the things she was doing to help herself, naturally he told her he practices Western medicine and that he does not believe in that stuff.

Not a good conversation.

A number of research studies have found that one in three patients routinely use alternative treatments, but …

I’m a palliative care doctor. This is what I do.

Andrew Thurston, MD

Physician

February 1, 2015

Some people who know what I do don’t really know what I do.

They picture me floating through the hospital extinguishing lives, blowing them out one by one like candles down an endless corridor. They think I practice euthanasia, that my presence alone hastens death — that I consume hope and happiness like a black hole, compressing it all into nothingness. Some call me the Grim Reaper, others the Death Doctor. …

Improve patient satisfaction from the eyes of the consumer

Jim Lahren

Patient

January 31, 2015

Although the Affordable Care Act’s second enrollment period is nearly over, politicians, medical professionals, and the public still debate its implications. According to David Houle and Jonathan Fleece, one-third of all hospitals in the United States will close or be reorganized into another kind of health care provider by 2020. What will differentiate the winners from the losers? Simply put, it will be high patient satisfaction.

In consumer terms what …

Most doctors are financially illiterate

Sanj Katyal, MD

Physician

January 31, 2015

Many physicians I know are struggling to make ends meet while making several hundred thousand dollars per year. Despite growing incomes, their savings rates remain extremely low due to ever increasing expenses. What they do manage to save, they turn over to professional money managers.

How does this happen? Why are some of the smartest, hardest-working and most responsible members of our society unable to create real wealth? The answer is …

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Most doctors are financially illiterate

Physicians: How to gain insight into your tax situation

Dave Denniston, CFA

Physician Finance

January 31, 2015

An excerpt from The Freedom Formula for Physicians.

Get the last copy of your pay stub. What is your year-to-date compensation? What is your annualized compensation?

Hint: Take your current compensation and multiple it by 12, divided by the number of months already compensated. For example, using an end-of-the-month May check, multiply the amount by 12 divided by 5.

Get the last copy …

Learning from physician burnout: Which pill will you choose?

Lisa Chu, MD

Physician

January 31, 2015

There is a scene in the movie, The Matrix, in which the main character Neo is offered a choice between the red pill and the blue pill.

This is your last chance. After this, there is no turning back. You take the blue pill — the story ends, you wake up in your bed and believe whatever you want to believe. You take the red pill — you stay in Wonderland, and I …

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Learning from physician burnout: Which pill will you choose?

Pathology plays a central role in the era of personalized medicine

Michael Misialek, MD

Conditions and Diseases

January 31, 2015

As a pathologist, I recognize the importance of every diagnosis. Behind each slide is a patient, a family, a network of family and friends. A string of dominoes that is set into motion with my diagnosis. All treatment begins with a diagnosis. Each day I make these diagnoses, but on holidays, it takes on even more meaning. As the rest of the world is celebrating the season, coming together, medicine …

How patients can be medical educators

Arshya Vahabzadeh, MD

Physician

January 30, 2015

Recently the Mayo Clinic named a patient as a visiting professor for 2015. The patient, Dave deBronkart (otherwise known as “e-Patient Dave”) was chosen by the internal medicine chief residents to fulfill this unique role, where he would have the opportunity to lead grand rounds, give educational talks to medical students, residents and faculty, and truly emphasize the message of patient engagement and empowerment.

So what is an …

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How patients can be medical educators

Children with developmental disabilities and the guilt parents feel

Lisa Shulman, MD

Conditions and Diseases

January 30, 2015

Recently, at a holiday meal with my extended family, it came to light that neither of my typically developing teenage children really knows how to tie his or her shoes. It seems that for the past decade or so, both have been using the “bunny ears” technique introduced to preschoolers for tying their shoes. My children appear never to have moved on from there to the mature “around the tree” …

The best doctors expect the unexpected

Skeptical Scalpel, MD

Physician

January 30, 2015

The following is based on an actual case that occurred a long time ago in a galaxy far, far away.

A 65-year-old man arrived in the emergency department by ambulance after being found unresponsive. His respiratory rate was 40 per minute, heart rate was 170 per minute, and temperature was 102.2°. He did not respond to Narcan or an ampule of 50 percent dextrose. Blood sugar was 600 mg/dL. The diagnosis …

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The best doctors expect the unexpected

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