| KevinMD.com

Health and wellness: We need to broaden our perspective

Health Policy

November 28, 2013

How do we keep the well people well while managing the devil out of the 1%?

This is one of our most complex and challenging questions, and there is no simple answer — but we needn’t look far to see that progress is being made.

Judging from the unprecedented groundswell of interest in health and wellness — and the corresponding emergence of a “wellbeing economy” — I think it’s fair to say …

Patients must be given the results of their tests

Fred N. Pelzman, MD

Physician

November 28, 2013

Just the other day one of the medicine residents presented a case to me, and mentioned that in looking through the patient’s chart he noticed that the patient had undergone a prostate biopsy 1 month prior to this visit, with a follow-up appointment in urology scheduled next month. The result of the biopsy was positive for cancer, but that had not been communicated to the patient. His first instinct, he …

The human side of medicine that no computer can ever touch

Suneel Dhand, MD

Health Technology

November 27, 2013

As I look back all those years ago to when I chose medicine as a career, I suspect that my motives were similar to most people who enter this wonderful profession. I wanted to become a doctor because I had a genuine and sincere desire to help people. I also liked the idea of a busy and energetic job, one where I was comfortably as far away as possible from …

Emergency medicine is a public service

Angelo Falcone, MD

Physician

November 27, 2013

I recently treated what looked like one of those unnecessary patients in one of our emergency departments. You know the ones. The ones that don’t need to be there because they should have gone somewhere else to receive care. She was a 28-year-old woman who presented with lower abdominal pain. Her pain started abruptly in her left lower abdomen. She had no nausea or vomiting or fever.

After my evaluation and …

Read more…

Emergency medicine is a public service

The impact of sleep is both immediate and intimate

David L. Katz, MD

Conditions and Diseases

November 27, 2013

We have long known that sleep is of profound importance to health. It is a requirement for living, much like breathing, but with awake and asleep playing out over longer spans and to slower rhythms than inhalation and exhalation. Sleep is essential. We must turn off if we are to go on.

Unlike many of the factors that affect health profoundly, the impact of sleep is both immediate and intimate. You …

Who do you want reading your EKG?

Wes Fisher, MD

Health Technology

November 27, 2013

I know what you’re thinking, punk. You’re thinking “did he fire six shots or only five?” Now to tell you the truth I forgot myself in all this excitement. But being this is a .44 Magnum, the most powerful handgun in the world and will blow you head clean off, you’ve gotta ask yourself a question: “Do I feel lucky?” Well, do ya, punk?
– Harry Callahan (played by Clint …

Read more…

Who do you want reading your EKG?

Will a personalized DNA report ever be commonly ordered?

James Marroquin, MD

Conditions and Diseases

November 27, 2013

About two weeks ago, my wife looked over at me in disgust as I spit a large volume of saliva into a plastic test tube just before we went to bed. I had recently received a testing kit from a company called 23andMe, which for $99 conducts a comprehensive analysis of your DNA.

I first learned about this kind of thing a few years ago reading Francis Collins’ book, “The Language of …

Is saving primary care simply a matter of seeing fewer patients?

Davis Liu, MD

Physician

November 26, 2013

As a practicing primary care doctor, I very much enjoy my career choice. I’m fortunate enough to be in a large multispecialty practice that is collegial and forward thinking. If I was in a smaller practice like other colleagues, I would not quite feel the same. Yet concern about how to make primary care attractive for both future doctors and those currently in practice has been something I’ve been occupied with …

Digging deeper into the new cholesterol guidelines

Janice Boughton, MD

Medications

November 26, 2013

The American Heart Association, in collaboration with the American College of Cardiology, recently released recommendations that should change the way we prescribe medications called statins, including drugs like Lipitor and Crestor and their generics, atorvastatin and rosuvastatin.

The headlines say stuff like, “More Americans may be Eligible to Receive Cholesterol Lowering Drugs!”

I am a bit skeptical of news about statin therapy because Lipitor, before it went generic, was responsible for over …

A quiet, contemplative man of inaction can be the true healer

Michael Kirsch, MD

Physician

November 26, 2013

I’m sending a patient downtown to see a pancreatic expert. He’s a young man who didn’t fully appreciate the health risks of a former alcohol addiction. He’s been sober for well over a year, but alcohol toxicity can be unforgiving and permanent.

We don’t fully understand why some alcoholics develop cirrhosis and other complications while others seem to skate by without a scratch. While I want folks who have the strength …

I am not a disease, I am not a checklist

Jordan Grumet, MD

Patient

November 26, 2013

I am not a disease.

Although when I enter your hospital, or office, or outpatient center, you may refer to me as one. You may lump me together with an odd set of symptoms, or signs. You will define me with those antiquated terms. You will pretend that you will know how I, my body, will react when placed under certain stressors. You will prescribe treatments for my disease, and yet …

I spend more time checking boxes than talking to patients

Regina Harrell, MD

Physician

November 26, 2013

I am a primary care doctor who makes house calls in and around Tuscaloosa, Alabama. Most of my visits are in neighborhoods, but today my rounds start at a house located down a dirt road a few miles outside of town.

Gingerly, I cross the front walk; Mrs. Edgars told me that she killed a rattlesnake in her flowerbed last year.

She is at the door, expecting my visit. Mr. Edgars sits …

A doctor is humbled about chronic pain

Jerome Groopman, MD and Pamela Hartzband, MD

Physician

November 26, 2013

We recently spoke with Jill Marshall, MD (name changed to protect identity), who works as an internist. “I unfortunately became a patient when I was 55-years-old,” she told us, “and I was diagnosed with breast cancer, a disease I had always feared I would get.”

Dr. Marshall was found to have multifocal disease and underwent a right mastectomy and lymph node dissection.

“Ever since I had seen mastectomies when I was in training, …

Read more…

A doctor is humbled about chronic pain

The difficult transition from substandard to standardized coverage

Manoj Jain, MD, MPH

Health Policy

November 25, 2013

Some years ago, driving through an end of town where pawn shops and boarded up homes are common, I saw a small placard sign nailed on a telephone pole. “Buy Health Insurance,” it touted with premiums as low as $25 a month. I was tempted.

Health insurance, for me and for most Americans, is a necessary part of life, similar to home rent or mortgage, grocery bills and gasoline. Insurance is …

Doctors who call patients hypochondriacs are committing malpractice

Zackary Berger, MD, PhD

Physician

November 25, 2013

There’s one question I get asked a lot: “I research my health problems on the Internet. Am I a hypochondriac?”

First, we should ban that word when talking about ourselves. No one wants to be called that, and doctors who use that word are committing malpractice. Everyone has some range of complaints and worries in life, often physical and mental together, and this is our job as doctors: to hear them …

The cholesterol debate: Seeking truth where there is no truth

Robert Centor, MD

Conditions and Diseases

November 25, 2013

The New York Times recently had one of their periodic debates: When Medical Experts Disagree.

This debate actually centers on the current cholesterol guidelines, but the problem recurs often. Different experts look at the data and develop differing opinions. We see this with prostate screening, mammography, and treatment decisions.

As one reads the varying opinions in this debate, an understanding of the affect heuristic makes the debate transparent. When we like …

Making the decision to be out on a medical school application

Michelle S. Davis, MA

Medical Education

November 25, 2013

After years of pounding the post-baccalaureate pre-med pavement, I did it. I got accepted to medical school. And I did it as an out lesbian on my application.

Disclosing my sexual identity on my AMCAS personal statement felt like a big risk even though my mentors assured me that it would pay off in the end. My hesitation to be out on my primary application was due, in part, to a …

Diabetes raise special concerns in the homeless

Duc Chung, MD

Conditions and Diseases

November 25, 2013

Diabetes is an emerging national crisis. It is the leading cause of heart disease and stroke and the 7th leading cause of death in the United States. According to recent data from the Centers for Disease Control and Prevention (CDC), an estimated 25.8 million people are affected with diabetes with a staggering 79 million more living at high risk for the disease, a stage known as pre-diabetes. Unfortunately, about a third …

AAFP: The right care by the right provider is more important than ever

Reid Blackwelder, MD

Health Policy

November 25, 2013

For several weeks, the bumpy rollout of the federal health insurance marketplaces has overshadowed almost all other health care topics. But after reviewing the timely Health Affairs issue dedicated to the health care work force, it is clear we must maintain our focus on building a primary care system of the highest quality and value. Within that increasingly complex system, primary care physicians are the first, most critical line of …

We really need 3 health care systems

J. Russell Strader, MD

Health Policy

November 24, 2013

I was reading a blog about health policy and the failings of the ACA rollout posted on CNN. The author spends time talking about how much we want to change our health care system. And how, since change is hard, no one should be surprised by the pains accompanying this change, particularly in terms of individuals loosing their current insurance policies due to the rollout of the ACA …

Read more…

We really need 3 health care systems

Most Popular

Past Week

Past 6 Months

Recent Posts

Subscribe to KevinMD and never miss a story!

Most Popular

Past Week

Past 6 Months

Recent Posts