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Anyone can fall prey to addiction and substance abuse

Conditions and Diseases

July 6, 2013

Over the course of a year, I have an alternating pattern of caffeinated coffee ingestion. As readers should know, I will not swallow Starbucks coffee as I do not think that I have sufficient stomach acid and other bodily defenses to successful prevail against this corrosive elixir. Of course, everything has a benefit if one is resourceful enough to discover it. For instance, I have found their coffee to be …

Dr. Wachter reflects after completing his term at the ABIM

Robert Wachter, MD

Medical Education

July 6, 2013

I recently completed my last day as chair of the ABIM, and ended my eight-year tenure on the Board. In this blog – a bookend to the one I wrote at the start of the year, which went near-viral – I’ll describe some of our accomplishments this year and a few of the challenges that I leave my talented successors to grapple with.

I had two very tangible tasks to …

Physicians: Learn to pick up the proverbial poop

Neil Baum, MD

Physician

July 6, 2013

As a little boy I had a dream that I have always wanted to join the circus. I thought for sure I could be a clown or even the ringmaster. At age 34 a friend who did public relations for Ringling Brothers and Barnum & Bailey Circus gave me the opportunity to make my dream come true and I was invited to be a clown in the circus.

The show was to …

What to do if your partner is in a bad mood

Alex Lickerman, MD

Conditions and Diseases

July 6, 2013

As with most things in life, romantic relationships are, for many of us, a double-edged sword: while most find it wonderful to love and be loved, developing intimate emotional ties to someone makes us emotionally vulnerable—vulnerable not only to being hurt by our partner’s opinions of and feelings toward us, but also vulnerable to being affected by our partner’s bad moods. If a colleague or a friend gets depressed, we’re …

The powers that be had spoken and I felt powerless

Jessica Heney

Medical Education

July 5, 2013

As a medical student, one quickly learns not to question the wisdom of authorities, and appropriately so. Do your work quietly and conscientiously and study hard. Take all criticism enthusiastically and graciously. Do not speak unless spoken to. Beyond the compassion and empathy we are all expected to champion, these are the proverbial medical student keys to success. In our roles as the lowest rung on the medical ladder, this …

This is why you should wear sunscreen

Joyce Ho, MD

Conditions and Diseases

July 5, 2013

I recently celebrated my birthday with a 9-hour picnic and for the first time in my life I was aware that some of my friends were starting to wear large hats and sunscreen. In fact, one of my friends was asking me about tinting her windows to block out excess sun.

Finally we are all now realizing what our mothers have been telling us since day 1 and what was popularized …

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This is why you should wear sunscreen

The transition to ICD-10: Where to begin?

Donald Tex Bryant

Health Policy

July 5, 2013

If you are a healthcare provider—physician, administrator, or some other leader at a healthcare site—then you know that you face many challenges. Some seem overwhelming and you may be thinking that you may not be able to handle some of them well. Perhaps the transition to ICD-10 coding is your main concern right now.

The solution to difficult challenges begins with the first step. I am taking the liberty of adapting …

Why doctors should take sabbaticals

Janice Boughton, MD

Physician

July 5, 2013

In October of 2011, I left my job of 17 years, which I loved, mostly, and started a 2 year sabbatical. Since sabbatical implies that there is one year of rest every 7 years, I have built up at least 2 years since finishing medical school in 1986. Nobody in my office or medical community did sabbaticals, but we discussed that it would be a great idea when we first …

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Why doctors should take sabbaticals

How to enhance access to mental healthcare in rural America

Shaili Jain, MD

Conditions and Diseases

July 5, 2013

Rural America has a higher proportion of people who are at risk for mental health disorders and state offices of rural health have identified suicide, depression, anxiety disorders and lack of access to mental healthcare, as major rural health issues. A particularly sobering statistic is that suicide is the second leading cause of death in states with primarily rural populations. There is a shortage of mental health professionals practicing in rural areas …

Does alarm fatigue really kill?

John Mandrola, MD

Physician

July 5, 2013

alarm fatigue

Patient safety and hospital quality is a scary topic. I’ll go easy. I’m just a doctor. I don’t know much.

Entire departments, filled with cubicles, computers and well-meaning people, now exist to keep hospitals tightly regulated and running perfectly. There is data to analyze, regulations to read, and oh so many meetings to attend. This place of healing will be safe—and perfect.

The …

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Does alarm fatigue really kill?

The third year of medical school serves a wonderful purpose

Robert Centor, MD

Medical Education

July 4, 2013

I still think that the third year of medical school serves a wonderful purpose. I never learned more during my entire school experience (perhaps I learned more as an intern, but that is post-graduate).

Danielle Ofri writes through darkened lenses: The Darkest Year of Medical School.

So for the non-physician readers let me give my opinions on the third year of medical school. After two years of mostly classroom experiences, our …

Should insurers pay for the Oncotype DX prostate cancer test?

Peter Ubel, MD

Conditions and Diseases

July 4, 2013

Recently, the makers of the Oncotype DX prostate cancer test presented results of a large study demonstrating that their test can help men decide whether their prostate cancer carries a low enough risk of progression to forgo surgical or radiation therapy, two treatments that typically eradicate prostate cancers but also cause most men to experience impotence and incontinence.

Lacking such a test, many men have felt compelled to …

The truth about guar gum

Dr. Charles

Medications

July 4, 2013

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It is increasingly difficult to find real ice cream. When reading the ingredient list it is discouraging how many cheap fillers, consistency modifiers, and shelf life extenders are included. One ingredient, namely guar gum, seems fairly ubiquitous. So what is guar gum, and why is it found in so many products including ice cream? Is it “bad” to eat?

Guar …

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The truth about guar gum

Help military families with TRICARE

Robert Luedecke, MD

Potpourri

July 4, 2013

As we celebrate Independence Day, I ask that you consider taking care of a few TRICARE patients as a way of thanking our service members for their sacrifice. I must admit I originally avoided taking care of any TRICARE patients because of the low pay. When one of the surgeons I work with first talked about caring for some of the military families, I gave a large internal groan as …

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Help military families with TRICARE

Herbal medicine: 6 tips to consider when talking to your patients

Robin Friedlander, MD

Medications

July 4, 2013

Herbal medicines make most doctors cringe, laugh, or want to put blinders on and pretend they don’t exist. This is understandable. While allopathic medical education hammers pharmaceutical formulas and mechanisms of action into our brains, we learn little-to-nothing about herbs in medical school. Quite the opposite – we are most often told to uniformly discourage our patients from taking herbs out of concern for safety; a conversation stopper with little …

Bed sharing and co-sleeping increases the risk of SIDS

Roy Benaroch, MD

Conditions and Diseases

July 3, 2013

The evidence has become quite clear: bed sharing, or co-sleeping, increases the risk of sudden infant death syndrome (SIDS).

The latest study to reinforce the risk of bed sharing comes out of the UK (with contributions from New Zealand and Germany). Published in the British Medical Journal, Bed sharing when parents do not smoke: is there a risk of SIDS? An individual level analysis of five major case–control studies, …

Directing cancer resources in a limited resource world

J. Leonard Lichtenfeld, MD

Health Policy

July 3, 2013

As we walk the halls and sit in the lectures at the annual meeting of the American Society of Clinical Oncology, there’s an elephant in the room. It is right there in front of us, but not many of us seem willing to talk about it. Fewer still are making any commitments to do something about it.

So what is …

Reflections after 4 years of emergency medicine training

Leana Wen, MD

Physician

July 3, 2013

On July 1st, four years ago, I walked through Massachusetts General and Brigham and Women’s Hospitals with an odd mixture of fear, relief, and excitement. Now, as I leave the hospital after my last shift of emergency medicine residency training, I am filled with a similar hodgepodge of emotions and reflections.

1. “You were terrified of being a doctor!” I mentioned this article to the attending who oversaw my first shift as …

Do we want big medicine or good medicine?

Jordan Grumet, MD

Health Policy

July 3, 2013

If you listen to the pundits, the future of medicine is big: big medicine, big data. And indeed the healthcare policy of our nation is couched in the promise of what is to come. Many dictates of the accountable care act focus on the ability to aggregate and consume a variety of inputs. ICD-10, EMRs, and meaningful use all tie nicely into a beautiful computational orgy.

Big data, however, has it drawbacks. One wonders if in …

In practicing medicine, offense wins championships

Victor Waters, MD, JD

Physician

July 3, 2013

It’s not surprising that physicians fear lawsuits, as more than 61 percent of doctors older than 55 have been sued at least once, according to the American Medical Association.

But is this fear completely justified? I believe that the media tends to sensationalize malpractice with stories about high judgments and horrific cases.

The facts are this: