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Medical schools need to produce more clinician-activists to help drive social change

Health Policy

September 30, 2019

For hundreds of years, health care providers have been on the front lines of social change. Think Margaret Sanger, a nurse who championed women’s rights and started the organization that later became Planned Parenthood, or Max Recamier, one of the physician founders of Doctors Without Borders, who openly worked against governments fomenting …

The breakdown of the rule of law in medicine

Vamsi Aribindi, MD

Physician

September 30, 2019

The United States is a nation of laws, not of men’s dictates. The rule of law is what keeps (most) drivers from routinely running red lights, police officers from demanding bribes, and our civil servants and elected officials largely honest. There, of course, will be violators of this code, as there are in any society, but nonetheless compared to many other nations in the US most citizens and state officials …

Do physicians really need such extensive training?

Erin Wildermuth

Medical Education

September 30, 2019

Last year the American Association of Nurse Practitioners announced a $2 million campaign to further expand independent practice, which they already have in 22 states. The relatively new doctorate of nursing (DNP) has led to a confusing scenario where nurses are indeed doctors, just not the kind you think of when you see a white coat. The profession (well, its money-making institutions) has fought hard to keep people confused.

Doctors are …

A physician’s career as an opioid prescriber and addict

Anonymous

Physician

September 30, 2019

I sat in the back seat of a police patrol car handcuffed with a mind imprisoned by addiction. My day had finally arrived after months of a manhunt by state detectives for operating a fraudulent prescription enterprise to support my obsession and compulsion with cocaine. No more unmarked police cars staked outside the crack houses that I frequented or my mother’s home or in pharmacy parking lots waiting to capture …

10 telltale signs that you’re ready for a mindset shift

Stephanie Wellington, MD

Physician

September 30, 2019

Physician wellness and work-life balance are hot topics in today’s medical arena. It is on the minds of medical students, residents, and physicians in practice. While the concepts and methods to achieve it are enticing, the question remains: how does the individual physician achieve it? Some believe that system-wide changes in medicine will get doctors closer to these goals. Then there are the supporters of strategies that physicians can implement …

Artificial intelligence in medicine raises legal and ethical concerns

Sharona Hoffman, JD

Health Technology

September 29, 2019

The use of artificial intelligence in medicine is generating great excitement and hope for treatment advances.

AI generally refers to computers’ ability to mimic human intelligence and to learn. For example, by using machine learning, scientists are working to develop algorithms that will help them make decisions about cancer treatment. They hope that computers will be able to analyze …

A patient confesses that he cuts himself

Dr. Nkeiruka U. Orajiaka

Conditions and Diseases

September 29, 2019

I walked into the room and said: “Hi, Jason.”

“Do you think it’s deep enough to need stitches? I am really scared of needles,” was his reply to me.

I said, “Why don’t you let me take a look, and we can both come up with a plan of how to make it look better?”

“So do you think it needs stitches or not? I’m really scared.”

After taking a good look at his …

Medicine must stop eating its own

Brian J. Yount, MD

Physician

September 29, 2019

Despair has been trying to find me again. That fickle nightmare is breathing down my neck once more. I know her all too well — she has nipped at my heels most of my career and has kept me running for the past 20 years. Running from friendships, running from family, running from loss, running from debt, running from jobs, running from guilt — running as hard as I can, …

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Medicine must stop eating its own

This doctor defines himself as a Christian, not a physician

Jeffrey McWilliams, MD

Physician

September 29, 2019

What is life? It’s the cumulation of the daily processes all wrapped up into one, filling the void of each day. These processes coalesce hour by hour, filled with demands, expectations, current crisis, and bills to pay. Life is a full-contact sport, each hour brimming with all-encompassing activities, expectations, and trivial pursuits. We live every second to its fullest, squeezing every ounce of information and productivity only to repeat it …

To reduce suicides, follow the data

Maureen O’Hagan

Conditions and Diseases

September 28, 2019

On Kimberly Repp’s office wall is a sign in Latin: Hic locus est ubi mors gaudet succurrere vitae. This is a place where the dead delight in helping the living.

For medical examiners, it’s a mission. Their job is to investigate deaths and learn from them, for the benefit of us all. Repp, however, isn’t a medical examiner; she’s a Ph.D. microbiologist. And as the Washington County epidemiologist, she was most accustomed …

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To reduce suicides, follow the data

Don’t underestimate the appeal of a Trump “health plan”

Bob Doherty

Health Policy

September 28, 2019

As the Democratic candidates for president continue to beat up each other on how best to achieve universal coverage (Medicare for all, a public option, closing the ACA’s coverage gaps), health care journalists keep wondering when President Trump will release his long-promised “phenomenal” plan to position the GOP as “the party of health care” for the 2020 election.

Skepticism is warranted over when or even if …

It’s time for presidential candidates to debate the safety of pharmaceutical products

Steven Reznick, MD

Medications

September 28, 2019

I watched all three presidential debates this summer with health care being a time-consuming topic for all. Universal health care and Medicare for all, with or without an option for private insurance, were debated and discussed at length.

At the same time, NBC Nightly News presented a story documenting that all our antibiotics come from production in China. With globalization policies, which promote moving production to lower-cost overseas factories, there is …

MKSAP: 40-year-old man with a flesh-colored lesion

mksap

Conditions and Diseases

September 28, 2019

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

A 40-year-old man is evaluated for a firm, flesh-colored lesion that has been growing on the back for several months. Foul-smelling material can be expressed from the lesion. The patient is bothered by the periodic drainage. He is otherwise healthy and takes no medications.

On physical examination, vital signs are …

4 reasons why physicians should hire a financial advisor

Wall Street Physician, MD

Physician Finance

September 27, 2019

I’m a big proponent of do-it-yourself investing. In the age of index funds, many investors can manage their own investments at very low cost.

And fees you pay to a financial advisor could be used to invest and grow your nest egg.

But that’s not to say that I believe that no one should have a financial advisor. There are many situations where it can be beneficial to hire a financial advisor.

Here are four …

The mystery illness of Kim Kardashian West

Michele R. Berman, MD and Mark S. Boguski, MD, PhD

Conditions and Diseases

September 27, 2019

Reality star and meta-celebrity Kim Kardashian West made the rounds on the network news and talk shows last week to promote her new line of shapewear. But she also talked about the recent health scare that was revealed on the latest episode of “Keeping Up with the Kardashians.”

Talking to Savannah Guthrie and Hoda Kotb on Today, …

Don’t let patient care interfere with documentation

Christopher Johnson, MD

Physician

September 27, 2019

I’m being sarcastic, of course, but that’s often how it seems some days. Those are days when I’ve been busy at patients’ bedsides all day and then struggle to get my documentation done later, typically many hours later. I jot notes to myself as I go along, but it can be hard to recall at 5 p.m. just what I did and why at 8 a.m.

It used to be very much the …

The answer to physician burnout isn’t resilience training

Hans Duvefelt, MD

Physician

September 27, 2019

The answer to physician burnout is purported to be resilience training. That’s like glorifying the natural ability of frogs to tolerate gradually heating and boiling water.

Unfortunately, health care today has some toxic ingredients, and physician burnout is directly related to them. Some forms of resilience training I have been exposed to are no more than mental escapes away from medicine, such as art, music, and personal relationships.

Those types of activities …

What has emergency medicine wrought? Helplessness.

Edwin Leap, MD

Physician

September 26, 2019

It seems that all day, every day, I care for patients who simply won’t take care of themselves. And I sometimes think that we in emergency medicine have caused more harm than we expected.

Now let me first say, I also take care of those who can’t care for themselves. There are those who, through age, infirmity, or poverty, simply have no means. The patient with a chronic condition who can’t …

What’s the best way to treat doctors and nurses with drug addiction?

Emma Yasinski

Medications

September 26, 2019

Dr. Wesley Boyd, an associate professor of psychiatry at Harvard, has spent years working with state programs that help doctors, nurses and other health care workers who have become addicted to opioids get back on their feet professionally.

He supports these non-disciplinary programs, in which doctors and nurses enroll for a number of years and are closely monitored by addiction specialists and state authorities as they seek to maintain or restore …

The keyboard is the sworn enemy of physicians

Fred N. Pelzman, MD

Health Technology

September 26, 2019

During one long ago very hot Washington, DC summer, at the suggestion of my parents, I enrolled in a typing course that was given at our elementary school.

This was the summer between sixth and seventh grades, and there were lots of things I would’ve preferred to have been doing, but my dad, who started out in advertising, felt that touch-typing …

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