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The case against the Step 2 Clinical Skills Exam

Medical Education

June 11, 2019

In the era of the recognition of vast burnout in medicine, particularly amongst medical students, there needs to be a call to address structural problems in medical education. One particularly low-hanging fruit is the Step 2 Clinical Skills Exam (Step 2 CS). The exam has a relatively short history. The National Board of Medical Examiners (NBME) developed the exam for American medical students Read more…

The case against the Step 2 Clinical Skills Exam

Speaking out about practicing medicine in Ethiopia

Dr. Yohannes Mengistu

Physician

June 11, 2019

I am a young physician practicing medicine in the “motherland” of God-gifted Ethiopia, which is located in eastern Africa, south of the Sahara Desert. I want to share my personal story, as well as to expose some of the serious problems facing physicians and patients in my country.

I started medical school, which requires the highest academic performance of any career path when I was 18 after completing secondary school. Despite …

To struggling medical students: Meet the physician who conquered the “no’s”

Diana Cejas, MD

Medical Education

June 11, 2019

I know what kinds of things I’m supposed to tell you. I know that your other would be advisors will usually stick to the same basic messages: “Keep reaching for your dreams” or “your hard work is all worth it in the end” or “your education will lay the world at your feet.” These platitudes are all well and good, but honestly, they’re forgettable. And pretty words don’t always translate …

Bottle-feeding grandmothers vs. breastfeeding daughters: advice from a pediatrician

Johanna Vidal Phelan, MD, MBA

Conditions and Diseases

June 10, 2019

Recently, a friend’s mother asked me how to best support her daughter’s decision to breastfeed her first grandchild. The new grandmother questioned her ability to encourage her daughter’s decision because she had not breastfed her own child, and this lack of experience made her feel unqualified to provide support. With mixed emotions and a lingering sense of guilt, this new grandmother wanted to learn, from a pediatrician friend, how best …

If you won the lottery, would you quit being a doctor?

Anonymous

Physician

June 10, 2019

On October 23, 2018, the Mega Millions lottery jackpot was 1.6 billion dollars, making it one of the largest lottery jackpots in history.

The hospital was abuzz with chatter in the week leading up to the drawing. Discussions about the possibility of becoming an instant billionaire were just too good to resist.

During that week, I found myself sitting at the nurse’s station in one of the ICUs at midnight. A nurse …

Language matters: the not-so-innocuous provider effect

Torie S. Sepah, MD

Health Policy

June 10, 2019

Language matters. The use of the word “provider” may seem innocuous, but it is significant both for patients and physicians.

For patients, it has been perhaps the most pronounced step — if not leap — away from transparency. (Who is who? Nurse, doctor, chiropractor, podiatrist, psychologist? Doesn’t matter — everyone is a “provider.”)

For physicians, the ramifications have been two-fold. One on hand, the use of the word is a demotion by …

Please, be kind to your doctor. We need it.

Dr. Sara R. Ahronheim

Physician

June 10, 2019

There’s always so much to write about, and there’s never any time. I work too much; it’s become evident recently that I need to cut down. I have started noticing that things affect me much more than they ever did; there are days I hide my tears, and days I show my tears, when before the tears would have waited for the occasional (yes, occasional) shower. This is a function …

Smart beds and sleep apps: Don’t sleep on their data collection practices

Julie Appleby

Health Technology

June 10, 2019

Your bed could be watching you.

OK, so not with a camera.

But if you have any of a variety of “smart beds,” mattress pads or sleep apps, it knows when you go to sleep. It knows when you toss and turn. It may even be able to tell when you’re having sex.

Sleep Number, one company that makes beds that can track heart rate, respiration and movement, said it collects more than …

The inspiring story of a female orthopaedic surgeon

Nancy Yen Shipley, MD

Physician

June 10, 2019

As a female orthopaedic surgeon, I am often asked how I ended up in this field. Although seeing women in orthopaedic surgery is becoming more common, we are still makeup only 6 percent of the orthopaedic surgeons in the U.S.

I actually had no idea what orthopedic surgery was before medical school. In fact, I started medical school thinking I would be an internist, but it really didn’t take me very …

How acknowledging others can keep us from burning out

Erica Howe, MD

Physician

June 9, 2019

Last Thursday I got up at 5 a.m. to bake a lasagna. Admittedly, lasagna for breakfast is not my typical go-to, but last Thursday was the last session of a year-long advanced faculty development course on teaching skills that I co-direct and teach.

In one of our first sessions of the year, we used the ice-breaker, “What would you choose for your last meal?” In the past, when I’ve asked this …

Putting patients first by letting patients go

Cynthia Williams, MD

Physician

June 9, 2019

Like many primary care physicians in this health care marketplace, I found myself operating on a hamster wheel of volume care, seeing more and more patients and spending less and less time with them. The pressure on my practice, my patients and my staff was unsustainable. With new regulations and declining reimbursements, there was no way to provide the levels of support and service that are so important, especially to …

9 things I learned when purchasing disability insurance

Altelisha Taylor, MD, MPH

Physician Finance

June 9, 2019

As an incoming resident physician, I need disability insurance. Although a group policy is offered through my employer, it doesn’t provide enough coverage to adequately cover my monthly expenses or insure my future income. Thus, I purchased an individual long-term disability insurance policy. This is what I discovered:

1. Disability insurance is expensive. A substantial number of people use disability insurance, so companies raise the price to cover the payouts and ensure …

Talk with family members about their wishes long before you think you’ll need to

Kristin Puhl, MD

Physician

June 9, 2019

I’ve been a doctor for a bit under a year now. I am a family medicine intern, working in blocks at a city hospital, wearing a lot of different hats. Sometimes I’m on the labor and delivery floor, helping new lives begin; sometimes I’m on the family medicine service, caring for ill patients who may be dying. Some of the moments that have stuck with me the most this year …

When should you be tested for vitamin B12?

Edward Hoffer, MD

Conditions and Diseases

June 8, 2019

Two recent patient experiences prompted this post. In the Wall Street Journal, Dana Hawkins-Simons described several years of being seen by specialist after specialist for her complaints of tiredness, dizziness, ringing in the ears, palpitations, shortness of breath and “brain fog.” She finally researched her symptoms and demanded that she be checked for vitamin B12 deficiency, which turned out to be the cause of her symptoms.

Recently, the …

How families maintain hope of improvement, regardless of logic and science

Justine G. Bedolla

Conditions and Diseases

June 8, 2019

I’ve always thought that I’ve understood illness and mortality very matter-of-factly. You live your life, you’ll most likely end up with some medical conditions along the way, and ultimately everyone’s life will come to an end because the body is not designed to function indefinitely. And do I cry at every funeral I attend? Absolutely. I understand physiologically and pathologically why things happen, but also realize human relationships will always …

A father and grandfather: A patient’s life lived in full

Ton La, Jr., MD, JD

Medical Education

June 8, 2019

“You were a Secret Service agent, Mr. Smith?”

“I was indeed. For Presidents Ford and Carter.”

“That’s incredible. What were they like?”

“Well, President Carter would get up at 2:00 am and ask us if we’d like to go on a walk. Since most of the staff worked nights, I walked with him. We would walk for hours and talk shop. Carter is the most interesting man I’ve ever met and had the …

MKSAP: 35-year-old woman with constipation

mksap

Medications

June 8, 2019

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

A 35-year-old woman is evaluated for constipation. She reports passage of hard stool every 3 to 4 days and associated bloating. Her symptoms have been present for more than 10 years and have progressed gradually. Trials of over-the-counter fiber supplementation and polyethylene glycol worsened the bloating, prompting discontinuation. Senna …

The journey from hand surgeon to entrepreneur

Eric George, MD

Physician

June 7, 2019

An excerpt from We: Ditch the Me Mindset and Change the World.

We use them to greet friends, congratulate acquaintances, and embrace loved ones.

To lay bricks, perform surgeries, and sculpt artwork.

Everyone uses them thousands of times a day in a variety of different ways.

It took me years to recognize …

In our health system, who “owns” patients?

Philip A. Masters, MD

Health Policy

June 7, 2019

A guest column by the American College of Physicians, exclusive to KevinMD.com.

When talking with patients – particularly those with multiple, complicated medical issues – it often doesn’t take very long to hear about their increasingly suboptimal and sometimes harrowing interactions with our health care system.

Examples include inpatient experiences in which care is provided by …

PTSD changed how this physician cared for pregnant women

Shivani Patel, MD

Conditions and Diseases

June 7, 2019

Appointments with my doctor make me nervous. That’s highly ironic, because I’m a doctor, a maternal-fetal medicine specialist who regularly deals with high-risk pregnancies. But ever since developing preeclampsia during my first pregnancy eight years ago, the thought of having my blood pressure taken triggers flashbacks and anxiety. The silver lining is that my experience has changed …

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