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An oncologist explains how to get your loved ones tested for cancer

Conditions and Diseases

March 10, 2019

I see several patients daily with cancer. Some days can be tough, but nothing compares to what they are going through. I know that. The physical anguish and toll that chemotherapy, radiation, and surgery can take on the body. The burden that the disease can take on the mind and the soul. It’s devastating and almost always life-changing. What makes things harder though is when a patient did not go …

Medicare for all and the problem of health care on demand

Michael Brant-Zawadzki, MD

Health Policy

March 10, 2019

The evolving politics of single-payer health care conflate the concepts of universal coverage, health care on demand and free health care. To the indiscriminate progressive mind, all three are part of the holy grail. The fly in the ointment is that highly attractive and altruistic politics runs into the brick wall of reality. As Thomas Sowell — a noted Stanford economist — wrote: “The first lesson of economics is scarcity: …

Have bad news for your patients? Mind your metaphors.

Shannon Casey, PA-C

Physician

March 9, 2019

First, the cancer diagnosis. Then, the barrage of trite encouragements: You can beat this! Don’t give up. Keep fighting! It’s not only friends and family members who utter these clichés — usually at a loss of what else to say. Health care providers also attempt to bolster patients’ morale with well-intentioned but well-worn phrases too. Unfortunately, these sentiments frequently fail to have the intended effect. Instead of conveying comfort and …

Physicians are now lab rats

Charles Dinerstein, MD, MBA

Health Policy

March 9, 2019

Pay for performance (P4P) is all the rage in health care. Big Pharma led the way, and the popular press would have you believe that one can “incentivize” physicians and their clinical colleagues with as little as a sandwich and a bag of chips. Corporations have used bonuses, stock options, and commissions for years as motivators. And the government and insurance companies, although late to the party, are all in …

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Physicians are now lab rats

#MeToo: A culture change is needed in health care

Health eCareers

Health Policy

March 9, 2019

This article is sponsored by Careers by KevinMD.com.

The #MeToo movement exploded into the national spotlight in October 2017 with The New York Times exposé of sexual abuse allegations against Hollywood media mogul Harvey Weinstein. It has since encouraged thousands (if not hundreds of thousands) of people to come forward and share their stories of sexual harassment, sexual assault …

MKSAP: 40-year-old man with a new skin rash of 10 days’ duration

mksap

Conditions and Diseases

March 9, 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 new skin rash of 10 days’ duration. The rash appeared abruptly and is not tender or pruritic. The patient has poorly controlled type 2 diabetes mellitus. His current medications include metformin and glyburide. Family history is unremarkable.

On physical examination, vital signs are …

A medical student’s first code. Here’s what he learned.

Timothy S. Kelly

Medical Education

March 8, 2019

Well, today it happened. I participated in my first code.

We were in the telemetry unit (the room where they monitor all the patients who have EKG strips) to ask about a different patient of mine only to find that a patient was coding (lost a life-sustaining heartbeat). With some coaxing from my attending, the other student and I wound our way through the around-20 people standing outside and inside of …

Remove your blindfold to your patient’s pain

Christina Abi Faraj

Medical Education

March 8, 2019

“We pass through the present with our eyes blindfolded … Only later when the cloth is untied can we glance at the past and find out what we have experienced and what meaning it has.”
– Milan Kundera

Two days ago, during a clinical skills session on lymph node examination, my classmates insisted that I get what appeared to be an enlarged lymph node in my neck checked by the physician …

5 ways physician recruiters can improve their relationship with doctors

Mitchel Schwindt, MD

Physician

March 8, 2019

A career in health care provides an incredible life full of experiences, challenges, and heartbreak, mixed with incredible satisfaction. With the rapidly shifting global economy, health professionals retain a large degree of flexibility and geographic independence. That said, it takes a unique proposition from a recruiter to pull one away from a satisfying position. I have, on a rare occasion, taken the bait and enjoyed great rewards as a result. …

Prescription for a healthy heart: pediatric-driven partnerships

Gerard Martin, MD

Conditions and Diseases

March 8, 2019

For pediatric cardiologists, February, National Heart Month, is a special time. We share health tips in the hospital and talk about heart health with those looking for advice, especially with patients and families impacted by CHD. It’s also a time to look back at what’s worked well in the field, while accelerating advancements for CHD treatment.

To start, congenital heart disease, a structural abnormality of the heart or of the blood …

Instead of Medicare for all, how about Medicare for more?

Brian C. Joondeph, MD

Health Policy

March 8, 2019

Medicare for all is one of the leading campaign issues among the Democratic presidential candidates.

Michigan Rep. John Conyers first introduced the idea in Congress in 2003. It went nowhere, but as the one-time party of JFK morphed into something much further left, Medicare for all rose from the dead.

Medicare for all promises universal coverage, so that no one is without insurance. Unfortunately, it is cost prohibitive, costing as much as …

Alex Trebek reminds us to go beyond fear of pancreatic cancer

Burton Eisenberg, MD

Conditions and Diseases

March 8, 2019

The news that beloved game show host Alex Trebek has advanced stage pancreatic cancer hit his millions of fans hard this week. His illness has elicited heartbreak and support. As a clinician who treats pancreatic cancer, I anticipated the reaction that would follow next.

Fear.

While it is a rare form of cancer, pancreatic cancer is possibly the most lethal. Survival rates are slim – fewer than 10 percent with advanced disease …

A paradigm shift in acute pain assessment and management

Myles Gart, MD

Medications

March 8, 2019

We have embarked upon a unique strategy to assess and manage pain. “Opioids Rarely Help Bodily Pain” is not a catchy phrase but a mnemonic related to educational learning which serves as the cornerstone of a new acute-pain management paradigm. As is known, the evaluation of pain is extremely difficult due to its subjective nature. However, this new evaluation not only accounts for the patients’ self-assessment but, for the first …

The commodification of health care is destroying the doctor-patient relationship

Jen Baker-Porazinski, MD

Physician

March 7, 2019

My elderly patients miss the days when, in an emergency, they could call their family doctor at home, and they’d be cared for. Retired doctors reminisce about the “good old days” when they were in charge of their own schedules and could prescribe whatever drug or test they felt necessary based on years of experience. While there was a strong doctor-patient relationship in those bygone days, it was not necessarily …

How self-awareness helps with patient interaction

Ton La, Jr., MD, JD

Medical Education

March 7, 2019

What is self-awareness? A quick Google search says that it is “conscious knowledge of one’s own character, feelings, motives, and desires.” In other words, my worldview is different than yours. Hypothetically, I am a Republican, and you are a Democrat. You don’t believe in vaccinations, but I do. I believe in universal health care, but you disagree with my stance. You believe in stricter gun laws, and I don’t. That …

A key tip for premedical students: Ask for help

Sheindel Ifrah

Medical Education

March 7, 2019

A simple Google search is all you need to do to gauge the difficulty individuals have with asking for help.

“How to ask to shadow someone.” 43.1 million results.

“How to ask for a letter of recommendation.” 66 million results.

“How to ask for help,” 3.73 billion results.

From the popularity of these topics, it is evident that people have a hard time reaching out and balancing coming across respectfully, but still receiving a …

To parents who have lost children: We never forget your children

Quinn Bensi, MD

Physician

March 7, 2019

Her name was Callie (identifying information changed). She was four years old. She loved glitter and princesses and anything sparkly. She was affectionate and silly, and I fell hard for her. She was a patient, my patient, on the pediatric oncology unit during my very first ward rotation intern year.

On my first day, I was as scared as any person can be, palms sweating, heart pounding, faced with these tiny, …

How to prevent ski injuries: tips from an orthopedic surgeon

Nancy Yen Shipley, MD

Conditions and Diseases

March 7, 2019

Ski season is here, and it’s time to think about how we can avoid injuries on the slopes. As an orthopaedic surgeon, I most often see knee injuries, but also plenty of wrist, elbow and shoulder injuries as well.

Hopefully, you’ve done some pre-season conditioning — but if not, go ahead and start now! Obviously, avoid a heavy workout the day before your first ski day, but if you have time …

The most loving thing: end of life and saying goodbye

Jonathan Staloff, MD

Conditions and Diseases

March 6, 2019

“Grandma fell and we’re in the emergency room. She’s very distressed and does not look good. I’m going to put the doctor on the phone.”

I could hear my mother’s voice strain on the other end of the phone line as I braced myself for my conversation with the emergency department physician.

The emergency physician told me that though the work-up was still developing, my grandmother was in respiratory distress, and that …