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A call for the end of routine opioid use after wisdom tooth removal

Medications

January 15, 2019

We are writing as a parent and a dentist to spread a message to parents and dental health care providers across Canada: there are alternatives to prescribing opioids after wisdom tooth removal.

Removing wisdom teeth is considered by many as a rite of passage for teenagers. It is one of the most common surgical procedures done in young people aged 16 to 24.

Amy’s 16-year-old son, Felix recently had his wisdom teeth …

The elderly couple who bought vitamins at the grocery store

Shabbir Hossain, MD

Physician

January 15, 2019

I recently stopped by our local grocery store after work to pick up a handful of items to bring home. With only four items in hand, I luckily found a short checkout line behind this lovely elderly couple who were almost done and ready to pay. As they smiled and made small talk with the cashier, I imagined a typical geriatric medical story about them.

They appeared in good health which …

The fallacy of work-life balance in medicine

Ellen Poulose Redger, MD

Physician

January 15, 2019

Physician well-being, burnout, and “work-life balance” are pretty common topics in training. We start at intern orientation, discussing how to work 80 hours a week, eat, sleep, exercise, and still have some semblance of social life. It’s like we’ve forgotten the origins of our job title: “resident” or “house staff” — implying that, until recently (and even now, in places outside of North America), we, the physicians-in-training, lived at the hospital. …

Physician income shouldn’t be what determines your level of success

Cory Fawcett, MD

Physician Finance

January 15, 2019

Too many doctors today believe that their income is what determines their level of success. This is a fallacy that is hurting way too many doctors. We hear things like, “Become a specialist so you can make the big bucks,” or “Now that I’m an attending, I can afford the payments on a new Tesla,” or “I’ve lived in an apartment too long, now is the time to get my …

Peanut allergies: What is the best policy for schools?

Roy Benaroch, MD

Conditions and Diseases

January 14, 2019

Peanut allergies can be a serious problem, and many exposures happen when our kids are at school. On average, there are probably about 5 peanut-allergic children in each of our nation’s 100,000 school buildings. What’s the best policy for schools to use to help protect these kids from potentially fatal reactions?

Different schools have taken different approaches, and as far as I can tell there is no authoritative national guideline …

There is no room for racism in medicine

Linda Girgis, MD

Physician

January 14, 2019

The news has recently reported the story about the Cleveland Clinic resident, Dr. Lara Kallab, who was fired after making anti-Semitic comments on twitter. Among them, she tweeted that, “I’ll purposely give all the [Jews] the wrong meds.” Not only were people horrified by her comments, but she also lost her job (and possibly career) because of it. However, was her punishment too harsh or not severe enough?

My opinion is …

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There is no room for racism in medicine

Using probiotics in children: a pediatrician’s take

Christopher Johnson, MD

Medications

January 14, 2019

The over-the-counter sale of probiotics is a huge industry. They are heavily promoted on social media as a cure-all for a wide variety of ills. Probiotics are live cultures of what are often called “good bacteria,” and there are solid physiological reasons for recommending them. But, and this is a huge but, actual clinical data demonstrating their usefulness behind some well-defined disorders is pretty scant. Their potential usefulness in many …

A physician’s New Year’s resolutions

Rosalind Kaplan, MD

Physician

January 14, 2019

2019 is here.

I started my year by doing an urgent care shift on New Year’s day. It was not quite as busy as I expected; most of the shifts I’ve done around the holidays were high-volume, with lots of flu, other respiratory infections, and lacerations sustained while cooking holiday meals. New Year’s day was a little slower on the illnesses, but the acuity of the injuries was high. That’s what …

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A physician’s New Year’s resolutions

How physicians can successfully wind down their practice

Smart Money, MD

Physician Finance

January 14, 2019

A retirement plan isn’t usually a top priority for fresh doctors looking for their first jobs, whether that final date is in five years or thirty. Perhaps knowing when to hang up your hat is immaterial so early in your career since most doctors will end up leaving their first job within the first five years anyway. However, I do wish that I had some inkling about the career paths …

How carefully do most patients or doctors read medical forms?

Michael Kirsch, MD

Physician

January 14, 2019

Does any living, breathing human believe that there is not enough paperwork in our lives? While we are all burdened, I believe that the medical profession is uniquely deluged with an absurd volume of documentation requirements, most of which should be filed under “N” for nonsense. Ask any physician or nurse about this and have antacids on hand as you will soon see some sizzling smoke emerging from the medical …

Countering misinformation about flu vaccine: Why it’s so hard

Matthew Motta, PhD, Dominik Stecula, PhD, and Kathryn Haglin, PhD

Medications

January 13, 2019

Many Americans hold beliefs about the flu vaccine that are at odds with the best available scientific evidence. For example, a recent study found that more than two-fifths, or 43 percent, of Americans believe that the seasonal flu vaccine can give us the flu. Scientific research strongly suggests that this is not true. Because most modern flu shots do not contain a live virus, the shot itself simply cannot get …

Horrific decisions that no parent should ever have to make

Allison Chang, PhD

Conditions and Diseases

January 13, 2019

“Is she in pain?” I asked quietly as the pearlescent baby-shaped image on the screen folded its legs and then extended them.

The radiologist doing my ultrasound had just finished pointing out a cluster of alarming abnormalities in our developing daughter, using a slew of medical terms my husband and I, both medical students, were grimly familiar with. Pleural …

Patient care suffers when you squeeze patients into a tight schedule

Fred N. Pelzman, MD

Physician

January 13, 2019

86 minutes.

That’s what I found when I added up how late patients were through a single practice session earlier in the week.

Some patients arrived on time, and some a few minutes early, but the average was about 8 minutes late, ranging up to one patient who showed up an hour and 12 minutes after their scheduled appointment time.

The reason I …

3 things this physician wished he could have done differently

Mitchel Schwindt, MD

Physician

January 13, 2019

“What took you so long? I’d have thought you would address this issue sooner.”

I felt a like a scolded child sitting in the principal’s office. In fact, the small couch I was sitting on rested nearly a foot lower than the chair on which he perched. All the while, the exam table glared back with unfriendly eyes.

I smirked and tossed the question back in his lap with a degree of …

We need to be more focused on those patients who find the holidays hard

Hans Duvefelt, MD

Physician

January 12, 2019

I am beginning to think that we should not see chronic care patients between Thanksgiving and New Year’s Day. It just makes us look bad.

Our quality metrics make the last blood pressure and the previous diabetic lab test of the year for each of our patients our final report card. We should quit while we’re ahead, in mid-November.

So here we are: The office has Christmas decorations up. There are trays …

New year, new thinking about treating obesity

Christopher Still, DO

Conditions and Diseases

January 12, 2019

Eat less, exercise more is a common refrain heard by millions of people with obesity. If only it were that simple. Decades of research shows obesity is a disease that is caused by a combination of genetic, environmental, biological, and behavioral factors that requires a range of interventions for treatment and prevention. The American Medical Association, the nation’s largest physician group, agreed when it officially recognized obesity as a disease …

When medicine stays in the family

Health eCareers

Physician

January 12, 2019

This article is sponsored by Careers by KevinMD.com.

It’s no secret that some businesses are family businesses and medicine is no exception. The anonymous Northern California cardiologist known as “Dads Dollars Debts” confesses in a blog that, yes, some days he feels like he’s made a difference, and other days, “I just feel like a customer service rep at …

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When medicine stays in the family

MKSAP: 55-year-old man with mild nausea and dyspepsia

mksap

Conditions and Diseases

January 12, 2019

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

A 55-year-old man is evaluated in the emergency department for a 2-day history of mild nausea and dyspepsia that is worse with fasting and improved with eating. He has also had a 24-hour history of frequent black stools and fatigue. He has no history of gastrointestinal bleeding, alcoholism, chronic liver disease, bleeding disorders, …

Investing in the stock market is like playing that game of rock-paper-scissors

Wall Street Physician, MD

Physician Finance

January 11, 2019

Rock-paper-scissors is a game that nearly all of us played as children.

It is a game with incredible opportunities to play mind games with your opponent.

There is no luck in rock-paper-scissors as with card games.

The game does not have complex rules like chess.

You simply have to figure out the patterns of your opponent (or induce patterns into them) and take advantage accordingly.

Can you beat the New York Times computer bot?

Back in …

A financial checklist for the pregnant woman physician

Bonnie Koo, MD

Physician Finance

January 11, 2019

Women physicians are disheartened when they discover the financial implications of having children. Most of us will not get paid leave. Many of us are the breadwinning partner. And most of us will not become stay at home moms so we will need to pay for high-quality childcare or have a stay at home spouse.

Certain things should be in place prior to becoming pregnant. So even if you’re single, I …