The art of medicine is needed to prevent migraine headaches

Conditions and Diseases
June 28, 2018

He spoke with an aura of superiority, in a slightly nasal voice, and his topic was migraines. It was in the late 70s, a time when there were few options to treat migraines.

“Most people who claim to have migraines just have simple tension headaches,” he scoffed. And in a move that seemed unorthodox at the time, he disclosed that he suffered from “real migraines,” so he knew all about this …

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The art of medicine is needed to prevent migraine headaches

How basic training changed me as a doctor

Physician
June 28, 2018

Written by George Kamajian as told by Bob Fedor.

I’m an old family doctor. I’ve seen much and forgot more. Life has taught me that we touch our patients’ lives for a moment, a season or a reason — and sometimes with unforeseen consequences.

I grew up in Erie, Pennsylvania. In 1968, when I was 19, the Tet Offensive in Vietnam caught the American military off-guard, and the Pentagon began frantically drafting …

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How basic training changed me as a doctor

Don’t let fear harm your health

Patient
June 28, 2018

I remember reciting a phrase during my childhood that goes something like this, “Step on a crack, break your mother’s back.” So as I would walk back and forth to school, I would make a conscious effort to avoid any and all cracks in the sidewalks for fear of bringing unwarranted harm to my mother. This was a pretty difficult task to accomplish since in my small hometown, cracks in …

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Don’t let fear harm your health

Financial independence requires sacrifice

Physician Finance
June 28, 2018

It is easy to look at someone’s net worth and ooh and ahh.  The response from my monthly income reports is fairly telling.  People see the numbers and wonder how I accumulated so much.  They peruse the Rockstar Finance’s Net Worth Tracker and daydream.  To capture these dreams, there are countless blog posts about how to become a millionaire.  If you just follow these three simple steps!  The headlines are alluring and the answers are …

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Financial independence requires sacrifice

A physician-father who made a lasting impression

Physician
June 27, 2018

Every small community has a unique but similar cast of characters. Our small Southern Utah town was no different. From a young boy’s perspective, the cops and docs were feared but cautiously idolized, the mayor was respected, the athletic coaches were immortalized, and of course, we had the homeless man in town, whom we feared. We will call ours Stu.

Stu had greasy disheveled hair and a gray beard. He wore …

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A physician-father who made a lasting impression

Restricting opioid prescribing: Some error has to be tolerated

Conditions and Diseases
June 27, 2018

I have written previously about the raging opioid epidemic in Ohio.  Attacking and reversing this tidal wave will require many weapons, resources and time.  Opioid addiction is a crafty and elusive adversary that will be difficult to vanquish.  Our battle plan will have to be nimble and adjusted over time, much as military leaders must do in actual armed conflict.

Here in Ohio and elsewhere, physicians must abide by new …

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Restricting opioid prescribing: Some error has to be tolerated

The risks of publically reported surgical outcomes

Conditions and Diseases
June 27, 2018

“Some data is better than no data at all.” Do you believe that?

I heard it frequently when the infamous ProPublica’s Surgeon Scorecard first appeared three years ago. Back then I blogged about it saying “To me, bad data is worse than no data at all.”

A recent study in BJU International confirmed my thoughts about this type of publicly posted data and identified a previously unreported issue. The paper attempted to …

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The risks of publically reported surgical outcomes

When does a condition become a medical issue?

Conditions and Diseases
June 27, 2018

It has become a sign of legitimacy to call a personal problem “medical.”  This aims to distinguish the problem from those of morality or character.  It implies both that the problem is serious, and that it is unbidden and largely out of the sufferer’s control.  Unfortunately, it isn’t clear what exactly qualifies as “medical,” so this label serves more as a rhetorical device than a scientific finding.

Alcoholism is …

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When does a condition become a medical issue?

Separating children at the border is a danger to their health

Health Policy
June 26, 2018

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Fair and just societies protect children. The Trump administration’s unconscionable practice of separating children from their families at the border between Mexico and the United States is making me rethink what kind of society I live in.

The images and the stories are heartbreaking.

In an effort to deter families from migrating to the United …

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Separating children at the border is a danger to their health

Bullying immigrant children in the name of politics

Health Policy
June 26, 2018

We’ve all seen the news and heard the stories about children being separated from their parents as they cross over the U.S. border. The pictures of human beings, including very young children, behind wire mesh (some argue that they are not really cages) is simply horrifying. Over the past decades, we have seen atrocities happening in many other countries around the world. And we sit and wonder why the citizens …

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Bullying immigrant children in the name of politics

The biggest health care fix: a relentless focus on primary care

Health Policy
June 26, 2018

There are so many theories out there about what we should or shouldn’t be doing with our complex and fragmented health care system. We are facing a perfect storm of factors: an aging population, a huge increase in chronic disease, new and expensive treatments, and rising expectations of what care we should be receiving. All of this is sending costs spiraling out of control. As a nation, we spend almost …

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The biggest health care fix: a relentless focus on primary care

Shouldering the experiences in medicine is both a burden and an honor

Physician
June 25, 2018

I’ve been a doctor for one year. Two years of clinical rotations in medical school ill-prepared me for the reality of this job. Not that I went to bad medical school by any means; working in health care is simply something you can’t learn from a textbook or even on the sidelines as a marginally involved medical student. It is immersive.

Working around death and dying individuals can be mentally and …

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Shouldering the experiences in medicine is both a burden and an honor

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How medical training can affect the physician psyche

Physician
June 25, 2018

Since the two very sudden public suicide deaths of Kate Spade and Anthony Bourdain, society has again recognized that we never know what is under the surface of another’s façade. As physicians, these tragic occurrences emphasize that our caregiving requires seeing the entirety of an individual’s many parts.

While we acknowledge that the façade is not fake — it is but one true representation of an individual, well-curated, like pages on …

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How medical training can affect the physician psyche

Confronting sexism in medicine

Physician
June 25, 2018

The recent prominence of the #MeToo movement has shined a light at many places in our society where insidious or even obvious sexism against women has long gone unremarked. Even when noticed it’s just shrugged off as the way things are. In honor of this, #MeToo was named Person of the Year for 2017 by Time Magazine. Medicine is no exception to this pervasive problem. A very interesting recent essay in the New …

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Confronting sexism in medicine

The physician reluctance to seek mental health treatment

Conditions and Diseases
June 25, 2018

The recent suicides of an NYU resident and a medical student highlight the growing mental health problem among physicians and physicians-in-training in this country.  This crisis is certainly not exclusive to physicians, as evidenced by the suicides of designer Kate Spade and television personality Anthony Bourdain.  However, suicide among physicians is of particular concern.  A literature review of physician suicide in Medline and PubMed yielded alarming results …

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The physician reluctance to seek mental health treatment

Dear CVS: Please change your hold music

Physician
June 24, 2018

Dear CVS,

Please change your hold music.

Please. Do the right thing.

It’ll take you, or someone who works for you, or even a barely pubescent adolescent who nevertheless knows how to program music on his iPhone with more aplomb than anyone born before 1975, only about 48 seconds.

And 48 seconds is substantially less than the amount of time I have listened to your never-changing hold music.

I have researched the source of this …

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Dear CVS: Please change your hold music

5 reasons to get involved in organized medicine

Health Policy
June 24, 2018

The following are intended to inspire to medical students and residents to learn more about organized medicine. Whether it be at the national, state, county, or specialty level, there are numerous societies with opportunities for contribution.

1. To pull back the curtain. Many physicians are innately curious and like to “see how the sausage is made,” so to speak. There is a great deal of policy behind the scenes of our …

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5 reasons to get involved in organized medicine

Bilateral empathy lowers patient expectations

Patient
June 24, 2018

Generally speaking, patients and physicians are working towards good health. While many patient expectations can be unreasonable, others are practical; this article amalgamates them. Can you identify the absurd demands?

But multiply half of the listed expectations by hundreds or thousands of patients, and we begin to understand why there is such a high rate of physician burnout. Bilateral empathy lowers expectations.

Bedside manner. Don’t accept a walk-in patient and leave us waiting …

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Bilateral empathy lowers patient expectations

How to create an app as a physician

Health Technology
June 24, 2018

“There’s an app for that.”

The phrase became so popular with the advent of smartphones that Apple even trademarked it. There are currently 3.8 million apps available on Android devices and over 2 million available to Apple iPhone users.

Does that mean that we’ve reached a limit on new and useful apps that can be created? Absolutely not. Especially in the medical world, it seems as if there’s so much room to …

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How to create an app as a physician

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