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MKSAP: 62-year-old woman with a left adrenal mass

mksap

Conditions and Diseases

March 24, 2018

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

A 62-year-old woman is evaluated for an incidentally discovered left adrenal mass. Two weeks ago, the patient was evaluated in the emergency department for diffuse abdominal pain and vomiting. A CT scan was obtained that was normal except for the adrenal mass. Three hours after presentation to the emergency department, the pain resolved …

How squeaky brakes reminded this doctor of the joys of primary care

Alexander Rakowsky, MD

Physician

March 23, 2018

Our local media, in an effort to raise awareness and increase vaccination rates, devoted a lot of time to the unusually harsh flu outbreak this winter. While well intended, the stories about children getting morbidly ill inadvertently led to a flood of families coming to our emergency room and urgent care centers fearful that their child would be next to get very ill or die.

On one of my recent Friday …

How obesity is a national security concern

Brian C. Joondeph, MD

Conditions and Diseases

March 23, 2018

When thinking about the United States military, we conjure up images of Rambo and GI Jane, or Maverick and Iceman from Top Gun. The images are of lean, mean fighting machines who are ripped, fit and ready to take on America’s enemies. Movies are one thing, but reality paints a different picture.

A recent report from The Heritage Foundation describes trouble ahead for the U.S. military. Based on 2017 …

Sometimes death is not an option

Kevin Haselhorst, MD

Physician

March 23, 2018

At 69, Bob appeared to be a broken man. He left the hospital the day before and returned to the emergency department (ED) because he wasn’t “acting right.” Bob became upset when a second injection to his abdomen burned, and family members were angry that the discharge instructions did not explain this.

After four years of receiving treatment for metastatic colon cancer, Bob had reached the breaking point of persecution, but …

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Sometimes death is not an option

Using marijuana 2 times a month cost this doctor his license

J. Wesley Boyd, MD, PhD

Physician

March 23, 2018

If a physician has a substance use or mental health problem, it is in everyone’s interest — the physicians themselves, their patients and their families — for them to get treatment. And if they go for treatment, they deserve to be treated fairly, but given my six years of experience as an associate director in one state physician health program (PHP) and in working with physicians from all across the …

5 ways to build a relationship with hospital administrators

Amy Baruch, MD

Physician

March 23, 2018

My desire to write this piece stems from my recent realization that I wasted a good part of my early career in medicine. While I was happily working in my pathology “bubble,” I was completely oblivious to the great untapped potential I had to affect change not just within, but also outside of, my department. In an effort to encourage other physicians to find ways to make an impact, I …

Physicians: How to find a financial advisor

Cory Fawcett, MD

Physician Finance

March 23, 2018

We all can use advice from time to time. Sometimes that advice is about personal finances, Investing, or borrowing. When choosing this person, stay away from financial advisors who have a conflict of interest. The advisor who makes money on your investment decisions is like the pharmaceutical rep who is telling you all about his new medication and why it is better than what you already use. The advice might …

Why this physician divested from a firearms maker

Cedric Dark, MD, MPH

Health Policy

March 22, 2018

I’ve got a confession to make. I own stock in a firearms maker.

Seems ironic that someone like myself — a physician has cared for countless victims of gun violence and someone who advocates for evidence-based policies to avert gun deaths — would not only own guns himself but also be a stockholder of a company that manufactures them.

Let me explain how this happened. When I first got out of residency, …

What you should know about colon polyps

Frederick Gandolfo, MD

Conditions and Diseases

March 22, 2018

When it comes to colon cancer prevention, the polyp is the key player to know. Colon polyps, called adenomas, are precancerous growths originating from the inner lining of the colon wall. There are other types of polyps in the colon which are not considered precancerous, but for our purposes in this article, we will consider the terms colon polyp and adenoma to be …

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What you should know about colon polyps

Solving the problem of non-emergent care in the emergency department

Michael Kirsch, MD

Health Policy

March 22, 2018

I recently opined about a decision by Anthem to deny paying for emergency room (ER) care that it deemed to be non-emergent. My point was that insurance companies should not be obligated to pay for routine, non-emergent care, recognizing that we need a fair and reasonable method to define a medical emergency. In my view, payment should not be denied to a patient who reasonably believes he needs ER care, even …

Recovery from substance-use disorder is not always celebrated

Luther Philaya, MD

Physician

March 22, 2018

In the fall of 2012, I entered treatment for addiction as a broken physician and man. Opioids were one of my drugs of choice, as they are for so many in today’s society. After weeks of intensive therapy, I was able to let go of the demons that had haunted me for decades, ones that I had medicated away with drugs and alcohol. More than 100 days later, I left the …

Physician speakers are ready to highlight your conference: Spring 2018 update

Kevin Pho, MD

Potpourri

March 22, 2018

It’s been a great start for my new speakers bureau, Physician Speaking by KevinMD. We are a group of practicing physicians who can tell a story, command the stage, and inspire your audience.

This Spring 2018, we’re highlighting the following events:

University of Maryland Community Medical Group, keynote
SUNY Downstate Medical Center, …
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Physician speakers are ready to highlight your conference: Spring 2018 update

Why nurses must help lead the NHS

Dr. Ben Janaway

Health Policy

March 22, 2018

The NHS is robust. And part of that is due to the passion of its workforce. Since its beginning in 1948, the service has met each new challenge with vigor. But never before has it’s existence been under such threat. And with it, the safety of a nation. And there is no one more qualified to save it than those who fight on the frontline. I sat …

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Why nurses must help lead the NHS

This physician is financially savvy. This is who he has to thank.

DocG, MD

Physician Finance

March 22, 2018

It’s a miracle that I’m not a financial moron. No one taught me about finances. I never took a course in college. In fact, a few years ago before I found the FIRE community, I was pretty clueless. Well, not exactly. I made reasonable financial decisions. Heck, even good decisions. I didn’t, however, have the vocabulary or knowledge behind what I was doing. So was I lucky? Did I merely …

The difficult conversations physicians have with patients

Uzma Khan, MD

Physician

March 21, 2018

A 60-year-old lady came for follow-up after a recent stay in the hospital. She was diabetic — horribly uncontrolled — the result of which was that she had already been on dialysis for four years. She ended up in the emergency room with chest pain. Diabetic patients are at higher risk than the general population of having heart attacks.

She underwent studies to evaluate for blockages in her heart. The cardiologist …

This medical student scored a 281 on the USMLE Step 2 CK. You can, too

Alyssa Ehrlich

Medical Education

March 21, 2018

Once a minor hurdle on the road to Match Day, the USMLE Step 2 CK is now required by many residency programs before ranking applicants. For those with low Step 1 scores, Step 2 CK is even more critical, as it represents a student’s only opportunity to compensate for Step 1 performance. I was happy with my Step 1 score but planned to take Step 2 CK well before applying …

What do you do when your loved one becomes suddenly ill?

Natalie Santiago, MD

Physician

March 21, 2018

When someone you love who has always been healthy and a go-getter suddenly takes ill, it can be very scary and confusing for both of you. It can be particularly scary and confusing for your loved one. Your loved one, while healing, is also experiencing grief/loss, and not just over the loss of health. Even as adults, we can sometimes feel like bad things won’t ever happen to us. Feeling …

What Frederick Douglass can teach us about health care

Ayden Jacob

Health Policy

March 21, 2018

“I’ve done this thousands of times. If you do not intubate him, he will die quickly. I’m a pro, but I don’t have all night: either decide to let me do my job, or he dies. But remember, he could die while I do the procedure as well.”

These were the words that echoed around a group of five siblings, a spouse and ten grandchildren, all lost in the chaos of …

Physicians: Focus on net time, rather than net income

Passive Income, MD

Physician Finance

March 21, 2018

We all understand the concept of net income or net pay. If you’re an employee, it’s what you see deposited into your bank account after federal and state taxes, Social Security taxes, Medicare taxes, etc. are all withheld. If you’re self-employed, it’s what you’re left with after you set aside the funds for many of those same taxes plus paid off your business expenses.

In real estate, the term is referred …

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