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The most frustrating things about being chronically ill

Patient

November 22, 2017

Healthy or not, everybody has his or her share of frustrations in life. The chronically ill don’t have a corner on that market! This piece focuses on frustrations that are unique to those with ongoing health issues. I’ve experienced all of them as a result of being chronically ill with a debilitating illness that settled in after I contracted what appeared to be an acute viral infection in 2001.

Here are …

Physicians share same mission across cultures and countries

Philip A. Masters, MD

Physician

November 22, 2017

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

As part of my role in International Programs at the American College of Physicians (ACP), I have a unique opportunity to travel frequently and engage with internists around the world. In fact, I am writing this while almost 7,000 miles away from home, …

Why are you in medicine?

Marc N. Katz, MD

Physician

November 22, 2017

I was recently interviewed on a podcast and was asked the simple question, “Why are you in medicine?” In retrospect, that’s the exact question I silently ask myself in frustration and exhaustion a little bit too often while I’m in the hospital. In those moments I recognize that I feel burnt out. In those moments if someone told me that I had to repeat intern year in order to finish …

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Why are you in medicine?

These are the biggest medical issues of 2017

Robert Centor, MD

Physician

November 21, 2017

Periodically we should reflect on what challenges face patients and physicians. Over the past few days, I have worked on a list of the issues that concern me the most. I welcome suggestions for expanding the list.

1. Diagnostic errors. All patient care requires that we make the proper diagnosis. Too often we make errors. A recent paper estimated that 30 percent of cellulitis admissions did not have cellulitis. A similar …

Who’s really to blame for the obesity epidemic?

Peter Ubel, MD

Health Policy

November 21, 2017

Growing up Republican, I have long believed in personal responsibility. In junior high school, when I observed close relatives who struggled with obesity, I vowed to never let myself get out of shape. (“Junior high” is what we called middle school back in the day.) When hip surgery gone wrong dramatically reduced my level of physical activity two and a half years ago, I cut back on what I ate …

Reporting an elderly doctor. And suffering from snitch guilt.

Jennifer Adaeze Okwerekwu, MD

Physician

November 21, 2017

He struggled to hear when people talked to him. He asked the same questions over and over. He fell asleep when really important conversations were going on around him.

But it wasn’t until he missed an emergency call that I knew I had to act.

I spoke to a higher-up about this elderly doctor out of concern for patient …

EMRs are robbing physicians of their writing skills

Hans Duvefelt, MD

Physician

November 21, 2017

Many physicians have become world famous writers, and in Greek mythology, Apollo was the god of both poetry and medicine. I can personally think of many prominent physician writers I have come across in my reading over the years:

There was the 12th-century rabbi Maimonides, Copernicus in the 15th century and the poet John Keats in the 1700s.

In the late 1800s to early 1900s, there were Anton Chekhov, Sir Arthur Conan …

Don’t let the opioid crisis affect the treatment course for your patients

T.J. Matsumoto, PA-C

Medications

November 21, 2017

Mrs. Smith is an 81-year-old female. She worked a long time doing very physical work and is now on a fixed income and comes to my office with chronic pain. X-rays show she has degenerative arthritis in her hips, knees and lumbar spine. She has taken Norco twice a day for years and has been able to be very stable on this. She has always been compliant with her medications. …

Are cultural sensitivities affecting care?

Esther Covington

Patient

November 21, 2017

My job as a standardized patient (SP) at several different medical schools means that I spend a lot of time being interviewed and examined by students at every stage of their education. Occasionally, the interview is of such a nature that the SPs are told to dress in a certain “costume” because it signifies to the student that there is something about our cultural representation that affects our medical care. …

Why do doctors who hate being doctors still practice?

Kristin Puhl, MD

Medical Education

November 20, 2017

How important is it for a doctor to want to be a doctor?

At first glance, that question is ludicrous. The path to becoming a practicing physician is so long and tortuous that no one would do it if they didn’t want to. Right? First, there’s the four years of undergraduate education, then four years of medical school, then at least three years of residency. No one has ever suggested that …

Women as leaders: reflections from the conference trail

Christine Ngaruiya, MD

Physician

November 20, 2017

October is the epitome of academic conference season. Returning home, suitcase laden, and a belt-hole wider from lost promises of exercise, and plans to “watch what I eat” while on the road, I am ready to get back into my routine. All the same, I come back refreshed by a new flavor to the mundane routine of conference experiences past. At the three conferences that I attended this fall, women …

Why your child should get the HPV vaccine

Valerie A. Jones, MD

Conditions and Diseases

November 20, 2017

My young daughter will be entering middle school in another year. However, she still likes coloring books. If she watches a scary movie, I have to lay with her in bed until she falls asleep.

She is still just a kid. Should I really be worried about HPV? Is this something you should consider for your daughter?

As an OB/GYN doctor, I know about the HPV virus and have seen so many …

Good doctoring transcends numbers

Linda Girgis, MD

Physician

November 20, 2017

Measuring metrics is a common catch-phrase in health care. The goal of capturing certain data is to improve patient outcomes. But, as doctors, we were taught to treat the patient and not the numbers. While optimizing clinical outcomes is a needed goal with all the complexities in medical treatment currently, the system seems to have gone too far in its quest for targeted numbers.

If, for example, a patient suffers metastatic …

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Good doctoring transcends numbers

Who’s responsible for polypharmacy in the elderly?

Michael Kirsch, MD

Medications

November 20, 2017

There’s a common affliction that’s rampant in my practice, but it’s not a gastrointestinal condition. It’s called polypharmacy, and it refers to patients who are receiving a pile of prescription and other medications. I see this daily in the office and in the hospital. It’s common enough to see patients who are receiving 10 or more medications, usually from 3 or 4 medical specialists.

Of course, every doctor feels that he …

Hospitals are struggling and the future is grim

Robert Pearl, MD

Health Policy

November 20, 2017

A strange thing happened last year in some the nation’s most established hospitals and health systems. Hundreds of millions of dollars in income suddenly disappeared.

This article, part two of a series that began with a look at primary care disruption, examines the economic struggles of inpatient facilities, the even harsher realities in front of them, and why hospitals are likely to aggravate, not address, health care’s rising …

Mental health problems in the transgender population

Anna Gorman

Conditions and Diseases

November 19, 2017

Diana Feliz Oliva, a 45-year-old transgender woman who grew up outside Fresno, Calif., remembers being bullied when she was younger and feeling confused about her gender identity. She was depressed and fearful about being found out, and she prayed every night for God to take her while she slept.

“I was living in turmoil,” said Oliva, who now works as health program manager in a clinic for transgender people at St. …

How burnout is plaguing doctors and harming patients

Jay Desai, MD

Physician

November 19, 2017

The presidential symposium at this year’s Annual Meeting of the Child Neurology Society of America in early October in Kansas City raised many eyebrows. The first presentation of this symposium focused on burnout rates among neurologists around the country.

Many of my colleagues felt that this was an inappropriate choice, especially with so many trainees and young child neurologists in the audience. Typically, the presidential symposium at a conference of such …

The new battleground of prime time media, disease, and death

Jeffrey M. Levine, MD

Physician

November 19, 2017

I first noticed this phenomenon while watching the world news on a weekday after work. It was a commercial for a new diabetes medicine that showed overweight people dancing at a barbecue, cooking and enjoying life. How different this was from my day in the wound clinic, where I saw patient after patient with obesity, diabetes, and nonhealing wounds, as well as other dire medical complications.

So I tucked this image …

Eliminate the middlemen of private insurance companies

Mark P. Abrams, MD

Health Policy

November 19, 2017

It’s no doubt that the health care conundrum our nation is facing is fraught with high-risk hypotheses and their unpalatable consequences. Complicating this further is the business-minded nature of many lobbyists and policy-makers influencing our government’s decisions, including President Trump’s. This is particularly timely given the recent executive orders Mr. Trump has unilaterally implemented that both sides of the aisle are concerned about. As a physician with a top priority …

What I learned as a corrections physician

Robert J. Tilley, MD, MBA

Physician

November 18, 2017

As a corrections physician I frequently heard the question, “How can you take care of those people?” I understood what they were asking, after all, I was caring for people convicted of such crimes as murder, rape and child abuse.

And yet I had very little difficulty providing the same care to inmates that I provided to everyone else. In fact, the corrections environment was generally easier to work in and …

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