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Don’t blame doctors for medication nonadherence

Medications

July 9, 2017

The New York Times says nonadherence to prescribed medications is “an out-of-control epidemic” in the U.S. and quotes a review in Annals of Internal Medicine, which found “20-30% of medication prescriptions are never filled, and approximately 50% of medications for chronic illness are not taken as prescribed.”

For example, “a third of kidney transplant patients don’t take their anti-rejection medications, 41% of heart attack patients don’t take …

Think doctors make too much money? Think again.

Patrick Connolly, MD

Physician

July 9, 2017

Lots of people write about how “doctors work so hard.” But let’s look at it from an economics and value-creation perspective.

I’m a neurosurgeon, so you know I do pretty well financially, but how much value am I adding to society? Here are a few examples:

1. A mail carrier couldn’t work because of a herniated lumbar disc. We’ll figure he makes $50,000/year. I operated on him; he goes back to work. …

Don’t just learn about medicine. Educate yourself about money, too.

Zoe Smothermon, DO

Physician Finance

July 9, 2017

In honor of everyone graduating and moving on to the next step, let’s talk about money. And by money — I mean debt because new doctors don’t have any money! All we have are bills to pay!

I am the one who does the finances in our household. It really happened by accident. My husband was deployed shortly after we got married, so all daily responsibilities were de facto handed off …

Real physician voices, twice a week

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We’re smart doctors. But why aren’t we so smart about our health?

Jenny Hartsock, MD

Physician

July 9, 2017

As doctors, we are good at lots of things — we are smart, efficient, hard-working, proficient, role models and leaders. Then why do so many of us place our own health and well-being after our jobs?

As a physician, my most prevalent discussions with patients always boil down to very simple recommendations: eat right, exercise, sleep and manage your stress. Lifestyle changes are really the key to solving many of the …

Is the medical profession at its end?

James C. Salwitz, MD

Physician

July 8, 2017

At the graveside, they still talk about judgment, intelligence, and the wisdom that is the practice of medicine.

Deans and health care leaders wax poetic as they tell stories of great cures to lift in memoriam remarkable healers. Yet, though we bow to Hippocrates, Osler, and Salk, the time has come to mark a revolution in human history: The art of medicine is dead.

It is not that doctors have fallen from …

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Is the medical profession at its end?

We are not shielding our patients from harm

Jordan Grumet, MD

Physician

July 8, 2017

You’ve been swindled.

At least that’s the conclusion I’ve come to. It wasn’t the hucksters or the snake oil salesman. It wasn’t big business, big medicine, or some greedy hospital administrator. It was most likely pharma with a large dose of helping from your doctor. Plain and simple.

I’ve learned quite a bit being a hospice medical director. Covering dozens of new admissions a week has given me much insight into doctor …

Her patients helped this doctor out of her despair

Jennifer Lycette, MD

Physician

July 8, 2017

Recently I found myself sitting in my car in the parking lot of my clinic, unable to will myself to open the door.

I didn’t want to head into the clinic that morning. Instead, I was filled with despair; overwhelmed with the events of the world.

How can I do it? I thought. How can I walk in there and summon the energy to see my patients?

An even worse thought: Why should …

MKSAP: 60-year-old woman with substernal chest pain

mksap

Conditions and Diseases

July 8, 2017

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

A 60-year-old woman is evaluated for a 3-week history of substernal chest pain. The pain is dull, nonradiating, and unrelated to activities. Sometimes the pain is worse after eating spicy foods and can be occasionally triggered by emotional stress. She has not had shortness of breath or weakness. She is moderately active, …

None of us should have to choose between MOC and DRexit

Karen S. Sibert, MD

Physician

July 7, 2017

I wish I knew who coined the term “DRexit” so I could send flowers or a bottle of whiskey as a thank you gift. There couldn’t be a more perfect term to describe the growing exodus of physicians from our beloved profession, which is turning into a morass of computer data entry and meaningless regulations thought up by people who never touch a patient.

The one bright note on the horizon …

Behind the scenes of a detox scam

Britt Marie Hermes, ND

Medications

July 7, 2017

It is surprisingly easy to sell snake oil. I know, because I’ve done it. In 2014, I helped create and sell The Right Detox. This was a bogus detoxification program that purported to improve anyone’s well-being and perhaps, cure disease. I was the face of the scam. I launched The Right Detox at a spring-time women’s health expo in Tucson, Arizona.

I kicked off my sales-pitch in front of a small …

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Behind the scenes of a detox scam

When your doctor’s computer crashes

Michael Kirsch, MD

Health Technology

July 7, 2017

Earlier this week, as I write this, our office lost a skirmish against technology.

It was my procedure day, where lucky patients file in awaiting the pleasures of scope examinations of their alimentary canals. A few will swallow the scope (under anesthesia), but most will have back-end work done. We are a small private practice equipped with an outstanding staff. We do our best every day to provide them with the …

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When your doctor’s computer crashes

The obsession with diagnosing President Trump

Dr. Saurabh Jha

Physician

July 7, 2017

When I first read about neurosyphilis in medical school, I became convinced that Mrs. Thatcher, who I detested intensely because it was fashionable detesting her, had general paralysis of the insane. The condition, marked by episodic bouts of temporary insanity, which indicated that the spirochetes were feasting on expensive real estate in the brain, seemed a plausible explanation why she had introduced the poll tax.

A little bit of medical knowledge …

5 ways to fix health IT immediately

Suneel Dhand, MD

Health Technology

July 6, 2017

Following my latest article on health care information technology, and how tragic the situation has become for physicians, I received a lot of correspondence. As always with articles that express physicians’ frustrations with the current batch of IT systems, there’s typically a lot of sympathy and agreement (although I believe that just nodding our heads and saying how bad a situation is, doesn’t really mean that …

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5 ways to fix health IT immediately

Drowning in a sea of misinformation: Dry drowning and secondary drowning

Seth Collings Hawkins, MD, Justin Sempsrott, MD, and Andrew Schmidt, DO, MPH

Conditions and Diseases

July 6, 2017

Recently, a young child died following days of vomiting. He had been in shallow water in a Texas dike about a week before his death. The story was picked up as an alleged case of a rare condition called dry drowning or secondary drowning. The media accounts went viral, spreading significant fear in parenting communities and among those learning about these alleged conditions from the news …

They said, “Third year of medical school is better.” It wasn’t nearly good enough.

Rohit Abraham

Medical Education

July 6, 2017

Everyone says that medical school gets better, especially third year. The traditional four-year curriculum covers basic science in the classroom for the first two years. Then suddenly, third year plunges us into clinical rotations in the hospital, where we’ve all dreamed of working for so long. Third year is when we transition from learning how to be scientists; we finally learn how to become doctors — except for one critical, …

10 ways for doctors to think outside of the box

Danish Siddiqui, MD

Physician

July 5, 2017

Thinking outside the box is a somewhat cliché way to illustrate thinking beyond the norm and imagining what “could be” with an innovative mindset. This imagery of being stuck in a box rings true for many physicians, given how many of us are quite literally surrounded by the four white walls of an exam room most of our lives.

Physicians work hard to treat each patient individually, but this feeling of …

Pre-authorization is hell. Here’s why.

Matthew Hahn, MD

Medications

July 5, 2017

This April, my turn to take the medical board exam rolled back around, necessary every ten years for maintenance of certification. I studied diligently for the better part of three months preceding the test (and I think I did well). It was actually pleasurable to go back over details that I had forgotten and to catch up on newer developments in the field. I realized that I don’t do nearly …

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Pre-authorization is hell. Here’s why.

My patient is dying, and I don’t know what to do

Jeremy Topin, MD

Physician

July 5, 2017

The patient in front of me is trying to die. Elderly and frail, he is lying in bed. His ribs outlined under the skin that should be smooth. His temples are concave where they should be flat. Both are an outward display of internal damage from his lung cancer. More striking than his cachexia are the strained muscles in his neck and his pursed-lip breathing. He is working hard for …

Communication in health care should be better than it is

Fred N. Pelzman, MD

Physician

July 4, 2017

A few days ago, just after dawn, while I was out walking the dog, our home phone rang and my wife answered it.

She’s used to my pager, cell phone, and home phone ringing at all hours, and so she was not all that surprised when an unidentified voice said,”We’re looking for the methadone dose for patient John Q. Smith.”

She told him I was out of the house at the moment, …

Real physician voices, twice a week

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