| KevinMD.com

MKSAP: 28-year-old man with elevated liver chemistry test result

mksap

Conditions and Diseases

March 18, 2017

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

A 28-year-old man is evaluated in follow-up for elevated liver chemistry test results, which were performed to assess a 3-month history of fatigue. He has no history of liver disease and has not had abdominal pain or fever. His medical history is significant for a 3-year history of diarrhea. Following a physical exam, …

The scary evolution of direct-to-consumer advertising

Martha Rosenberg

Conditions and Diseases

March 17, 2017

One night in 1997, as Americans watched Touched by an Angel they were touched by something else unexpected: an ad for a prescription allergy pill called Claritin, sold directly to patients.

Prescription drugs had never been sold directly to the public before — a marketing tactic called direct-to-consumer or DTC advertising. How could average people, who certainly had not been to medical school, know if the medication was appropriate or safe …

How the ER touches the untouchables in society

Amy Faith Ho, MD

Physician

March 17, 2017

I met a man recently who had wandered about life dragging the rotting corpse of his arm barely attached to the rest of his body for over a year. His limb carried such a pungent malodor he stopped eating months ago because the noxious stench of his own dripping pus made him perpetually nauseous. A former handyman, he had jimmied up a poor-man’s sling with a tattered Hanes undershirt. It too …

Real physician voices, twice a week

Join 100,000+ subscribers. Free, and one click to unsubscribe.

How hospice helped my mother find peace

Debbie Moore-Black, RN

Patient

March 17, 2017

There was a lot about that place I didn’t want to see or hear.

The buzzing and whirring of ventilators; the loud call bells; near-dead patients; nurses running around with IV pumps and tubes dangling along behind them; the heart-stopping “Code Blue” warning; or the electrical sizzle of a patient getting shocked as someone screams, “All clear!”

I didn’t want to do it.

Just a few days before, I had buried my mom.

First …

Read more…

How hospice helped my mother find peace

It’s time to teach residents money management skills

Taison Bell, MD

Medical Education

March 17, 2017

The scene at the resident teaching session was all too familiar: Awkward silence with either blank stares or brows furrowed in deep valleys of confusion. As I scanned the room, I recognized the moment many lecturers experience: I had completely lost my audience. And, whatever I had planned for the next 10 minutes, would now be spent “taking a step back.” We weren’t talking about a crazy exam finding or …

How hospital executives wish their hospitalists would act

Leslie Flores

Physician

March 17, 2017

Recently, I wrote a letter to hospital executives, urging them to deliberately invest their own personal time and effort in fostering hospitalist well-being. I suggested several actions that leaders can take to enhance hospitalist job satisfaction and reduce the risk of burnout and turnover. Following the publication of that post, I heard from several hospital executives and was pleasantly surprised that they all responded positively to my message. Several execs …

Finding contentment in rural emergency medicine

Mitchel Schwindt, MD

Physician

March 17, 2017

The frenetic pace and chaos of working in an urban trauma center are addicting — at least for a while. Interesting, unusual, and tragic patients test the mettle of even seasoned physicians. For some, the lure is too strong to step away.

For others, the attraction of a quieter life and promise of a more sane existence is too powerful to resist.

My story

After training in one of the busiest level 1 …

Today’s version of the Hippocratic oath

Paul D. Simmons, MD

Physician

March 16, 2017

I swear by Epic, by eClinicalWorks, by Allscripts, by AthenaHealth, and by all the coders and accountants, making them my witnesses, that I will carry out, according to my ability and judgment, this oath and this indenture.

To hold my mouse in this art equal to my own hand; to make it right-click as well as left-click; when my ACO is in need of money to share an “at-risk” portion of …

Read more…

Today’s version of the Hippocratic oath

The one immigrant who has nothing good to contribute to the American story

Sean Gallagher, MD

Physician

March 16, 2017

To be clear, this is about one person. It warms my heart to know that people want to come and start new lives as Americans. Some of the best doctors got their education and training overseas. Not only have I worked with many of them, I’m related to three by marriage. Most people have heard of Mr. Andrew Wakefield. He used to be a British doctor before being stripped of …

It’s 2017. There’s no excuse to be disconnected.

Greg Smith, MD

Physician

March 16, 2017

“I attribute my success to this-I never gave or took any excuse.”
-Florence Nightingale

I was publicly thanked today for doing my job. No, really. By two of my coworkers, actually. It sort of took me aback just a bit.

Over the past Christmas holiday a couple of patients, being human as we all are, forgot to get their medications squared away before the clinic was going to close for a total of …

What does it mean to be well? Ask an opiate addict.

Casey Grover, MD and Paul Harper

Physician

March 16, 2017

Wellness. It’s all the rage these days as we try to manage our crazy work schedules while still maintaining balance in life. We have wellness committees, wellness workshops, wellness coaches, and wellness apps for our smartphones.

So, then, what does it mean to be well?

To the average person, and to the dictionary, to be well is to be “in good health” or “in a good or satisfactory way.”

However, to those suffering …

How to apply business to medicine

Akhilesh Pathipati, MD

Medical Education

March 16, 2017

Just after I started at Stanford’s Graduate School of Business, I wrote an article on why I’m doing an MD/MBA. I argued that business school can help clinicians develop a new perspective, acquire important skills and build bridges between doctors, policymakers, and administrators.

I heard from dozens of students, faculty, and physicians who supported the idea of an MD/MBA. However, a question repeatedly came up about as to …

Read more…

How to apply business to medicine

How do physician-mothers do it all?

Uchenna O. Njiaju, MD

Physician

March 16, 2017

So, how do you do it all?

It’s a Monday morning. After a flurry of activities, I am walking into the office at 8:00 a.m. I think back to the past 2 to 3 hours. I was up at 5:30 a.m., and in my workout clothes soon after. I managed to squeeze in a 20-minute workout, thanks to a video on YouTube. I then reviewed my schedule and patient charts for …

Read more…

How do physician-mothers do it all?

The fundamental problem with the American Health Care Act

Marshall Chin, MD, MPH

Health Policy

March 15, 2017

As the immediate past-president of the Society of General Internal Medicine (SGIM), the major professional association of academic general internists, I participated in SGIM’s Hill Day on March 8, 2017. Hill Day is when an organization mobilizes its members to visit the offices of Senators and Congresspersons on Capitol Hill in Washington, DC to discuss key issues. Coincidentally, March 8 was also the day two House Committees began deliberations on …

A resident’s guide to being a medical student: In the OR

M. Alexandra Friedman, MD

Medical Education

March 15, 2017

As a medical student, I had nightmares about my first day in the OR: scrubbing incorrectly, contaminating a sterile field, forgetting the anatomy I had so carefully studied the night before. It seemed like the only thing I could do in that artificially lit room was mess up. After a few cases I came to love the routine and ceremony of each surgery: the timeout; the rhythmic pattern of suture, …

The AMA’s letter on the American Health Care Act was too narrowly focused

Corey Howard, MD

Health Policy

March 15, 2017

I am a member of the American Medical Association and chair the Delegation from the Florida Medical Association. As an advocate for the medical profession, I am very proud of the work that we do, but I also realize that much more is needed. In particular, we desperately need to address the growing disconnect between the AMA and the broader physician community. This disconnect is one of the key reasons …

The decisions that changed this physician’s career

Jeremy Topin, MD

Physician

March 15, 2017

I knew the moment when my career in pediatrics was over. I was in the fourth year of my med-peds residency, taking overnight call in the pediatric ICU. Nights were busy, stressful and I was alone. A young boy came in as an unrestrained MVA after his father hit another car. Dad was OK (although severely distraught), but the five-year-old towhead boy in front of me was not, with his head immobilized in …

This the one thing that makes me feel like everything is OK

Jordan Grumet, MD

Physician

March 15, 2017

“Too many times I feel
We are losing time once shared
And only when you’re in ecstasy
You seem to really care”

I recognize the song immediately — Chuckii Booker’s “Turned Away.” Not the regular version, but the extended one. As the words rush over me, caressing my nostalgia, a memory, a moment comes back.

I was standing behind the counter at Homer’s Ice Cream on a brilliant summer morning before the doors opened. We …

The feds say restrict opioid use. Now what?

Cindy Perlin, LCSW

Medications

March 15, 2017

The federal government has declared, through its major health policy agencies, that the number of pain patients on opioids and the dosages they are on should be severely restricted. The Center for Disease Control (CDC), Veteran’s Administration (VA) and Centers for Medicare and Medicaid Services (CMS) have all issued new guidelines within the past year to that effect. Private insurers are following suit, in many cases refusing to pay for …

My mother isn’t a drug-seeking patient. She’s in pain.

Christina Phillips

Patient

March 15, 2017

The patient, age forty-nine, complained of abdominal pain. She was taking both slow- and fast-acting oxycodone to manage the pain, and she also took antidepressants and a sleeping aid. She’d come to the hospital several times in the past year, always with the same complaint. This time, not feeling well enough to drive, she’d come by taxi. The veins in her arms were small, threadlike and collapsed, like those of …

Real physician voices, twice a week

The Podcast

Latest episodes

The Podcast

Latest episodes