| KevinMD.com

February 7, 2017Feb 7, 2017

In hospitals today, administrators are eager to impose guidelines and metrics onto any facet of patient care they can measure. The sentiment that business people and clinical people are at odds flares with each new initiative. Clinicians feel ignored. Patients complain about how little attention they receive. Administrators try to distill complex pieces of information into smooth line items. We all spend as much time with computers as we do …

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Health care is teaching to the test

Physician

My case for no-fault medical care

Hans Duvefelt, MD

February 6, 2017Feb 6, 2017

As a physician with a strong sense of calling, I always see myself working for each patient, regardless of who pays the bill. Following in the footsteps of role models like Hippocrates and Osler, how could I do anything else?…

Ted has been my patient for decades. He can’t seem to lose weight.

John has admitted he doesn’t know how long he can keep doing the kind of work that has supported …

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My case for no-fault medical care

Medical Education

If you go to medical school, you will be stressed. Bigly.

Skeptical Scalpel, MD

February 6, 2017Feb 6, 2017

Two posts on KevinMD highlight the problems facing many medical students today. The first was by an anonymous rising fourth-year student who has come to the conclusion that going to medical school was “a terrible, terrible decision.” It ended with…

Two posts on KevinMD highlight the problems facing many medical students today.

The first was by an anonymous rising fourth-year student who has come to the conclusion that going to medical school was “a terrible, terrible decision.” It ended with a comment that medical school “is not fun. It’s jarring, scary, disappointing and absolutely depressing.”

The second was by another anonymous student who described how miserable he (or …

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Physician

How do I fix communication with my patients?

Jordan Grumet, MD

February 6, 2017Feb 6, 2017

There is a basic communication gap between you and me. How could there not be? It's not what you expect. I say you have cancer, or heart failure, or emphysema. Full stop. A conversation ensues. This is not what I'm…

There is a basic communication gap between you and me. How could there not be? It’s not what you expect. I say you have cancer, or heart failure, or emphysema. Full stop. A conversation ensues. This is not what I’m talking about.

It’s more like when I report to you a series of normal lab results, and at the end flippantly mention a slight elevation of the white blood cell count. …

Physician

Building a career and a life around the difficult moments

Bruce Campbell, MD

February 6, 2017Feb 6, 2017

“An expert is a person who has made all the mistakes that can be made in a very narrow field.” - Niels Bohr Five experienced, well-published, and widely respected head and neck cancer surgeons are sharing the dais at the…

“An expert is a person who has made all the mistakes that can be made in a very narrow field.”
– Niels Bohr

Five experienced, well-published, and widely respected head and neck cancer surgeons are sharing the dais at the national medical meeting to explore the topic “Can We Be Better?” The panel represents a spectrum of experts from around North America, and they have served as program leaders, department chairs, and …

Physician

What this physician learned from teaching his kids to ride bikes

Jeffrey McWilliams, MD

February 5, 2017Feb 5, 2017

Sometimes the minuscule moment is the most relevant; the least anticipated becomes the most profound. Endless searches for wisdom and insight fade with each passing day, only to be shadowed by an unintentional conversation or event. Wisdom is profound in the simple, while often hidden, complicated or forgotten in the complex or intentional. This ironic phenomenon is as old as time, obvious in God’s creations and man’s discoveries. I’ve reached …

Physician

Why I would still encourage my daughter to go into medicine

Shikha Jain, MD

February 5, 2017Feb 5, 2017

There was an article recently published in Forbes titled "Mamas, Don't Let Your Babies Grow Up To Be Doctors." It was a well-written piece that outlined the multitude of reasons that many physicians have become disillusioned with a field they…

There was an article recently published in Forbes titled “Mamas, Don’t Let Your Babies Grow Up To Be Doctors.” It was a well-written piece that outlined the multitude of reasons that many physicians have become disillusioned with a field they once felt a passionate draw to. The reasons listed in the article were accurate and included the loss of autonomy, mental exhaustion, and asymmetrical rewards.

Many physicians feel …

Medical Education

How running marathons helped prepare me for medical training

John Biemer, MD

February 5, 2017Feb 5, 2017

It’s not a sprint, it’s a marathon. You often hear this analogy about the medical training process, but, having run a few marathons myself, I think it’s particularly apt. I'm working my way through my fourth and final year of…

It’s not a sprint, it’s a marathon.

You often hear this analogy about the medical training process, but, having run a few marathons myself, I think it’s particularly apt. I’m working my way through my fourth and final year of residency now, and I can attest that running marathons was one of the better things that prepared me mentally for the challenges of med school and beyond.

26.2 miles is no trivial …

Physician

A pediatrician, silently screaming for the Syrian children

Henna Qureshi, DO

February 5, 2017Feb 5, 2017

On the eve of President Trump signing an executive order on immigration, I lay here awake, silently screaming for the Syrian children. What will become of the hundreds of children I met recently at the Zaatari camp in Jordan whose hopeful eyes searched my own for answers? Unable to return home because of a war that has stretched more than 5 years, where will they go if we turn our …

Physician

A man halfway between worlds

Edwin Leap, MD

February 4, 2017Feb 4, 2017

Alfred is 95 years old, and sits quietly in his wheelchair, rocking back and forth. His strength is gone, and his veins and tendons bulge through fair, translucent skin, stretched over muscles of long lost size and use. His greatest foe is gravity, which holds his lithe, bird-like form in the chair enough to cause sores on his hips, but only barely. It looks as if he might float away.

He remembers little, but …

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A man halfway between worlds

Conditions and Diseases

The secret way to eating fewer brownies

Peter Ubel, MD

February 4, 2017Feb 4, 2017

I know why I sometimes eat too many brownies. They taste great! The same goes, of course, for a whole slew of desserts -- I love me my strawberry rhubarb pie, and I never say no to a ginger snap.…

I know why I sometimes eat too many brownies. They taste great! The same goes, of course, for a whole slew of desserts — I love me my strawberry rhubarb pie, and I never say no to a ginger snap. And while a touch of dessert is often a fine way to top off dinner, many of us get in trouble when we gorge on desserts.

So how can we get …

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The secret way to eating fewer brownies

Medications

Why most natural remedies seem to work

Roy Benaroch, MD

February 4, 2017Feb 4, 2017

Rachel had a fair question, and I really haven’t answered it yet: My daughter and I were talking the other day and saying we would like to ask a doctor what his thoughts are about all these "natural" remedies that…

Rachel had a fair question, and I really haven’t answered it yet:

My daughter and I were talking the other day and saying we would like to ask a doctor what his thoughts are about all these “natural” remedies that are available. Recently a friend made the remark, “I do everything I can to avoid a doctor.” I lean more toward the medical system and the knowledge they have acquired over …

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Why most natural remedies seem to work

Conditions and Diseases

MKSAP: 45-year-old man with cough and right-sided chest discomfort

mksap

February 4, 2017Feb 4, 2017

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 45-year-old man is evaluated for right-sided chest discomfort and cough of 2 weeks' duration. His chest discomfort is described as a vague, painful…

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

A 45-year-old man is evaluated for right-sided chest discomfort and cough of 2 weeks’ duration. His chest discomfort is described as a vague, painful sensation on the right. The cough occasionally produces a small amount of sputum; he reports no hemoptysis or shortness of breath. He has felt feverish with mild fatigue but …

Physician

We all have glitches. I know I do.

Greg Smith, MD

February 3, 2017Feb 3, 2017

He was a small but very intelligent and articulate young man. I had seen him before, but it had been quite a while. He came to me complaining (as did his family) that he was having some trouble controlling his anger, dealing with quarrelsome students at school, and not always getting his assignments inside or outside of school completed in a timely manner.

We discussed the usual ways to approach this, I …

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We all have glitches. I know I do.

Physician

Schools should discontinue support for football. Here’s why.

Christopher Johnson, MD

February 3, 2017Feb 3, 2017

Should school boards discontinue support for high school football? That’s the provocative title of a recent article in Pediatrics, the journal of the American Academy of Pediatrics. The background to this controversy is the increasing recognition that chronic traumatic encephalopathy…

Should school boards discontinue support for high school football?

That’s the provocative title of a recent article in Pediatrics, the journal of the American Academy of Pediatrics. The background to this controversy is the increasing recognition that chronic traumatic encephalopathy (CTE), a severe and debilitating brain problem first identified in former professional football players, can have its beginnings in college or even high school football …

Physician

The doctor fired for having cancer speaks up

Pamela Wible, MD & Stephanie Waggel, MD

February 3, 2017Feb 3, 2017

I recently reported on Stephanie Waggel, the doctor fired by a prestigious U.S. hospital for getting cancer (story also the Washington Post). In a transcription of her whistleblower video, Stephanie describes how she nearly died due to obstruction of medical…

It started during my intern year of residency. Which, bizarrely, was the happiest year of my life. And all my friends are …

Physician

Have a mean patient? Don’t take it personally.

Lisa Walker, PA-C

February 3, 2017Feb 3, 2017

My brother-in-law, Ron, was a curmudgeon; grumpy, sullen, even downright mean at times. By blood, he and my husband Bill were cousins. In the 1950s, when Bill was just a child, his mother died unexpectedly, and Ron's mother took Bill…

My brother-in-law, Ron, was a curmudgeon; grumpy, sullen, even downright mean at times.

By blood, he and my husband Bill were cousins. In the 1950s, when Bill was just a child, his mother died unexpectedly, and Ron’s mother took Bill in to live with her and her four children. They were an African-American family living in the midst of a middle-class, predominantly white Connecticut township. Their home, located on a wealthy …

Patient

8 survival tips for families with babies in the NICU

Raissa Hacohen

February 3, 2017Feb 3, 2017

Bringing a child into the world is nothing short of a miracle. It’s not comforting to think about, but even if you do everything “right,” there can always be circumstances beyond your control. Whether you have been told to plan for a stay in the NICU or it’s unexpected, here are survival tips from nurses for orienting yourself to the NICU.

1. Try to see your baby as soon as possible. It …

Physician

On National Women Physician Day, how far have we come?

Eve Kellner, DO

February 3, 2017Feb 3, 2017

I was thrilled when I found out that February 3rd is officially National Women Physician Day. Then I realized that February 3rd coincided with the 195th birthday of Elizabeth Blackwell, the first woman to receive a medical degree in America. Dr. Blackwell had the strength and determination of a superhero. She faced extreme opposition, was rejected numerous times, and was still seen as an oddity and inferior when she was …

Physician

A physician’s first code. See how it turned out.

Ben Gold, MD

February 2, 2017Feb 2, 2017

“CODE BLUE, 7 SOUTH. CODE BLUE, 7 SOUTH.” I’m up and out of my call room bed before fully regaining consciousness from my light sleep. It’s 4 AM. I should feel ready: I’ve trained with simulations labs, mock codes, and test questions. I passed my CPR and ACLS courses. I’ve done chest compressions as an intern. But this is different. I’m the resident on call, and if I get there first, I’ll be running the …