| KevinMD.com

November 17, 2016Nov 17, 2016

Over the past two days, listening to separate podcasts, I have heard the same story and now have a better understanding of artificial intelligence. A Freakonomics podcast — The Future (Probably) Isn’t as Scary as You Think: And in general,…

And in general, what’s happened in the past couple of years is the best chess player on this planet is not an AI. And it’s not a human. It’s the team that …

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There’s something missing in the doctors vs. AI debate

Health Technology

Sharing your personal health data? Don’t be scared!

Joseph Kvedar, MD

November 17, 2016Nov 17, 2016

I recently had the opportunity to join Boston news media veteran, Dan Rea, on his AM radio program, Nightside with Dan Rea. It was a one-hour call-in program and an eye-opening experience for me. Dan and I chatted about connected health and how it can truly disrupt care delivery and put the individual at the center of their own health. Then Dan opened the lines to …

Physician

It’s time to update the physical exam

Peter Pronovost, MD, PhD

November 16, 2016Nov 16, 2016

In the technology-thick landscape of modern health care, the physical exam remains in a backwoods. Sure, there have been advances — blood-pressure cuffs, for example, now inflate themselves — but on the whole, the exam has barely changed in the…

In the technology-thick landscape of modern health care, the physical exam remains in a backwoods.

Sure, there have been advances — blood-pressure cuffs, for example, now inflate themselves — but on the whole, the exam has barely changed in the past century. Patients still open up and say “ah,” take deep breaths and gaze at a tiny light peering into the back of their eyes.

A well-done exam can still determine whether …

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It’s time to update the physical exam

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Medications

The fuzzy line between medication use and abuse

Steven Reidbord, MD

November 16, 2016Nov 16, 2016

Opioid painkillers, such as Vicodin (hydrocodone) and OxyContin (oxycodone), are crucial medical tools that are addictive and widely abused. Tranquilizers and sleeping pills of the benzodiazepine class, like Xanax (alprazolam), Ativan (lorazepam) and Klonopin (clonazepam), are safe and effective in limited, short-term use, but are often taken too freely, leading to drug tolerance and withdrawal risks. Stimulants such as Ritalin (methylphenidate) and Adderall (amphetamine) ease the burden of ADHD but …

Physician

What this physician learned from Pantsuit Nation

Mari Siegel, MD

November 16, 2016Nov 16, 2016

A few months before election day, a grassroots group was created on Facebook called Pantsuit Nation. As the name probably implies, it was a group for Clinton supporters, where we shared our positivity about Hillary Clinton as a candidate and offered endless empowering stories about why we were voting for her. The group was secret, but as its numbers swelled to over 3,000,000, it was hard to keep …

Physician

What you think is wrong: Real men cry

Anne Katz, RN, PhD

November 16, 2016Nov 16, 2016

We’ve come a long way from the 1940s and 1950s when men didn’t cry — not when they stubbed a toe or came back from the war and certainly not in front of strangers. In the last 20-plus years, we have seen a loosening up of the “stiff upper lip,” and we now see men crying in all sorts of places. …

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What you think is wrong: Real men cry

Physician

This physician voted for Donald Trump. Here’s why.

Anonymous

November 16, 2016Nov 16, 2016

I am writing why I as a physician voted for Donald Trump for president. This election has caused such outcry that I hesitate to put my name. I want to also say that I am a female physician. I feel…

I am writing why I as a physician voted for Donald Trump for president. This election has caused such outcry that I hesitate to put my name. I want to also say that I am a female physician. I feel that I need to express why I voted the way that I did.

I am still in an independent practice with one other physician. We are hanging on by a thread, …

Medical Education

What is the mistake that every pre-med makes?

Bryan Miles

November 16, 2016Nov 16, 2016

Pre-med students are characterized by a number of things. Most notoriously, they prominently carry type A labels. Perhaps the intricately color-coordinated notes give you away. Maybe it is your strict, military-like regimen with which you go about your daily existence. Whatever it is, you are not alone. Many pre-meds turned medical student harbor these behaviors to some degree. After all, we get to where we are because of years of …

Physician

Why doctors resist change

James C. Salwitz, MD

November 15, 2016Nov 15, 2016

In my home, we have two conversations: politics and medicine. The most vociferous discussions are around their product, health care. We know doctors on the right and left, Democrat and Republican, boisterous blues, rebellious reds and garrulous grays. Respecting opinions and debate, we love ‘em all. However, no matter on what side of the aisle they stand, which lever they pull, they share one trait. All physicians are deeply conservative. …

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Why doctors resist change

Physician

Doctors should stop using the language of war. Here’s why.

Robert Pearl, MD

November 15, 2016Nov 15, 2016

As soon as the microphone opened for Q&A at a conference I recently attended in New York City, a physician in the audience began his question with, “as a front-line physician.” Another asked from the perspective of someone “in the trenches.” And a third wondered how to provide medical care when we are getting “bombarded by mandates.”

As I speak to physicians across the country, I am increasingly jarred by these …

Physician

After the election: I am frustrated with how people have been expressing themselves

Anonymous

November 15, 2016Nov 15, 2016

I have a memory of feeling overwhelming anger and animosity as a 10 year old. I was holding my father’s spot in the checkout line at Walmart in rural Illinois as he ran to grab the paper towels he had forgotten. He quickly darted back in line into the spot that I had saved him as he knew leaving me surrounded by candy for longer than a couple of minutes …

Physician

For those who want to be doctors: Follow this piece of advice

Suneel Dhand, MD

November 15, 2016Nov 15, 2016

I recently had the privilege of speaking to a group of high school students who were interested in becoming doctors. A large number of them were volunteering in my hospital, and their coordinator asked me if I could spare some…

I remember as if it were yesterday when I was their …

Health Policy

Don’t like the election outcome? Here’s what you can do from now on.

Morgan Leafe, MD

November 15, 2016Nov 15, 2016

Like many of you, I have experienced a turmoil of emotions since Tuesday night’s presidential election. Sadness, anger, fear, disgust, and uncertainty have permeated my thoughts since I learned of our new reality. What does the future hold? What will the consequences be for my gay, minority, and Muslim friends, family, and patients? How will this affect the vulnerable children that I care for every day?

As I began to process …

Physician

Saying goodbye to a patient who’s your friend

Don S. Dizon, MD

November 15, 2016Nov 15, 2016

Sometimes, I think that many folks see oncology as an acute care specialty: patients get cancer, get sick, and then they die. There’s an impression that we meet patients only for a moment in time before they are gone forever.…

Health Policy

Is it fair to reward Medicaid patients for routine health care?

Peter Ubel, MD

November 14, 2016Nov 14, 2016

My son was underperforming at school, and I was gently encouraging him to try harder (if gesticulating like an over-caffeinated Italian qualifies as gentle encouragement). He could not understand why I was upset: “Dad, most of my friends are doing…

“Reward you for not being bad?!,” I replied incredulously. That made no sense to …

Medical Education

In memory of what medical education used to be

Anonymous

November 14, 2016Nov 14, 2016

I arrive 7:15, 15 minutes before I was supposed to come in. I make sure to bring a shelf review book, knowing that I will be getting significant use of it that day. After surreptitiously observing my surroundings, I attempt…

I arrive 7:15, 15 minutes before I was supposed to come in. I make sure to bring a shelf review book, knowing that I will be getting significant use of it that day.

After surreptitiously observing my surroundings, I attempt to seek out a physician of sorts, a guide, a mentor, a guru that could aid in my quest for knowledge and experience. I am seated in a chair against a …

Health Policy

What will Trumpcare bring?

Niran S. Al-Agba, MD

November 14, 2016Nov 14, 2016

The world is not going to end. We witnessed a revolution earlier recently. The people have spoken, and they chose the anti-establishment, street smart, government shrinking candidate who bucks the status quo. We find ourselves in uncharted territory, with an unpredictable President-elect, who has unclear plans for health care. Here is what we do know. Mr. Trump is a successful entrepreneur. Forbes describes the entrepreneurship pathway as having no …

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What will Trumpcare bring?

Medical Education

The new hour restrictions for residents: Stop with the manipulation

Michael Ward and Nicole Zagelbaum

November 14, 2016Nov 14, 2016

On Friday, November 4, Thomas Nasca, MD, the chief executive officer of the Accreditation Council for Graduate Medical Education (ACGME), released a letter outlining the proposed changes to intern work hour restrictions and other regulations. Specifically, the proposed update is…

Specifically, the proposed update is expanding the previous restrictions to the length of the intern (who is a physician in their very first year out of medical school) work day from 16 to up to 28 …

Health Policy

What does the Trump victory mean for health care?

Linda Girgis, MD

November 14, 2016Nov 14, 2016

While health care was a hot topic during previous presidential races, not much attention was paid to it in our current one. For the most part, many people think that Obamacare cannot continue as is: It costs too much, only a few insurances are now participating eliminating the market competition and laden with poor coverage with high deductibles. The world watched with bated breath as Donald Trump surprisingly won the …

Physician

Burgers with a side of glomerulonephritis

Ethan L. Bernstein, MD

November 14, 2016Nov 14, 2016

Kicking off intern year means BBQs, team dinners, and block parties. Every invitation encourages us to bring our significant others, those people who define our existence outside of the hospital. And yet, hot dog and cold drink in hand, it seems we can’t help but alienate our non-medical partners by talking exclusively about the minutiae of our medical lives: our interesting patients, our frustrations, and our philosophies of medicine. They …