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The bittersweet truth about the epidemic affecting health care workers

Anonymous

Conditions and Diseases

May 28, 2016

It was the first day of my prestigious internship at the cardiac and pulmonary rehabilitation center. I was a senior in college and eager to apply my knowledge from the field of exercise physiology to make an impact on the people beginning rehab. This was my first real opportunity to work as part of a health care team while proving that this is the right field for me to be …

Zika virus infection in semen: A call to action and research

Chantel Washington, MD

Conditions and Diseases

May 28, 2016

It’s difficult to turn to any major media outlet without being confronted with the latest breaking information on Zika virus infection. The images of newborns from Brazil with excessively small heads are searing. To most of the U.S. population, the Zika virus epidemic in South and Central America is mainly a travel concern. But to the millions of people living in areas from the Caribbean to Central and South America, …

MKSAP: 44-year-old man with type 2 diabetes mellitus

mksap

Conditions and Diseases

May 28, 2016

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

A 44-year-old man is evaluated for management of type 2 diabetes mellitus. He was diagnosed with diabetes 6 months ago after being admitted to the hospital with diabetic ketoacidosis. He was discharged from the hospital on a basal and preprandial insulin regimen. Medications are regular insulin before meals and neutral protamine Hagedorn (NPH) …

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Insurance companies cannot dictate which medical devices we prescribe

David Ahn, MD

Health Technology

May 27, 2016

The diabetes community has been set ablaze after UnitedHealthcare announced an agreement for Medtronic devices to be the “preferred” in-network, durable medical equipment (DME) provider of insulin pumps. Starting July 1, 2016, UnitedHealthcare patients will be funneled toward using a Medtronic insulin pump instead of offerings from manufacturers like Tandem and Animas.

Many diabetes advocates have eloquently voiced their outrage …

More needs to be done about sexual harassment in health care

Cory Michael, MD

Physician

May 27, 2016

Having recently watched a cable television recreation of the Clarence Thomas confirmation hearings, I am left thinking about how far some of us have come and how far some of us haven’t.

The confirmation hearings of Supreme Court Justice nominee Clarence Thomas in 1991 changed the concept of sexual harassment in the workplace by bringing the issue to the forefront. By the time, I started residency nearly 20 years after the …

I will make a concerted effort every day to do my job with love

Angelina Somoracki, DO

Physician

May 27, 2016

Since beginning my medical education, I had been on one side of the curtain; the side where the doctors confer and discuss before telling the patient his or her fate, going from room to room giving updates and prognoses. I interacted with patients for the purpose of getting their histories and physical examinations, collecting all the data so that I could present the case to my attending. I was engrossed …

Your medical records are a gold mine for cybercriminals

Martine Ehrenclou, MA

Patient

May 27, 2016

Some say privacy is an illusion. I hope that isn’t true, but I do know that our medical records are not safe. Why should you care? Because our medical records contain our social security numbers, health insurance information, our home addresses, phone numbers, emergency contacts and their phone numbers, our email addresses, possibly our driver’s license numbers, and likely credit card payment information. Ever paid your co-pay with a credit card?

Your …

I am a doctor, but I didn’t cause the opioid epidemic

Tanya Feke, MD

Medications

May 26, 2016

Heroin-Sports-Injury

Let’s get this straight. I am a doctor, but I didn’t cause the opioid epidemic. That is not exactly what you hear in the media these days. After all, doctors are the ones with the prescription pads, and someone must be to blame.

The truth is that death from opioid abuse is on the rise. The Centers for Disease Control and Prevention (CDC) has …

A patient with a right brain injury. And an accusation.

Freida McFadden, MD

Physician

May 26, 2016

You can’t pick your parents, and you can’t pick the side of your brain that you damage.

I always thought that injuries to the left side of the brain would be the worst, because that’s where the language centers generally are. And talking is basically all I do. But after seeing uncountable numbers of strokes and brain injuries, I’ve changed my mind. Right brain injuries are worse.

The right side of the …

California’s End of Life Option Act will provoke meaningful conversations

Tenessa MacKenzie, MD

Physician

May 26, 2016

I hoped that my feisty patient who prevailed over brain cancer would be spared another terminal diagnosis, but after two years in remission, her mammogram showed breast cancer. She agreed to surgery, but declined further chemotherapy. When the time comes, she asked, would I help her end her life?

The End of Life Option Act goes into effect in California on June 9, 2016, joining a handful of other …

How I am leading doctors through change

Karen Weiner, MD, MMM

Physician

May 26, 2016

Here’s a leadership challenge: Get a group of highly independent, intelligent individuals to come together to build a boat. But imagine the blueprint for that boat is vague and untested. Now imagine that this boat must be built in choppy, progressively inhospitable waters, while said individuals are frantically treading water to stay afloat. Convincing these smart people that there’s a problem isn’t the issue. Convincing them to abandon their desperate …

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How I am leading doctors through change

Here are the lessons I learned from caring for my ailing father

Michael Goldberg, MD

Physician

May 26, 2016

I very distinctly remember March 16, 2015. I was the chief surgical resident on call for trauma at my busy urban training program. Like any other springtime trauma call I was steadily busy, running back and forth from penetrating and blunt trauma victims in the trauma bay to inpatients, OR cases, and attending rounds. The characteristically hectic flow of the day was interrupted when I got a call from my …

Why now is the time to talk to your children about terrorist attacks

Marjorie S. Rosenthal, MD, MPH

Conditions and Diseases

May 25, 2016

It’s field trip season in middle school.

Which means that all over the country young adolescents are headed to memorials and museums. In New Haven, Connecticut, field trip season means the 8th graders are going to the World Trade Center in New York City. Which means that at my kitchen table, my daughters and I are discussing how safe it is to be at the World Trade Center. Two of us think it’s one of the …

Thinking of starting a cash-based practice? Here are the pros and cons.

Ashley Maltz, MD, MPH

Physician

May 25, 2016

As an integrative medicine physician, I am often questioned about what I do and how I decided to diverge from the normalcy of allopathic medicine. I usually go into a short spiel about my love for thinking outside the box and creating solutions for patients that seek a kinder, gentler style of medicine; one that blends effective healing modalities from all over the globe with my traditional allopathic training.

Most people …

Nurses take DC to save patient lives

Rebecca Love, RN

Health Policy

May 25, 2016

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When nurses stand on the steps of our nation’s capital, it is a warning that something is seriously wrong in health care. Much like a canary in the coal mine, nurses are the barometer of the health of our hospitals, nursing homes and health care facilities.

On May 12th 2016, nurses from around the United States convened on our nation’s capital for the …

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Nurses take DC to save patient lives

Health IT: The weakest links in a system are actually the people who use it

Kerri Vincenti, MD

Health Technology

May 25, 2016

Among the plethora of emails that I receive on a daily basis, there seems to always be at least one sent from my hospital’s information services department. Usually, I receive alerts about system downtime or notifications about resolved tickets. They all have the same general look and feel, and so I hardly ever question that they are official. And then I come across a communication with the message similar to …

Maybe it’s time to go back to index cards for medical records

Niran S. Al-Agba, MD

Physician

May 25, 2016

During our dermatology section in medical school, a classmate recounted having had Henoch-Schonlein purpura as a child. Over a holiday break, he visited his primary care physician and asked if he could review his records out of curiosity. His family physician pulled out the index card that served as this man’s medical record. Yes, you read that correctly. It was not a chart or computer printout; rather a 4 x …

Systemic racism and racial bias in mental health care

Katie Bayne

Conditions and Diseases

May 24, 2016

Mental health issues are something I’m passionate about and have a lot of experience with, both professionally and personally. One of the biggest lessons I’ve learned over the years is how complicated and broken our mental health system is. When one or even multiple parts aren’t functioning at their highest level, we end up with a fractured system and patients falling through the cracks.

One chasm in our mental health care …

What it takes to be a great doctor: Master the fundamentals

Robert Centor, MD

Medical Education

May 24, 2016

Charles Bukowski once said, “Wherever the crowd goes, run in the other direction. They’re always wrong.”

How does one become a master? What process do we use to have the highest probability of success? Here are some examples.

“Picasso was an extraordinary craftsman, even when measured against the old masters. That he chose to struggle to overcome his visual heritage in order to find a language more responsive to the modern world …

The controversy that surrounds trigger warnings

Maria Yang, MD

Conditions and Diseases

May 24, 2016

A reader I respect asked me for my thoughts on trigger warnings.

Per Wikipedia, trigger warnings are “warnings that the ensuing content contains strong writing or images which could unsettle those with mental health difficulties.”

Let’s put aside the last part of that definition, “those with mental health difficulties”, as some articles suggest that trigger warnings are not limited to those with mental health difficulties. Part of …

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