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It’s time for physicians to practice an evidence-based life

Physician Finance

April 20, 2016

Evidence-based medicine is at the heart of what we physicians do. It is the basis for professional decision-making, and a focus of most journal articles we read. Using solid evidence to practice good medicine has been a foundation of clinical practice for decades.

There are consequences for failing to follow evidence-based guidelines. If patient harm results from straying from a more loosely defined “standard of care,” which tends to be evidence-based, …

Technology in health care: Is medicine really evolving?

Dr. Eunice J. Minford

Health Technology

April 20, 2016

Evolution is part of life, something we accept as a fact and evidenced by the changes we see and know compared to hundreds of years ago. No one can dispute the great technological advances that have been made; transport has been revolutionized from the animal power of horse and cart to the mechanized systems of train, plane and automobile we have today.

Communication systems once reliant upon the written word and …

What does a perfect world for postpartum moms look like?

Jennifer Lincoln, MD

Conditions and Diseases

April 19, 2016

“One can dream.”

That’s often a quote we hear when we talk about winning the lottery or landing a job that lets us do something great like being a taster of new ice cream flavors for a living (I wish).

However, what’s sad is that many American moms utter those same words when they think about life after baby. A year of paid maternity leave. Access to a good lactation consultant. Family members who …

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Medicine is the most emotional profession. This story proves it.

Free N. Hess, MD

Physician

April 19, 2016

There you are in your father’s arms. He is practically running to keep up with the triage nurse. The nurse is walking quickly toward the room that we leave open for true emergencies and the sickest patients. Your father’s eyes are full of fear, and the nurse’s tone is worrisome.

I look down at you all snuggled up to your father’s chest. You are beautiful. So small and bright-eyed. You don’t …

You should want surgery residents for your operation. Here’s why.

James Wu, MD

Physician

April 19, 2016

A few months ago, I got the dreaded 2 a.m. consult from the emergency department. I met Mr. Smith, a man with a very strange looking and inflamed gallbladder. The abnormal appearance on ultrasound meant we had to discuss the possibility of malignancy. Instead of the usual 15-minute spiel about removing the gallbladder, I spoke to the patient and his wife for nearly an hour. I drew the anatomy. I discussed …

How to destroy a great ER: A step by step guide

Thomas Paine, MD

Physician

April 19, 2016

I took a fantastic emergency medicine (EM) job when I finished residency. There was no question in my mind that it was the best job within a hundred mile radius, maybe more. When I first started, my expectations were met. My group held a contract to staff a busy but well-staffed suburban emergency department, and had held that contract for almost 20 years when I signed. The hospital was independent, …

God is in the statins

Dr. Saurabh Jha

Medications

April 18, 2016

Of life’s two certainties, death, and cataracts, it seems statins defer one and prompt the other, although not necessarily in the same person. If you blindly love life, you may be blinded by your love for life.

In the HOPE-3 trial, ethnically diverse people without cardiovascular disease were randomized to 10 mg of rosuvastatin daily and placebo. The treatment group had fewer primary events: death from myocardial infarction (MI), …

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God is in the statins

Identifying a rare disease: Why proper communication is key

Richard Robinson, MD

Conditions and Diseases

April 18, 2016

Today’s restless society has taken its toll on modern medicine. Among all the strategies for protocol optimization and health insurance improvements, doctors get to spend less and less time actually talking to their patients. Each check-up needs to be performed in a certain amount of time, and every procedure needs to be completed as quickly as possible so that hospitals are efficient and profitable.

While this makes perfect financial sense, it …

What is food waste and how can we fix it?

Manoj Jain, MD, MPH

Physician

April 18, 2016

I am about to place my plate in the sink, until I see a single pea left on my plate. I recall a recent article in National Geographic that stated that one-third of all the food we produce is wasted.

I have a Zen moment, and think of the journey the pea made to reach my plate. A farmer in California sowed the seeds six months earlier. A farm worker harvested …

Doctors need to fall back in love with medicine. Here’s how to do it.

John Gonzalez, MD, MBA

Physician

April 17, 2016

If you are a doctor, everywhere you hear or read about all that is wrong in medicine. Please do not get me wrong, the medical profession is under assault. Change is occurring all around us, and much of it has the potential to be disastrous to not only us and our families, but more importantly to our patients. For many of us in the profession, we feel helpless. We feel …

Transgender and gender non-conforming health: What you need to know #PushforPronouns

Al York

Medical Education

April 17, 2016

Fidgeting in my seat, I waited nervously in one of the most crowded waiting rooms I had ever been in. Suddenly, I felt like a bucket of ice water had been dumped down my back; my legal name was being called over the dozens of waiting room sniffles. My instinct was to remain glued to my seat, not to let anyone know that I was the person attached to that …

Your anger towards doctors is misplaced

Allison Fox, MD

Physician

April 17, 2016

I learned that the 148-year-old community hospital that I did my residency at will be closing, and I am angry. Who am I angry at? Myself. Oh, and you. I’m angry at us because we as a country have turned our backs on one another. And in the end, your relationship with your own doctor is in jeopardy.

Pawtucket, Rhode Island, home of Memorial Hospital, used to be a prosperous mill …

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Your anger towards doctors is misplaced

6 medical breakdowns in my mother’s care. And 1 close call.

Marion Mass, MD

Physician

April 17, 2016

I dialed the number to return the call of the nursing home. The nurse who answered the phone was relieved to hear my voice on the other line: “Dr. Mass, thank God you called back! She has been pacing since she woke up, and she refuses to take her meds. We’ve kept her away from Catherine, so they don’t get into another fistfight. But we can’t handle her here anymore. …

Connected health: It’s time to write a different headline

Joseph Kvedar, MD

Health Technology

April 16, 2016

We live in a headline/hyperlinked world. A couple of years back, I learned through happenstance that my most popular blog posts all had catchy titles. I’m pretty confident that people who read my blog do more than scan the titles, but there is so much information coming at us these days, it’s often difficult to get much beyond the headline. Another phenomenon of information overload is that we naturally apply heuristics or …

In defense of Medicare’s observation status

Ronald Hirsch, MD

Health Policy

April 16, 2016

A recent article suggested that using observation status for a hospitalized veteran was dishonorable to his years of service to our country because observation would subject him to higher out-of-pocket costs. This post created quite a lot of discussion and debate. While I agree with the author and commenters that observation is confusing to all and that there has to be a better way, the premise that observation …

Medical education needs literature. Here’s why.

Stephanie Adler Yuan

Medical Education

April 16, 2016

The family medicine fellow set down her pen and inhaled deeply. “So when is it OK to cry with a patient?” she asked the senior attending across the table, a veteran internist in her mid-60s.

About a dozen of us — fellows, physicians, writers — sat hunched over a paper- and laptop-strewn table in the fellows’ shared office, talking about a poem: Sharon Olds’ “Death of Marilyn Monroe.” In it, Olds …

MKSAP: 77-year-old woman with a left middle cerebral artery ischemic stroke

mksap

Conditions and Diseases

April 16, 2016

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

A 77-year-old woman is evaluated 4 months following a left middle cerebral artery ischemic stroke. The severity of her stroke required prolonged initial hospitalization and a 3-month stay in a rehabilitation center before returning home. Residual deficits include dense right-sided hemiparesis and dysphagia requiring oral feeding with thickened liquids. Medical history is otherwise significant for …

The joy of practicing medicine in the frontier

Edwin Leap, MD

Physician

April 15, 2016

Like many boys born in the 60s, my heroes were often frontiersmen. I grew up watching the Daniel Boone television series, with Fess Parker. (I can hear the theme song in my head as I type.) I watched the Disney production of Davy Crockett, and had a comic book of the same. I never missed a chance to watch John Wayne die on the walls of the Alamo (also as Davy …

Doctors can’t see the forest from the trees. And it’s cost them.

James C. Salwitz, MD

Physician

April 15, 2016

Doctors have an interesting problem. They have an ingrained professional obsessive-compulsive habit; they fixate on the care of individual patients and on the science of healing. This is an admirable trait; it results in high-quality care. However, when physicians need to change their attention from healer to leader, from medicine to the business of medicine, from health care to the health care system, they falter. Stuck in silos, they fail to …

Real physician voices, twice a week

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