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4 questions every woman should ask about heart disease

Conditions and Diseases

February 25, 2016

February is American Heart Month, and the Go Red For Women campaign reminds us to bring awareness to cardiovascular disease in women all month long. Today in the U.S., nearly 44 million women are living with heart disease. Even though heart disease is quite prevalent in women, only 1 in 5 women are aware that they are at risk for developing a cardiovascular problem in their lifetime.

Cardiovascular disease is the #1 …

Why are mental health questions still allowed on physician job applications?

Pamela Wible, MD

Physician

February 24, 2016

DearPamela

Dear Pamela,

Question for you in regards to disclosure about mental illness. In every job that I have applied for, as part of the credentialing process, there are questions about felonies, treatment for drug/alcohol abuse and mental illness. Why are mental health questions still allowed to be on there? I have had postpartum anxiety/depression three times now, and I feel like it is …

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Why are mental health questions still allowed on physician job applications?

An oncologist reflects on his inpatient internal medicine service

Nathan A. Pennell, MD, PhD

Physician

February 24, 2016

I recently finished 2 weeks of inpatient hospital service, and the sense of relief was so palpable it felt like taking a breath after swimming the length of a pool underwater. At first, there is anxiety and a sense of excitement at the challenge, but soon you feel strong and assured that you’ve got this under control. The house …

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Helpful tips for your first day at a new hospital

Elizabeth Lumpkin, MD

Physician

February 24, 2016

An excerpt from Road Warrior Physician: Locum Tenens a How-to Guide.

There are few things that are more frustrating than to be delayed while en route to your assignment. It happens, so be prepared for it. Keep all travel emergency contact numbers handy. This is one of my prime Evernote uses. Note any additional flights in and around yours in case of delay or cancelation. Have the main …

Am I a health care business metric or a physician?

Craig Bowron, MD

Health Policy

February 24, 2016

The title of Noam Scheiber’s January 9, 2016 New York Times piece on hospitalists, “Doctors Unionize to Resist the Medical Machine,” skirts the bigger issue for doctors, which has less to do with contracts, salaries and labor relations, and much more to do with the question, “Is health care just another business, and if so, can physicians be managed that way?”

I’m a silverback hospitalist, and when I started …

Justice Scalia: Why didn’t they perform an autopsy?

John Biemer, MD

Conditions and Diseases

February 23, 2016

With the Supreme Court in the balance, every aspect of the unexpected demise of U.S. Supreme Court Justice Antonin Scalia has received intense scrutiny, from the cause of his recent death to the politically charged choice of his successor. An autopsy was not performed on the 79-year-old jurist, who was found dead in his room in a West Texas hunting resort, and that too has become a lightning rod for …

Should you have a precolonoscopy visit? The answers may surprise you.

Frederick Gandolfo, MD

Conditions and Diseases

February 23, 2016

Your primary care doctor has been nagging you for years. Your wife and brother seem to be in on the scheme too. Every once and a while one of your coworkers even says (with a chuckle) “C’mon Bob, you’re fifty-seven, you really need to get it done!”

“OK, enough,” you finally say, “I’ll go for a colonoscopy!” So at your next visit you ask your primary doctor how to set it …

10 simple facts about Zika virus

Tanu S. Pandey, MD

Conditions and Diseases

February 23, 2016

1. Zika is an infectious disease caused by a virus and transmitted by mosquitoes. It is one of four worrisome viral infections that have spread rapidly across the world recently including dengue, chikungunya, and West Nile virus, all of which are transmitted by mosquitoes or ticks. The most dangerous mosquito type is the one that spreads yellow fever (Aedes).

2. Though Zika is mostly spread by mosquito bites, there is emerging …

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10 simple facts about Zika virus

Why daughters need their fathers

Meg Meeker, MD

Physician

February 23, 2016

Men, we need you.

We — mothers, daughters, and sisters — need your help in raising healthy young women. We need every ounce of masculine courage and wit you own because a father, more than anyone else, sets the course for a daughter’s life.

After more than 20 years of listening to daughters — and doling out antibiotics, antidepressants, and stimulants to girls who have gone without a father’s love — I …

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Why daughters need their fathers

The challenges this doctor faces when caring for the homeless

Vincent DeGennaro, Jr., MD, MPH

Physician

February 23, 2016

“Fifty-three-year-old homeless woman with diabetic ketoacidosis and severe emphysema exacerbation.” And suffering from adomicilia, too, I added in my head.

Much like apraxia means the inability to perform purposeful movements (praxis), adomicilia jokingly means those who are not domiciled, a pretentious attempt at gallows humor in the medical profession.

I read through the patient’s electronic record imagining a withered woman, wrinkled from years of drinking and smoking, perhaps with signs of schizophrenia. Most …

Tips to rank your match list. Here’s how this medical student did it.

Jennifer Adaeze Anyaegbunam

Medical Education

February 22, 2016

As an early third year medical student, I had a few attending physicians tell me that MD stands for “make decisions.” I find myself subject to these sorts of pep talks when I answer their clinical questions with a response influenced by a high pitched vocal inflection that suggests that I’m uncertain.

For example, while being pimped on the next step in managing a patient, I might have responded with a …

These are the technologies that can help achieve the cancer moonshot

Bertalan Mesko, MD, PhD

Health Technology

February 22, 2016

In his State of the Union address in 2016, President Obama pledged a new national effort to find a cure for cancer. This is the cancer “moonshot.” Last year, he announced the launch of the Precision Medicine Initiative — a bold new research effort to revolutionize how we improve health and treat disease. These two strategies together hold the promise of curing cancer or, at least, transforming it …

It’s time to free doctors from their boxes

Rhea Boyd, MD

Health Policy

February 22, 2016

The American health care system is set up to care for a certain subset of the population — sick people — people with chronic disease, acute illness, acute injury, and complex disorders like cancer or metabolic issues.

The problem is, this set up doesn’t create market incentives to care for the well effectively, or to identify those at risk for disease and efficiently and reliably intervene, at scale.

To reconcile this cognitive dissonance …

Insider tips for drug reps to get more face time with clinicians

Paul B. Kubin, PA-C

Medications

February 22, 2016

Dear drug reps,

I write you today as a primary care provider who — at the risk of giving you “the keys to the kingdom” — has advice for you.

First, I am not anti-pharma. I recognize the need that my patients and I have for new medications, and I believe that innovation in medicine can grow from free enterprise. But it’s rare that I walk away from an interaction with you …

A Generation X physician embraces the millennial doctor perspective

Sherwin Gallardo, MD

Physician

February 21, 2016

I have been practicing family medicine as part of a large urban managed-care organization for about 15 years now. As part of my practice, I teach medical students and residents. And as a card-carrying member of Generation X, I often find myself right in the middle of the ebb and flow of the work-life balance and physician wellness discussion between my older Baby Boomer “workaholic” and “pay-your-dues” vocation-driven colleagues, and …

A physician aces his USMLE and ABIM board exams. Here are his tips for success.

Farokh Jamalyaria, MD

Medical Education

February 21, 2016

In this article, I’ll discuss a medicine-specific strategy that many of my physician colleagues and I have used over the years to learn dense, complicated information quickly and effectively, and to do well on board exams.

These are the two most important tenets of studying for a medical board examination:

1. Find the highest-yield information and memorize it cold. With active methods such as mnemonics, teaching others, lecturing “to the wall,” writing notes …

The questionable competency of today’s medical and surgical residents

Gary B. Nackman, MD

Medical Education

February 21, 2016

What does it mean to be competent at something? Competency may be defined as the ability to do something successfully or efficiently. When it comes to determining if a physician is competent in his profession, no one, board, no organization, no government, no residency training program or hospital actually will state that an individual is competent. There are significant legal ramifications to declaring someone as competent to practice medicine, and …

Trust is the foundation of quality patient care at the end of life

Brian J. Carlisle, MD

Physician

February 21, 2016

“It’s those pain medicines you are giving her. She’s very sensitive to them. I think that’s why she’s confused — she is doped up.”

Two months after receiving her diagnosis Mrs. M signed up for hospice. At our first visit, she was suffering and visibly uncomfortable. Her skin appeared excoriated from weeks of scratching. She was confused, restless, and racked by pain.

Mrs. M had metastatic liver cancer resulting from underlying cirrhosis. …

The decline and fall of medical writing

Richard Gunderman, MD, PhD and James Lynch, MD

Medical Education

February 20, 2016

George Orwell said, “If people cannot write well, they cannot think well, and if they cannot think well, others will do their thinking for them.” If Orwell was right, the profession of medicine and the patients it cares for could be in big trouble. As a result of ongoing changes in healthcare, today’s medical students and residents are being asked to write much less than in the past, with a …

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The decline and fall of medical writing

The psychiatric secrets that harm physicians

Melanie Watkins, MD

Physician

February 20, 2016

I know your secrets. I keep secrets for a living.

I know about the eye opener before your shift; the Adderall prescribed for your son that you take in the morning; the Xanax a colleague gave you for upcoming air travel that that you take at night; the near DUI that you got out of by showing your hospital badge, the letters “Dr.” prominent on the left side; your wife who …

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