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The single most important lesson for doctors in training

Medical Education

February 4, 2016

I recently saw a patient who, against all odds, survived an aortic dissection. Miraculously, he was alive after the wall of his aorta — the largest and most important vessel in the body — began to rip apart. Aortic dissections are so violent and agonizing that a large portion of these patients don’t survive. Yet somehow, my patient was still able to sit upright in his chair and recount his …

The truth about fevers in infants

Chad Hayes, MD

Conditions and Diseases

February 4, 2016

Fever phobia is common among parents. The vast majority of the time, these fears are unfounded, because a fever is very rarely a cause for significant concern. One important exception is in newborns under 2 months of age. Compared to older children, these very young infants are at high risk for serious infections, so any fever in this age group requires urgent medical evaluation. Here’s what parents needs to know …

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The truth about fevers in infants

Why this doctor won’t close her practice to new patients

Lucy Hornstein, MD

Physician

February 3, 2016

Closing a medical practice to new patients is like cutting off the very top of a tree. It’s the beginning of the end.

The top of the tree, the crown, is where the newest leaves are. It’s also the part that continues growing ever upward, at least until it reaches it’s maximal genetic height, depending on environmental factors like the availability of water and sunlight (both of which also depend on …

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Anything but dignified: The problem with forced fetal remains arrangements

Jennifer Gunter, MD

Conditions and Diseases

February 3, 2016

Ohio is attempting to introduce legislation that would require abortion clinics to incinerate or bury products of conception from abortion. This legislation is already in place in Arkansas and Indiana. These laws are supposed to afford human tissue a “respectful and proper” end as lawmakers were apparently horrified that products of conception were disposed of as medical waste.

Medical waste is not an …

Physicians: Sometimes it’s not what you say, but how you say it

Val Jones, MD

Conditions and Diseases

February 3, 2016

Most physicians will be thrust into the role of patient or caregiver at some point during their careers. Unfortunately, it’s not until this occurs that many become fully aware of the finer points of excellent care and communication. Take, for example, the simple act of reporting test results to a patient. We do this every day, but may not realize that how we frame the information is as important as …

Celebrate National Women Physicians Day #Iamblackwell #NWPD

Hala Sabry, DO, MBA

Physician

February 3, 2016

It’s amazing what you can learn from the stranger sitting next to you on a flight.

As I wait for my neighbor to grab her seat next to me, I secretly hope she embodies the qualities I hope for in a fellow passenger — keeping to herself and not requiring in-flight medical assistance. I make eye contact with a young woman who gives me the nod that she has the middle …

The interview before transferring to a new doctor

Hans Duvefelt, MD

Physician

February 3, 2016

Today I met a man who wanted to interview me before transferring his records.

He was about my age and seemed polite and pleasant enough. He told me his doctor of a dozen years had started to taper him off his long-term narcotics after he reported some of them missing because of theft. He used to take the equivalent of about 1,200 mg of morphine per day for his back pain. …

The remarkable story of a psychiatrically hospitalized clinician

Liat Katz, LCSW-C

Conditions and Diseases

February 2, 2016

I am a licensed clinical social worker. And, occasionally, a mental patient. Today, in this inpatient psychiatric unit, I am more a patient than a social worker.

It is Monday morning, and I am eating breakfast across from Owen, a muscular, flannel-clad, Paul Bunyan-looking patient. Little pieces of his scrambled eggs keep landing on his copper-colored beard. I sort of want to motion with my hand at where the eggs are …

This is the key to shared decision-making with patients

Don S. Dizon, MD

Physician

February 2, 2016

I like to consider myself an “evolved” clinician — one who believes in the patient’s voice, personally invested in shared decision-making, always ready to support my patient’s decisions, as long as I know it’s informed by the best data I have available, even when it is not the course I would want them to make. Most of …

A kind word at bedside can be life-changing for patients

Jeffrey McWilliams, MD

Physician

February 2, 2016

As a goal-oriented individual, I pack my days with appointments, deadlines, and to-do lists. Unfortunately, the time I spend getting from one task to the next gets lost in my focus on end results — a common blindness of Westerners who measure success or achievement by results and not by how one “plays the game.” As parents, we teach our children it’s not whether you win or lose, but how …

Doctors: Feel like a fraud? You’re not alone.

Arlene S. Chung, MD

Physician

February 2, 2016

Imposter syndrome (n.): Term coined in 1970 by psychologists and researchers to informally describe people who are unable to internalize their accomplishments despite external evidence of their competence.

When I was in medical school, I remember walking outside the library and trying not to glance inside to see how many of my classmates appeared to be meticulously studying for final exams. I remember trying to ignore their off-hand, and occasionally self-congratulating, …

You’re a doctor and you’re sick. Make your health a priority.

Joyce Park, MD

Medical Education

February 1, 2016

Last week I, like many around me, came down with a horrible cold. My husband got sick the week before and was in bed all weekend sleeping and trying to recover, and lo and behold, come Monday, I started having the same symptoms.

I knew the approximate course of the cold since I’m a doctor, and I saw my husband go through it, but I thought I could be strong and push through. I continued …

Don’t rely on Google for medical judgment

Michael Kirsch, MD

Physician

February 1, 2016

You see your gastroenterologist with long-standing stomach pain. You have undergone a reasonable evaluation and all the endoscopic bodily invasions, and imaging studies of your abdomen have been normal. Repeated lab work provides no clue explaining your distress. You have been twice to the emergency room and were sent home with prescriptions that didn’t work. You are frustrated and so is your gastro guy. You are convinced that there is …

The critical medical and moral stakes for all patients in pain

Jay Baruch, MD

Conditions and Diseases

February 1, 2016

We, as a society, can’t ignore these numbers: over 47,000 human lives lost prematurely in one year from drug overdoses, a 7 percent spike over the previous year, with opioid painkillers and heroin driving much of this tragic surge. If this trend isn’t disturbing enough, four out of five new heroin abusers began their habit by abusing painkillers.

These numbers have faces. Caring for patients who abuse and …

We need to demand technology that lets doctors be doctors

Zubin Damania, MD

Health Technology

February 1, 2016

A long time ago in a galaxy far, far away … what an uncannily accurate description of how it feels to practice in our very own “modern” health care system. In a world brimming over with exponential tech advances — supercomputer smartphones with user interfaces an embryo could master, an open Internet backbone that connects us across continents and cultures — our health care universe languishes with software that’s …

Customer service in health care: Does AIDET really work?

Janice Boughton, MD

Physician

February 1, 2016

Mnemonics can be incredibly cool. When I was in medical school, there was just too much stuff to remember and memory aids were so very helpful. Most specifically I refer to the vile and inappropriate one that helped me remember the cranial nerves which I remember to this day and will not share in print.

In ancient times orators used memory palaces to memorize long speeches or poems, associating words with …

Stop MOC: An open letter to the American Board of Pediatrics

Meg Edison, MD

Physician

January 31, 2016

Dear American Board of Pediatrics:

On December 17 2015, at 3:01 in the middle of my busy day seeing patients, I voluntarily gave up my American Board of Pediatrics certification. I thought I should write this letter, hopefully preempting any more threatening emails warning me that I must pay up or lose my certification. This was not mere oversight on my part. This was purposeful.

The reason I am no longer ABP …

Watch out and be informed: There is dishonesty in every profession

Suneel Dhand, MD

Physician

January 31, 2016

Within the last several weeks, I’ve had two plumbing issues that have caused me to reflect on the honorability of various professions and the way in which people go about earning an honest day’s crust.

Let me take you back to the beginning of the story. I was actually working nights a couple of months ago when I noticed, just before I was about to leave for the hospital, that my …

The evolution of the medical second opinion

Abbie Leibowitz, MD

Physician

January 31, 2016

Requesting a second opinion can be a touchy subject for a patient. I’d like to think that when I was in practice, I was never offended when a patient’s family requested a second opinion, but that probably doesn’t universally reflect my response in every circumstance. But I am confident in saying that as often as not, I would be the one suggesting that we get another pair of eyes to …

Championing your specialty through awareness weeks

Kenneth Elmassian, DO

Physician

January 31, 2016

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

Fire Prevention Week. National Volunteer Week. Save Your Vision Week. The list goes on! These observances or “awareness weeks” aim to advocate important messages both locally and nationally to the media and public. You may wonder about the effectiveness of an overload of awareness weeks, …

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