Conditions and Diseases

Physicians writing on KevinMD about the diseases they treat and the people who have them: cancer and its screening arguments, pain and the drugs that treat it, diabetes and the obesity argument, mental illness and who gets treated for it, and the decisions at the end of a life. Five maintained records draw on this archive: Cancer: what physicians say, in their own words, Opioids: what physicians and pain patients say, in their own words, End of life: what physicians say, in their own words, Diabetes and obesity: what physicians say, in their own words, and Mental health: what psychiatrists and physicians say, in their own words.

There are not enough nurses to care for the coronavirus pandemic

Susan Shannon, RN

March 15, 2020

It’s a cliché but the horse is out of the barn. There is no doubt that coronavirus is widespread in the United States and the situation is getting worse. No one — not the government, not hospitals — are addressing the elephant in the room. There are not enough nurses to care for a worsening coronavirus outbreak in the U.S.

With decreased reimbursement, hospitals run a tight ship. Hospitals don’t even …

There has never been a greater need for telemedicine than now

Patricia Pechter, MD

Conditions and Diseases

March 15, 2020

I left the U.S. just in time. During my vacation in Australia, I was relieved I would dodge some of the angst and uncertainty in the midst of the COVID-19 epidemic. As it turns out, even this getaway on the opposite side of the world was no escape. Within the span of a day, the markets dropped 10 percent, the remainder of the NBA season was canceled, and the …

Love for doctors in the COVID-19 coronavirus era

Alpa Patel Shah, DO

Conditions and Diseases

March 15, 2020

All across the world, physicians have answered an internal call to action in response to COVID-19 coronavirus. Early on, there was an online mobilization. Existing closed physician Facebook groups were beginning to share information regarding the novel coronavirus when it had not yet spread to the states.

At the time, because physicians are human scientists and not fortune tellers, there was a lot of self-questioning. “Am …

How coronavirus will tax already overcrowded U.S. emergency departments

Joe Twanmoh, MD

Conditions and Diseases

March 15, 2020

The novel coronavirus (COVID-19) is already having far-reaching effects on our nation. The stock market has taken a historic plunge from its all-time high. Major entertainment and sporting events have been canceled. I recently took a cross-country flight from Maryland to Oregon have not seen this many empty seats on a plane in a very long time.

While other public venues may be empty, emergency departments will likely get very busy. …

Please listen to the COVID-19 coronavirus experts. Help us save lives.

Sara Shelton Kerley, MD

Conditions and Diseases

March 15, 2020

Sigh. I don’t know how to say this without coming across as a complete a-hole, but when epidemiologists, the majority of physicians, public health experts, etc. are all recommending major social distancing measures in order to prevent the COVID-19 outbreak in the U.S. from looking like that in Italy or Iran, you may want to listen and take heed.

We are not a group generally known to be alarmists. We routinely …

COVID-19 is exposing our broken health care system. Young physicians will help.

Anonymous

Conditions and Diseases

March 14, 2020

News trends come, and news trends go. The coronavirus disease (COVID-19) pandemic is a news topic that, for the time being, is here to stay. This pandemic has already revealed deeper issues within the culture of medicine here in the United States and focused young physicians on what really matters.

As this pandemic progresses, a debate will undoubtedly emerge in our system as to whether or not doctors may avoid treating …

A COVID-19 coronavirus update from concerned physicians

Howard J. Luks, MD, Joel Topf, MD, Ethan J. Weiss, MD, Carrie Diulus, MD, Nancy Yen Shipley, MD, and Dr. Eric Levi

Conditions and Diseases

March 14, 2020

“Everything we do before a pandemic will seem alarmist. Everything we do after will seem inadequate.”
– Michael Leavitt

Why are we writing this?

The COVID-19 pandemic has reached a point where containment is no longer possible. The COVID-19 threat is real, and rapidly getting worse. Many of you are very nervous; some are unsure of the validity of the information you are reading. As physician leaders, we felt it was important to …

Will the coronavirus make primary care physicians cool again?

Mario Amaro, MD

Conditions and Diseases

March 14, 2020

Two topics that have been flooding everyone’s timeline and twitter feed over the past few weeks: COVID-19 and remote work–or for our health care folks, virtual care. I won’t touch too much on COVID-19. There are tons of experts doing amazing work to help spread accurate public information, and I thank you all for everything that you’re doing.

As someone who has spent the majority of their health care …

MKSAP: 26-year-old man with back pain

mksap

Conditions and Diseases

March 14, 2020

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

A 26-year-old man is evaluated during a follow-up visit after presenting to an urgent care clinic for back pain 1 week ago. Laboratory studies at that time were significant for a serum creatinine level of 1.4 mg/dL (123.8 µmol/L); other laboratory studies, including urinalysis, were normal. A …

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MKSAP: 26-year-old man with back pain

The coronavirus cost that no one can count

Chiduzie Madubata, MD

Conditions and Diseases

March 14, 2020

On December 31, 2019, the world changed as we knew it, but the future implications for the United States were not apparent at the time. On that day, the World Health Organization (WHO) China Country Office was informed of new cases of “pneumonia of unknown etiology” originating from Wuhan City, Hubei Province of China. The cause of pneumonia was eventually identified as COVID-19, a new type …

COVID-19: Test medical students, accelerate the Match, and let us graduate early to join the fight

Lee Hiromoto, JD

Conditions and Diseases

March 13, 2020

As the novel coronavirus (COVID-19) makes its way across the country and globe, I have been thinking about how we fourth-year medical students fit into the picture. Not quite out one door, yet not quite in the other, our liminal perspective is liable to be overwhelmed by the many other considerations that predominate the public discourse. To that end, I offer three humble proposals relating to the fourth-year student experience: …

A plea from an emergency physician on the front lines

Vanessa Beckett, MD

Conditions and Diseases

March 13, 2020

Our lives are quickly changing. Schools are closing. Sports are being canceled. People are working from home. Disneyland is closing. Toilet paper is in short supply.

We are about to hit a real struggle with our health care system. We are about to hit a real struggle with our economy.

Let this be a time where we come together and support each other.

Please use health care responsibly.

If you have a fever or …

Prevent the spread of COVID-19 with telemedicine

Solmaz Amirnazmi, MD

Conditions and Diseases

March 13, 2020

I am a board-certified internal medicine physician practicing in a small outpatient clinic with a highly reputable academic organization in the greater Boston area. Regarding COVID-19, I am not panicked, but I am concerned– concerned for our patients, concerned for our workforce and health care providers, concerned for our parents and loved ones.

The situation in Massachusetts and across the country is evolving rapidly in response to COVID-19. In the past …

An ER physician’s advice to the general public: How to flatten the curve

Mercy Hylton, MD

Conditions and Diseases

March 13, 2020

Some advice as an emergency physician, daughter, mother, and concerned citizen.

Help keep older relatives and neighbors self-quarantined at home. Same goes for those of any age who are immune-compromised (cancer-patients, on immune-suppressant meds for autoimmune diseases, etc.) Pick up and deliver their groceries and prescriptions to their front-door for them.

Health care workers (physicians, nurses, respiratory therapists, social workers, pharmacists, environmental services, EMS, etc.), law enforcement, and other public agency workers …

COVID-19 coronavirus needs apolitical truth-telling

Jeffrey Hall Dobken, MD, MPH

Conditions and Diseases

March 13, 2020

She is 11, a fifth-grader, as prepubescent as nature allows, and utterly terrified.

She hasn’t eaten normally for nearly a month, her mother reports. She sleeps poorly, reports nightmares, and cleans her hands so obsessively that she is literally bleeding raw.

Her fifth-grade peer group typically does not guard its language nor govern its remarks, so every utterance is attention-demanding, black-and-white, dripping with drama. And she hears the constant drumbeat reporting of …

The accuracy of COVID-19 tests

Richard L. Hutchison, MD

Conditions and Diseases

March 12, 2020

The current COVID-19 epidemic has highlighted the availability and the results of medical diagnostic tests. As a physician, I treat the results of lab tests like I treat movie recommendations from a friend – I am always skeptical. For the movies, I need to consider my friend’s suggestion in the context of their mood, tastes, current life crises, and track record. A context also needs to be created for ordering and interpreting test …

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The accuracy of COVID-19 tests

We can’t deny death, even if it’s a colleague

Patricia M. Fogelman, DNP

Conditions and Diseases

March 12, 2020

Does care fall short or go higher when the patient is one of our own?

It depends on who you ask: We, the medical team, believe we try hard for everyone, but go the extra mile when it’s one of our own. Perhaps to family/outsiders, we’re not doing enough.

A recent case illustrates this phenomenon: a gifted physician colleague, a new diagnosis of advanced cancer. Needs control as part of a coping …

A previously healthy clinician, now critically ill with COVID-19

Kristina Fiore

Conditions and Diseases

March 12, 2020

A New Jersey physician assistant who was the state’s first COVID-19 patient is speaking out from his hospital bed, calling his illness “severe” and raising concerns about his treatment.

James Cai, a 32-year-old non-smoker with no other health conditions, has been at Hackensack University Medical Center for about a week and says his illness has worsened significantly over that time.

“In the …

I’m an infectious disease doctor and I’m in quarantine

Aabha Jain, MD

Conditions and Diseases

March 12, 2020

Last week, I saw a patient who may have contracted COVID-19. The patient had come into the emergency department overnight due to respiratory distress and overseas travel history. While his clinical picture and history were cause for concern, due to limited testing reserved for “highly suspicious” cases, the initial decision was to hold on testing for COVID-19, and the patient was removed from isolation precautions. Several hours later, I was …

COVID-19: Don’t listen to the political spin of either side

Vincent DeGennaro, Jr., MD, MPH

Conditions and Diseases

March 11, 2020

The U.S. response to coronavirus reminds me of recent disasters when official facts were at odds with the reality I encountered.

Governments have a long history of lying to their people about the risks of illness, either as a way to minimize political damage or to drum up hatred for “the other.” China was accused of covering up the true breadth of the SARS epidemic in 2003, …

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