KevinMD.com

April 23, 2016Apr 23, 2016

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 55-year-old man is evaluated following a screening for type 2 diabetes mellitus. He is asymptomatic. He has a history of hypertension and hyperlipidemia.…

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

A 55-year-old man is evaluated following a screening for type 2 diabetes mellitus. He is asymptomatic. He has a history of hypertension and hyperlipidemia. There is no history of anemia, liver disease, or kidney disease. Medications are lisinopril and rosuvastatin.

On physical examination, blood pressure is 123/76 mm Hg and pulse rate is 72/min. …

Conditions and Diseases

Drug addiction is a learning disorder

Randi Hutter Epstein, MD, MPH

April 22, 2016Apr 22, 2016

When I think back about what I learned about drug addiction in medical school in the 1980s, I can’t think of much. Sure, I talked to plenty of patients who had been snorting coke and injecting heroine. One man with…

When I think back about what I learned about drug addiction in medical school in the 1980s, I can’t think of much.

Sure, I talked to plenty of patients who had been snorting coke and injecting heroine. One man with AIDS promised to teach me how to draw blood, if I’d sit by his side and keep him company. He didn’t have any other visitors. Maximum security prison where he was …

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Drug addiction is a learning disorder

Physician

How a physician suicide 30 years ago affected this doctor today

Niran S. Al-Agba, MD

April 22, 2016Apr 22, 2016

Physicians have one of the highest rates of suicide of any profession: nearly twice the rate of the general population. 400 physicians commit suicide each year in the United States. The stress of being a doctor is constant and unrelenting. The majority of us are perfectionists with a strong work ethic: your classic Type A personality. Maybe we set ourselves up for failure and then cannot accept when it inevitably …

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Medical Education

An objective national standard for clinical skills is critical. Here’s why.

Kenneth Simons, MD

April 22, 2016Apr 22, 2016

How do you learn to be a good doctor? Sure, you study anatomy, and make flashcards, and memorize nerve pathways, but what makes someone a good doctor is the way they apply all that knowledge to real patients with compassion and diagnostic expertise. Strong “doctoring” skills, like listening carefully, taking a comprehensive history, explaining medication and treatment options clearly and patiently, and writing notes that colleagues can understand, are what …

Medical Education

Stop telling younger generations not to become doctors

Darin Williams, MD

April 22, 2016Apr 22, 2016

His eyes were as wide open as his mouth as he slowly placed his beer on the bar without looking away from me. Making no effort to wipe the thick foam from his upper lip, the man continued to stare…

His eyes were as wide open as his mouth as he slowly placed his beer on the bar without looking away from me. Making no effort to wipe the thick foam from his upper lip, the man continued to stare in disbelief, “That’s the coolest thing I’ve ever heard.”

The thirty-something C-something-O was blown away by what I did for work. By this time a small crowd had gathered, standing in …

Conditions and Diseases

Should cardiologists evaluate their obsession with LDLs and HDLs?

Robert Centor, MD

April 21, 2016Apr 21, 2016

This post is purposely controversial. I write it because I believe that mounting evidence suggests that we should encourage “out of the box” thinking about this issue. This post is hypothesis challenging. I may be right, or I may be…

The latest blow to the cholesterol hypothesis: “Dashing Hopes, Study Shows a Cholesterol Drug Had No Effect on Heart …

Physician

A death that feels good to a surgeon’s soul

Jamie Coleman, MD

April 21, 2016Apr 21, 2016

He had loved her with all his being for more than six decades. In the last two years of their 61-year marriage, he had watched helplessly as dementia wrapped its noose around her, slowly tightening its grip on her mind…

When I met him, I knew the injury was irrecoverable. Her brain was consumed by hemorrhage that had filled the space (cerebral atrophy) left behind by progressive dementia …

Conditions and Diseases

Is the government’s National Pain Strategy doomed to fail?

Kenneth Lin, MD

April 21, 2016Apr 21, 2016

Over the past few months, the federal government has mobilized against what is being called "the opioid crisis": a national epidemic of fatal overdoses that in 2014 claimed more than 14,000 lives, the most ever recorded. Since most of these…

Over the past few months, the federal government has mobilized against what is being called “the opioid crisis“: a national epidemic of fatal overdoses that in 2014 claimed more than 14,000 lives, the most ever recorded. Since most of these opioids were originally prescribed by physicians to treat pain, the Centers for Disease Control and Prevention recently finalized a guideline containing recommendations …

Health Technology

If meaningful use is a great idea, why isn’t it employed more widely?

Richard Gunderman, MD, PhD

April 20, 2016Apr 20, 2016

A decade ago, electronic health records were aggressively promoted for a number of reasons. Proponents claimed that they would facilitate the sharing of health information, reduce error rates in health care, increase health care efficiency, and lower costs. Enthusiasts included the technology companies, consultants, and IT specialists who stood to reap substantial financial rewards from a system-wide switch to electronic records.

Even some health professionals shared in the enthusiasm. Compared to the …

Physician

Meals for new parents is food for the soul

Katie Lockwood, MD

April 20, 2016Apr 20, 2016

When I had my first baby, one of my friends coordinated a meal train where coworkers could sign up to bring our new family a dinner every other night. Those first few weeks of motherhood were such a chaotic blur that I do not even remember how many weeks this meal delivery went on for except to say that it was both long enough and over too quickly. There was …

Physician Finance

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

Physician on FIRE, MD

April 20, 2016Apr 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…

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, …

Health Technology

Technology in health care: Is medicine really evolving?

Dr. Eunice J. Minford

April 20, 2016Apr 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 …

Conditions and Diseases

What does a perfect world for postpartum moms look like?

Jennifer Lincoln, MD

April 19, 2016Apr 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).…

“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 …

Physician

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

Free N. Hess, MD

April 19, 2016Apr 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…

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 …

Physician

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

James Wu, MD

April 19, 2016Apr 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 …

Physician

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

Thomas Paine, MD

April 19, 2016Apr 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, …

Medications

God is in the statins

Dr. Saurabh Jha

April 18, 2016Apr 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…

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

Social Media in Medicine

A warning against crowdsourcing your medical care on social media

Emily McCullar, MD

April 18, 2016Apr 18, 2016

Whether big questions or small, medically related or otherwise, social media users love to take their ponderings and perplexities to their friends to gather advice. Certainly, social media is a great place to poll opinions about the latest movie or…

Sure, some might find asking friends for medical advice online easier than going to the doctor. Some might even feel that this collective problem solving protects them if they believe …

Conditions and Diseases

Identifying a rare disease: Why proper communication is key

Richard Robinson, MD

April 18, 2016Apr 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 …

Physician

What is food waste and how can we fix it?

Manoj Jain, MD, MPH

April 18, 2016Apr 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 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 …

Real physician voices, twice a week

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