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Spare your loved ones from this dreaded scenario

Physician

March 7, 2016

What if you woke up tomorrow and learned that your grandmother had been kidnapped overnight by a couple of strangers, thrown in a white van, and taken to a distant warehouse where she spent the subsequent forty-five minutes being tortured before finally succumbing to her death?

Where she was repeatedly beaten in the chest, where a tube was shoved down her throat, where she was tasered with high voltage, where a …

Why we need to build bridges between primary care and anesthesiology

Karen S. Sibert, MD

Physician

March 7, 2016

The numbers haven’t changed significantly in several years — only five percent of the U.S. population consumes a full 50 percent of annual health care spending, and just one percent is responsible for nearly 23 percent of spending.

Within the top 10 percent of high spenders, most (nearly 80 percent) are age 45 or older. About 42 percent are persistent high consumers year after year, while the majority requires high spending …

Society must decide what it wants from health insurance

Mark Lopatin, MD

Physician

March 7, 2016

Jeffrey Lurie is the owner of my beloved Philadelphia Eagles. He pays the players. He picks the coaches. But I think we would agree that his checkbook should not allow him to be the one who calls the offensive plays. The coach should do that.

So why is it different in health care?

I have a patient who was diagnosed with polymyositis. Polymyositis is an autoimmune disease that causes inflammation of muscles …

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It’s time for an honest conversation about pain management

Holly Clowers, MD

Medications

March 7, 2016

Psoriatic arthritis can be a debilitating condition. It can lead to painful complications such as neuropathy. Its treatments can lead to complications such as shingles, which can leave a patient with continuing pain. Ehlers-Danlos Syndrome is for most patients a painful condition that leads to spontaneous dislocations, early arthritis, and frequent migraines. My husband and I have decades of experience between us in living with these conditions.

My husband and I …

Why Sir William Osler is the cure to online cynicism

Janice Mancuso

Physician

March 6, 2016

Comments have again morphed into an essay. And, once again, they’re in response to a blog post by Dr. Suneel Dhand: When it comes to positive change, physicians are their own worst enemy. I thought it was excellent and spot-on. My first comment read in part:

When reading this post — before I read the comments — I found myself silently nodding … maybe because I agree with much …

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Why Sir William Osler is the cure to online cynicism

A family caught in a vortex of questionable medical care

Elizabeth Kemp Baker and Sujana S. Chandrasekhar, MD

Patient

March 6, 2016

I am an ENT surgeon, a friend of the author, the patient, and their daughter, whose intervention saved his life. This is a smart, loving family caught in a terrible vortex of terrible medical care until they pulled themselves out, and a story that physicians must read, as we struggle to reinstate humanity and humility into our noble profession. Here is Paul’s tale, as told by his wife.

***

On a mid-December …

These are the 4 words every child needs to hear

Vanita Braver, MD

Physician

March 6, 2016

As a child and adolescent psychiatrist, I have the privilege of working with many children who are victims of severe abuse, neglect, and trauma. Some, in turn, become perpetrators of violence. One adolescent, let’s call him Steven, told me that he wants to be an electrician, but he is struggling to earn his high school diploma, which he needs in order to enroll in technical school. When I inquired about …

An ounce of influenza vaccine is worth at least a few tons of Tamiflu

Keith Pochick, MD

Conditions and Diseases

March 6, 2016

It’s still flu season, although the flu gods have shown a bit more mercy than in years past. So many variables determine whether each winter brings a relatively mild flu season, a “flunami,” or something in between. I’m a country boy doing primary care in the city, and I have only a modest understanding of which influenza strain is circulating, the concepts of antigenic drift and shift, and how the …

HIPAA doesn’t apply to rich hospital donors

Edwin Leap, MD

Physician

March 5, 2016

I’ve written a lot lately about caring for our patients, and about caring for our spouses, and those things make me very happy. But now and then, things rub me the wrong way.

I was recently working at TMH, or Tiny Memorial Hospital, my vague name for small facilities since I work at several and wish to preserve their anonymity. While there a patient checked into the ED for a fairly unremarkable …

A resident’s guide to being a medical student

M. Alexandra Friedman, MD

Medical Education

March 5, 2016

Though I am two years into my residency, I still experience flashbacks to my time as a medical student on the wards. The adrenaline of arriving at the hospital 2 hours before rounds, scrambling to see my patients, constructing a note that no one would ever look at, and preparing a hastily-constructed presentation to deliver in a half-performance, half-examination outside of our patient’s room.

I remember being the object of a …

10 truths of physician parents

Nisha Mehta, MD

Physician

March 5, 2016

1. You either over or under-react to everything related to your child’s health. Your kid chokes? You perform the Heimlich and are back to dinner conversation 2 minutes later. Your infant spits up a little more than usual after their introduction to rice cereal? You decide they may have FPIES and stay up all night worried they may require tube feeds. True story.

2. You can’t go to …

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10 truths of physician parents

MKSAP: 53-year-old woman with a skin lesion

mksap

Conditions and Diseases

March 5, 2016

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

A 53-year-old woman is evaluated for a slowly enlarging, telangiectatic, pearly, ulcerated 1-cm plaque on the left temple. It bleeds periodically when traumatized. Medical history is significant for atrial fibrillation. She takes warfarin daily. She is otherwise in good health.

On physical examination, vital signs are normal. Cardiac examination shows an irregular heart rate but is …

Medical mistakes happen. It’s what doesn’t follow that is unforgivable.

Lisa Goodman-Helfand

Patient

March 4, 2016

38 states currently have an apology act. This means that if doctors feel they owe a patient an apology, they may provide one without any ramifications, if future legal actions are taken by the patient/patient’s family.

In 2006, I spent 218 days in the hospital after the healthy birth of my daughter. My chronic autoimmune disease, scleroderma, masked certain signs of preeclampsia, which went undiagnosed. This led to a massive infection …

Physicians must admit and recognize their biases

Neha Sharma, DO

Physician

March 4, 2016

My name is Dr. Neha Sharma, and I have a confession.

Recently, a patient was transferred to me from New Mexico. He was found in his house, unresponsive. By the time I admitted him, he was connected to a breathing machine, and had a serious lung infection. Over a course of a few days, his condition improved. We were able to remove his breathing tube and successfully treat his infection. However, …

We are human beings before we are doctors

Dr. Eunice J. Minford

Physician

March 4, 2016

Mental illness has long been associated with shame and stigma. Although progress has been made through the efforts of global celebrities like Stephen Fry and many others to de-stigmatize mental illness — many are still ashamed to admit to it, and the stigma is far from being annihilated.

Nowhere is this stigma more entrenched than within the medical profession itself. A fact that should shock us out of our judgmental slumbers …

Why you should care about the Syrian refugee health crisis

Tanu S. Pandey, MD

Physician

March 4, 2016

“We are witnessing a paradigm change, an unchecked slide into an era in which the scale of global forced displacement as well as the response required is now clearly dwarfing anything seen before.”
– Antonio Guterres, United Nations High Commissioner for Refugees

The global political upheaval caused by the Syrian refugee crisis could potentially mask a critical issue that has all the signs of a catastrophic public health disaster — the health of …

A surprising amount of thought goes into the radiology report

Dr. Saurabh Jha

Physician

March 3, 2016

“‘Normal’ is one of the most powerful words a radiologist can use.”
– Curtis P. Langlotz, professor of radiology, Stanford University

After I used “clinically correlate” thrice in a row in my report, the attending radiologist asked, “How would you feel if the referring clinician said on the requisition for the study ‘correlate with images’? When you ask them to clinically correlate, you’re reminding them to do their job.”

I had been a …

A star medical student feels like he made a terrible decision

Anonymous

Medical Education

March 3, 2016

It is February of our last few months of clinical rotations. I am a rising fourth-year medical student at a well-known East Coast institution with a not-so-bad track record, I guess you could say. I scored in the top percentile for the USMLE Step 1, honored my third-year rotations, and have comments from attendings about how I am destined to succeed in this career. One might think that at this point …

Working in the ICU, I now know what hell feels like

Edwin Acevedo, Jr., MD

Physician

March 3, 2016

I walk up to the ICU. Ecstatic.

I just placed a subclavian line, a chest tube, and performed a bronchoscopy on my patient. Intern year is going well, and today is a great day.

For me.

I have been learning so much, been trusted to do even more, and been a part of gratifying experiences. Successes. Life-changing procedures. Things that still make me sit in awe that we can transform the human body, …

A doctor who forgot the basics they teach you in medical school

Cory Michael, MD

Physician

March 3, 2016

I was spending time with friends and family over the holiday when I started to experience various vague symptoms without an obvious etiology. Having been treated for high blood pressure about ten years prior before successfully overcoming the issue with exercise, I immediately recognized the return of the condition. (As an aside, it should be stated that elevated blood pressure typically produces no symptoms at all.)

Stopping by my local pharmacy, …

Real physician voices, twice a week

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