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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 …

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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, …

Please address suffering in the care of the dying

Monica Williams-Murphy, MD

Physician

January 31, 2016

“Oh God!” she groaned, looking upward with tears flooding her cheeks, which were stretched into the shape of agony. Her chest heaved uncontrollably with grief.

“I am so very sorry,” I whispered again while leaning in and stroking her hand.

This is what death notification often looks like and feels like. We doctors should be masters of delivering some of the worst news that could ever be uttered; the worst news that …

Doctors need to learn to say no. Here’s how to do it.

Starla Fitch, MD

Physician

January 30, 2016

If you have a life where you never, ever say yes when you mean no, then you can stop reading right now.

But I guess that you’re a lot like me. Now and then, you get caught off guard.

And before you know it, you’re staying late to see that emergency patient. Bringing cupcakes for the second-grade class. Volunteering for the coffee meet-and-greet at church next Sunday.

What’s up with that? We’re smart. …

When patients question the motives of their physicians

Heather Flynn

Medical Education

January 30, 2016

I was recently scrolling through my Facebook newsfeed when I came upon a long message chain started by one of my friends, an older woman from my hometown in New Jersey. She had seen a discussion given by a drug representative who was promoting administering Gardasil to early adolescents for the prevention of cervical cancer, and my friend wanted to know how other parents felt about allowing their children to …

What smartphone apps can learn from the humble pager

John Torous, MD

Health Technology

January 30, 2016

Despite high interest and hopes, the clinical adoption of new mobile technologies such as smartphone apps and wearables for health care has been modest. While some clinicians and clinics are of course using the newest connected devices and apps, most would report they don’t regularly use mobile health technology yet. But they actually do. The vast majority of clinicians have been using mobile health technology for decades without even realizing …

MKSAP: 59-year-old woman with continued substernal chest pain

mksap

Conditions and Diseases

January 30, 2016

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

A 59-year-old woman is evaluated for continued substernal chest pain. She presented with exertional chest pain 6 months ago that occurred with minimal ambulation. She was evaluated with a stress nuclear medicine myocardial perfusion study that showed no ST-segment changes but a small area of inducible ischemia in the lateral area of the left ventricle …

The shocking confessions of a naturopathic doctor

Britt Marie Hermes, ND

Physician

January 29, 2016

I was a licensed naturopathic doctor in two states. I quit practicing naturopathic medicine after discovering my former boss, also a licensed ND, had been importing and administering an illegal cancer drug. I trusted my boss, as did his patients, because he was well respected in the naturopathic community and his credentials included “FABNO” (Fellow of the American Board of Naturopathic Oncology). This FABNO treated any kind of cancer, even …

Solving homelessness requires finding answers to these 2 questions

Margot Kushel, MD

Conditions and Diseases

January 29, 2016

On any given night in the United States, according to the Department of Housing and Urban Development, over half a million people are without a home. That number may have decreased nationwide in the past few years, but California remains on the forefront of the problem, accounting for 20 percent of the country’s homeless in 2014.

With the winter’s freezing temperatures and El Niño’s massive rainstorms, what to do about the …

Scared about Zika virus? Here are some answers that you need to know.

Wendy Sue Swanson, MD

Conditions and Diseases

January 29, 2016

It’s January 2016. News stories have inspired significant anxiety about Zika virus. It’s a scary topic because news about the outbreaks are just unfolding, and this affects an already anxious group: pregnant mamas and expecting families. I want to share with you real-time information and data to try to alleviate anxiety and educate the best I can.

I suspect with time some of this will change. I’ve curated the most common questions and answers …

Create magic, one patient at a time

Nicholas Cozzi, Alex Ghannam, and Chris Khoury

Physician

January 29, 2016

Every business on earth has an angle on the market. Business leaders around the world work tirelessly, attempting to edge out their competitors by delivering the best service to their customers. When all is said and done, physicians want to deliver the best care they can to each patient. As medical students who are eager to serve, we are committed to examining the space where business and medicine intertwine …

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Create magic, one patient at a time

The potential solution to Zika is hidden in its name

Trisha Kadakia, MD

Conditions and Diseases

January 29, 2016

There is no doubt that Zika is causing worldwide hysteria as a rapidly spreading virus with potential of pandemic proportions. The virus is transmitted by the Aedes aegypti mosquito, which also carries both dengue fever and yellow fever.

While a relatively innocuous virus with 80 percent of those affected being asymptomatic, mild symptoms of illness such as fever, rash, joint pain, and conjunctivitis are associated. The most worrisome outcome of this …

The benefits of trauma-informed care in the NICU

Kara Wahlin, MFT

Conditions and Diseases

January 29, 2016

When my twin sons were born prematurely at 26 weeks’ gestation, my family’s lives were thrust into the whirlwind of the NICU and living daily with the reality of the babies (William and Elliott) being on life support. Having had no prior intense and prolonged experiences with the hospital, and watching helplessly and fretfully as my tiny two-pounders fought for their lives, it’s almost impossible to put into language what …

The imaginary line between doctor and patient is truly precarious

Laura Patel, MD

Physician

January 28, 2016

As I sat in my hospice interdisciplinary group meeting, reviewing the many patients who have died in the past two weeks as well as our new patients, there was a slight break in the discussion. Being ever the multitasker, I clicked on a New York Times article I had been meaning to read and scanned the first two sentences: “When my husband died from cancer last March at age 37, …

Here’s why medical record have opinions

Craig Monsen, MD

Health Technology

January 28, 2016

Software has opinions. No, I’m not talking about opinions on the next presidential election or opinions about flossing before or after brushing. Software has opinions about how data should be displayed, opinions about users’ comfort with the mouse, even, in some cases, opinions about what you should have for dinner (see your local on-demand food ordering service).

We tend to view software as a tool that is either good or bad. …

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Here’s why medical record have opinions