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The truth about antidepressants and autism

Conditions and Diseases

January 3, 2016

Recently, another study was published showing that SSRI antidepressant use during pregnancy is associated with increased rates of autism in the children. By my count, this is now the tenth study on this topic — all of which found links between SSRI antidepressant use in pregnancy and autism in the offspring. Most of these studies were recently reviewed, and also concluded that SSRI antidepressant use during pregnancy is associated …

How partnering with urgent care created a dream primary care job

Rebekah Bernard, MD

Physician

January 3, 2016

I have a dream job.

I make my own hours, working three 12-hour shifts on Tuesday, Wednesday, and Thursday. I’m off Friday through Monday, and I don’t take any call. I take as much vacation as my budget will allow, and if I wake up with the flu, I call off from work without the usual feeling of guilt and anxiety.

It wasn’t always this way. Like all new doctors recently out …

10 tips to make residency more enjoyable

Jessica Deslauriers, MD

Medical Education

January 3, 2016

As a second year resident, I often do not feel like an expert in anything. Every day I learn more about medicine and realize how much more I still want to learn. In spite of the emotional, physical and mental challenges that being a young doctor entails, I have remained positive and have grown stronger throughout residency. As I reflect on the past year and a half, I appreciate the …

Real physician voices, twice a week

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Physicians: Listen to voices of the past. And learn.

Jeffrey McWilliams, MD

Physician

January 3, 2016

I’ve noticed as I get older, life seems to travel full circle no matter your path or destination. I find myself trying to teach my son Grant things that my father attempted to teach me not so long ago. “Don’t do that, you’ll fall and hurt yourself.” Or, “Try it this way and the process will be much easier.” There is that brief moment of acknowledgment often followed by scraped …

The difficult questions have to be asked in the exam room

Nazish Malik

Medical Education

January 2, 2016

As a medical scribe to physicians, I’ve entered over a thousand different exam rooms and listened to a thousand different patients give their unique histories, but the morning of October 28th was quite different.

On this chilly late October morning, I knocked and stepped into the exam room of my very first “patient.”

“Mrs. Laura Williams” was an elderly woman, old enough to be my grandmother, but slightly taller and a lot …

I’m not worried about colon cancer. I’m worried about the potential colonoscopy.

Justin Reno, MD

Physician

January 2, 2016

“Don’t forget to bring that stool card back in, OK?”

As he walked out of the room, carrying his portable oxygen, he turned back, with the nasal cannula in his nose, and replied, “I’ll get it back to you soon. I’d hate to have colon cancer.”

At this point, I’d hate for him to have a positive occult blood card. I could really care less about colon cancer. Colon cancer isn’t going …

The key to preventing depression in residents? Value young physicians.

Vivek Datta, MD, MPH

Physician

January 2, 2016

Up to a third of resident physicians suffer from clinical depression or its symptoms. This was the finding of a large review of 54 studies involving 17,560 resident physicians, published in JAMA recently. In some of the studies reviewed, up to 40 percent of resident physicians reported depressive symptoms. The study found these physicians were 4.5 times more likely to suffer from depressive symptoms following beginning …

MKSAP: 48-year-old man with newly diagnosed hypertension

mksap

Conditions and Diseases

January 2, 2016

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

A 48-year-old man with newly diagnosed hypertension is referred for an echocardiogram to assess findings of left ventricular hypertrophy noted on the electrocardiogram. He is asymptomatic, and his medical history is unremarkable other than hypertension. His only medication is chlorthalidone.

On physical examination, blood pressure is 128/70 mm Hg, pulse rate is 60/min and regular, and …

A physician goes on paternity leave. Here are 6 things he learned.

Nadim Lalani, MD

Physician

January 1, 2016

It is important that I make two disclaimers:

Disclaimer 1: I am a human being. I feel we run the risk of idolizing people through social media and I want to come out and say that I am really no different than any other person — flaws and all.
Disclaimer 2: I am well aware that your amazing blog aims to promote the stories, journeys and challenges of women in EM … …
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A physician goes on paternity leave. Here are 6 things he learned.

We owe it to our patients to lead and support climate change action

Richard Bruno, MD and Elizabeth Wiley, MD, JD, MPH

Physician

January 1, 2016

After months of negotiations, the Conference of Parties 21 (COP21) adopted a historic and unprecedented climate change agreement in Paris recently. The Paris Agreement reflects nearly universal recognition among parties that climate change demands an urgent, coordinated response. This agreement includes cutting greenhouse gas emissions to curtail the average global temperature rise to “well below 2ºC above pre-industrial levels and to pursue efforts to limit the temperature …

This surgeon loves her job. But it’s killing her.

Anonymous

Physician

January 1, 2016

What do you do when you love your job, but it’s killing you?

That’s an easy question if it’s asked by someone else. It’s a hard question when you’re asking it of yourself. As a physician, I give advice to people all the time — other people. If you have diabetes, control your diet. If you are obese, then lose weight and exercise. If you have COPD, then you better not …

These are the 10 most popular KevinMD posts of 2015

Admin

Potpourri

January 1, 2016

Thank you for another great year! I sincerely appreciate your continuing readership.

Here are the 10 most-read posts of 2015. Enjoy.

Watch 2 magicians destroy the anti-vaccine movement in 90 seconds.

Measles in Disneyland should be a wake-up call for the anti-vaccine movement. Will it? Magicians Penn and Teller do their part and show us why anti-vaccination is nonsense. (Warning: explicit language.)

An R&B anthem on hospital readmissions. It captures what’s wrong so perfectly.

ZDoggMD …

Physicians with anxiety shouldn’t suffer in silence

Anonymous

Physician

January 1, 2016

I thought about you, the patient that I’m about to perform surgery on, all night last night and because I doubted myself, I took clonazepam to calm the anxiety so I could sleep. Today I’ve taken 10 mg of propranolol and some Kava, a natural supplement known to decrease anxiety.

As I start the surgery, the propranolol coursing through my veins blocking the sympathetic nervous system, I fear it will come. …

Is your doctor a marijuana user? Maybe you should ask.

Raymond Abbott

Conditions and Diseases

December 31, 2015

Marijuana use today is not limited to the poor, the marginalized among us; nor is it kept in the inner city, as it pretty much was when I was a kid. Now it is widespread, even legal in some states. One might even make the argument it has become a substantial part of the life of the elite, the affluent of America. And when we think of elite and powerful …

Accidental death is a public health problem. What can we do about it?

Natasha Bhuyan, MD

Physician

December 31, 2015

“Do you have a family history of sudden death?”

In medical school, I learned to ask my patients this standard prompt during sports physicals, in search of possible hypertrophic cardiomyopathy. Their answers often surprised me.

Many of my patients do have relatives who suffered a “sudden, unexplained death,” often the result of a murder or suicide. Which feels, in a way, utterly unexplainable.

The impact of violence, including deliberate self-harm, is overwhelming: According …

How physicians can curb the prescription opioid epidemic

Anita Gupta, DO, PharmD

Medications

December 31, 2015

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

With the holiday season upon us, there is no better time to reflect on how we as physicians can better serve our patients — not only in the treatments we provide — but in how we tackle growing health issues such as the overuse …

Fear, anger, and loss should have burned me out. But it hasn’t.

James C. Salwitz, MD

Physician

December 31, 2015

Three decades at cancer’s bedside has taught me about fear. I have seen denial postpone critical diagnosis. I have watched mistrust and anger yield poor choice. I have fought against terror that spreads malignancy by delaying treatment. I have shared fury and devastation as horrid growths rip apart bodies, destroy families and end life.

After so many thousands of patients, so many wasted lives, you would think I would have given …

These are the words medical educators should think about

Robert Centor, MD

Medical Education

December 30, 2015

Readers are slowly learning about my admiration for the Farnam Street Blog. The about page describes the blog in this way:

My goal is to help you go to bed each night smarter than when you woke up. I’ll do this by giving you tools, ideas, and frameworks for thinking.

I’m not smart enough to figure all of this out myself. I try to master the best of what other …

Read more…

These are the words medical educators should think about

The exotic choice of staying home: Why CME rules have to change

David M. Mitchell, MD, PhD

Physician

December 30, 2015

San Diego, Tucson, Orlando, and Dallas. Those are a few of the modest destinations to which I have traveled, as a hospitalist, to attend CME conferences, using the pre-tax CME benefit from my employer, including paid days off.

As a young professional, my yearly CME trips gave me a mildly magical sense of privilege: “Really? They’re going to pay for all of this?” Browsing through various CME conference options and dreaming …

The best way to inspire others is to be inspired. The best way to motivate is to be motivated.

Jeffrey McWilliams, MD

Physician

December 30, 2015

How do you motivate and inspire? How do you create an environment where people are eager or excited about their daily work?

This question has created a multi-million dollar industry of motivational speakers, consultants, and higher education learning curriculum. I have to admit that I’ve been an avid pupil of the movement, focusing on others when the answer is literally staring me in the face each morning while brushing my teeth. …

Real physician voices, twice a week

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