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What a pediatrician learned from having ranch dressing on his stethoscope

Physician

November 11, 2015

Every weekday during lunch time, I scurry out of my clinic and head towards the doctor’s lounge because the food is free. (Even though most of the time I am not sure what it is!) But more appealing than the costless lunch are the conversations that I have in that lounge with other physicians from the hospital. Being a pediatrician, I am more inclined to pay closer attention to stories …

Should tackling be removed from youth football?

Claire McCarthy, MD

Conditions and Diseases

November 10, 2015

Tackling: in so many ways, it’s what football is all about.

Now, of course running, passing and scoring (and strategy) are important parts of football too. But it’s tackling that stops the opponent. Without tackling, you can’t play football.

Or can you?

A policy statement just released by the American Academy of Pediatrics (AAP) suggests that we need to do some thinking about tackling and its impact — literally — on …

It’s time to stop comparing health care to manufacturing

Hans Duvefelt, MD

Physician

November 10, 2015

From ancient times, doctors have appreciated that, for all their similarities, no two patients are exactly alike. This understanding is what made physicians act like, and earn society’s respect as, professionals.

The commercialization of health care has brought in managers from other industries and other branches of academia, and their rise to power has been predicated on their ability to treat patients and doctors not as individuals, but as small cogs …

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4 questions about Theranos that are actually worth discussing

Dave Steiner, MD, PhD

Conditions and Diseases

November 10, 2015

Combine a hot start-up valued at 9 billion dollars, an articulate Stanford drop-out CEO with celebrity-like press coverage, and a recent Wall Street Journal report that calls into question the reliability of the company’s “revolutionary” testing, and you have the perfect storm to set the internet abuzz about Theranos.

Amidst the melee of accusations, “change-the-world” start-up jargon, and anecdotes of incongruent lab results, something has been missing: an organized, …

Is it time to update antiquated medical buzzwords?

John Biemer, MD

Physician

November 10, 2015

“What is the term we use to describe the cells that help us diagnose papillary thyroid cancer?” the attending pathologist asked a room full of residents at a noon didactic.

“Orphan Annie Eyes,” they nearly all responded at once.

“And does anyone here know who Orphan Annie was?” he asked next.

It is something memorized by every medical student — the papillary thyroid carcinoma cells with cleared out nuclei are called “Orphan Annie …

You have no idea what it’s like working in the ER as a pregnant physician

Archana Reddy Shrestha, MD

Physician

November 9, 2015

When I was pregnant with my first child, I worked full time as a physician in the emergency department. I worked mostly 9-hour shifts, but some 12-hour shifts as well. Days, evenings, nights, holidays and weekends were divided up amongst the entire group of physicians. I worked my share of those shifts as well.

I have worked in the ER while pregnant twice now, and while I am proud to be …

Beware of predatory journals when it comes to homeopathy studies

Roy Benaroch, MD

Medications

November 9, 2015

An August, 2015 study in Multidisciplinary Respiratory Medicine is being touted as evidence that homeopathy is as effective as antibiotics for respiratory infections in children. It doesn’t show that at all — in fact, it doesn’t show anything, except that crappy studies in crappy journals can nonetheless be used to manipulate opinion. Beware.

First, the study itself. Researchers in Italy looked at about 90 children with ordinary …

The FDA’s epic regulatory failure

Brian Klepper, PhD

Medications

November 9, 2015

A new study in JAMA Internal Medicine finds that two-thirds of cancer drugs considered by the U.S. Food and Drug Administration (FDA) over the past five years were approved without evidence that they improve health outcomes or length of life. (This study closely corroborates and acknowledges the findings published last year by John Fauber of the Milwaukee Journal Sentinel and Elbert Chu of MedPage Today.)

Follow-up …

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The FDA’s epic regulatory failure

Why male physicians should care about maternity leave

Jamie Coleman, MD

Physician

November 9, 2015

You all have prostates.

Seriously. But let me explain further to those people who simply can not fathom as to how a woman could dare ask for maternity leave and expect her other team members to “pick up her slack, because she chose to get pregnant.” (Yep, check the comments section on my last post. Pretty entertaining, in fact!)

Life happens to everyone.

If my profession as a trauma surgeon has taught me …

Smoking is the ultimate thief of time

Samuel M. Chen, MD

Physician

November 8, 2015

I sit at my desk in a cubicle with high ceilings and an open entryway. It is dark except for the somewhat eerie glow of light emitted by CRT monitors. With concentration and some sense of urgency, I methodically plow through the queue of studies to be interpreted. Some are marked STAT, some not. I address the former first.

Our ER is a busy one. Many cases come from that department. …

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Smoking is the ultimate thief of time

A physician’s life with epilepsy

Kristin Seaborg, MD

Conditions and Diseases

November 8, 2015

In May 2003, during my second year of pediatric residency, I had a right temporal lobectomy to remove a seizure focus in my right hippocampus. Although the surgery proceeded without complications, I was unable to walk unsupported for several weeks after the operation. My experiences taught me what makes an exceptional physician.

An excerpt from The Sacred Disease: My Life with Epilepsy.

The day after my surgery, Nancy was my new …

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A physician’s life with epilepsy

The patient experience: 4 observations from a physician

Thomas D. Guastavino, MD

Physician

November 8, 2015

Last year, I retired from full-time practice and moved to a new area. At about the same time, my wife was diagnosed with breast cancer, and because she was in good health prior, she had relatively little contact with the health care system as a patient.

Before our move she worked as a part-time school nurse, so we were able to share provider horror stories from different perspectives. Since we moved …

It’s dangerous. It can kill. But physicians don’t want to talk about it.

Tehreem Rehman

Conditions and Diseases

November 8, 2015

“You need to come to the ED ASAP.”

A new patient was admitted at 2 a.m. and requested for a crisis counselor. Unlike with cases of sexual assault, survivors of domestic violence had to specifically request for the presence of an advocate when I was volunteering in NYC back in 2009. This woman, I’ll call her Sadie, had already taken the first courageous step to seek help.

I briskly walked past …

In medicine, too many disruptors disrupt disruption

Dr. Saurabh Jha

Health Technology

November 7, 2015

Recently, I was dining with elite radiologists. In that uncomfortable silence between dessert and the check, I said, “radiology must shift the traditional paradigm by creating value streams using disruptive innovation to leverage population health to build strong ecosystems and a robust ectoplasm.”

I was experimenting if excreted verbiage hastens the check. Instead, it sparked a vigorous conversation about disruptive innovation, compelling me to drink more cognac.

In health care, no two …

Mental health in America requires a collaborative solution

Jeffrey A. Katz, PA-C and James Cannon, PA-C

Conditions and Diseases

November 7, 2015

Getting mental health right for all Americans is a huge undertaking. For the last 150 years, our “solutions” to mental illness can, at best, be characterized as a series of good intentions that were poorly, if not disastrously, implemented. But while there may be a conversation that needs to happen about how we got here, what’s important right now is how we go about shoring up a system that is …

Test your medicine knowledge: 59-year-old man with gout

mksap

Conditions and Diseases

November 7, 2015

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

A 59-year-old man is evaluated for a 6-month history of gout. He was doing well on colchicine and allopurinol but developed hypersensitivity to allopurinol, which resolved with cessation of the agent. He then began to have more frequent gout flares; two flares occurred in the past month and were treated with prednisone. History is also …

Physician, heal thyself. A reflection on physician self-care.

Chiduzie Madubata, MD

Physician

November 6, 2015

Another workday comes to an end. 11 a.m. rolls around and freedom from the hospital beckons after another 24-hour call is finished. In the span of the preceding day, it is likely that numerous important decisions had to be made with the expectation that all of your mental faculties would be used, irrespective of what time of day it was or how much sleep was obtained. It is a day …

Failure to communicate is a patient safety issue

Steven Reznick, MD

Physician

November 6, 2015

My 66-year-old professional athletic patient had a history of a scar tissue related small bowel obstruction seven years ago related to a previous appendectomy. He now had similar symptoms with cramping, lower abdominal pain, and some nausea.

Since his office was next door to his longtime friend and gastroenterologist, he called over there. He was given an appointment with the junior partner since his buddy was out of town. Thirty years …

Why a doctor stopped taking a particular health insurer

Lucy Hornstein, MD

Physician

November 6, 2015

For the moment, I still take almost all insurances in my practice. And as long as I see enough patients (i.e., as long as the phone rings) I’m doing OK. I’ve been billing electronically with a free clearinghouse for about five years now, and things are pretty good.

Over all these years, I’ve only dropped one insurance company. It covered a fair number of patients, including many of my …

We are morally scarring our future physicians

Alex Smith, MD

Medical Education

November 6, 2015

Have you ever had that experience when you think what you’re doing is futile, and that thought goes through your mind:

“Why am I doing this?”

“I’m torturing him.”

“This feels wrong.”

For those of us that are physicians, think back to your internship and residency training. I think we can all remember at least one of these situations, if not more.

I remember being in the ICU as a third-year internal medicine resident, being sent …

Real physician voices, twice a week

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