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It’s time for hospitals to take nutrition seriously

Physician

September 27, 2015

I remember the day like it was yesterday. I was a medical student, rounding with my team, and we had just talked to a diabetic patient who was recovering from a myocardial infarction. The attending looked over at the side and saw some chocolate donuts and cakes lying on the tray table, which had been brought in by the patient’s relatives. The attending shook his head disapprovingly and said, “I don’t think those are going to …

How call rooms reflect the personality of residency programs

Katie Lockwood, MD

Physician

September 27, 2015

An intern pushed open the call room door so that twelve medical students could crowd their eager faces together to see where we might sleep for the next three years. Only a few months away from medical school herself, the intern acted as if sleeping in such quarters were second nature. She gestured to the fluffy quilts the residents had brought from home to adorn their beds and giggled about …

3 tips to help physicians manage online criticism

Kevin Pho, MD

KevinMD

September 27, 2015

A continuing series on physician online reputation. Created in partnership with the Doctors Company as part of their social media resources for physicians.

Patients have more avenues than ever to express themselves online, whether it’s through a physician rating site or through social media. It’s inevitable that every single doctor eventually will be faced with criticism on the web, so you need to know what …

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Tips to meet challenges of administering and tracking immunizations

Yul Ejnes, MD

Physician

September 26, 2015

A guest column by the American College of Physicians, exclusive to KevinMD.com.

When I entered practice over 25 years ago, planning for influenza vaccination season was straightforward. Every late spring, we looked at how many doses we gave out the previous year, added a few doses, ordered the vaccine, and immunized our patients in the fall. If …

Patient autonomy is held to be sacrosanct. A doctor reconsiders this view.

Anonymous

Conditions and Diseases

September 26, 2015

The refusal of blood products by the Jehovah’s witnesses has often been cited as a great example of patient religious freedom triumphing over the traditional paternalism of medicine. Patients are free to refuse transfusion even at the risk of death. Many hospital-based physicians have, at one time or another, been witness to the demise of a patient refusing blood products, perhaps a preventable demise. Patient autonomy is held to be …

Conversations lead to better health, not interrogations

Matthew Walvick, DO

Physician

September 26, 2015

Most patients think they need to come to their doctor’s visits with a strict agenda. It’s a habit forged out of wanting to get quick fix and a by-product of time constraints. This paradigm seems logical and can sometimes accomplish its goal, but too often, this approach falls short in harnessing the immense value that can result from a connected physician-patient relationship.

I can vividly remember the days when the idea …

Test your medicine knowledge: 27-year-old woman with an intensely pruritic rash

mksap

Conditions and Diseases

September 26, 2015

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

A 27-year-old woman is evaluated for a 1-week history of an intensely pruritic rash on her eyelids. She applied a new brand of eye makeup just prior to the onset of the rash. She immediately discontinued its use and has been applying a moisturizing lotion to both eyelids since then without improvement in her symptoms. …

How a neurosurgeon balances life and work

Jeffrey S. Henn, MD

Physician

September 25, 2015

“For Me There Are Mountains.”

This is the title of a poem written by a college friend. It’s been almost 30 years, and I have yet to come across words that better define my life, words that immediately resonated with my soul and “understood” me — understood that for me, mountains symbolize at once life’s challenges and rewards, and understood that “there are” is neither choice nor conviction, there just are.

For …

Osteoporosis: A silent assailant turned me from physician to patient

Karen S. Sibert, MD

Conditions and Diseases

September 25, 2015

It’s amazing how quickly my role changed from physician to patient, thanks to a silent assailant: osteoporosis.

I went to the gym in the morning before work 12 days ago, as I often do now that my children are all grown up and out of the house. First, a couple of light sets of leg exercises served as a warm-up, and then I started a set with a barbell on my …

When it comes to end-of-life care, perhaps we do need a bigger hammer

Richard D. Sontheimer, MD

Physician

September 25, 2015

While sitting one evening with my terminally ill elderly mother, she again asked me to help her end her suffering. This time it was, “Could you just go get the hammer and hit me in the head?” Her previous requests had included “Son, you are a doctor, can’t you do something to help me with this?” And then, “They treat animals better than this.”

On previous occasions, I had to remind …

Doctors: All of you have a superpower

Saurabh Sinha

Physician

September 25, 2015

Recent essays have shed light on the Herculean task of maintaining humanism in medicine in the face of added responsibility during residency and the seemingly inevitable cynicism embroiled in patient care. The solution appears to be rooted in active reflection on the process of training and clinical practice and recognition of what it is that brought us here.

In this moment of active reflection, I contend that you have …

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Doctors: All of you have a superpower

Not all patients want to be autonomous

Don S. Dizon, MD

Conditions and Diseases

September 24, 2015

Jodi (name and descriptors changed to protect patient identity.) had been diagnosed with ovarian cancer several years earlier, had received adjuvant carboplatin and paclitaxel therapy, relapsed three years later, and since then, had been on several forms of therapy — most recently receiving weekly paclitaxel. She was tolerating treatment well, but a CT scan done to re-evaluate her extent …

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Not all patients want to be autonomous

When a doctor is in doubt, she asks a family member

Val Jones, MD

Physician

September 24, 2015

I learned a valuable lesson recently about how difficult it can be to make the correct diagnosis when you see a patient for a very short period of time. In the acute rehab setting, I admit patients who are recovering from severe, life-altering brain events such as strokes, head injuries, and complex medical illnesses. It is challenging to know what these patients’ usual mental function was prior to their injuries, …

Thank you for your humanity: A resident night float story

Gregory Shumer, MD

Physician

September 24, 2015

BEEEP BEEEP BEEEP BEEEP … I pressed a button to silence my pager and rose groggily from the bed in the on-call room. I hadn’t truly been asleep, just catching a quick rest between pages. It was 2 a.m. I was 19 hours into my shift and, from the looks of the page, there was a new patient ready for admission to our family medicine inpatient service. I picked up the …

A liquid biopsy for cancer: Too good to be true?

J. Leonard Lichtenfeld, MD

Conditions and Diseases

September 24, 2015

The recent announcement by a California company offering DNA blood tests (also known as “liquid biopsies“) for the early detection of cancer takes us to a place most of us expected we would get to, but much earlier than we are prepared for. Simply stated, our technology and rush to get new tests to market — even before we have a basic understanding of how to use those …

Do patients contribute to the God complex in surgeons?

Dr. Henry Woo

Physician

September 23, 2015

Medical oncologist, Dr. Ranjana Srivastava wrote on the subject on how doctors treat doctors may be medicine’s secret shame in the Guardian back in February 2015.

About a month later, vascular surgeon Dr. Gabrielle McMullin used a book launch speech to expose the problems of sexual harassment in the surgical profession. She highlighted a story of where a neurosurgical trainee had refused sexual advances and subsequent to launching a formal complaint, …

Women medical organizations are still relevant. Here’s why.

Fatima Fahs

Physician

September 23, 2015

Did you know that September is Women in Medicine Month?

When I tell someone I’m involved in the American Medical Women’s Association (AMWA), my favorite response is, “Are organizations like that still necessary? It’s 2015.”

First, thanks for the clarification of what year we are in. Isn’t it shocking that in 2015 women in medicine are still not equal to their male counterparts? And second, to answer your question: Yes, AMWA is extremely …

Seeking help for mental health problems: Change the culture for providers

Katie Fortenberry, PhD

Physician

September 23, 2015

“I don’t need meds,” the young psychology major told me confidently. “Or therapy really. Maybe I’ll just touch base with you every once in a while. I should be able to handle this on my own.” The young woman’s physician had been concerned enough in a recent visit about this patient’s panic attacks and passive suicidal ideation to refer her to meet with me for a primary care psychology consultation. …

What I learned about childproofing from working in the ER

Archana Reddy Shrestha, MD

Physician

September 23, 2015

As a new mother, working in an emergency department made me want to go home and childproof every nook and cranny of our house. On a daily basis at work I care for children, most often toddlers, injured at home in various ways. I learned of all the potential household dangers and how to keep my children safe.

I remember vividly caring for the 2-year-old girl who burnt her entire hand …