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This is great medical care. With a large helping of unnecessary suffering.

Val Jones, MD

Physician

August 17, 2015

I watched helplessly as a dear friend went through the emotional meat grinder of a new cancer diagnosis. Her husband was found to have melanoma on a recent skin biopsy, and she knew that this was a dangerous disease. Because she is exceptionally intelligent and diligent, she set out to optimize his outcome with good information and the best care possible. Without much help from me, she located the finest …

The tension between traditional medical values and expanding commercialism is real

Steven Reidbord, MD

Health Policy

August 17, 2015

The history of American medicine is the story of the rise and fall of a professional guild. In the 19th and early 20th centuries, physicians distinguished themselves from other healers by banding together to form professional associations dedicated to science-based practice. Even more important, medical ethics put the patient first, above considerations of personal gain or even collective social goods. The medical guild may have been insular, self-protectively territorial and …

After surgery, the scars will always remain

Bruce Campbell, MD

Physician

August 17, 2015

“To be trusted is a greater compliment than to be loved.”
– George MacDonald

As we adjust her position on the surgical table, I spot some short, vertical scars on the front of her neck. The parallel slashes sit directly over her enlarged thyroid — a goiter — and appear to have been deliberately placed. There are two sets of scratches, one set on either side of the neck, nearly identical in length and evenly …

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Yes, I am a Rhodes Scholar who is “just” a family doctor. Here’s why.

Yan Yu, MD

Physician

August 17, 2015

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“So you’re a Rhodes Scholar, and you’re just a family doctor?”

If I was paid a dollar each time I’m asked this question, I can safely retire. It seems innocent enough, and it’s usually asked without malice. But the fundamental assumption behind this question alarms me: that family doctors are somehow less competent and less valuable to society than specialist doctors. It’s an …

Is the crusade against pill mills turning into a witch hunt?

Steven Reznick, MD

Medications

August 16, 2015

I care for a 65-year-old woman suffering from sarcoidosis affecting her lungs, her skin, her bones, her nerves, her blood chemistries, her kidneys, her colon and her mind. She has gone from an active spouse, mother, grandmother, tearing up the dance floors with her husband, to a home recluse calling friends to drive her to medical and care appointments while ambulating with …

7 ways physicians can improve health care quality

Robert Pearl, MD

Physician

August 16, 2015

Patients want to receive health care that is of the highest quality. Physicians want to provide it. But what is “high-quality health care?” On that, few agree.

Ask most Americans and they’re unsure where to find it. They know they want to be kept healthy, have rapid access to personalized care whenever they need it and be charged only what they can afford.

Ask the leaders of the national medical and surgical …

A fetal complication is an extension of a mother

Cia Bishop, MD

Conditions and Diseases

August 16, 2015

While sitting in the study lounge of my med school, I had on my computer screen one of our three slides on anencephaly. I was trying to memorize the two key phrases framing the graphic photograph of a stillborn baby with bulging eyes and a cratered head — “anterior neural tube defect,” and “elevated alpha-fetoprotein.” A third year walked past me and sneaked a glance at my screen. Without faltering …

Doctors now diagnose in code. ICD code, that is.

Frederick Gandolfo, MD

Physician

August 16, 2015

“Hi, it’s Dr. Smith, are you taking consults today?” the voice on the other side of my short-range hospital phone said. I recognized the caller’s name as one of the new hospital doctors, known as hospitalists.

“Of course,” I said, “What have you got?” I guess some groups have a specific doctor for the day “take” the consults. If I am in the hospital, I am always taking consults.

“Great,” the hospitalist …

Patients can spot the fake: They need the authentic

Kathryn A. Hughes, MD

Physician

August 15, 2015

“There are only two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle.”
– Albert Einstein

“Miracles happen every day; change your perception of what a miracle is, and you’ll see them all around you.”
— Jon Bon Jovi

“The miracle is this: The more we share, the more we have.”
— Leonard Nimoy

It is amazing when things in medicine work just the way …

OTC Lipitor? Why Pfizer made the right decision for the wrong reason.

Ira Nash, MD

Medications

August 15, 2015

There were several news stories recently that reported that Pfizer had abandoned its efforts to have its Lipitor brand of atorvastatin made available over the counter (OTC), without a prescription. I was never a big fan of OTC statins, but I was struck by the reason that Pfizer put out:

The study did not meet its primary objectives of demonstrating patient compliance with the direction to check their low-density lipoprotein cholesterol …

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OTC Lipitor? Why Pfizer made the right decision for the wrong reason.

What does a doctor look like?

Lara Devgan, MD, MPH

Physician

August 15, 2015

As a plastic surgeon, I am interested in how people look. Whether I am piecing together a fractured face or reconstructing a cancer-scarred breast, I am focused on appearance, symmetry, contour, and lines. I am always thinking about how our bodies are the physical manifestations of who we are.

What I am never thinking about is how that sentiment applies to me.

An intern …

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What does a doctor look like?

What is the diagnosis in this woman with an enlarging neck mass?

mksap

Conditions and Diseases

August 15, 2015

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

A 78-year-old woman is evaluated for a rapidly enlarging neck mass that has been present for 4 weeks and is associated with neck discomfort, dysphagia, and hoarseness. The patient has had Hashimoto thyroiditis and hypothyroidism since age 24 years and has been taking levothyroxine since that time.

Physical examination reveals an older woman …

Ain’t the way to die: The stories that this physician will never forget

Zubin Damania, MD

Physician

August 14, 2015

Like so many other medical professionals, I felt voiceless in the face of a gargantuan health care non-system built to do things to people, rather than for people. But after a decade of hospital practice, my “cry for help” looked slightly different than the typical midlife crisis: It involved the creation of a somewhat ridiculous blue-scrubbed rapping doctor alter ego. “ZDoggMD” could …

Please, don’t eat your placenta. Here’s why.

Jennifer Gunter, MD

Conditions and Diseases

August 14, 2015

Every few news cycles placenta-eating seems to make the rounds. I’ve already seen it a couple of times this year, so I figured the Internet is trying to tell me something.

Some women, but mostly those who recommend and/or prepare placenta for them, think that ingesting placenta can cure/help postpartum depression and possibly a host of other postpartum ills and issues. Some …

This is how one physician became a happy doctor

Pamela Wible, MD

Physician

August 14, 2015

I was a physician employee, many times for many hospitals and clinics. I’d stay a year or two, but eventually I’d quit. Then, in 2005, I opened an ideal clinic designed by my patients. Ten years later, I still love private practice. Why? I’m finally practicing medicine the way I had always imagined.

When I decided to open a private practice, I was …

What happens when moral physicians stand up to power

Richard Gunderman, MD, PhD

Health Policy

August 14, 2015

Dr. Melos is a gastroenterologist in solo practice in a medium-sized Midwestern city. One day she hears a knock on her door. When she answers, she finds two representatives of Athenian Health System, who request a few minutes of her time. She invites them to take a seat in her office.

After exchanging pleasantries, the visitors get down to business. They extend Dr. Melos an …

The Hunger Games of health care is here. Who will be our Katniss?

Regina Druz, MD

Health Policy

August 13, 2015

“Doctor, the patient is complaining,” said my secretary in a hush-hush voice. “She has been waiting for 30 minutes.”

“She” had an appointment for later in the afternoon but phoned our office about 2 hours before the scheduled time, and requested to come earlier. No emergency. No acute complaints. We always try to accommodate, and pushed to “squeeze” her in. The earlier time, …

When doctors win, patients are the ones that sometimes lose

Jordan Grumet, MD

Physician

August 13, 2015

Like two ships passing in the night, we sidled up to each other at the nursing station on the hospital telemetry ward. I had already been home, ate with the kids, and returned, while he hadn’t left floors all day. We typed away at our computer stations, and chatted from time to time.

After we exchanged common pleasantries, we jumped into local politics. …

Health care could use someone like Donald Trump. Wait, what?

Suneel Dhand, MD

Health Policy

August 13, 2015

He’s loud, brash and audacious. He’s been a celebrity for decades, a well-known businessman and reality TV star. And anyone who is even remotely following the news at the moment knows he’s also dominating headlines with his presidential run. I’m going to pause here to say that I’m not going to get into the politics of anything he has said — no …

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