If I had groused two years ago that we were getting doctored to death, you would’ve thought me obtuse. When I claim today, though, that every head bump doesn’t need an MRI, you get it.
There’s a growing buzz about Americans receiving too much health care. In fact, overtesting and overtreatment are the main source of health care’s amazing expense. You can …
Doctors are short on curiosity. Here’s why.
Smoking is a major cause of heart attacks, strokes, emphysema, and lung cancer. Smoking rates have steadily declined in the U.S. in the last 50 years, but about a fifth of U.S. adults still smoke. Helping them quit would make a major contribution to their health.
A study in the New England Journal of Medicine (NEJM) studied the effectiveness of different …
Paying people to quit smoking. Does it work?
Paying someone to mow your lawn is a pretty straightforward affair. Ryan the lawn guy will look at the lawn size and maybe the hilliness of your yard, and you’ll settle on a price for mowing and trimming it. When you decide to contract for Ryan’s services on a more regular basis, payment might get a little more complicated. If you pay Ryan every time he mows your lawn he …
Paying for health care is hard. Just take a look at bundled payments.
It’s two months into my second year of medical school, and I’m at the clinic, preparing to shadow Dr. Neiland, a primary care physician.
I didn’t want to come here this morning.
Yesterday, one of my preceptors decided that it was my turn to be “pimped.” Pimping, in medical education, is when the preceptor asks you questions until you get one wrong. Then he asks more questions, highlighting your ignorance. Theoretically, this …
Pimping the patient: Please make it stop
Here’s a question for you: Which causes more deaths, motor vehicle traffics accidents or firearms?
I asked a bunch of people that question, including a bunch of doctors, and everyone said that motor vehicles did, by a lot.
According to the Centers for Disease Control and Prevention (CDC), in 2013, 33,804 people died from motor vehicle traffic accidents — and 33, 636 died from firearms.
They kill the same number of …
Which kills more? Guns or cars? The answer will surprise you.
Two years ago, during my second year of medical school, my classmates and I sat in cramped auditorium chairs as our instructor presented us with a clinical scenario.
We were learning about arrhythmias, and our instructor flipped through slides of different ECG patterns, asking how we would respond to each. After several less concerning ones, the slide flashed ventricular fibrillation: an irregular …
Doctor, what next? The thoughts of a graduating medical student.
Question: What do all these cancers have in common: melanoma, lung, kidney, bladder, ovarian, head and neck, Hodgkin lymphoma, stomach, breast (and others)?
Answer: They have all shown evidence of meaningful, durable responses when treated with one or more of the new immunotherapy drugs. And that is truly amazing, not to mention very unexpected, even by the …
The fascinating journey of new immunotherapy drugs to treat cancer
Quintessential Messi. One moment he is standing over the ball, in a seemingly harmless position at midfield, the next thing you know you are picking the ball out of the back of the net. How did this come to pass? How did things change so rapidly? When you watch it the first time, it’s disorienting. It makes no sense. How does …
The physical genius of Lionel Messi, and how it relates to surgery
The best way to avoid being sued for malpractice is to make certain that all your patients are happy and all their outcomes are good.
Reality is seldom so rosy. Patients aren’t necessarily happy even when their clinical outcomes are as good as they can get. In the event of an undesired outcome, an unhappy patient may easily become a litigious one. A 2011 study in the New England Journal …
Following evidence-based guidelines won’t protect you from malpractice
While there are worse times to sprain an ankle and chip a bone than just one week before a longawaited trip to Venice, I couldn’t think of one as I sat in the emergency room for eight hours last fall.
Venice, the place of canals and not cars; ancient bridges sans escalators. How ironic that just a few days before I was crowing to my husband over my hotel coup. A …
The saga of the boot illustrates the problem of health care costs
Desiree wrote in, “My 15-month daughter and a few other kids at her daycare were just diagnosed with hand-foot-mouth disease. I would like to hear how common it is, what treatments (or ways to soothe) you find helpful, and how you would differentiate this from measles or chickenpox. For example, my little one has blisters all over her body, not just H-F-M. …
My child has hand-foot-and-mouth disease. What do I need to know?
Recently I’ve been asked to write about rural surgery, what it’s like, what’s good about it. Everything has its ups and downs.
First of all let me say that whatever your job is, the money you get paid to do that job is for the crappy part, and every job has a crappy part. The trick is to find a job that …
What’s it like to be a rural surgeon? Read this to find out.
A recent series of articles in the Washington Post and a segment on NPR have caused quite a stir. The articles are about what we have called for decades shaken baby syndrome. It can be fatal. We now use the term non-accidental head trauma. This term replaced the older one because it is more specific; children …
The controversy about shaken baby syndrome actually isn’t one at all
ADVERTISEMENT
Currently the HPV (human papilloma virus) vaccines are approved in the United States up to the age of 26. This has nothing to do with safety but due to the fact that the studies submitted to the Food and Drug Administration (FDA) involved this age range. The HPV vaccines were primarily studied in women aged 26 years and younger because age …
HPV vaccine after age 26: Should you get one?
It could be the title of a new prime time show (maybe it should be): The Great Discharge Paperwork Makeover. Assemble a group of bright and creative minds from across the country and put them together in an exotic location for a week to talk about something that will affect all of us one day — either ourselves or a relative. …
It’s time to give discharge paperwork a makeover
As a little kid, I used to love the bedtime story about Humpty Dumpty and his fall from the wall. “Humpty Dumpty sat on a wall. Humpty Dumpty had a great fall. All the king’s horses and all the king’s men couldn’t put Humpty together again.” Until recently, I never thought about this story as a logical and sad analogy to …
Stop the Humpty Dumpty approach to health care
Momentum remains in favor the flow of physicians to employed positions. Is this wisest path for physicians? That is unknown and likely depends upon the particular circumstance. Either way, independent physicians are an increasingly shrinking, yet curiously heterogeneous group. Independent practices vary in size, composition and philosophy. The impact of size (from solo to very large) and composition (primary or specialty care, single or multispecialty and physician demographics) is relatively …
Complete independence for a small practice today is unwise
When I was growing up, I thought that doctors had it made. About three months into med school I realized how wrong I was.
Question: “Hi professor, what part of the chapter do I focus on?”
Answer: “Everything.”
My text books would be out of date by the time I finished them. Just as I learned where they kept supplies in the hospital it …
The survival strategy of a new doctor
I am going to make a bold statement here. Are you ready for it? There is nothing wrong with health care providers thinking like businessmen.
I know what you’re thinking, but I feel the word “business” gets a bad reputation in medicine. We immediately associate the term with profit-hungry, egocentric individuals, a preconceived notion probably rooted in their unfair depiction in popular …
4 reasons why business and medicine go together
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 28-year-old man is evaluated for a 5-year history of recurrent headache that occurs several times per month and lasts 12 to 24 hours. He describes the headache as a bilateral frontal pressure associated with nasal congestion and sensitivity to light, sound, and …
Test your medicine knowledge: 28-year-old man with recurrent headaches
Get free updates delivered free to your inbox.
