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How racism makes us sick: The medical repercussions of segregation

Jennifer Tsai

Conditions and Diseases

April 15, 2015

In medical school, class is scheduled for approximately 30 hours a week. This includes lectures on basic life sciences, histology, anatomy, and clinical examination skills. In addition, my first semester included approximately three hours of classroom time a month devoted to a supplemental curriculum called Health Systems and Policy, which covers the legal aspects of health care, public policy, and, briefly, health disparities. Now, in my second semester, these efforts …

We have already changed the way we think about cancer

Leonel Ampie

Conditions and Diseases

April 15, 2015

The tenets engendered by cancer have been slowly elucidated throughout the years. The hallmarks of cancer have been well documented by Douglas Hanahan and Robert Weinberg in Hallmarks of Cancer: The Next Generation. Some of these features are well known and are inclusive of sustained proliferative signaling, evading growth suppressions, and others clearly outlined in their review. These cellular processes have been discovered by basic science researchers and subsequently, modern …

Why it is critical we learn from past health care mistakes

Joshua Tepper, MD and Danielle Martin, MD

Physician

April 15, 2015

Forty is the new thirty. Orange is the new black. And failure is the new success.

It seems these days that no success story is complete without a failure (or two) along the way: the bankruptcy that gave birth to a successful company; the entrepreneur who lost it all just before hitting the Fortune 500. Entire issues of the Harvard Business Review and the New York Times Magazine have been devoted …

Is it time to abandon the 9 to 5 workweek in hospitals?

Kathryn A. Hughes, MD

Physician

April 15, 2015

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Party Weekend
– Joe “King” Carrasco

Fight for Your Right (To Party)!
– Beastie Boys

We Just Wanna Dance
– The Flirts

My favorite radio station, WHFS, had a ritual every Friday afternoon to start off the weekend, back in the day. DJs Weasel and Bob Here would exchange pleasantries as they exchanged shifts, and would launch the same set of songs at the same …

The line between being compassionate and being unprofessional

Ellen Kolton

Patient

April 15, 2015

“He’s just expired,” said the nurse as I approached Ray’s room in the large inner-city hospital where I work as a patient advocate. “And his wife has just arrived. Why don’t you go in?”

I found Natalie bent over Ray’s body. His hollow cheek was drenched with her tears.

“I’m so sor –”

“I told him yesterday to talk to Jesus,” Natalie interrupted, speaking quickly. “I told him if the two of them …

Executive workups: The ultimate in patient-centered care

FirstWorldEM, MD

Physician

April 14, 2015

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The following article is satire.

LAS VEGAS, Nevada — As times have become harder for emergency departments around the country, one local hospital, Snooty Hospital and Casino (SHC), has come up with a solution to capture precious reimbursement from individuals with “enhanced diagnosis and treatment goals.” When checking into the ED either by ambulance or at the front desk, patients now have the ability …

We need to reframe alternative medicine in a new way. Like this.

Chad Hayes, MD

Medications

April 14, 2015

I’ve written before about various forms of complementary and alternative medicine — most recently about the use of essential oils for serious medical conditions. I’m planning to dive deeper into that topic in an upcoming post. But before I do, I want to take some time to reframe how we think about alternative therapies. And I want to make it clear from the beginning that doctors don’t get paid for prescribing medications; we …

Alcohol or marijuana? Rethinking what to take when you unwind.

Jeffrey Parks, MD

Medications

April 14, 2015

Aaron Carroll, a pediatrician who blogs at the Incidental Economist, had a piece published a few weeks ago in the New York Times concluding that adolescents and college kids would be better off — given a choice of illicit substances — opting for marijuana over alcohol. Of course, he would prefer that his kids chose neither. But he is a …

When it comes to the ABIM, physicians must choose wisely

Jordan Grumet, MD

Physician

April 14, 2015

The American Board of Internal Medicine is irrelevant. It has always been. I realized this when I first certified in internal medicine in 2002. The test was largely fact-based and filled with information that I would never need to know in practice. It did not measure my diagnostic acumen, or my physical exam skills, or my ability to listen and empathize …

Change the culture of uneven power dynamics

Abigail Schildcrout, MD

Physician

April 14, 2015

My career is based on communication and empowerment within the medical world. I educate on the patient/family side and the medical professional side. It takes understanding and empathy from both sides of the stethoscope to optimize communication. It takes communication between both sides to bridge perceived power differentials. It takes work on both sides to change a culture of uneven power dynamics.

I read two Facebook posts within the past few days dealing with a …

Good health care leaders have these 3 traits

Suneel Dhand, MD

Physician

April 14, 2015

In my travels up and down the East coast, I’ve worked with a number of health care administrators (and even temporarily been one myself, although quickly discovered that it wasn’t quite my cup of tea). The experiences that I’ve had have been highly variable, and I’ve seen the full spectrum of administrators ranging from the brilliant to the quite dire. As someone who has read many autobiographies of famous leaders, …

As the doctor exits, what does it mean for the humanity left behind?

James C. Salwitz, MD

Health Technology

April 13, 2015

The nightmare sickens me. A small child trusts a man to protect her, take care of her, and shield her from harm. The man, for incomprehensible and useless reasons, neglects her unto death. For me, when I think of Germanwings flight 9525, I am haunted by the photo of a single tiny girl, taken in the last days of life; the obliteration of that perfect life’s potential. Waste, tragedy, evil.

In the …

Pseudodiseases, the age of misinformation, and the death of the null hypothesis

Thomas Paine, MD

Conditions and Diseases

April 13, 2015

She was lying there stretched out, her mouth open, her eyelids sealed, her fingers straight, immobile, and paler than an image made of wax. From out of her eyes came two streams of tears flowing slowly down onto the pillow …

For forty-three days, Charles did not leave her. He neglected his patients; he sat up every night, he was constantly taking her pulse, applying sinapisms, cold-water compresses. He sent Justin to …

Read more…

Pseudodiseases, the age of misinformation, and the death of the null hypothesis

Should we give patients our cell phone numbers?

Anne Katz, RN, PhD

Physician

April 13, 2015

I recently attended the David Stroud Adolescent and Young Adult [AYA] Symposium at Keck Medicine of University of Southern California. It was a very interesting symposium with experts in adolescent and young adult cancer presenting on many different topics important for this population. There was also a panel of young adult …

Accountable care for Medicaid. No, we need real solutions.

Shirie Leng, MD

Health Policy

April 13, 2015

New York officials are doing an “experiment” that should strike fear, anger, and outrage in the hearts of doctors who take care of Medicare patients. (New York has the highest Medicaid budget of any state.)

As any doctor who has a high volume of Medicaid patients knows, Medicaid pays practically nothing. Doctors who take Medicaid usually have to carry a bigger patient load to survive. Medicaid patients are often sicker than …

Why patients lie to physicians

Val Jones, MD

Physician

April 13, 2015

Popular TV doctor, Gregory House’s favorite adage about patients is: “Everybody lies.” I used to believe that this was a cynical and inaccurate statement, but I had to revisit it recently when faced with a patient whose signs and symptoms were consistent with a diagnosis that she vehemently denied.

A young woman was admitted to my rehab unit with brain damage of …

Read more…

Why patients lie to physicians

A psychiatrist. Undercover.

Maria Yang, MD

Physician

April 13, 2015

My husband was in the aisle seat, I was in the middle seat, and The Man was in the window seat.

The Man had one white earbud in his ear; the other one was dangling in his lap. His right thumb swiped through several screens of his smartphone in less than a second. He heaved a sigh.

“This is f*cking lame,” he muttered.

The plane was supposed to take off 15 minutes ago. …

Read more…

A psychiatrist. Undercover.

Can hospitals tell workers not to smoke at home?

Michael Kirsch, MD

Physician

April 12, 2015

I practice gastroenterology in Cleveland in the dark shadow of a large medical institution whose name contains the name of our city. They are a world class medical institution whose reputation is largely derived from its cardiovascular department. Presumably, these practitioners, like all doctors, advise patients who smoke that cigarettes have deleterious health effects. The entire campus is smoke-free, as …

After a verdict: Doctors need to be taught a lesson. Really?

Dr. Saurabh Jha

Physician

April 12, 2015

Recently, a jury awarded a young California resident $28.2 million for a delayed diagnosis of a pelvic tumor. The jury found Kaiser Permanente (KP) negligent. Doctors in the system, touted to be one of the finest systems by the president, allegedly refused an immediate MRI for back pain in a 17 year old. The patient eventually received an MRI three months after …

So you want to be a surgeon? Here are 10 tips to help you.

Dr. Nikki Stamp

Physician

April 12, 2015

My interns started the term with mixed career aspirations. One wanted to do interventional radiology, the other, “not sure.” Now, in their last few weeks of our term, they’re thinking about a surgical career. Which I think is great. I’ve been lucky enough to have had some great advice over the years, and I’ve nutted a few things out myself along the …

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