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Forget the ivory tower: We need more Disney in medicine

Physician

January 27, 2015

This isn’t a debate about vaccines.

The fight here has nothing to do with that. For the record, I strongly support the concept of vaccination. Public health is better in the 21st century because of it. Measles? Mumps? Oh, I can find you in the United States, but we aren’t living our lives every day petrified of an outbreak. Smallpox? Polio? Where did you go? Not here, that’s for sure. And, …

After a doctor’s murder: All you hear about is deflated footballs

Shirie Leng, MD

Physician

January 27, 2015

michael davidson

This week the local and national attention has been riveted on accusations that Bill Belichick and the Patriots football team deliberately deflated the footballs used in the division championship game. Football, remember, is a multi-billion dollar industry in which the commodity being sold is grown men throwing brown, oblong balls at each other and knocking each other down. Boston.com, a …

Truth in advertising: When is a doctor really a doctor?

Daniel Campos, MD, MPH

Physician

January 27, 2015

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

In an emergency, the first question people often ask is: “Is there a doctor in the house?” When you have a medical problem, the best advice is, “Ask your doctor.” Most people automatically assume that “doctor” in this context refers to a physician with a …

Money matters, despite what medical students say

Michael McClurkin

Medical Education

January 27, 2015

In a recent article posted on this site, the author (a radiologist) waxed rhapsodic about a young medical student that was convinced to pursue primary care. When the author asked the student about the economic downsides to primary care, he responded by saying, “I’m not in it for the money … What matters to me isn’t the money — it’s making a difference in my patients’ lives.”

Well, good for him. Time …

How to start your own board certification organization

Edward J. Volpintesta, MD

Physician

January 27, 2015

1. Before anything, advertise yourself as a protector of the public against incompetent physicians.

2. Design the examinations for each specialty with a “one size fits all” approach. You can achieve this by disregarding the fact that many physicians prune their practices over time to accommodate to the demographics of their communities and their availability of specialty care. This has particular significance for internal medicine and family medicine.

Also, by including a large …

Reflecting on the end of residency training

Brian J. Secemsky, MD

Medical Education

January 27, 2015

We’ve almost made it.

Long gone are the purgatory stints of library study, slaving to solve esoteric problems relating to planks and pulleys. Innumerable several-day exams have been conquered and tucked far away in our memories, hopefully never to haunt us again. The last of our forced smiles and faux-eager nods have been displayed toward ambivalent instructors and medical teams during the throes of our student rotations.

Post-graduate training is also nearing …

Medical conferences feel like funerals. Here’s why.

Pamela Wible, MD

Physician

January 27, 2015

A friend just got back from a big medical conference at a fancy hotel. The cleaning ladies actually pulled her aside to ask, “What’s with all the grim faces and sad eyes?”

Do doctors realize medical conferences look like funerals? That’s what the cleaning ladies think. I bet they’re not the only ones.

Why do medical conferences feel like funerals? Maybe because doctors …

The medical testing industry needs to become extinct

David Mann, MD

Physician

January 26, 2015

Times change, and, as with Darwinian natural selection, those who adjust survive and those who don’t perish. Henry Ford’s assembly line greatly ramped up the production of automobiles but put many people out of work. The elevator operators of my childhood are long gone. Those who have embraced new technology have usually thrived; those who have fought it or failed to understand it have suffered. Witness the success of Amazon versus …

How much testing should you do in chronic abdominal pain?

Michael Kirsch, MD

Conditions and Diseases

January 26, 2015

I see patients with abdominal pain every day. Over my career, I’ve sat across the desk facing thousands of folks with every variety of stomach ache imaginable. I’ve listened to them, palpated them, scanned them, scoped them and at times referred them elsewhere for another opinion. With this level of experience, one would suspect that I have become a virtual sleuth at determining the obvious and stealth causes of abdominal …

To remember who is the customer and who is the servant

P. J. Parmar, MD

Physician

January 26, 2015

I’m a family doctor working in underserved medicine. My friend Pierre Wolfe was one of Denver’s top restaurateurs for decades. When we get together I often think of the parallels between our industries.

A postcard of Pierre’s Quorum Restaurant from the 1960s shows Pierre at the front door of his restaurant, holding a menu, and says “Pierre Wolfe himself greets you at …

The Affordable Care Act’s Medicaid bait and switch

Kevin R. Campbell, MD

Health Policy

January 26, 2015

As we enter year two of the Affordable Care Act, we have seen many issues arise during implementation. Through both executive order and executive memorandum, President Obama has unilaterally changed the law more than 100 times in order to advance his political agenda.

When it became important to publicize enrollment and increased coverage of the uninsured, the president, and the ACA provided for an increased payment scale for patients with Medicaid. …

The patient’s son is a doctor. But he’s also scared.

Tracy Cardin, ACNP

Physician

January 26, 2015

Recently I received an elderly patient who had been transferred from another hospital where she had been admitted for two weeks. The pertinent information about this patient is that her son, a doctor, a pathologist, had arranged the transfer.

The worst thing to have is a patient with a doctor for a relative. No, the worst thing is to have a patient …

Dear health IT: Please understand our frustrations

Edwin Leap, MD

Health Technology

January 26, 2015

Dear health IT staff,

I know that, on many levels, physicians must be the absolute banes of your existence. We are grumpy and resistant to change. And some of us are still confused by graphing calculators, much less complex modern computer systems. We call you because we forgot our passwords, then because we forgot the new passwords. We call because the system …

What have we lost with the progress of medical training?

Karan Chhabra

Medical Education

January 25, 2015

Every third-year has heard it: “When I was in your position, I was taking 24-hour calls every other night. If my resident was there, I was there …”

We’re regaled about the glory days, without shelf exams, without phlebotomists, and — by God — without those work-hour restrictions. The days when medical students wouldn’t dare ask their residents for help, or residents their chiefs, or chiefs their attendings, and so on. …

Doctors moonlight as nurses to stay competitive

GomerBlog

Physician

January 25, 2015

Nurse Shannon Wilkens on floor 4 west thought she saw someone she knew in scrubs walking into room 414.

“He was tall, I swore he looked familiar. Our charge nurse informed me he was recently hired and volunteered to work nights,” Wilkens recalled. “So being that it was slow, and I had only three patients as opposed to …

The time to regulate e-cigarettes is now

Ruth Macklin, PhD

Medications

January 25, 2015

A new revelation has added to the ongoing controversy over the health risks of e-cigarettes. Some commentators have viewed the use of this electronic delivery system for nicotine as a way for smokers to cut down on tobacco cigarettes or quit the habit altogether. Others have contended that e-cigarettes can be a “gateway” to smoking and may actually increase …

What are doctors thinking when you’re talking in the exam room?

Lucy Hornstein, MD

Physician

January 25, 2015

Ever wonder what your doctor is thinking while taking your history? If we’re doing it right, we’re looking at you instead of a computer. We’re making appropriate eye contact while displaying welcoming body language. And we’re letting you tell your story with as few interruptions as possible. Clearly we are listening intently, but did you ever wonder what’s going through our minds while you’re speaking?

I’ve been thinking about this lately …

Here’s why we need evidence-based pediatrics

Chad Hayes, MD

Physician

January 25, 2015

There have been countless instances in which the traditional practice of medicine has been disproved when someone actually took the time to perform a study. But who cares if a treatment doesn’t work — why does it really matter? Let me walk you through why it’s important, starting with the Hippocratic oath.

As physicians, our top priority is to “do no harm.”

But this priority often clashes with the patient’s reason for …

Stop yelling at your kids. Here’s how to do it.

Claire McCarthy, MD

Conditions and Diseases

January 24, 2015

Everyone yells at their kids. Oh, I’m sure there are some truly perfect parents out there who don’t (and some who don’t because they are physically unable to yell), but the rest of us do. Parents are human; we all get frustrated, angry, exhausted and scared and, well, yell.

But yelling rarely helps. It usually makes things worse. And it makes us …

What do you value most at the end of life?

Anne Katz, RN, PhD

Conditions and Diseases

January 24, 2015

A friend of mine died after outliving her prognosis for more than a year. I was with her at almost all her appointments with various oncologists. She had asked me to be the note taker for these appointments so that she could focus on the discussion as it happened and then have the notes to review afterwards.

Her treatment course was …

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