KevinMD.com

Drug addiction: 5 things we can learn from Cory Monteith

Jan Gurley, MD

Conditions and Diseases

August 6, 2013

503591-cory-monteith-glee-golden-globes-617-409

Hollywood stars, like Glee’s Cory Monteith, aren’t the only Americans struggling with addiction that kills. Monteith, who died of a heroin and alcohol overdose, exemplifies the public health tragedy that is opioid overdose deaths in America. The fact is, there is no greater public health issue.

From as far back as 2008, we have been dying more from poisoning – almost all poisonings …

Limiting your choice of doctors: Is Obamacare to blame?

Trudy Lieberman

Health Policy

August 6, 2013

The specter of loss of choice and freedom to select the doctor you want haunts again. This time it’s being raised on the airwaves with an ad from Americans for Prosperity, a group that advocates limited government and free markets. The ad, an attack on Obamacare, plants doubt in viewers’ minds about whether they can choose their own doctor, a theme that continues to resonate with both the public and …

Is the Mexican abortion pill safe?

Jennifer Gunter, MD

Medications

August 6, 2013

With Governor Rick Perry signing the restrictive Texas abortion bill into law many news organizations have shed light on traveling to Mexico for abortion and there has been much talk about the “Mexican abortion pill.”

The medication that people typically call the Mexican abortion pill is misoprostol, marketed under the trade name Cytotec. It is a prostaglandin analogue and is used for prevention of stomach ulcers. It also has many uses in OB/GYN …

Read more…

Is the Mexican abortion pill safe?

Technologists versus doctors: Who wins?

Robert Pearl, MD

Physician

August 5, 2013

The notion that doctors can be replaced by technology has sparked a series of brawls between doctors and technologists over the last couple of years. Today, both sides continue to throw punches in the press and online.

As health care technologies become more sophisticated, the opportunity to automate medical decisions becomes more seductive. Yet, physicians are unwilling to throw in the towel. They point to the importance of human interaction and …

Read more…

Technologists versus doctors: Who wins?

Burnout: The perfect storm of physician stress

Karen S. Sibert, MD

Physician

August 5, 2013

burnout

To the literal-minded, burning out is the fate of light bulbs and matches. But whether you read the popular press or medical journals today, you’re likely to find writers who are deeply concerned about physician burnout.

What defines physician burnout, and who exactly is suffering from it? Is burnout an actual clinical syndrome, a slang term connoting fatigue and boredom, or a hazy …

The gratitude of a terrified parent when kindness is shown

Pat Mastors

Patient

August 5, 2013

Hospital transport arrives to take my daughter just after 9am. We’d been told her ultrasound and x-ray were scheduled for 10am, an hour away. Jess and I exchange a look. She’s just about to take another swig of the laxative drink she’s been drinking since 8:30.

“I’ll go with you,” I say.

“We’ll make sure there’s a bathroom nearby.”

Strike one for the Golden Cocoon.

We get to the ultrasound department, and are left …

Jenny McCarthy on The View: Trading experience for expertise

Wendy Sue Swanson, MD

Physician

August 5, 2013

Jenny McCarthy is officially joining The View. “Do I have opinions?” one reporter asked. Yup.

My concerns center around Jenny McCarthy’s past willingness to trade-in her experience for expertise. That is, she widely shared her theories and anecdotes about her son’s experience with learning challenges and falsely placed blame on vaccines for his then-diagnosed autism. I will not discount her private experience.

What I discount …

Why one doctor throws away insurer mailings

Lucy Hornstein, MD

Physician

August 5, 2013

There are lots of generalized complaints out there about insurance companies increasing physician workloads without additional compensation. I thought I would share a specific instance of this so everyone else can get an idea of what we’re up against.

I received the following mailing:

We want you to screen our members for cancer. Please do these things:

Call the member to discuss colorectal, skin, and prostate …
Read more…

Why one doctor throws away insurer mailings

Doctors: Fight burnout like it’s the plague

Stella Safo, MD, MPH

Physician

August 4, 2013

When I was a med student, the thing I loved most about primary care was continuity of care. I loved feeling like I had a sense of my patients’ lives, of the intimate details of their day to day, of their fears and dreams. I thought that this connectedness was all I needed to have a successful career as a primary care …

Guantanamo: End forced nasogastric tube gagging

Nuriel Moghavem and Marty Makary, MD

Physician

August 4, 2013

Guantanamo detainees on a hunger strike are now being strapped into chairs and gagged as doctors push a feeding tube through their nose into the back of their throat and into their stomach as often as twice a day. It’s a disturbing new practice, but one we must examine in full as we consider whether Guantanamo reflects American values.

Anyone who has had a nasogastric tube placed through their throat …

Each patient is still human and deserves to be treated as such

Joyce Ho, MD

Medical Education

August 4, 2013

“I don’t want a tube down my nose. I’ve been through it before and I don’t want it again.” Charlie turned his head away from the team and crossed his arms in defiance. “I’d rather be sick.”

I looked at the intern, who looked at the resident, who just said, “Well, think about it. We’ll be back in the afternoon.”

“I’m also hungry and haven’t eaten in days,” Charlie added.

“Maybe some food …

Our patients pay for dumbed down American medicine

Jordan Grumet, MD

Health Policy

August 4, 2013

I guess what is so utterly frustrating is that the guys up there don’t see what is going on down here. The march of health care reform continues with little realization of what it feels like to be one of the tiny peon foot soldiers on the ground. We are not deaf. We hear the politicians and policy wonks. We read as non-clinician “doctors,” ivory towered administrators, and the business …

MKSAP: 27-year-old woman is evaluated for a 4-week history of wheals

mksap

Conditions and Diseases

August 4, 2013

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 4-week history of wheals, characterized by a burning sensation without pruritus. Each individual lesion persists for 48 hours and slowly resolves, leaving a bruise. Current medications are diphenhydramine, hydroxyzine, cetirizine and oral contraceptives. The patient’s mother has systemic lupus erythematosus.

On physical examination, vital signs are normal. She …

Healthcare professionals need to be proficient in sales

Edward Leigh

Patient

August 4, 2013

Most healthcare professionals do not consider themselves to be in the field of sales. However, healthcare professionals do sell something so they are in sales! Even if you may not have the titles of “salesman” or “saleswoman,” you are still in sales. Everyone sells something. Kindergarten teachers sell something (i.e., the value of education). What do healthcare professionals sell? We sell the benefits of treating illness and promoting wellness. During …

Are we unfair to the RUC? A view from the inside

Yul Ejnes, MD

Health Policy

August 3, 2013

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

I will begin this month’s column with a confession on something that most people don’t know about me. I hope it doesn’t lose me any friends. I am a member of the AMA/Specialty Society Relative Value Scale Update Committee, better known as the RUC. Actually, I’m an alternate, but …

I know I’m a real doctor, and I will die happy doing this

Emily Gibson, MD

Physician

August 3, 2013

Nothing seems to please a fly so much as to be taken for a currant;
and if it can be baked in a cake and palmed off on the unwary, it dies happy.
-Mark Twain

Returning to clinic after time off for a summer break, I worry I’m like a fly hiding among the black currants hoping to eventually become part of the currant cake. Just maybe no one will notice I don’t …

What Detroit’s bankruptcy means for patients

Birju Rao

Health Policy

August 3, 2013

Detroit

On July 18th 2013, the city of Detroit filed for bankruptcy. Early estimates size up Detroit’s as the biggest in history with composite debt figures approaching the ballpark of $20 billion. Through the eyes of a clinician why should we care and what does this mean for our practices.

Detroit is dying.

While filing for Chapter 9 bankruptcy may give the city an extra lifeline, …

Skip breakfast at your own risk

David L. Katz, MD

Conditions and Diseases

August 3, 2013

That breakfast is important is denoted by the name itself. At some point, we either break our fast, or just keep fasting — and eventually, starve. So for those of us disinclined to starve, fast breaking has to happen at some point. By convention, that’s breakfast.

Much else about breakfast, what we eat and when for instance, also tends to be a matter …

Read more…

Skip breakfast at your own risk

How can doctors and patients regain trust in each other?

Shirie Leng, MD

Physician

August 3, 2013

The Mayo Clinic Proceedings came out with a study that shows that many of the treatments that doctors once swore by are useless or worse.

The New York Times did a piece on it and the commentary contained a great deal of doctor-bashing. So of course I opened my big mouth and pointed this doctor hatred out. The comment I got back was this: “It’s not hatred, it’s fear.”

Wow. If people …

MKSAP: 76-year-old woman with dizziness and palpitations

mksap

Conditions and Diseases

August 3, 2013

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

A 76-year-old woman is evaluated in the emergency department for dizziness, shortness of breath, and palpitations that began acutely 1 hour ago. She has a history of hypertension and heart failure with preserved ejection fraction. Medications are hydrochlorothiazide, lisinopril, and aspirin.

On physical examination, she is afebrile, blood pressure is 80/60 mm Hg, pulse rate …