KevinMD.com

August 10, 2013Aug 10, 20132

Have you ever felt that claims about the effects of our access to new and more health information overshoot the mark? For example, you may be searching for help in understanding some ambiguous findings from diagnostic tests. Perhaps you think you are having troubling side effects from your new medication but then it may just be a reaction to something you ate last night. You may be hunting high and …

Physician voices

The demand apathy that doctors increasingly face

Jordan Grumet, MD

August 10, 2013Aug 10, 20133

Monday afternoons are always the same. I pick up the kids from their grandparents. We drive home with their backpacks and a carton of home made food. We park in the garage, and carry all the contents of the car into the house. As the kids unload, I push the recycle container to the front for street pickup the next day.

Occasionally, I stop and socialize. Yesterday, I waited at the edge …

Physician voices

The very best physicians do not judge their patients

James C. Salwitz, MD

August 10, 2013Aug 10, 201315

It occurs to me there are several keys to being an excellent physician. One must love science, enjoy hard work, have the courage to make tough decisions, carry a modicum of intelligence and suffer angst at receiving 94% on an organic chemistry test. In addition, the very best physicians, those we admire and to whom we flock, have a secret weapon. They do not care.

I do not mean that they …

Real physician voices, twice a week

Free, and one click to unsubscribe.

Conditions and diseases

MKSAP: 58-year old woman with fatigue and weight loss

mksap

August 10, 2013Aug 10, 2013

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 58-year old woman is evaluated for a 3-week history of fatigue and weight loss. The patient has no significant medical history and takes…

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

A 58-year old woman is evaluated for a 3-week history of fatigue and weight loss. The patient has no significant medical history and takes no prescription medication, but she does take a daily over-the-counter multivitamin and a calcium supplement. She has a 50-pack-year smoking history.

Physical examination reveals a lethargic, ill-appearing woman. Temperature is 37.3 …

Physician voices

This was not a congenital deformity, but a preventable crime

Bhupesh Vasisht, MD

August 9, 2013Aug 9, 20138

I started seeing patients the moment we arrived at Apollo Hospital in the small rural town of Bilaspur. There was no time to rest. These patients had been waiting for us for weeks to arrive. It was during this clinic time, on this day, that I realized something that really struck me to the core. I have been to India to do these missions many times. Heck, I have been …

Physician voices

To change health care, we need more physician leaders

Davis Liu, MD

August 9, 2013Aug 9, 201310

There is a stunning gap between what we know and what we need to do in health care to make it more affordable, accessible, and higher quality. In a recent piece by NPR, research shows that when it comes to treatment of low back pain, doctors are prescribing more powerful pain medications (narcotics) and ordering more imaging tests like MRI and CT scans when there is no evidence these are …

Patient voices

6 tips to prevent being intimidated at the doctor’s office

Toni Bernhard, JD

August 9, 2013Aug 9, 201348

I’ve had my share of unsuccessful experiences with doctors and at medical clinics, including being intimidated by them. But after twelve years of chronic illness, I’m happy to report that I’m doing better in this uncomfortable setting. Here are six strategies to help minimize the odds you’ll be intimidated and to help ensure you make the most of the short time allotted …

Physician voices

Immunization workers murdered: The price of killing Osama bin Laden

Edward Pullen, MD

August 9, 2013Aug 9, 20135

The price has been in lives. The capture and killing of Osama bin Laden occurred without loss of any U.S. military lives. It was hailed as a hugely successful special forces and intelligence operation. Still to believe that the operation was accomplished without the loss of life is both incorrect and naive. The lives lost have been those of polio vaccination workers murdered in the backlash against the use of …

Health policy

My health care wish list if I were king

Bob Doherty

August 9, 2013Aug 9, 201318

I think we all have fantasies from time-to-time what we might do it we were made King for a day (only benevolent kings, of course—no despots need apply!) What decrees might we issue to make the world a better place? What changes would we order to make our politics better? What improvements would we institute to make health care better? Well, here’s my (health care) list:

1. I would decree that every …

Read more…

My health care wish list if I were king

Physician voices

When a doctor offers to speak the language of medicine for you

Miranda Fielding, MD

August 9, 2013Aug 9, 20138

These days they have navigators for everything. When we got lost back in the day, we used to consult a map, or lacking a map, we would pull in to the nearest “filling station” (what we used to call gas pumps) and ask for directions from the friendly young man who would appear to wash our windshield, check the oil and the tire pressures, and of course, pump the gas. …

Physician voices

Doctors need to place their families first

Neil Baum, MD

August 8, 2013Aug 8, 201315

Several years ago I wrote an article for physicians on the topic of balance, and one of the suggestions was to place family first. There are two stories that I have learned since the publication of that article that I…

Balance in a doctor’s life is best achieved if there is balance between family and work. One of the best suggestions is to place …

Physician voices

Why family physicians are a threat to themselves

Paul D. Simmons, MD

August 8, 2013Aug 8, 201332

In recent months, AAFP President Reid Blackwelder has been editorializing and debating what they see as the encroachment of nurse practitioners (NPs) and other "mid-level providers" (physicians are, presumably, "upper-level") on the practice territory of family physicians (FPs). Dr. Blackwelder…

In recent months, AAFP President Reid Blackwelder has been editorializing and debating what they see as the encroachment of nurse practitioners (NPs) and other “mid-level providers” (physicians are, presumably, “upper-level”) on the practice territory of family physicians (FPs). Dr. Blackwelder has repeatedly said that NP and physician roles are “not interchangeable.” The AAFP’s position on this issue seems to be resistance to the increasingly common decisions by state legislatures to …

Patient voices

A doctor’s attitude toward his older patients

Martha Deed, PhD

August 8, 2013Aug 8, 20138

At first we thought it was funny when the doctor said, “Fatigue. That's a tough one. At 75-years-young, your chronic conditions are catching up with you, sapping your energy.” That was the end of exploring the presenting problem at my…

At first we thought it was funny when the doctor said, “Fatigue. That’s a tough one. At 75-years-young, your chronic conditions are catching up with you, sapping your energy.”

That was the end of exploring the presenting problem at my husband’s twice a year primary care visit.

On the way out to the parking lot, we said we’d like to be bugs on the wall when, 25 years from now, someone says …

Physician voices

Radical changes to how I think about care

Rob Lamberts, MD

August 8, 2013Aug 8, 20135

A patient calls or emails me with a problem. I talk with them over the course of a few days, using whatever form of communication works best. Eventually, they need to come to the office to be seen – either for something needing to be done in-person (examination, procedure, or lab test), or because of the advantages of face-to-face communication. At the visit, I not only deal with one problem, …

Physician voices

Can prayer heal the sick?

Michael Kirsch, MD

August 8, 2013Aug 8, 201310

Faith and reason entered my medical universe recently. A patient underwent surgery to resect a colon cancer. The tumor had metastasized to the lymph nodes, an unfavorable prognostic event. The surgeon entered the room and advised the patient that her…

Faith and reason entered my medical universe recently.

A patient underwent surgery to resect a colon cancer. The tumor had metastasized to the lymph nodes, an unfavorable prognostic event. The surgeon entered the room and advised the patient that her survival is likely limited to 1-2 years. The patient and her husband were devastated. The distraught husband spent the next 24 hours sobbing in a painful and despondent state. He related …

Read more…

Can prayer heal the sick?

Physician voices

Why I pray for my patients

Rajeev Kurapati, MD

August 7, 2013Aug 7, 20135

We have come a long way in medicine, treating serious illnesses and preventing life-threatening diseases. As a hospital-based physician, I treat various severe diseases every day throughout the ICU, medical, and surgical floors. On a normal day, I roll at a fast pace — admitting, treating and, discharging patients has become fairly routine for me. On any given day, we have an …

Read more…

Why I pray for my patients

Patient voices

Good doctors are those who genuinely care about patients

Robert Spencer, MD

August 7, 2013Aug 7, 201368

Helpless. That is how I felt when my mother found out she had a fibroid the size of a cantaloupe living in her uterus. In my role as a medical student I might have dismissed the finding as nothing serious, telling my patient, “Don’t worry, it could be much worse.” But as a loving son I was not quite as cavalier. At first my mother resolved to ignore the fibroid, …

Patient voices

The relationship with my doctor has been taken away

Rob Burnside

August 7, 2013Aug 7, 201319

Over the years, since the early 1990s, I've been treated for depression. Initially adjustment disorder, and lately, major depression. Perhaps I'm just getting older, and the "black dog" heavier. Then, I ponder all the changes I've encountered and wonder if…

Over the years, since the early 1990s, I’ve been treated for depression. Initially adjustment disorder, and lately, major depression. Perhaps I’m just getting older, and the “black dog” heavier. Then, I ponder all the changes I’ve encountered and wonder if they haven’t played a part. It may surprise you, but I’m thinking primarily of setting right now, and how much the therapeutic scene has morphed over those same years. I …

Conditions and diseases

Do you worry about the diseases you learn in medical school?

Hans Duvefelt, MD

August 7, 2013Aug 7, 20132

It was spring. My medical school class, two years along in our five-and-a-half year endeavor, had earned the “medicinae kandidat” degree. We were now worthy of leaving the basic sciences and research center on the outskirts of town and starting our preparatory clinical, “propedeutic” semester at the University Hospital. In Sweden, at that time, we used a lot of Latin words and phrases. Crohn’s disease was Morbus Crohn, chart notes …

Drugs and prescribing

E-cigarettes: Are they effective? Are they safe?

Deep Ramachandran, MD

August 7, 2013Aug 7, 20132

Electronic cigarettes are here, settling over the country, quite literally, like a fine white fog. Smokers in turn, have been turning to them as a tool to help them quit, though the device manufacturers are not allowed to market them that way in U.S. It seems intuitive that a device that mimics the action of smoking but without the combustion and …

Real physician voices, twice a week

The Podcast

Latest episodes

Most popular

The Podcast

Latest episodes

Most popular