KevinMD.com

August 7, 2013Aug 7, 201313

You may not remember me, but when I asked how you were, you said, “alive.” A few weeks earlier you were afraid of going under anesthesia and not waking up. They said you’d do great; that this was routine; that…

You may not remember me, but when I asked how you were, you said, “alive.”

A few weeks earlier you were afraid of going under anesthesia and not waking up. They said you’d do great; that this was routine; that we’d see you again soon. Then you coded on the table. I’ve never met someone who was grateful for life the way you expressed to me that day.

You may not remember …

Conditions and diseases

Melanoma refuses to abide the laws of general civilization

Samyukta Mullangi

August 6, 2013Aug 6, 201312

The man who had been seated in room 2 by the medical assistant had been seen 6 months previously for a small, pigmented lesion behind his left ear, which a punch biopsy subsequently proved to be malignant melanoma in situ. He was sent to the Mohs surgeon in the interim who carefully excised just as much skin as was absolutely necessary and …

Physician voices

What happens to all the miscarriages?

Pamela Wible, MD

August 6, 2013Aug 6, 2013345

Last week a woman told me that she had a miscarriage in her bathroom. She was terrified. She didn’t know what to do. So she flushed it down the toilet. A miscarriage is the spontaneous expulsion of a fetus from…

Last week a woman told me that she had a miscarriage in her bathroom. She was terrified. She didn’t know what to do. So she flushed it down the toilet.

A miscarriage is the spontaneous expulsion of a fetus from the womb before it is able to survive on its own. One in five pregnancies ends in miscarriage. Many women don’t know they are miscarrying. Those who know usually suffer grief …

Read more…

What happens to all the miscarriages?

Real physician voices, twice a week

Free, and one click to unsubscribe.

Health policy

For patients, reforming the RUC matters

David Margolius, MD

August 6, 2013Aug 6, 2013

"Doc, if I have cancer, I don’t want to know. Stop bugging me about this colonoscopy.” Mr. H said to me, his primary care physician, during our appointment. He folded his arms and nodded his head, indicating that his decision…

“Doc, if I have cancer, I don’t want to know. Stop bugging me about this colonoscopy.”

Mr. H said to me, his primary care physician, during our appointment. He folded his arms and nodded his head, indicating that his decision was final.

“Mr. H, as uncomfortable as colonoscopies seem, they can actually find lumps that might grow into cancer, and cut them out before they ever become cancer. That’s why I’m bugging you so much about this.”

I …

Read more…

For patients, reforming the RUC matters

Conditions and diseases

Drug addiction: 5 things we can learn from Cory Monteith

Jan Gurley, MD

August 6, 2013Aug 6, 201314

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…

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

Health policy

Limiting your choice of doctors: Is Obamacare to blame?

Trudy Lieberman

August 6, 2013Aug 6, 201310

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 …

Drugs and prescribing

Is the Mexican abortion pill safe?

Jennifer Gunter, MD

August 6, 2013Aug 6, 201313

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…

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?

Physician voices

Technologists versus doctors: Who wins?

Robert Pearl, MD

August 5, 2013Aug 5, 20138

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…

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?

Physician voices

Burnout: The perfect storm of physician stress

Karen S. Sibert, MD

August 5, 2013Aug 5, 20136

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,…

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 …

Patient voices

The gratitude of a terrified parent when kindness is shown

Pat Mastors

August 5, 2013Aug 5, 201312

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…

“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 …

Physician voices

Jenny McCarthy on The View: Trading experience for expertise

Wendy Sue Swanson, MD

August 5, 2013Aug 5, 20136

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…

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 …

Physician voices

Why one doctor throws away insurer mailings

Lucy Hornstein, MD

August 5, 2013Aug 5, 201321

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…

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

…

Physician voices

Doctors: Fight burnout like it’s the plague

Stella Safo, MD, MPH

August 4, 2013Aug 4, 201310

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 …

Physician voices

Guantanamo: End forced nasogastric tube gagging

Marty Makary, MD, MPH & Nuriel Moghavem

August 4, 2013Aug 4, 20139

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 …

Medical education

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

Joyce Ho, MD

August 4, 2013Aug 4, 201310

“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…

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 …

Health policy

Our patients pay for dumbed down American medicine

Jordan Grumet, MD

August 4, 2013Aug 4, 201370

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…

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 …

Conditions and diseases

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

mksap

August 4, 2013Aug 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…

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 …

Patient voices

Healthcare professionals need to be proficient in sales

Edward Leigh

August 4, 2013Aug 4, 201327

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 …

Health policy

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

American College of Physicians & Yul Ejnes, MD

August 3, 2013Aug 3, 201319

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 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 that’s close enough. I just completed my first year …

Physician voices

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

Emily Gibson, MD

August 3, 2013Aug 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…

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 …

Real physician voices, twice a week

The Podcast

Latest episodes

Most popular

The Podcast

Latest episodes

Most popular