KevinMD.com

August 3, 2013Aug 3, 20137

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…

Detroit is dying.

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

Conditions and diseases

Skip breakfast at your own risk

David L. Katz, MD

August 3, 2013Aug 3, 20132

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…

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

Physician voices

How can doctors and patients regain trust in each other?

Shirie Leng, MD

August 3, 2013Aug 3, 2013126

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…

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 …

Real physician voices, twice a week

Free, and one click to unsubscribe.

Conditions and diseases

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

mksap

August 3, 2013Aug 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…

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 …

Health technology

A deal with the devil: The security of electronic medical records

David Mokotoff, MD

August 2, 2013Aug 2, 20137

With the recent NSA admission of recording phone conversations of US citizens, there has been renewed interest in the right to privacy. For the record, it is worth recalling what the Fourth Amendment to the Constitution says. "The right of…

“The right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated, and no Warrants shall issue, but upon probable cause, supported …

Health technology

Disruptive technology in medicine has the ability to heal or harm

Kunmi Sobowale, MD

August 2, 2013Aug 2, 2013

Disruptive technology is a term used to describe new technology that disrupts the status quo. These technologies displace existing technology—dramatically changing the production, delivery, or use of a product or service. For example, 3D printing is an innovative method of producing three dimensional objects using digital prototypes and will change manufacturing as we know it. Although the term is traditionally used in a positive light, this technology, as its name …

Medical education

When the patient represents tedious work

Rich Joseph

August 2, 2013Aug 2, 2013

I have reached a new milestone in my medical training—third year—the year when we transition from the classroom into the hospital, from the preclinical to the clinical curriculum. Those who have come before me understand that this is a major turning point in one’s medical education where the theory and memorizing from the first two years is put into play in order to manage patients with complex conditions.

It is an …

Health policy

Are doctors ethically obligated to sign patients up for Obamacare?

Bob Doherty

August 2, 2013Aug 2, 201360

One of the most disheartening developments in the unrelenting political fight over the health reform law is the organized effort by its opponents to dissuade the public from signing up for coverage. Having failed in efforts to block Obamacare in the Supreme Court, or to elect a president or Senate that would work for its repeal, they are now working to kill the law by persuading people to not sign …

Physician voices

Locums tenens physicians change the face of medicine for the better

Edwin Leap, MD

August 2, 2013Aug 2, 2013

I remember a time when many physicians, especially residents in various specialties, would moonlight in small emergency departments. They viewed it as a convenient way to supplement their low salaries. Some of them were excellent doctors. Sadly, quite a few…

I did the same thing, although I was a second- and third-year emergency medicine resident at the time. Indeed, the money came …

Conditions and diseases

It’s time primary care doctors diagnose autism

Denise A. Somsak, MD

August 1, 2013Aug 1, 20134

I remember how my son’s autism diagnosis was delivered. He was three years old. It wasn’t a surprise really, merely a confirmation of something that I expected and feared. He was already enrolled in speech and occupational therapy making very little progress. He saw a developmental specialist at age two and two and half who initially believed that he was not autistic but merely delayed with sensory issues. After we …

Conditions and diseases

Anesthesiology and obstructive sleep apnea: A patient safety challenge

American Society of Anesthesiologists & Jeffrey S. Jacobs, MD

August 1, 2013Aug 1, 20134

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Obstructive sleep apnea (OSA) has been diagnosed in more than 18 million American adults, but there are likely millions of others who suffer with OSA, but are undiagnosed.…

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

Obstructive sleep apnea (OSA) has been diagnosed in more than 18 million American adults, but there are likely millions of others who suffer with OSA, but are undiagnosed. While OSA is frustrating to the patient and the patient’s family, it is crucial to remember OSA is a significant disease that can affect the patient’s safety during and after medical and …

Patient voices

Why patients have to be their own advocates

Angie Dresie

August 1, 2013Aug 1, 201312

I am a 47-year-old female. In December of 2010, I had surgery to remove a 2 inch atrial myxoma (a heart tumor) in my left atrium. The costs for that were astronomical. That is not what I am writing about. I am writing about what happened in the months after my surgery and a cure that cost $9.19 if you don’t count all of the unnecessary doctor visits and

…

Conditions and diseases

Losing my temporarily able-bodied status

Sandra L. Shea, PhD

August 1, 2013Aug 1, 2013

I thought of Peter when I lost my TAB status. I lost it on vacation. These things happen. Suddenly, one Friday night in Florida, I was no longer a TAB. Shouldn't have been too surprised, I guess. But I didn't…

I thought of Peter when I lost my TAB status.

I lost it on vacation. These things happen. Suddenly, one Friday night in Florida, I was no longer a TAB. Shouldn’t have been too surprised, I guess.

But I didn’t expect it would involve a chicken.

I should explain.

I’m a medical educator: I have a PhD in experimental psychology/neuroscience, and I teach first-year medical students. In our curriculum, the students work through patient …

Conditions and diseases

Exercise is a powerful tool in the fight against cancer

James C. Salwitz, MD

August 1, 2013Aug 1, 20136

If you had cancer, how good would a treatment have to be, how much would it have to help, for you to use it? How about if it gave you a 5% better chance of cure? A 10% chance? How…

If you had cancer, how good would a treatment have to be, how much would it have to help, for you to use it? How about if it gave you a 5% better chance of cure? A 10% chance? How about a 20% chance to be beat the disease using a treatment without side effects that is free? “Sign me up,” you say? Nonetheless, only 8% of breast cancer patients …

Physician voices

How no shows hurt private practice doctors

Michael Kirsch, MD

August 1, 2013Aug 1, 201399

I’ve had two jobs since I completed a fellowship is gastroenterology over 20 years ago. For the first decade, I was a salaried physician. Afterwards, I promoted myself to private practice. Each model has its advantages and drawbacks, but for me the private practice model wins out. The climate in Cleveland is extremely inhospitable to private practice, because of two mega-medical institutions that incinerate private practices as their boiling …

Conditions and diseases

Is obesity a symptom or a disease?

Shirie Leng, MD

July 31, 2013Jul 31, 201310

There’s a great scene in the classic West Side Story in which members of the Jets gang go through all the different things people say is wrong with them. "The problem is he’s crazy, the problem is he drinks, the…

There’s a great scene in the classic West Side Story in which members of the Jets gang go through all the different things people say is wrong with them.

“The problem is he’s crazy, the problem is he drinks, the problem is his mother, the problem is he stinks.”

“I’m depraved on account ‘a I’m deprived!”

It’s satire, and it’s funny, and it’s a catchy song, but it illustrates the complexity of social and …

Read more…

Is obesity a symptom or a disease?

Medical education

The medical school interview: Strategies from an admissions officer

Samir Desai, MD

July 31, 2013Jul 31, 20132

As a member of the medical school admissions committee, I've interviewed many amazing applicants. Here's what I wish I could say to them: 1. Your interview performance is critical. As interviewers, we're amazed by the quality of today's applicants. In…

As a member of the medical school admissions committee, I’ve interviewed many amazing applicants. Here’s what I wish I could say to them:

1. Your interview performance is critical. As interviewers, we’re amazed by the quality of today’s applicants. In fact, many of us wonder if we would get into med school today. “I can’t believe how much she’s done,” is something I hear time and time again from my colleagues. The sad …

Conditions and diseases

Hospital care practically guarantees that we won’t get good sleep

Peter Ubel, MD

July 31, 2013Jul 31, 20138

The importance of sleep is perhaps most realized when we become sick. When we are hospitalized and most in need of every ounce of health, though, hospital care practically guarantees that we won’t get good sleep. Fortunately, two approaches hold promise to improve sleep for patients: one organizational, and the other a common trick of the trade among those of us working in behavioral economics.

Recently I was all-too-miserably reminded of …

Real physician voices, twice a week

The Podcast

Latest episodes

Most popular

The Podcast

Latest episodes

Most popular