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Reduce the chance that you will be harmed by an incidentaloma

Physician

April 18, 2013

Mrs. Smith (not her real name) fidgeted in her chair in my examination room as I scanned the radiology report she had given me. She had visited the emergency room the previous evening with severe abdominal pain that had eventually been diagnosed as gastritis, or swelling of the stomach lining due to a virus. During her evaluation, the ER physician had ordered a CT scan of her abdomen and pelvis. …

Should physicians discuss spirituality with their patients?

Peter Ubel, MD

Physician

April 18, 2013

“I can fix this.”

The neurosurgeon was nothing if not confident.

“The cyst is pushing on your spinal cord. If it continues to expand, it will damage your nerves and you may lose the ability to walk. But I can remove the cyst, and cure you.”

The patient was a business school professor, a man comfortable with risk-benefit ratios and complex decisions. He probed for more information. The surgeon was happy to provide …

Training to become a surgeon: Embrace the journey

Justin Steggerda

Medical Education

April 18, 2013

bart-yasso

I’ve never been one with much affection for cold or inclement weather and as such, between November and April, most of my training is done on the treadmill. While many people lament the monotony and unchanging scenery that treadmill running brings, I take the time to lose myself in podcasts.

Recently, during a set of race-pace intervals, I listened to a podcast that …

Anesthesiologists are victims of their own success

Karen S. Sibert, MD

Physician

April 18, 2013

New research just out in the journal Psychology and Aging says pessimists live longer and healthier lives. If this is true, then contemplating the future of anesthesiology ought to make us immortal, because our professional prospects don’t look bright. As we teach residents to do what we’ve always done, shouldn’t we ask ourselves honestly if we’re training them for a future that doesn’t exist?

Especially here in California, it seems …

Who are the physicians that make the decision to deny care?

Wes Fisher, MD

Physician

April 17, 2013

A phone conference had been arranged. They wanted to talk to me about a denial for payment on a portion of a patient’s pre-authorized procedure after the fact. Its participants: the regional medical director of a large insurance company, his female assistant administrator, and me.

He cordially introduced himself as a pediatrician by trade from a large well-known (and highly respected) academic institution with impeccable credentials responsible for our region of the United States. …

TEDMED 2013 recap: Day 1

Michael Moore

Potpourri

April 17, 2013

We’re here at TEDMED 2013, excited to be part of a unique group of people passionate about the future of medicine and curious to walk the path that will take us there. We’ll be reporting through the rest of the week on the talks, demos, and people that make TEDMED the world’s premier medical conference.

The first session of TEDMED 2013 opened with performing artist Kishi Bashi setting the stage …

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TEDMED 2013 recap: Day 1

Medicine does not compel us to like everyone we treat

Don S. Dizon, MD

Physician

April 17, 2013

“Great,” I thought, as I stood at my desk, looking at my patient list early in the morning. She was coming in today. “She” was a patient of mine in her forties, with newly diagnosed triple-negative breast cancer, without nodal involvement. Our first meeting had been several months ago, and it had not been a good one.

I had asked about her …

Dear Congress: Listen to doctors on the front lines of medicine

Matthew Moeller, MD

Health Policy

April 17, 2013

A follow-up to Dear lawmakers: This is what it’s like to be a doctor today.

Thank you to everyone for the positive feedback. Over 60,000 Facebook “likes”, tweets, and newspaper requests was quite a surprise. I was especially moved by the multiple tweets from hospices, physician groups, and individuals recommending my article. This article really has hit a nerve and shed …

Because I said so: Why that doesn’t work with patients

Jennifer Middleton, MD

Physician

April 17, 2013

Let’s explore one of the most well-studied health behavior theories – the health belief model (HBM).

The HBM states that our health choices are a direct consequence of our perceived susceptibility to a disease, our perceived severity of a disease, and the perceived barriers that keep us from adopting better habits.

Perceived susceptibility, perceived severity, and perceived barriers are three of the main constructs from the HBM. The word “perceived” is very …

I am a surgeon: Therefore I think

Richard Patterson, MD

Physician

April 17, 2013

“If you can’t do this drunk, you shouldn’t be doing it at all.”

The eminent professor was speaking to a friend of mine about heart surgery. He was not supporting operating under the influence, or am I.

The point is that the technical component of surgery — the cutting, the sewing, the rearranging — is very easy. It is true that in the OR, as on the golf course, some are more …

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I am a surgeon: Therefore I think

This is what it’s like to have a colonoscopy

David L. Katz, MD

Conditions and Diseases

April 17, 2013

I am just back from my colonoscopy more or less. All went well, but I am still shrugging off the lingering tendrils of my sedation. So let’s chalk up any grammatical snafus to that, shall we?

I had, of late, had some GI symptoms. But those were mostly coincidental and likely due to extensive travel and the havoc changing time zones wreaks on circadian rhythms.

Mostly, it was just time to have …

How to know when to call the doctor

Claire McCarthy, MD

Physician

April 16, 2013

Sometimes, when a parent tells me about something that happened with their child, I think (and say, as nicely as I can): Why didn’t they call right away?

And sometimes, when I’m talking to a parent or seeing their child in the office, I think (but don’t say): Why did they call about this?

It can be really hard to know when to call the doctor.

It’s hard because sometimes you plain old …

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How to know when to call the doctor

Getting into residency: 5 tips for a dynamic personal statement

Helen M. Farrell, MD

Medical Education

April 16, 2013

It’s that time of year when third year medical students are grappling with anxiety as they prepare their residency applications. Those uncertain feelings of ambivalence can only be assuaged by a successful “match.” Critical to recruitment committees, but often overlooked by students, are the influential personal statements.

Everybody coming out of medical school has a long list of accomplishments and abilities. The competition is steep. A powerful narrative has the potential to …

So your partner wants to remove your pubic hair

Jennifer Gunter, MD

Physician

April 16, 2013

A divorced friend of mine who recently started dating was shocked to find that the complete absence of female pubic hair seemed to be an expectation among her potential partners. I’m not surprised, when I was in the dating pool a couple of years back there were men who actually listed full clamscaping required among the personal attributes they were seeking in a girlfriend (and here I was looking for …

When I grow up, I want to be a drunk

Maria Yang, MD

Physician

April 16, 2013

I want to wake up feeling restless and uncomfortable. It’ll be neat to drag myself out of bed to open that first bottle of wine. I’ll drink all of it within an hour. Then I’ll go to the liquor store. The guy behind the counter will know that, everyday, I will buy a pint of vodka from him. He will look at …

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When I grow up, I want to be a drunk

End of life discussions require all hands on deck

Ishani Ganguli, MD

Physician

April 16, 2013

When I attended the Association of Health Care Journalists (AHCJ) conference in Boston recently, discussion swirled on the topics of unsustainable costs of care, doctors’ incentives under traditional payment models to order more tests and treatments, and the struggles of patients’ family members to avoid unwanted care at the end of life. That Sunday night, I was back at my day job (so to speak) in …

How the nanny state mentality hurts public health

Sherry Pagoto, PhD

Conditions and Diseases

April 16, 2013

When my daughter was born, I hired a nanny. Her name was Kelly. She was great, a savior. She collaborated with me in running the household, enforcing the rules of the home. She even had a set of her own rules. I learned from her and her rules because she had more experience tending children than me. She wasn’t a dictator, …

What happened in the wake of 9/11 saved lives in Boston

Miranda Fielding, MD

Physician

April 16, 2013

Today the road all runners come,
Shoulder high we bring you home
And set you at your threshold down
Townsman of a stiller town.
-A.E Housman

As the afternoon’s events unfolded, I sat glued to my computer screen between patients. My life has really been a tale of three cities—Houston, Boston and San Diego. Boston was where I did my residency training, met my husband, had my three children and my first “real” jobs. I …

After the Boston Marathon, we are just like the rest of the world

Natasha Deonarain, MD, MBA

Physician

April 16, 2013

A few years ago my best friend ran the Boston Marathon. She came back glowing, proud that she’d qualified, amazed by the crowds and energized by the feeling of community. Never once did she think that she could have died from a bomb exploding at the finish line.

America seems to be facing tragedy after tragedy. From the Aurora shootings, to Sandy Hook Elementary, to the Boston Marathon bombings, each time …

We should tell our medical histories to our children

Dr. Charles

Physician

April 16, 2013

There was an article in the New York Times recently about the importance of cultivating a family narrative to instill a sense of identity, control, and resilience in children. The more children know about their family story, the better equipped they are to handle stresses that would shake their foundation. Is it possible that, in the realm of personal health and well being, the cultivation of an …

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