KevinMD.com

April 6, 2013Apr 6, 20139

Politicians, financial experts, pundits and main street America would love to predict what’s going to happen to America in the next five years. But we don’t have to dust off the Dow Jones or the S&P, or even wonder what…

All we have to is understand the five stages of grief first developed by Dr. Elizabeth Kubler-Ross.

Elizabeth …

Physician voices

Blaming others for their health problems helps no one

Jennifer Middleton, MD

April 5, 2013Apr 5, 20134

I inherited motion sickness from my father's side of the family. I can't sit in the back seat of a car for more than 10 minutes without becoming sick. I take meclizine before every plane flight. I inherited asthma from…

I inherited motion sickness from my father’s side of the family. I can’t sit in the back seat of a car for more than 10 minutes without becoming sick. I take meclizine before every plane flight.

I inherited asthma from my mother’s side of the family. Exposure to perfume, 90+ degree temps with 90+% humidity, or even a good laugh will all prompt me to cough.

These two maladies of mine have …

Medical education

Our medical education system does not tolerate emotional cracks

Shara Yurkiewicz

April 5, 2013Apr 5, 20132

When we told the patient and his family that the mass in his lung was highly concerning for cancer, he didn’t say anything. His daughter asked about his symptoms. His son-in-law asked when and how he could get a definitive…

“I’m sorry for being so much trouble.” The tone was casually apologetic, …

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Physician voices

Let patients be their own people inside the system of care

Zackary Berger, MD, PhD

April 5, 2013Apr 5, 20133

The more I try to help people in this field of mine, the more I realize that it doesn't take a village. It takes a huge industrialized city, all its wires and arteries humming with constant activity, just to try…

The more I try to help people in this field of mine, the more I realize that it doesn’t take a village. It takes a huge industrialized city, all its wires and arteries humming with constant activity, just to try and make one woman better. In this case, one smiling woman in her 50s, ethnicity I couldn’t figure and of dubious relevance, who came to our clinic seeking advice about …

Health policy

Why physicians should sympathize with federal employees

Bob Doherty

April 5, 2013Apr 5, 20137

“Physicians care more about their pocketbooks than taking care of patients. They are self-interested and overpaid. They want to control everything. They don’t know what life is like in the real world of patients.” By now, I am sure that…

By now, I am sure that physician readers of this blog can feel their blood boiling, for good reason. Why would I, as the principal staff advocate for internal medicine physicians, put such pernicious, unfair, inaccurate quotes …

Social media in medicine

How a doctor’s online reputation survived a front page newspaper story

Kevin Pho, MD

April 5, 2013Apr 5, 201327

The Boston Globe recently had a front page story on how a neurosurgeon sued a patient’s husband for a blog critical of the physician. According to the story, the patient underwent a complicated back operation as a result of her…

The Boston Globe recently had a front page story on how a neurosurgeon sued a patient’s husband for a blog critical of the physician.

According to the story, the patient underwent a complicated back operation as a result of her bone cancer. She tragically had a stroke post-operatively, and that’s where the situation between the family and doctor deteriorated. On the advice of his psychiatrist, the patient’s husband wrote a …

Patient voices

The simple act of truth in the face of incurable cancer

Elaine Waples

April 5, 2013Apr 5, 20135

Most of us have spent some time thinking about our own deaths. We do it with a sense of dreadful curiosity, but then we push it aside with “well, we’ve all got to go sometime.” Unlike most people, I probably…

Most of us have spent some time thinking about our own deaths. We do it with a sense of dreadful curiosity, but then we push it aside with “well, we’ve all got to go sometime.”

Unlike most people, I probably know the how, the why, and maybe even the when of that event. It is profound information that turns the world upside down for us, our families, friends and caregivers.

I have …

Health technology

What patients want from mobile apps

Jessie Gruman, PhD

April 4, 2013Apr 4, 20139

Dear mobile health app developers, We—patients and caregivers—need your help to reduce the demands of self care. Mobile health (mHealth) apps have enormous potential to lessen our burdens. But our needs are often only loosely related to what clinicians and/or…

Dear mobile health app developers,

We—patients and caregivers—need your help to reduce the demands of self care. Mobile health (mHealth) apps have enormous potential to lessen our burdens. But our needs are often only loosely related to what clinicians and/or the evidence expect us to do. Most mobile app developers have ignored this fact by designing tools that primarily reflect the imperatives of …

Read more…

What patients want from mobile apps

Conditions and diseases

Sexual health in women treated for cancer

Don S. Dizon, MD

April 4, 2013Apr 4, 20132

As an oncologist who also runs a sexual health clinic for women treated (or under treatment), I am discovering that my perspective on both issues of cancer treatment (and survival) and life after cancer (and quality of life) is somewhat unique. I am conscious of how difficult it is to bring up cancer therapy and survivorship (let alone sexual health) within …

Conditions and diseases

I let my hope and optimism interfere with accurate communication

Peter Ubel, MD

April 4, 2013Apr 4, 2013

Andrews was easily the most anxious patient I took care of that month, a gray Michigan February (is there any other kind?) which I spent in the hospital caring for patients admitted to the general medical ward at the Ann Arbor Veterans Affairs Medical Center. (Andrews is a pseudonym, as are all the patients I blog about, unless otherwise indicated.) He had plenty to be anxious about, too. His leukemia …

Conditions and diseases

The quality and quantity of calories both count

David L. Katz, MD

April 4, 2013Apr 4, 20136

Among others, Gary Taubes has famously argued that calories don't count. Perhaps the more nuanced version is that the quality of calories, not the quantity, is what counts. Mr. Taubes and I have discussed this, and agreed to disagree. Leaving…

Among others, Gary Taubes has famously argued that calories don’t count. Perhaps the more nuanced version is that the quality of calories, not the quantity, is what counts. Mr. Taubes and I have discussed this, and agreed to disagree. Leaving aside Newton and laws of thermodynamics, there is the Twinkie Diet on my side: evidence that weight can be lost when calories are restricted, no matter how truly dreadful the …

Health policy

Lawmakers shouldn’t care about the personal hardships of doctors

Anonymous

April 4, 2013Apr 4, 201347

With a family and financial background that eerily matches Dr. Moeller’s, please count me as one soon-to-be physician who does not share the notion that lawmakers should spend their time being overly concerned with the demands placed on physicians or…

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

Patient voices

A reminder to slow down and focus on the human being

Audrey Cortez, RN

April 4, 2013Apr 4, 20137

Years ago I worked as a registered nurse in a busy surgical pre-admission clinic, preparing patients who'd been scheduled for surgery for the upcoming operation and hospital experience. My workdays were packed with back-to-back, hour-long appointments. Whatever surgery the patient…

Years ago I worked as a registered nurse in a busy surgical pre-admission clinic, preparing patients who’d been scheduled for surgery for the upcoming operation and hospital experience.

My workdays were packed with back-to-back, hour-long appointments. Whatever surgery the patient was facing–oral, orthopedic or anything else–every interview followed the same format. I would greet the patient, who’d often bring along a family member, and quickly escort them both into my small …

Physician voices

The only thing that truly separates doctors from nurses

Shirie Leng, MD

April 3, 2013Apr 3, 201365

, a journal of the American Association of Medical Colleges, has sent out a recent call for articles addressing the 2013 question of the year: “What is a doctor? What is a nurse?” Thirty years ago this would have been…

Academic Medicine, a journal of the American Association of Medical Colleges, has sent out a recent call for articles addressing the 2013 question of the year: “What is a doctor? What is a nurse?” Thirty years ago this would have been an absurd question. Not only would it have been absurd for doctors and nurses, but for patients too. Roles were …

Physician voices

Beware of hidden agendas in cancer support groups

Miranda Fielding, MD

April 3, 2013Apr 3, 201310

My husband likes to say, “No good deed goes unpunished.” I don’t always agree, but sometimes you just can’t argue that concept. One of my favorite patients, a forty nine year old woman who I treated for head and neck…

My husband likes to say, “No good deed goes unpunished.”

I don’t always agree, but sometimes you just can’t argue that concept. One of my favorite patients, a forty nine year old woman who I treated for head and neck cancer a year ago is a good case in point. Head and neck cancer is on the rise, and is linked, like cervical cancer, to infection with human papilloma virus which …

Health policy

Doctors should stop being compared to the airline industry

Jordan Grumet, MD

April 3, 2013Apr 3, 201316

We have to stop comparing ourselves to the airline industry. Sitting on the lounge chair at the pool, I can't believe that just hours ago I was sludging the wintry streets of Chicago, rushing to the airport. The kids clucked…

We have to stop comparing ourselves to the airline industry.

Sitting on the lounge chair at the pool, I can’t believe that just hours ago I was sludging the wintry streets of Chicago, rushing to the airport. The kids clucked away happily in the back seat as the adults in front where more subdued. As grownups do, we kept running through our mental checklists even though the ship had already sailed, we …

Conditions and diseases

5 essential concepts to know about code status

Brian J. Secemsky, MD

April 3, 2013Apr 3, 20135

Full Code. Do not resuscitate. Do not intubate. Ask anyone without a personal or family history of a hospitalization on the implication of these terms and you’d likely get a blank stare in response. Unfortunately, this incomprehension often rings true…

Full Code. Do not resuscitate. Do not intubate.

Ask anyone without a personal or family history of a hospitalization on the implication of these terms and you’d likely get a blank stare in response.

Unfortunately, this incomprehension often rings true with those who need to know it most: the hospitalized patients themselves.

Many clinical reports (see here and here) have demonstrated that most physicians are not only inadequate in discussing code status with …

Physician voices

A duty to guide patients through the process of death

Kevin R. Campbell, MD

April 3, 2013Apr 3, 2013

As healthcare providers we are focused on life. We are committed to healing. We measure success by lives saved. Unfortunately, many diseases remain incurable. Some diagnoses do carry with them a death sentence in spite of the best that modern medicine has to offer. Even in theses extremely devastating cases, We can still make a huge difference in the lives of our patients in the way in which we help …

Physician voices

Should family members be present when performing CPR?

Troy Madsen, MD

April 2, 2013Apr 2, 20136

“We’re doing everything we can,” I said as I put my hand on the sobbing woman’s shoulder. “We’re going to keep trying for about 10 more minutes, but I don’t know if we’re going to be successful with this.” These…

These are the moments that are truly difficult in my job. Telling people their loved ones have passed away, or preparing them for what seems inevitable.

“You can do it!” the woman said …

Physician voices

Is the era of patient centered care decidedly anti-physician?

Mona Kotecha, MD

April 2, 2013Apr 2, 201345

I’m lucky to practice in a national regional anesthesiology center, a hospital with five dedicated nerve block suites, each with the latest in ultrasound equipment, nurses trained in conscious sedation, regional anesthesiology colleagues and infrastructure to support regional practitioners. It seems like there is so much we can do for patients, but really, there is only so much a physician can do. We need a little help from the patient …

Real physician voices, twice a week

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