KevinMD.com

October 23, 2012Oct 23, 20127

Most patients I see are surprised to find out that there’s something they should have brought to their doctor’s visit. Granted, I’m an emergency physician, and many of my patients come to me in emergency situations that they can’t plan for. However, most people have some heads-up for going to their doctor. Certainly if you’re going to your annual check-up or a routine appointment, you should bring these items with …

Physician voices

Are medical device companies being demonized?

Michael Kirsch, MD

October 23, 2012Oct 23, 20123

All parents have heard their kids complain that but for 1 or 2 percentage points, they would have achieved a higher grade. “This is so unfair! My average is 89.9999 and he is still giving me a B+!” Every kid…

All parents have heard their kids complain that but for 1 or 2 percentage points, they would have achieved a higher grade.

“This is so unfair! My average is 89.9999 and he is still giving me a B+!”

Every kid should receive an A, of course, since psychologists are now professing that every kid is a prodigy in some new measure of intelligence. Academic intelligence, the conventional and obsolescent notion, has been …

Patient voices

Attitude is half the battle when you’re sick

Elaine Waples

October 23, 2012Oct 23, 20122

I’ve come to believe that seriously sick people are often subject to some very interesting comments from well-intentioned non-sick people. They are frequently inspired by platitudes from self-help-books, Google chat rooms (heaven forbid), or beliefs that have been around for…

To be fair, when we are confronted with the uncomfortable task of talking to a sick person, our conversation can …

Real physician voices, twice a week

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Health policy

Understanding the patients who are the most expensive to care for

Ishani Ganguli, MD

October 23, 2012Oct 23, 2012

We’ve known for decades that a small fraction of Americans incurs the bulk of health care costs. A report released last month by the National Institute for Health Care Management (NIHCM) analyzes 2009 data to shed light on the patients we should worry about most. Their findings take on special relevance in the wake of Massachusetts lawmakers passing an ambitious health care cost control bill.

As …

Physician voices

Defending the American cowboy in medicine

Wes Fisher, MD

October 23, 2012Oct 23, 20128

Atul Gawande, MD is a brilliant writer, no-doubt an excellent surgeon, and many would say a physician-visionary for all that ails America’s health care system. He speaks first-hand of the changes that have occurred in American health care and recently offered his perspective for fixing our health care system to the fertile minds of Harvard’s recent graduating class of 2011.

In his graduation speech, published front and center (yet …

Physician voices

Improve the triple aim by adding a fourth: Provider satisfaction

Ann Lindsay, MD

October 22, 2012Oct 22, 2012

My husband and I had a family practice in Arcata, California, for 28 years, during which time we learned the importance of addressing the patient’s context outside of the medical visit in order to maximize health and self-efficacy. We went…

We went to great lengths to keep patients out of the ER and hospital. I saw one patient with massive pedal edema twice weekly for months to wrap her legs, since she lived …

Physician voices

Should standardization end when the exam room door closes?

Suzanne Koven, MD

October 22, 2012Oct 22, 2012

The Pap smear, in which a clinician gently scrapes and brushes cells from a woman's cervix (the lower portion of her uterus or womb), swishes them in a bottle of fixative solution, and then sends them to the lab to…

The Pap smear, in which a clinician gently scrapes and brushes cells from a woman’s cervix (the lower portion of her uterus or womb), swishes them in a bottle of fixative solution, and then sends them to the lab to determine if the cells show pre-cancerous or cancerous changes caused by the sexually transmitted human papilloma virus (HPV), is a pretty simple procedure that takes less than a minute to …

Conditions and diseases

A moral duty to help build healthier societies

James C. Salwitz, MD

October 22, 2012Oct 22, 20123

Nairobi, Kenya basks under a brilliant sun, its dusty frontier soul, noise, construction and vital humanity speak for a nation and a people rushing into the modern world. Full of ideas, growing exports and exploding industry, its expanding middle class has seized on education and commerce as the path to tomorrow. One of the richest nations in Africa, with a new Constitution and new hope, it races forward. Tragically, even …

Conditions and diseases

It’s not all in the genes: How to reduce your risk of cancer

Toni Brayer, MD

October 22, 2012Oct 22, 20122

There are an estimated 1,638,910 new cases of the dreadful disease diagnosed in 2012 in the United States, not including non-melanoma skin cancers. Cancer is not just one disease but is a term that represents more than 100 diseases with…

There are an estimated 1,638,910 new cases of the dreadful disease diagnosed in 2012 in the United States, not including non-melanoma skin cancers.

Cancer is not just one disease but is a term that represents more than 100 diseases with different causes. The basic unit of life is cells, and cancer always begins in cells. When the normal process of cell growth and division is altered, these abnormal cells divide without …

Physician voices

I have seen faith present its various faces many times

StorytellERdoc, MD

October 22, 2012Oct 22, 20124

Faith. A simple word with complicated meaning. It is a seed buried deep within our spiritual cores, ready to be nourished and blossom with the sprinklings of tragedy. It is a belief that things will work out, despite our lack of vision for fate’s secretive reasons of the bumpy journey we must endure. It is an inherent hope that has either sustained us or has failed us miserably. Yes, to …

Health policy

National reporting isn’t the answer to reduce medical errors

Kevin R. Campbell, MD

October 21, 2012Oct 21, 20123

Two articles recently addressed medical errors. In the Wall Street Journal, surgeon Dr. Marty Makary discusses the alarming costs of medical errors and offers suggestions to improve the system. In medicine, particularly during the training years of residency and fellowship,…

Two articles recently addressed medical errors.

In the Wall Street Journal, surgeon Dr. Marty Makary discusses the alarming costs of medical errors and offers suggestions to improve the system. In medicine, particularly during the training years of residency and fellowship, young doctors are not given the opportunity or security to report shortcomings of their superiors.

As discussed in the article, all of us have a memory of a particular surgeon …

Health policy

Democrats versus Republicans: Two different approaches to Medicare

Stephen C. Schimpff, MD

October 21, 2012Oct 21, 20125

The two party’s approaches are quite different. Politicians realize that Medicare will not be able to continue on its current track. Something has to change since the country will simply not be able to afford the inexorable growth and expenditures. But politicians do not like to take away entitlements so proposals generally are couched in vague terms and often with positions that are unrealistic.

The Democrats’ plans are contained generally in …

Physician voices

It is both a privilege and an honor to be a primary care physician

Solmaz Amirnazmi, MD

October 21, 2012Oct 21, 2012

With all of its frustrations and challenges, I love my job. In fact, the very things that make primary care so difficult and often times exhausting are also what make it in my opinion the most awesome field in medicine.…

When I was in grade school, I wanted to be a physician. My parents would take me to the pediatrician for routine check-ups or when I wasn’t feeling so great and I remember …

Medical education

How gross anatomy changes you forever

Anonymous

October 21, 2012Oct 21, 20122

After a week of medical school orientation, followed by two weeks in the classroom studying cellular organelles and biochemical pathways, our class was finally going to start the centuries-old rite of passage that is human gross anatomy. For many students, it will be first time seeing a dead body. The anatomy lab is where future surgeons will make their first cut with a scalpel, without the pressure of life and …

Read more…

How gross anatomy changes you forever

Patient voices

Both the scientific and the social sides of medicine are needed

Clarissa Schilstra

October 21, 2012Oct 21, 20122

The word medicine, in today’s world, seems to indicate a hard science in search of cures for many kinds of human ailments, such as cancer. However, I believe that the true definition of medicine is the practice of healing. Medicine is both an art and a science because it involves both human and technological interaction. The art of compassionate care and social interaction must be combined with the science of …

Physician voices

Our medical system needs more positive stories

Stewart Segal, MD

October 20, 2012Oct 20, 20125

I’ve been asked to appear on a radio talk show to discuss one of my blog articles. It seems that the producers of the show were impressed by my article on the beauty of medicine when it works the way…

“When It Works Right, It’s a Thing of Beauty” was published this summer and is one of my favorite articles. The practice of medicine is a beautiful thing. …

Patient voices

How to strengthen the partnership with your medical team

Andrew Griffith

October 20, 2012Oct 20, 20123

Most of us have find it challenging to make sense of the wave of information when we enter our cancer journey. This is foreign territory, with its own language, culture and routines. It takes time to absorb and understand. We…

We are not oncologists or hematologists. However, we can learn to improve our discussion with our medical team.

Build your knowledge. By the time you start your treatment, you will likely have searched the …

Conditions and diseases

Chickenpox, herpes zoster, and understanding the shingles vaccine

Brian J. Secemsky, MD

October 20, 2012Oct 20, 20128

Chickenpox was all the rage back in the day. Oatmeal baths with your siblings, unexplained weekday sleep-overs with pox-laden, peripheral childhood friends. Even the sweet but short-lived relief of itching and scratching made the week-long infectious endeavor, if anything, a…

Unfortunately for a handful of us unsuspecting chickenpox veterans, the infection that we so fondly include in our potpourri of childhood nostalgia will …

Physician voices

Why doctors should care about fracking

Deep Ramachandran, MD

October 20, 2012Oct 20, 20122

Let’s all agree on two things. First, that energy independence is good for our country. Second that clean drinking water is also good for the country. The development of America’s huge stores of natural gas, have given us a remarkable…

Let’s all agree on two things.

First, that energy independence is good for our country. Second that clean drinking water is also good for the country.

The development of America’s huge stores of natural gas, have given us a remarkable opportunity to accomplish the former. In particular, the process of “fracking” has made it possible to increasingly tap those huge natural gas stores. Natural gas sits in rock formations, but releasing it …

Read more…

Why doctors should care about fracking

Conditions and diseases

Health risks of tattoos and tips for safer inking

Orly Avitzur, MD

October 20, 2012Oct 20, 2012

I’m often surprised to hear my patients say that they got their tattoos while they were intoxicated. These confessions usually pour out spontaneously, prompted by anxiety, as I prepare to insert a needle for medical reasons. Getting a tattoo may…

Permanent tattoos have been growing in popularity (pop star Justin Bieber’s tattoos even have their own …

Real physician voices, twice a week

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