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What medicine can learn from the Titanic

Rushil Patel

Physician

May 26, 2012

April 15th marked the 100th anniversary of the sinking of the Titanic, yet the mystique surrounding its demise has not faded. When the colossal vessel first collided with the iceberg, eyewitness accounts described an eerie sense of serenity that pervaded the ship. Passenger J.J. Astor even remarked, “We are safer here than in that little boat,” before later drowning.

To prefer drowning over safety strike us as irrational, but this behavior …

Are the poor more likely to sue their doctors?

Neil Baum, MD

Health Policy

May 26, 2012

Many physicians, including myself, have the misconception that the indigent patient is more likely to be litigious than those patients with greater financial resources. A well-organized study that was reported in Clinical Orthopeaedics and Related Research reported that socioeconomically disadvantaged patients tend to sue physicians less often than their more affluent patients.

Dr. Ramon Jimenez and his colleagues at the Monterey Orthopaedic and Sports Medicine Institute and his team demonstrated that patients …

MKSAP: 65-year-old man is evaluated for worsening gait unsteadiness and falls

mksap

Conditions and Diseases

May 26, 2012

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 65-year-old man is evaluated for worsening gait unsteadiness and falls. He first noticed the unsteadiness 1 year ago while walking and has started to fall recently, falling four times in the past 2 weeks. Approximately 3 years ago, he developed erectile dysfunction and has had …

Our medical-industrial system is long overdue for a real shakeup

Jim deMaine, MD

Health Policy

May 25, 2012

Recently I was sent this commentary on the issue of health care costs. It seemed like a pretty good summary of the problem to me, though it didn’t delve into solutions or the current controversy about the Affordable Health Care Act. In our country, we’ve built up a huge medical-industrial system that can do lots of good but at a huge cost. It seems that we are on the brink of a …

One simple question that is the essence of medicine

Steven Lucas, MBA

Patient

May 25, 2012

A friend recently told me his daughter has been accepted into medical school with hopes of becoming a pediatrician. Along with this accomplishment will come $250,000.00 in debt.

I could not help but think of how her educational experience and future practice model will be so different from those who hold leadership positions in medicine today. Tablet computers will replace books and she will live in a 24/7 wired world.

I came …

What American medicine can learn from a cruise ship clinic

Barbara Hales, MD

Health Policy

May 25, 2012

Recently, I had a wonderful opportunity to cruise the Mediterranean and visit some fascinating cities. The land excursions were mind-expanding but quite physical. The rugged terrain and steep hills were not difficult to walk upon because I was in good shape and healthy.

But, what if I wasn’t? Questions raced through my mind such as:

What if I got sick onboard the ship?

What if I got injured?

What type of doctor signs on …

A medical student’s first patient interview

Charles Casassa

Medical Education

May 25, 2012

“Um—Hi there, I’m a, uh, you know. Medical student. First year. For, you know, the Patient-Doctor—err, Patient-Physician course—”

The nurse smiled and turned to a woman of shorter stature with bony, scrunched- up shoulders. “Mary, do you want this first year to interview you?”

Mary was about to set foot in the lounge when she heard this. She let out a sigh and faced me. Her eyes looked worn; I could tell …

Failure of communication led to an excessive hospital stay

Kelly Donovan

Physician

May 24, 2012

On a late afternoon in mid-July I was finishing up my first Sunday on call as a third year medical student. I glanced over the patient list for 4 East, the internal medicine floor I had been assigned to cover. Familiar with patients in their eighties and nineties, I was surprised to see a 22-year-old patient admitted with acute kidney injury.

He was a nice-looking young man in good spirits. Spanish …

What is the truth about Zithromax?

Rob Lamberts, MD

Medications

May 24, 2012

It was during my residency that the first indication of heart toxicity of antibiotics affected me personally. The threat was related to the use of the first of the non-drowsy antihistamines – Seldane – in combination with macrolide antibiotics, such as Erythromycin causing a potentially fatal heart arrhythmia. I remember the expressions fear from other residents, as we had used this combination of medications often. Were we killing people when we treated their …

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What is the truth about Zithromax?

The scope of the standard of care in medicine has changed

Paul Levy

Health Policy

May 24, 2012

Malpractice lawsuits are a necessary evil in our society. At times, they are frivolous, often resulting from a patient’s or family’s anger at a result that was not what they had hoped. Some are actually designed just to try to get a financial settlement. When doctors are sued for malpractice, it is a searing process, isolating and painful. I have known several excellent doctors who have given up established practices …

Marijuana should be should be legal, regulated, and taxed

George Lundberg, MD

Medications

May 24, 2012

I grew up in the American Deep South, in Lower Alabama, with Jim Crow and Old Crow, where fire-breathing preachers, Harper Lee, Truman Capote, and I all knew that one may never kill a mockingbird.

And in that day and place, the “War on Drugs” was actively waged county by county. The drug was alcohol and the method of war was called “local option.” Every several years, the Baptists and the …

Patients are our best teachers

Michael Kirsch, MD

Physician

May 23, 2012

There are some patients we doctors never forget. They linger in our memories for various reasons. Often, it is their serious or unusual medical condition that stays with us. On other occasions, it is a zany or unique personality that we recall, even years later. Rarely, when the doctor-patient relationship becomes injured, then the patient may become unforgettable.

I remember a particular patient from 20 years ago for a very different …

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Patients are our best teachers

A good doctor should rarely be surprised by test results

Angry Orthopod, MD

Physician

May 23, 2012

I got into medicine because it is fun, and, of course, to help people. I think most of my colleagues did so as well. I get up every day and I get to go to work and figure out puzzles all day. How cool is that? Sure, it may not always be unwarranted or a bad thing, but testing and more testing can definitely take the fun out of taking …

An inside look at the FDA drug approval process

Lisa Gualtieri, PhD

Medications

May 23, 2012

Behind the headlines “FDA Panel Unanimously Rejects…” and “Arthritis Pill From Pfizer Wins Support…” was, for me, over 600 pages of reading and two days at the FDA as the Consumer Representative to the Arthritis Advisory Committee (AAC).

These were my first meetings following an almost yearlong process that started with a nomination by Diane Aronson, the Consumer Representative whose term was ending, and culminated with my four year …

How medical school changed me

Matthew Gibson, MD

Medical Education

May 22, 2012

I have been thinking a lot over the last few weeks about all the many ways that the experience of medical school has changed me.

The most obvious is knowledge. I’ve drunk from the proverbial “firehose” of information that we experience in medical school, and apparently enough of the facts stuck with me to pass all my exams, and secure myself a residency program back in my home state of California. …

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How medical school changed me

Mobile health apps don’t always follow conventional wisdom

Richard Meyer

Health Technology

May 22, 2012

Propaganda and non-truths abound all around the Internet saying that mobile health apps are everything from a threat to Big Pharma to a way to save billions of dollars in healthcare costs. There may be a future for mobile apps but a lot of work is yet to be done.

Last year I led some market research into mobile apps across all demographic segments and several disease conditions. While we did …

Why Priscilla Chan may become the country’s most influential doctor

Kevin Pho, MD

KevinMD

May 22, 2012

Who has the potential to be the most influential physician of our generation?

It’s Priscilla Chan, who not only recently graduated from medical school, but also married Facebook founder Mark Zuckerberg.

When I brought this up on Twitter, someone responded that it was “disappointing at the same time. I’m certain her own merits and studies would have made waves alone.”

But her influence …

Confused about prostate cancer screening? Make a shared decision

Kevin Pho, MD

KevinMD

May 22, 2012

In a widely anticipated move, the USPSTF officially recommended against prostate cancer screening in healthy men.

Case closed, right?

Hardly.

The prostate cancer screening debate has been raging for the past decade. Increasing amounts of evidence show that screening does not save lives, and increase the risk of complications like impotence and urinary incontinence that stem from invasive diagnostic tests and treatments.

Regular …

When patient care becomes secondary to filling out the medical record

Jordan Grumet, MD

Health Technology

May 22, 2012

The policeman was two cars in front of me. I meandered down the road cautiously adjusting my speed a few ticks above the limit. I lamented the forced, measured pace as the road lazily formed a long straight path. The clock refused to slow for my new found law abiding citizenry.

A sports car motored around a curve and flew past us unaware. The cop switched on his lights and tried …

Take on the problem of obesity with dignity and respect

Katherine Ellington

Conditions and Diseases

May 21, 2012

At a time when 2 out of 3 Americans are overweight, a story about black women and fat has gone viral. Perceptions about what women see in the mirror, feel about their bodies and others tell them about beauty is not sufficient for health. The opinion that “many black women are fat because we want to be” may nurture bias that can hinder health care for those who are …

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