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Overtreatment and the ethics of end of life care

Physician

March 1, 2012

There was an exceptionally well-written piece published in the Washington Post recently. I presume a hospitalist wrote it, which magnifies its significance. In it, he describes the difficulties in caring for terminally ill patients.

As I read it, it reminded me of a story my dad told me several years ago. His friend, I will call him Steve, was experiencing a great deal of stress because of his dad’s ailing …

A sick care system instead of a health care system

Stephen C. Schimpff, MD

Health Policy

March 1, 2012

An excerpt from The Future of Health Care Delivery.

We Americans like to pride ourselves on having the best health care system in the world, but unfortunately that is not the case. We have a medical (that is, sick) care system—a system that waits until we become ill before it kicks into action—instead of a health care system focused on helping us stay healthy. We give lip service to prevention and, depending …

The hidden crisis of binge drinking

Stewart Segal, MD

Conditions and Diseases

February 29, 2012

According to an article entitled, Binge Drinking Common Among Adults, “about one in every six U.S. adults binges on alcohol.”

According to the article, “binge drinking — defined as at least four drinks in one sitting for women and five drinks for men — carries substantial risks and high costs. It accounts for more than half of the estimated 80,000 annual deaths and three-quarters of the $223.5 billion in economic …

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The hidden crisis of binge drinking

Tips for feeding your picky eater

Yolanda Wong, MD

Conditions and Diseases

February 29, 2012

Your baby had a great appetite. Happily ate everything. Tried lots of flavors and foods. Then your baby became a toddler. Suddenly meals feel like a horrible battle.

Sound familiar?

Picky eating is very common, especially in toddlers and pre-schoolers. After the first year of life, a toddler’s appetite decreases quite a bit as the rate of growth slows down. Meanwhile, a toddler grows in independence, expressed by pushing limits, exploring new skills, and forming lots of opinions …

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Tips for feeding your picky eater

How cancer can strengthen your relationship

Jennifer Kelly, MD, PhD

Conditions and Diseases

February 29, 2012

When one partner has cancer, both partners are affected, as is their relationship. Although cancer is a health crisis that can wreak havoc on any relationship, many marriages survive, and even flourish, after cancer. Approaching cancer as “our problem” and finding opportunities to continue to connect as a couple can help to minimize both partners’ emotional distress. It is possible to fight the battle against cancer together and to strengthen …

6 reasons why applicants fail to get into medical school

Jessica Freedman, MD

Medical Education

February 28, 2012

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Every year medical school applicants feel confused and in the dark about why they have been rejected by medical schools. They do not understand what they did wrong or what they need to do differently when they reapply. Whether you are a premedical student trying to make sure to “do everything right” or a medical school applicant who has not yet …

Why medicine will still be plagued by conflicts of interest

Daniel Wolfson

Physician

February 28, 2012

A couple of weeks ago, the New York Times published a story entitled I Disclose … Nothing by Elisabeth Rosenthal. The premise of the article dealt with conflicts of interests in several professions, including those in medicine. It got me thinking about whether or not the concept of disclosure can successfully manage conflicts of interest in medicine as much as people expect it to.

The conclusion I …

Chronic pain has a price

Kim Kristiansen, MD

Conditions and Diseases

February 28, 2012

Everyone who knows a person with chronic pain is aware that it comes with a huge price on quality of life, but indeed chronic pain also have a heavy economic price for the society in general. A price we might be able to reduce by awareness and intervention for those who need it and especially for those who need it most.

The size of the economic burden is of cause different …

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Chronic pain has a price

My mother fell through the cracks of the system and died

Erika S.

Patient

February 27, 2012

Recently, my mother died.

She was giving, kind, funny and would do anything in her power to help those who needed her. As a single parent divorced from a drug addict, she was all that I ever truly had in the realm of parenting and, as a result, she was everything to me. And she touched and was loved by so, so many people. She also had asthma and, most years, …

Physician burnout presents differently in male and female doctors

Dike Drummond, MD

Physician

February 27, 2012

Numerous studies have shown that an average of 1 in 3 practicing physicians are suffering from symptomatic burnout on any given office day worldwide, regardless of specialty.

The three classic signs and symptoms of burnout are measured by a standardized evaluation: the Maslach Burnout Inventory (MBI).

They are:

1. Emotional exhaustion

The doctor is tapped out after the office day, hospital rounds or being on call and is unable to recover with time off. …

Taking care of patients is a great honor

Elizabeth Breuer, MD

Physician

February 26, 2012

As my husband and I try and make a long term financial plan for paying off my almost $200,000 in loans from medical school, I sit here wondering, why did I pay 200 grand so that I can get peed on, pooped on, bled on, screamed at and sworn at? I’ve delivered a baby without gloves on (it was an emergency). I’ve been kicked so hard I almost fell off …

Reducing the emotional impact of medical malpractice

Kevin Pho, MD

KevinMD

February 26, 2012

A version of this op-ed was published on January 17, 2012 in USA Today.

Ask doctors about what concerns them the most, and chances are they’ll say, “medical malpractice.” Indeed, most physicians will be sued sometime during their careers. A recent New England Journal of Medicine study found that 75% of doctors who practice psychiatry, pediatrics or family medicine will be …

Shared language between doctors and patients

Beth Austin

Patient

February 26, 2012

A while back, my brother-in-law was experiencing low back pain and my sister told me that the doctor had diagnosed it as a “herniated disc.” The conversation eventually evolved into a discussion about the difference between a “herniated” disc and a “ruptured” disc. My position was that ruptured was worse; my sister’s that they were the same thing. Since inquiring minds want to know these things, I decided to look …

We aren’t getting our money’s worth from electronic medical records

Barbara J. Moore, MD

Health Technology

February 25, 2012

How many people would purchase phones if those phones only communicated with other phones in their household? Would a postal service create sufficient value if you could only send letters within your town? Would the value obtained by purchasing a $20,000 car that included a powerful engine, nice audio system, seats with lumbar support and a great air conditioner justify purchase if, after the fact, you learned that to be …

Why physicians should care about Amanda Trujillo

J. Doe, RN

Patient

February 25, 2012

For the past month, the case of Amanda Trujillo has resonated deeply among nurses, triggering an avalanche of postings on Facebook, Twitter and in the nursing blogosphere. Trujillo is the Arizona nurse who was fired in April 2011 after providing education and making a hospice care consult request for an end-stage liver disease patient. This patient was slotted for pre-transplant evaluation …

Doctors need to stop being so complacent

Anonymous

Physician

February 24, 2012

Four brutally honest declarations:

1. I can perfectly decide what is best for myself, my family, my patients, and my practice. I don’t need outside guidance telling me how to lead.

2. I decide what works best on my terms to practice the best medicine.

3. I will succeed and lead because I am focused on my goals just as much (if not more) than my patient’s goals.

4. My goal is to make …

When is it better for doctors to make mistakes?

Karen S. Sibert, MD

Physician

February 24, 2012

Back in the 1990’s, my husband and I spent a year working at one of the largest hospitals in West Virginia. The patients were the nicest people in the world, and the hospital staff was terrific—kind, generous, and hard working. Some of the surgeons were excellent, but others definitely were not. My husband (a cardiac anesthesiologist) and I had to cope with surgical complications the likes of which we had …

Why maintaining a distance is necessary for doctors

Michelle Au, MD, MPH

Physician

February 24, 2012

You would think that for doctors, who work with life and death issues every day, the issues of our own frailties or the tenuous line between health and sickness for our own families would be, if not accentuated, then at least more immediate than to those who, say, do investment banking for a living. But the strange thing is that despite our easy familiarity with human mortality, it is not …

Why the civil litigation system is unfair to physicians

Chris Rangel, MD

Physician

February 24, 2012

It’s unclear how many non-legal persons actually understand how different civil trials are from criminal proceedings. Most people have heard that juries in criminal trials are told that they can only find a defendant guilty if their belief that the defendant is guilty is beyond a reasonable doubt. Federal courts define this term further as, “proof of such a convincing character that a reasonable person would not hesitate to act …

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