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Reporters and doctors are more similar than you think

Joyce Ho, MD

Medical Education

February 12, 2012

One of the things I have come to really enjoy and appreciate is the opportunity to interview the subjects of my articles and multimedia pieces. In a way, being a reporter reminds me a lot of being a physician-in-training – both roles require me to go into a room, learn an individual’s story inside out, and present the learned information for a further goal.

In my Public Issues Reporting class, the …

Benefits of the Medicare Adult Wellness Visit

Evan Saulino, MD

Physician

February 12, 2012

One of the things I love about family medicine is that I get to care for people of all ages. I almost went into pediatrics, but the time I spend with older adults was too valuable to give up. Our elders have such great stories and knowledge to impart – it’s an honor to participate in their lives and share their experience.

Since I first realized in residency training that Medicare …

How to get ready for death

Rob A. Ruff

Patient

February 12, 2012

No one wants to die. Even people who want to go to heaven don’t want to die to get there. And yet death is the destination we all share. No one has ever escaped it. And that is as it should be, because death is very likely the single best invention of life. It is life’s change agent. It clears out the old to make way for the new.
-Steve Jobs, …

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How to get ready for death

The long term cost of a pain in the neck

Renee Lux

Patient

February 11, 2012

One morning this May, I woke up with a stiff neck. I applied hot and cold therapy all day and took an Advil before bed. By the end of that week, I was unable to comfortably move my head and I was feeling numbness down my left arm to my fingertips. I saw my doctor within 24 hours of calling his office. After a brief exam, he was sure of …

How erectile dysfunction might save your life

John Ludlow, MD

Conditions and Diseases

February 11, 2012

Just the other day, I saw a 52 year old man in my office for what I thought was a routine prostate issue. I walked in the exam room, introduced myself and immediately knew his prostate was fine. His eye contact was non-existent. He was nervous and his handshake was clammy and brief. I see these patients everyday. Their prostates are just fine. It’s their love life that’s the issue. …

Why ultimate fighting is better than boxing

George Lundberg, MD

Conditions and Diseases

February 11, 2012

There seems to be a deep, even innate, need on the part of many young men to actually, or vicariously, strike out at other people to cause pain and injury while striving to dominate.

In 1996, I wrote an editorial entitled “Blunt Force Violence in America” describing “a modern continuum from street fights to barroom brawls to domestic child, spousal, and elder abuse, to ultimate fighting to extreme fighting, to …

MKSAP: 78-year-old woman is seen for management of her diabetes mellitus

mksap

Conditions and Diseases

February 11, 2012

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

A 78-year-old woman who resides in a nursing home is seen for management of her diabetes mellitus. The patient’s blood glucose log shows levels ranging between 40 and 400 mg/dL (2.2 and 22.2 mmol/L). She otherwise feels well. She has been on insulin for more than …

Surviving the new landscape of physician reimbursement

Donald Tex Bryant

Health Policy

February 10, 2012

CNN recently posted an article titled “Doctors Going Broke.” It described several cases of independent physicians who are near bankruptcy although they once were quite well off. For instance, the article detailed the case of Dr. William Pentz, a cardiologist in a small group practice, who had to borrow money last month to make payroll. He and the other cardiologists have cut their salaries in order to meet overhead. Dr. …

Conflicts of interest don’t always involve money

Andreas Laupacis, MD and Karen Born, MSc

Medical Education

February 10, 2012

Conflicts of interest in medical research are extremely common – one recent study found that 52% of the experts involved in developing clinical practice guidelines for the management of diabetes in the United States and Canada had a financial conflict of interest. Although doctors and researchers often declare financial conflicts of interests when they make presentations and publish papers, there are many who argue that declaring financial conflicts is no longer …

Avoid malpractice while treating minor head trauma in children

Maxwell S. Kennerly

Conditions and Diseases

February 10, 2012

In October 2011, the Centers for Disease Control and Prevention reported a 60% increase in “emergency department visits for sports– and recreation–related traumatic brain injuries, including concussions, among children and adolescents” over the past decade. That’s good news: as the CDC’s press release said, they believe the increase was due in part to “growing awareness among parents and coaches, and the public as a whole, about the need for individuals with a suspected …

When medical advances do the world a disservice

Reflex Hammer

Conditions and Diseases

February 10, 2012

There is a healthy debate over whether a lab that created an extremely infectious version of influenza ought to publish the genetic sequence. The debate speaks to a larger problem: sometimes, medical advances do the world a disservice. The medical field could use some soul-searching, just as physicists did in the wake of the Manhattan Project.

A few years ago, I read a neat research finding. In a pregnant woman, …

There is a patient attached to that implantable defibrillator

David Lee Scher, MD

Health Technology

February 9, 2012

As a follow-up to my post on why patients with implantable defibrillators should have access to their device’s data, I am going to talk about what your physician looks for when a device is interrogated. Many times this happens in silence or with few words, and some pushes of a button, when done in the office, and when done with remote patient management, is accomplished either automatically or with …

6 things I wish I had known at the beginning of medical school

Rick Pescatore, DO

Medical Education

February 9, 2012

It’s amazing how quickly you can lose track of time as you power through the books. Once everything is setup — coffee to the left, pens and highlighters to the right, Grooveshark playlist perfectly tuned — you can suddenly look up and realize that three weeks have flown by and there are 123 multiple choice questions to be answered in the morning.

Over the past year and a half, I’ve learned …

Cancer has a way of teaching us poignant life lessons

Anees Chagpar, MD

Physician

February 9, 2012

I just finished reading George’s recent post on Evelyn Lauder, who recently passed away from ovarian cancer, and am still stirred by the passing of Patrick Swayze from pancreatic cancer and Elizabeth Edwards from metastatic breast cancer. There’s a reason I am a surgeon, and not a medical oncologist. Death has this bleak sadness about it, that eternal …

The challenge of creating a palliative care program

Jordan Grumet, MD

Physician

February 9, 2012

The orders came indirectly from the government.

Reduce hospital re-admissions. Cut costs.

So, the hospital contacted the local hospice-palliative care center and asked for help. Of course, overwhelmed with work and understaffed, the project was handed off to me.

My task sounded simple. Create a palliative care program at the nursing home. But as I gathered for the first meeting with the administrator, social worker, and clinical staff, I knew there would be …

Why we should eliminate the diagnosis of ADHD

Steve Balt, MD

Conditions and Diseases

February 8, 2012

I’m reluctant to write a post about ADHD. It just seems like treacherous ground. Judging by comments I’ve read online and in magazines, and my own personal experience, expressing an opinion about this diagnosis—or just about anything in child psychiatry—will be met with criticism from one side or another. But after reading L. Alan Sroufe’s article (“Ritalin Gone Wild”) in the New York Times, I feel compelled to write.

If …

Doctors lobby Congress to repeal the SGR

Bob Doherty

Health Policy

February 8, 2012

One of the things that I like most about my job is engaging with ACP’s physician leadership—the internal medicine doctors who dedicate enormous amounts of time, at great personal sacrifice, to represent the interests of our members and their patients.

One of the things that I like least is when an ACP member (or non-member physician) caustically dismisses their efforts, usually because they disagree with some aspects of ACP policy. It …

The foundation of medicine is care

Stewart Segal, MD

Physician

February 8, 2012

I recently wrote that “diagnosis is job number one.” In sports, there are times when two teams share the number one position. Each team competes to make it to the championship; and, ultimately, one team has to lose its top ranking.

In medicine, care and diagnosis share the number one spot, working together toward a common goal: to promote health. Some would say that, without care, the diagnosis is worthless. Certainly, …

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The foundation of medicine is care

Patients in the waiting room do not know why doctors are running late

Tabor Flickinger, MD

Physician

February 8, 2012

I hate running late. I prefer to arrive five minutes early for any meeting. I was that compulsive student who always turned in papers before they were due. Now I turn in conference abstracts, grant applications, and even poetry contest submissions, well before their deadlines. Unfortunately, timing is not always in my control.

I particularly hate running late in clinic. I want to see all my patients on time. It is …

A look behind the growing cost of cancer drugs

Merrill Goozner

Medications

February 7, 2012

Julie Gralow, an oncologist at the Fred Hutchinson Cancer Center in Seattle, recently prescribed an exciting new therapy for a 60-year-old woman with metastatic breast cancer. Three-and-a-half years into her battle against the disease, the patient had already exhausted three different anti-estrogen therapies, each of which only put a temporary check on the spreading tumors.

The newly prescribed drug, Novartis’ Afinitor, is one of the recently approved targeted therapies that have …