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Medical Education

December 7, 2011

I never thought I would call cancer “cool.”

It was the last day of anatomy lab. Finally, we had dissected through everything: starting with the back, moving through arms and legs, hands and feet, chest cavity with lungs and heart, abdominal cavity with gastrointestinal organs, pelvis, and ending with head and neck.

Looking at our cadaver was disorienting. There were insides where outsides should be. Organs completely removed. The head literally sawed …

Primary care doctors are set to lose more than half of their salary

Matthew Mintz, MD

Health Policy

December 7, 2011

Fortunately, the 27% reduction in Medicare payments to physicians that is set to take place in a matter of weeks unless congress acts is getting some press. Fox News published a piece recently, as did the Washington Post. Writer Merrill Goozner breaks things down nicely in his article, “Is There a Doctor Fix in the House … and Senate?”

However, one thing that seems to be getting confused in all the …

Technological advances can solve our current healthcare crisis

Hiep Nguyen, MD

Health Technology

December 7, 2011

It can’t be ignored that dramatic transformation in our healthcare system is imminent. The economy, market forces and increasing political demands will soon force physicians and healthcare professionals to change how we take care of our patients. Just as the days of housecalls are gone, so is our current system of delivering care.

The rising cost of healthcare now has the government and insurance companies placing more emphasis on controlling costs, …

Good doctor qualities for your aging parent

Maria Basso Lipani

Patient

December 6, 2011

As we get older, having a good doctor in our corner becomes incredibly important.

And you don’t want just any doctor for your parent. Smarts, signs of basic compassion and a few other things are essential for the relationship to work.

Good doctor quality #1: Listening skills

Picture it: Your Mom’s doctor’s office. 10am Tuesday. She reaches into her pocket for her list of three concerning symptoms she plans to mention, if she can …

What do you say to a person who has cancer?

Ann Silberman

Patient

December 6, 2011

Well-meaning but clueless person: “Let me know if you need anything.”
Snarky me: “Really? Thanks! Empty your purse and let’s see what you have in there. Wait, is that purse Prada? I need that; I have medical bills to pay and want to look good paying them. Oh, that’s a pretty wedding ring, lots of diamonds, can I have that too?”

What you should say is absolutely nothing. This is a time …

Let’s close the chapter on statin safety

John Mandrola, MD

Medications

December 6, 2011

There was important news recently on statin drugs. As one of the world’s most effective and commonly used medications, statins provide great writing topics. Lots of people have high cholesterol–including cyclists. Lots of people are interested in avoiding our mostly deadly disease.

I’d like to tell you about a recently-published landmark study in the Lancet that should quell safety concerns over statin drugs.

The punch line after I tell you the study’s …

Find a physician, not a general

Jeffrey Gladd, MD

Physician

December 6, 2011

“Superior doctors prevent the disease.
Mediocre doctors treat the disease before evident.
Inferior doctors treat the full-blown disease.”
-Huang Dee Nai-Chan 2600 BC; 1st Chinese Medical Text.

Not only does my work in integrative medicine have me on the front lines of big pharma-created “syndromes”, like chronic fatigue, fibromyalgia and irritable bowel (these are real for patients, but are not formal syndromes), but I get to see the worst of our sickcare system. I …

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Find a physician, not a general

Young doctors don’t see value in primary care careers

John Schumann, MD

Physician

December 5, 2011

In my new role as one of the directors of an internal medicine training program, I help select new interns out of medical school for the three year training stint of residency.

At the end of residency, many graduates go on to subspecialty fellowships, another two to four year period of intensive training in fields like cardiology, nephrology, critical care etc.

For those that don’t choose a subspecialty, one choice remains: traditional …

Are doctors given more responsibility than they can handle?

Nagarathna Manjappa, MD

Physician

December 5, 2011

Doctors inevitably come into spotlight, being at the front end of health care delivery. Sometimes seen as guardian angels restoring health and life, other times, greedy minds sucking resources while they carelessly harm and kill patients to fill their wallets. After experiencing, observing, and hearing from others like me, I wonder if doctors are given more responsibility than they can handle, often attributed more aura than they deserve and frequently …

Government and insurance companies should have little say in death

Anna Tran, MD

Health Policy

December 5, 2011

My colleagues who advocate improvement to our healthcare often say, “It’s a non-issue. We all benefit from better care.” Yet the political vehicle that’s to drive the reform has stirred emotions and controversy at almost every turn, leaving us baffled. Why wouldn’t anyone want better coverage, lower cost, and more evidence-based treatments? These targeted goals improve healthcare, which is why they poll well. When asked for a general impression of the …

Is there truth to the unintended consequences of hospitalists?

George Lundberg, MD

Physician

December 5, 2011

When I first learned that the U.S. was going to develop a new specialty, the hospitalist, I was very pleased.

I had long believed from study and direct observation that some of the better healthcare systems in Europe were benefited in a major way by the general separation of office and hospital medical practices and practitioners.

In the U.S., historically most patients have been taken care of by physicians practicing medicine in …

The honor of patient responsibility

Albinoblackbear

Patient

December 4, 2011

“So the patient has been temporarily paralyzed by the drugs, and you’re the one keeping them alive by squeezing air into their lungs, but … no pressure”.

Gulp.

I was holding the mask as tightly against her face as I could, sealing the rubber to her cheeks in the effort to keep highly oxygenated air from leaking out. Looking down at her from the head of the bed I saw the patient from …

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The honor of patient responsibility

When is it time to break up with your doctor?

Marni Nicholas, MD

Physician

December 4, 2011

“When is it time to break up with your doctor? It can be a tough decision to make. After all, if you don’t like your experience at a store, you shop somewhere else next time. If you go for a haircut and hate it, you find someone else.

With your doctor, it’s a bit different. This is someone who might know some of your deepest, darkest secrets. There is a history …

What patients need to know about coding

Brandon Betancourt

Physician

December 4, 2011

Health insurance is very complicated. At our practice, we deal with health insurance all the time and even for us, it gets to be very complicated sometimes. So it is natural that patients have a hard time understanding it as well.

Therefore, I decided to summarize a conversation I had with a patient in an effort to help other patients understand, at the very least, a portion of how medical health …

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What patients need to know about coding

MKSAP: 55-year-old man to undergo coronary artery bypass graft surgery

mksap

Conditions and Diseases

December 4, 2011

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

A 55-year-old man with a history of coronary artery disease and diabetes mellitus will undergo elective coronary artery bypass graft surgery. His last hemoglobin A1c value was 7.8%, and his plasma glucose level 2 hours prior to scheduled surgery was 238 mg/dL (13.2 mmol/L). Hemoglobin is …

If you want to know how well the medicine works, ask the patient

Stan Goldberg

Patient

December 3, 2011

It was an invitation that made no sense. I was asked to be a special guest of the South Korean Ministry of Tourism and KMI International, a company that markets medical tourism. Why me, I wondered? As I re-read the invitation, I remembered another strange offer I received in the 1970’s during a tense period in Israeli-Arab relations.

“Hello Dr. Goldberg,” an official from the Jordan Ministry of Education had said. …

Why doctors need Hollywood

Adam Bitterman, DO

Physician

December 3, 2011

Sex sells. US Weekly and People fly off the shelves with the latest reality star drama. Unfortunately, the same does not apply to the diseases running rampant in today’s society. Is there an answer? I would like to say yes, but the ultimate answer remains to be seen. After my four years of undergraduate work and four more years of medical school, I am confident that there are a myriad …

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Why doctors need Hollywood

MKSAP: 52-year-old man with perineal and suprapubic pain

mksap

Conditions and Diseases

December 3, 2011

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

A 52-year-old man is evaluated for a 3-month history of perineal and suprapubic pain. He has experienced urinary frequency and dysuria for 4 to 6 weeks. The patient reports fatigue, insomnia, and low mood for the past 6 months. He has hypertension. Current medications are hydrochlorothiazide …

The day our hospital lost its heart

Dr. Martin Young

Physician

December 2, 2011

In about 1985, as I remember it, my training hospital underwent a pivotal change. In Cape Town, at the southern tip of Africa, Groote Schuur Hospital was world famous for being the place where in 1967 an arrogant, brash and brilliant surgeon by the name of Christiaan Barnard stunned the world by performing the world’s first heart transplant. Nearly twenty years later, Groote Schuur (Dutch for “Big Barn”) still retained …

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The day our hospital lost its heart

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