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Considering cancer and heart disease in opposing ways

Physician

November 18, 2011

The American public seems to consider cancer and cardiovascular disease in diametrically opposing ways. Cancer evokes the threat of relentless, painful suffering and whatever medical science can do to delay the judgement day is appreciated. Therapeutic regimens may involve disfiguring operations, prolonged toxic irradiation and chemotherapeutic agents that may be beneficial if they do not kill you first.

Response to treatment of limited incidence and duration are accepted and deemed beneficial. …

Can physicians survive the new world being foist upon us?

Jordan Grumet, MD

Physician

November 18, 2011

As I walked up the stairs I thought about the history of the building I was about to enter. Although the foundation was the same, almost everything else had changed. The hallways were updated. The patient rooms decked out with comfortable furniture and fancy televisions. I even marveled at the bathroom as I answered nature’s calling. I could have been in a fancy hotel.

Yes. Things were different than when I …

Useful tips when looking for a new doctor

Dominic A. Carone, PhD

Patient

November 18, 2011

These days, it is not uncommon for people to need to find a new doctor. The most common reasons include a) moving to a new city, b) dissatisfaction with your former doctor, c) your old doctor no longer accepts your new or old insurance, or d) you were diagnosed with a new medical condition and need specialized treatment.

Often, people go to their insurance company website or provider book, search for …

Running a marathon when pregnant

Linda Burke, MD

Conditions and Diseases

November 18, 2011

The fact that Amber Miller did not fall or faint or develop complications while running in the Chicago Marathon is nothing short of a miracle. An ounce of prevention is worth a pound of cure. What on earth was her physician thinking when she was given the green light to half-run half-walk a 26.2 mile marathon? Miller was not your usual runner; she was approximately 39 weeks pregnant.

Although pregnant women …

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Running a marathon when pregnant

Unsupervised anesthesia care by a nurse anesthetist is a threat to patient safety

Karen S. Sibert, MD

Physician

November 17, 2011

No matter how quickly you tried to switch the television channel lately, you probably couldn’t escape the trial of Dr. Conrad Murray or avoid hearing about propofol, an anesthesia drug that can be fatally easy to use.

What you may not have heard is that the American people just dodged a serious threat to their anesthesia care, and most don’t know how near a miss it was.

The Centers for Medicare and …

The hesitation before shaking a patient’s hand in the hospital

Nonmaleficence

Physician

November 17, 2011

Today, during my psychiatry rotation, a very grateful patient confronted my attending and thanked him profusely for saving him. The patient had been severely depressed and was at his wit’s end before they met. The doctor listened to him, analyzed his situation, and came up with a plan to help which included involving the patient’ family as well as using proper medication. The patient had a great response to this …

A cancer survivor’s perspective on wounded warriors

Itzhak Brook, MD

Physician

November 17, 2011

I was at the Walter Reed National Medical Center where I get medical care as a retired naval officer, and decided to use my time between medical appointments to get a much needed haircut. I walked into the barber shop, took a number, and sat down to await my turn. The three chairs were occupied by young men getting haircuts. Their chests and lower bodies were covered with long blue aprons to protect them from the …

Your worst days can bring out your best resiliency skills

Bobbi Emel

Physician

November 16, 2011

I’ve been talking via email with my stepsister, Lori, whose teenage daughter has Asperger’s Syndrome. Our online conversation was mostly about the highs and lows of raising her neuro-diverse daughter and she shared with me many of the gifts that come along with having a special needs child.

Then, one day, this was the message in my inbox: “Today is a day in the trenches! It’s a battle and I’m bawling …

AMA: Health insurance monopolies hurt patients and physicians

Peter W. Carmel, MD

Health Policy

November 16, 2011

A guest column by the American Medical Association, exclusive to KevinMD.com.

Anyone making a major purchase wants to maximize value by exploring their options. Shopping for the best option drives market competition and promotes innovation and efficiency. Shopping for competitive health insurance options can be difficult when a market is controlled by one or two large commercial insurers. The lack a competitive …

How to talk with your teen about marijuana

Nelson Branco, MD

Patient

November 16, 2011

Adolescence is filled with challenges – at school, at home, with friends, on stage and in sports. Even their own body betrays them from time to time. Acne, hair, changing bodies and voices, parents, siblings and friends are all possible sources of gut-wrenching shame for a normal teen. Parents of teens have challenges too – and high on the list is the challenge of talking about important topics like sex, …

A few more minutes with Andy Rooney

Pat Mastors

Patient

November 16, 2011

“I died last week, just a month after I said goodbye to you all from this very desk. I had a long and happy life – well, as happy as a cranky old guy could ever be. 92. Not bad. And gotta say, seeing my Margie, and Walter, and all my old friends again is great.

But then I read what killed me: ‘serious complications following minor surgery.’

Now what the heck …

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A few more minutes with Andy Rooney

What patients with heart disease need to learn from cancer patients

Carolyn Thomas

Patient

November 15, 2011

Cardiologist Dr. Richard Fogoros has issued this blunt warning to those at risk for developing heart disease: “You need to change your life. If you don’t, you will suffer the consequences – possibly decades earlier than is necessary.”

In his Heart Health Center column, he observed that most high-risk people end up making only half-hearted efforts to modify their heart attack risk. And he blamed doctors for enabling this lack of …

The risks of exercise injury can increase health care utilization

Juliet K. Mavromatis, MD

Conditions and Diseases

November 15, 2011

The health benefits of exercise are well-established. A recent study published in the Journal of the American College of Cardiology showed that one’s fitness level, as measured a person’s one mile run speed, compared to other cardiovascular risk factors, was the best single predictor of heart attack risk and life span. Studies have shown that regular exercise reduces one’s risk of obesity, diabetes, and hypertension. Exercise has been shown to …

The stigma of HIV continues today

Jessica Gold

Conditions and Diseases

November 15, 2011

Firefighters are heroes because they run into a burning building. They run towards a fire, risking their lives to save others. No one would doubt that they are heroic, but most will wonder how this is even possible. How is it that some people can ignore our innate drives to survive to instead, help others do just that?

Doctors are not typically equated with this type of heroic measure, we give …

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The stigma of HIV continues today

Why we must Occupy Healthcare

Mark Ryan, MD

Health Policy

November 15, 2011

Why do we need to occupy healthcare? Why are we here, on this website, calling for change? We are so often told that America has the best healthcare system in the world. If that were so, then there would be no need to change anything. We could continue running things as we currently are, and all would be well …

Except that we do not have the best healthcare system in …

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Why we must Occupy Healthcare

Medicine introduces us to loss early in life

Edwin Leap, MD

Physician

November 14, 2011

I recently sat by a man whose young wife was dying. Her cancer was taking her away from her husband and toddler. She was sleeping intermittently as the pain medication we administered did its work. Her husband’s eyes were red from crying and he could barely suppress a sob. He touched her and looked at me. I barely kept my own composure.

I wanted to avoid that room and that patient. …

Give meaningful use value for physicians

Matthew Mintz, MD

Health Technology

November 14, 2011

Before I took over one of the classes that now teach at the medical school, I asked students why the value of that class was so low. One of the reasons they gave was that it was so hard to do well in the class, and there were so many other things to study, students only put in enough effort to pass. In other words, incentives are only good if …

Can vaccine recommendations be based solely on individual and public health?

William Schaffner, MD

Medications

November 14, 2011

Have you heard the parable about the blind men and the elephant? Each is holding a different part of the animal and comes to a different conclusion about what he’s dealing with. The man holding the tail is sure it’s a rope; the one with the trunk fears a snake; the one holding the tusk is certain he has a spear. It’s all in their perspective. They’ll need to share …

The problem with healthy fats

Roxanne B. Sukol, MD

Conditions and Diseases

November 14, 2011

Frankly, it rankles me when people use the term “healthy fats.” We don’t make a distinction like that when we’re talking about carbohydrates, although there are certainly carbs that are nutritious and carbs that are not.

Consider the Atkins diet. I like to believe that Dr. Atkins was on the right track, but that he had some of the details wrong. Clearly, he realized that there was something about carbohydrate in …

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The problem with healthy fats

Simple tips to improve your blood pressure checks

Dr. Charles

Conditions and Diseases

November 13, 2011

A recent study confirmed that the doctor’s office may be one of the worst places to determine if your blood pressure is under control. The automatic rise in tension many people experience when they are being scrutinized contributes to artificially high blood pressure readings. Although many times the only way improve one’s blood pressure is through treatment (such as medication, a low salt diet, and weight loss), other times …

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