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Physician voices

A diagnosis of stomach cancer profoundly changes an oncologist

Jennifer Kelly, MD, PhD

February 19, 2012Feb 19, 201211

I was jogging one day while on a business trip in LA and collapsed during the run. Within hours, I was at the hospital at UCLA Medical Center on a gurney headed for a CT scan of my abdominal cavity. I remember telling the ER physicians that I was a doctor and recommending my own course of action. As my advice to the ER doctors went largely ignored, I realized, …

What you need to know about antithrombotic guidelines

Gordon Guyatt, MD

February 19, 2012Feb 19, 2012

The lack of evidence supporting the “economy class syndrome” myth in air travel made major news headlines recently. While certainly interesting and accurate, that topic was just one among many topics addressed in the larger framework of the new evidence-based…

The American College of Chest Physicians (ACCP) released the Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines in its February issue …

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Vivian E. von Gruenigen, MD

Why are labor and deliveries closing?

February 18, 2012Feb 18, 201224

Labor and deliveries are slowly closing across the United States: California, Pennsylvania, and Ohio. In regional areas where there have been no closures, conversations in hospital boardrooms are probably questioning whether they should be. But why? Because of health care reform, increasing medical expenditures, hospitals are making less money due to reduced reimbursement, and because of the financial margin of obstetrics. To explain the complex answer further, we need to …

Why are labor and deliveries closing?

MKSAP: 35-year-old woman with right upper quadrant abdominal pain

mksap

February 18, 2012Feb 18, 2012

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 35-year-old woman is evaluated for a 6-month history of right upper quadrant abdominal pain that has slowly increased in intensity and is worse…

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

A 35-year-old woman is evaluated for a 6-month history of right upper quadrant abdominal pain that has slowly increased in intensity and is worse on deep inspiration. The patient is otherwise well, and her only medication is an oral contraceptive pill that she has taken for …

A Grammy artist with Tourette Syndrome

Michele R. Berman, MD

February 17, 2012Feb 17, 2012

Would you consider a career as a singer if you had involuntary tics from Tourette Syndrome? Well, it apparently didn’t stop 20-year-old Contemporary Christian musician Jamie Grace. In fact, Grace attributes singing with helping her cope with her disease. And…

Would you consider a career as a singer if you had involuntary tics from Tourette Syndrome?

Well, it apparently didn’t stop 20-year-old Contemporary Christian musician Jamie Grace.

In fact, Grace attributes singing with helping her cope with her disease.

And now she is being rewarded with a Grammy nomination for best contemporary Christian music song, Hold Me. The song features TobyMac, who is a Grammy winning Christian recording and hip/hop artist. He …

A Grammy artist with Tourette Syndrome

Physician voices

Turn away from interventions that merely prolong dying

Marya Zilberberg, MD, MPH

February 17, 2012Feb 17, 201225

"Twenty years ago, I helped save a man's life." So begins this New York Times essay by Peter Bach, MD, where he talks about the inadequacy of resource use at the end of life as a policy metric. Now, I…

“Twenty years ago, I helped save a man’s life.”

So begins this New York Times essay by Peter Bach, MD, where he talks about the inadequacy of resource use at the end of life as a policy metric. Now, I am not very fond of policy metrics, as most of you know. So, imagine my surprise when I found myself disagreeing vehemently with Peter’s argument. Well, to be fair, I did …

Medical education

Reward or punishment in medical training

Christopher Johnson, MD

February 17, 2012Feb 17, 20129

Like many of my colleagues, I teach and supervise students, residents, nurses, and respiratory therapists. I’m also the medical director of a PICU. Overall, I’ve been teaching and doing administration for over 30 years. And, like most of my colleagues, I never received any formal instruction at all in how to do these things. To some extent I got help from my own mentors, primarily by watching what they did, …

Health technology

Break out of the prison of the American health care delivery system

Kent Bottles, MD

February 17, 2012Feb 17, 20128

Speaker after speaker at the recent Care Innovations Summit in Washington, DC concluded that increasing the quality and decreasing the per-capita cost of health care is the dominant political, social, and economic issue of our time. More than one expert…

“Jailbreak” for me meant either an obscure English reality television show or an expression applied to overriding the software limitations deliberately placed on computer systems for security …

A physician shares her anxiety management tips

Susan Biali Haas, MD

February 16, 2012Feb 16, 20122

I started working with a new coaching client the other day. I'd already been following the twists and turns of her life saga for about a year, via excited emails she'd been sending me ever since reading my book Live…

I started working with a new coaching client the other day. I’d already been following the twists and turns of her life saga for about a year, via excited emails she’d been sending me ever since reading my book Live a Life You Love.

“As you know, I’ve made all kinds of wonderful changes in my life,” she told me over the phone, “I left a job I couldn’t stand, sold …

Physician voices

Plastic surgery is part of the ENT surgeon repertoire

Mike Armstrong, MD

February 16, 2012Feb 16, 20125

Do ear surgeons perform facelifts? Absolutely! And we perform nose surgery and throat surgery, too! A recent article in the New York Times presented a scathing editorial on complications caused by poorly trained surgeons. However, the implication of the title…

Do ear surgeons perform facelifts? Absolutely!

And we perform nose surgery and throat surgery, too!

A recent article in the New York Times presented a scathing editorial on complications caused by poorly trained surgeons. However, the implication of the title “Ear surgeons performing facelifts,” is misleading and overlooks the fact that a large portion of training in the specialty of ear, nose and throat surgery includes plastic and reconstructive surgery of …

Why we need truth in labeling of medical conditions

Toni Bernhard, JD

February 16, 2012Feb 16, 201220

Labels matter. We quickly form judgments based on them. If we hear someone called lazy, the label “lazy person” attaches in our mind even though we may not have even met the person. The same is true for labels given to various medical conditions. If the label for an illness uses language such as “fatigue,” we abstract from our experience and think we know what it’s like to suffer from …

What you need to know about popular diets

Daxaben Amin, RD

February 16, 2012Feb 16, 20129

Losing weight can help lower your chances for cancer if you’re overweight or obese. But not just any weight-loss plan will give your body the nutrients it needs to fight off diseases like cancer. Below, I’ve separated out the good…

Losing weight can help lower your chances for cancer if you’re overweight or obese.

But not just any weight-loss plan will give your body the nutrients it needs to fight off diseases like cancer.

Below, I’ve separated out the good from the bad among popular diets.

Good nutrition is not a fast fix

Diets that make the “good list” encourage long-term change. They also give you a variety of options from all …

Patient voices

Question the price of drugs and medical procedures

Court Nederveld

February 15, 2012Feb 15, 201215

Hypertension was the trigger that forced medical cost awareness to the forefront. My doctor decided that with my rise in blood pressure it would be prudent to prescribe a blood pressure medication and order a nuclear stress test. With only a catastrophic insurance policy and a $5000 deductible it was imperative for my financial health to know the cost of both the drugs and the procedure up front.

The prescription was …

The psychological basis of Morgellons disease

Dominic A. Carone, PhD

February 15, 2012Feb 15, 20125

If you are like most people, you have probably never heard of Morgellons disease or Morgellons. The first reason you have likely never heard if it is because it is so bizarre and uncommon. Most of what is known about it is based on rare case reports or anecdotal stories. The second reason is because it is not recognized in the medical community as a legitimate medical disease. It is …

America has a health care paradox

Stephen C. Schimpff, MD

February 15, 2012Feb 15, 201225

We have a real paradox in American healthcare. On the one hand we have exceptionally well educated and well trained providers who are committed to our care. We are the envy of the world for our biomedical research prowess, funded largely by the National Institutes of Health and conducted across the county in universities and medical schools. The pharmaceutical industry continuously brings forth life saving and disease altering medications. The …

America has a health care paradox

Health technology

We need an app for credible information on vaccines

Wendy Sue Swanson, MD

February 14, 2012Feb 14, 201213

Stop what you’re doing to read this The New England Journal of Medicine perspective by Dr. Doug Diekema. It’s about vaccines, opportunities for health, and physician obligation. Written for physicians, it also speaks loudly to parents and includes a few…

Stop what you’re doing to read this The New England Journal of Medicine perspective by Dr. Doug Diekema. It’s about vaccines, opportunities for health, and physician obligation. Written for physicians, it also speaks loudly to parents and includes a few very essential points. The whole time I read the article, my thoughts kept leaping to our imminent opportunities. Today, in 2012, we can harness the tools of social media …

How patient satisfaction can kill

Kevin Pho, MD

February 14, 2012Feb 14, 201252

Patient satisfaction is all the rage. Medicare is beginning to tie patient satisfaction scores with hospital reimbursement, and doctors across the country are under pressure from administrative executives to raise patient satisfaction scores. High scores are even used by hospitals…

Patient satisfaction is all the rage.

Medicare is beginning to tie patient satisfaction scores with hospital reimbursement, and doctors across the country are under pressure from administrative executives to raise patient satisfaction scores.

High scores are even used by hospitals as a powerful marketing tool.

But, in the end, are patient satisfaction scores hurting patients?

I wrote about the issue previously, saying that patient …

How patient satisfaction can kill