KevinMD.com

December 4, 2011Dec 4, 20116

"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…

“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 …

Physician voices

What patients need to know about coding

Brandon Betancourt

December 4, 2011Dec 4, 20117

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…

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

Conditions and diseases

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

mksap

December 4, 2011Dec 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…

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 …

Real physician voices, twice a week

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Patient voices

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

Stan Goldberg

December 3, 2011Dec 3, 20112

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. …

Physician voices

Why doctors need Hollywood

Adam Bitterman, DO

December 3, 2011Dec 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,…

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

Conditions and diseases

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

mksap

December 3, 2011Dec 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…

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 …

Physician voices

The day our hospital lost its heart

Dr. Martin Young

December 2, 2011Dec 2, 20116

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

Physician voices

Why rheumatology is sexy

Ronan Kavanagh, MD

December 2, 2011Dec 2, 20112

Although as a medical student rheumatology was always associated with an air of mystery and complexity to me - factors which might have aroused a younger me had they been associated with a member of the opposite sex – the…

Although as a medical student rheumatology was always associated with an air of mystery and complexity to me – factors which might have aroused a younger me had they been associated with a member of the opposite sex – the specialty didn’t catch my eye at all as an undergraduate. To a medical student cruising for medical action in the 1980′s, rheumatology wouldn’t have got as far as a first …

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Why rheumatology is sexy

Health policy

Rigid regulation can become detrimental to patient care

David Gelber, MD

December 2, 2011Dec 2, 20117

The last four days have provided a sharp glimpse into the future that awaits those of us in the health care profession, physicians in particular. Over the last few years physicians have been burdened with mountains of paperwork, most of which contributes little to patient care, but does take time away that could be better utilized caring for our patients. However, the last four days have demonstrated that the administrative …

Medical education

Nutrition needs to be taught in medical school

James Haddad

December 2, 2011Dec 2, 201134

The study of medicine can be overwhelming. We’ve simply discovered too much for one person to master completely. This is the challenge medical educators are tasked with – what’s so important that it must be allotted time in the brief…

Students face a similar time-management challenge – first, we must decide what’s important enough to focus on, but the real question I think …

Drugs and prescribing

Explaining Propofol to patients after Michael Jackson and Conrad Murray

American Society of Anesthesiologists & John E. Vazquez, MD

December 1, 2011Dec 1, 2011

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Since the passing of Michael Jackson and the recent trial of his physician, Dr. Conrad Murray, I have been frequently asked by patients whether they will receive the…

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

Since the passing of Michael Jackson and the recent trial of his physician, Dr. Conrad Murray, I have been frequently asked by patients whether they will receive the drug that killed the singer. As have many of my anesthesiologist colleagues, I have taken this opportunity to educate patients on what propofol is and how it should be safely …

Physician voices

Impersonal care from the new generation of physicians

Norman Silverman, MD

December 1, 2011Dec 1, 201124

Historically, American physicians and surgeons were fiercely independent practitioners, who owned their own practices, worked long days and maybe longer nights, made a good income, but saw little of their families. They trained in a male-dominated world in “residency,” so named originally because their extended 120 hour/week work schedule demanded them living in dormitory type residence adjacent to the hospital.

They developed long-standing professional commitment to their patients that superseded time …

Drugs and prescribing

I eat lunch with drug company representatives and I’m proud of it

Stewart Segal, MD

December 1, 2011Dec 1, 201159

Today, I want to review another article I wrote in last year. That article started with a confession: "I confessed that I ate lunch with a representative of a pharmaceutical company." I must now confess that I often eat lunch…

Today, I want to review another article I wrote in last year. That article started with a confession: “I confessed that I ate lunch with a representative of a pharmaceutical company.”

I must now confess that I often eat lunch with representatives of pharmaceutical companies and I’m proud of it. At this stage of my career, I can well afford my own lunch. I could sit quietly and relax over a cup …

Physician voices

Cancer rehab dramatically improves cancer care

Julie Silver, MD

November 30, 2011Nov 30, 20114

In this day and age, with excellent rehabilitation care available for nearly every injury or illness—no matter how serious—it’s hard to believe that there are millions of people who leave the acute medical system far worse off than they entered it, and aren’t routinely offered rehab. I’m talking about cancer survivors– a group of individuals known for their tremendous advocacy abilities. It’s no surprise that these folks are really starting …

Physician voices

The art of Alzheimer’s disease

Michael Chorney

November 30, 2011Nov 30, 20113

Physicians are not trained to interpret paintings, and most patients do not have a lifetime of artwork to analyze. However, a rare opportunity for both to occur is at the Museum of Modern Art’s exhibition de Kooning: A Retrospective. Wilem…

Wilem de Kooning, regarded as one of the most prolific American artists of the twentieth century, grounded himself in the Abstract Expression movement. The AbEx movement is widely associated and recognized with …

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The art of Alzheimer’s disease

Physician voices

The therapeutic value of touch in medicine

Steve Wilkins, MPH

November 30, 2011Nov 30, 20119

My wife has two world-class oncologists who help her manage her stage 4 lung cancer. Both are excellent clinicians. Yet their skills differ in one very important way. Her radiation oncologist physically touches her a lot (in a good way of course!). There are the touches on her arm, a hand on the shoulder, hugs, and of course a thorough hands-on physician exam. Her medical oncologist not so much.

We all …

Patient voices

When applications ask about your psychiatric history

Dinah Miller, MD

November 30, 2011Nov 30, 20117

Sam is young man is applying for a summer program, a real resume builder. Among other things, the application asks if he has been treated for a psychiatric disorder. In fact, he's seen a therapist and he's felt anxious at…

Sam is young man is applying for a summer program, a real resume builder. Among other things, the application asks if he has been treated for a psychiatric disorder. In fact, he’s seen a therapist and he’s felt anxious at times. His internist gave him some Lexapro samples and he feels better. The symptoms of his problems have been limited to his own subjective distress. His anxiety is not something …

Health technology

Health IT has problems, but is worth the price

George Lundberg, MD

November 29, 2011Nov 29, 20118

I started working with computers in medicine in 1963. I was a Captain in the United States Army Medical Corps in San Francisco when a Lieutenant Colonel told me to "automate the California Tumor Tissue Registry." I said, "Yes, Sir.…

I started working with computers in medicine in 1963. I was a Captain in the United States Army Medical Corps in San Francisco when a Lieutenant Colonel told me to “automate the California Tumor Tissue Registry.”

I said, “Yes, Sir. How would I do that?” He told me to walk across the Presidio parking lot and go into a building that had a big machine in it that is called a …

Physician voices

First world healthcare expectations in a third world country

Ryan Brooks, MD

November 29, 2011Nov 29, 20112

I am a third world doctor. My patients have first world expectations. Somewhere in the middle, I end up working too hard and then going home feeling cheated. For I too have expectations. I am in a tension between the…

I am a third world doctor.

My patients have first world expectations.

Somewhere in the middle, I end up working too hard and then going home feeling cheated. For I too have expectations. I am in a tension between the reality and my aspirations.

In Jamaica, health care is free. Day after day, and night after night its freeness is confirmed, tested. But the system is inanimate. It doesn’t feel its own failure, …

Real physician voices, twice a week

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