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MKSAP: 50-year-old woman with advanced multiple myeloma

mksap

Conditions and Diseases

June 11, 2011

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

A 50-year-old woman with advanced multiple myeloma diagnosed 6 months ago undergoes a follow-up visit. Treatment includes daily oral thalidomide and pulse dexamethasone. The patient now feels well.

Laboratory studies indicate a serum monoclonal protein concentration of 3.0 g/dL (30 g/L). Hemoglobin concentration, serum calcium level, and …

Medicare’s high cost end stage renal disease patients

Merrill Goozner

Conditions and Diseases

June 11, 2011

Anyone who thinks America has the best health care system in the world ought to take a look at its miserable record on caring for end stage renal disease patients on dialysis.

About one of every five people who go on dialysis dies in the first year here, compared to less than one in seven in Europe and one in sixteen in Japan. Even after adjusting for age, gender, race …

Securing mobile devices in healthcare

Kevin

Health Technology

June 11, 2011

by David Ting

With the mobile market exploding, healthcare IT administrators are now faced with physicians and other clinicians requesting to use their personal devices, such as iPads and iPhones, to access patient information from anywhere, anytime.

With this ability, clinicians are able to make faster decisions for their patients – improving their overall workflow and patient outcomes. This seductive mobile technology, however, is not …

Read more…

Securing mobile devices in healthcare

ABIM Maintenance of Certification (MOC) internal medicine exam tips

Kevin Pho, MD

KevinMD

June 10, 2011

This past spring, I took the American Board of Internal Medicine (ABIM) Maintenance of Certification (MOC) exam.

7 weeks later, I received my results. Thankfully, I passed.

This was not entirely a surprise, as the pass rate for first-time test takers was 88%. But it definitely requires some studying. It’s not a gimmie.

Considering that I last took my board exam in …

The unintended consequences of medical marijuana

Emily Gibson, MD

Medications

June 10, 2011

It was 1978 and I was a third year medical student when my friend was slowly dying of metastatic breast cancer.

Her deteriorating cervical spine, riddled with tumor, was stabilized by a metal halo drilled into her skull and attached to a scaffolding-like contraption resting on her shoulders. Vomiting while immobilized in a halo became a form of medieval torture. During her third round of chemotherapy, her nausea was so …

Students who are the evangelists of family medicine for tomorrow

Allen Perkins, MD

Medical Education

June 10, 2011

Recently, I was in a meeting organized by the American Academy of Family Physicians in an effort to understand the lack of student interest in family medicine as well as to encourage brainstorming among those of us charged with facilitating interest on ideas that might work and be transportable.

I was with Bill Coleman from Alabama (among others) and was pleased to discover that we were ahead of the region. …

How shopping for an EHR is like buying a car

Margalit Gur-Arie

Health Technology

June 10, 2011

So you’ve been hearing all about the recent EHR buzz and decided to give it a try.

Whether you are convinced that electronic records are the way to go, or you have reached a point where you are willing to give it a try, the first thing to do is buy one of those EHRs. You may be staring at a glossy brochure or website featuring a distinguished silver-haired doctor …

How robots will teach us who we are as humans

Kent Bottles, MD

Health Technology

June 10, 2011

Recently, I took a Megabus from Philadelphia to Hunter College in New York City to attend Man-Made Minds: Living With Thinking Machines, a World Science Festival program.

Rodney Brooks, who until recently was Panasonic Professor of Robotics at MIT and who now is Chief Technology Officer at Heartland Robotics, was the first expert to speak, and he emphasized a very practical approach that was not too concerned with any negative consequences …

Thoughts after your family doctor retires

Jackie Fox

Patient

June 10, 2011

My family doctor recently announced he’s retiring from medicine after 37 years, and my husband and I were his patients for more than 18 of those years. We had a lot of one-offs before finding him, but he was worth the wait. I want to explain why he inspired our loyalty.

He saved my husband’s mobility. A glass coffee pot separated from its handle and a shard went straight into …

Baby Boomers are driving the next wave of joint replacements in medicine

Eric Marcotte, MD

Physician

June 10, 2011

by Eric Marcotte, MD

Associated Press health writer Marilynn Marchione recently reported on the rapid growth of so-called “fix-me-it is” in orthopedic surgery. Healthier and younger than the typical patients undergoing joint replacement, Baby Boomers are driving the next big wave of joint replacements in medicine.

This is definitely welcome news for Zimmer, Biomet, and our other fine biomedical companies here in Indiana. Whether this …

Why private practice surgeons perform more open breast biopsies

Jeffrey Parks, MD

Physician

June 9, 2011

A Florida study assessed the rate of needle versus surgical breast biopsies over a period of five years.

What we’re talking about here are non-palpable abnormalities that are identified on screening mammography. A mammogram report will come back that assesses the relative risk of an abnormal collection of calcifications harboring an invasive or pre-invasive cancer (staged on a scale from I-V). With such data, one is obligated, …

Reasons behind the image mutation of physicians

Richard A. Foullon, MD

Physician

June 9, 2011

As far back in history as in the day of Hippocrates of Cos, often referred to as the father of Western medicine, 460 BC – 370 BC, a physician was viewed in a paternalistic manner, one in which a physician’s opinion(s) were simply just believed and their recommendation(s) were followed without question. The prevailing culture was definitely one of passive, submissive acceptance.

Although there will more likely than not always be …

Should doctors be blamed for bad decisions by patients?

Jaan Sidorov, MD

Patient

June 9, 2011

The Disease Management Care Blog attended a professional hockey game recently and it must say it was quite the spectacle.

While the athleticism on the ice was quite remarkable, the real wonderment involved the hometown fans. Questionable referee calls prompted thousands of all ages to chant phrases that the DMCB has not recently read in any medical journals, while the willingness of grown men to display, in stereo fashion, obscene gestures …

AMA: Revisions, clarity needed before physicians form Medicare ACOs

Cecil B. Wilson, MD

Health Policy

June 9, 2011

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

There is said to be an old Chinese curse: May you live in interesting times. As I wrap up my year traveling the country as President of the AMA, I can without a doubt say physicians are living – and practicing medicine – in interesting times. This can be a challenge, but does not need to be a curse.

There are …

Baby monitors abuse the vulnerability of parents for profit

Claudia M. Gold, MD

Physician

June 9, 2011

Recently I was interviewed by a reporter about the effects of the newest baby monitors on parent-child relationships. A teddy bear with a camera in its nose hooks up to a TV, allowing parents to watch their baby’s every move.

One product called an exmobaby is actually worn against the baby’s skin and measures heart rate and respirations. A CEO of …

Why families and advocacy groups accept the torture of dying patients

Kevin

Physician

June 9, 2011

by Aroop Mangalik, MD

A man has lung cancer that has spread to the brain. The cancer in the brain has been growing despite full dose radiation. His lungs have failed and he has been on a respirator for 10 days with progressive worsening of lung function.

Despite multiple discussions between the doctors and the Intensive Care Unit’s team …

A doctor’s letter to a patient with newly diagnosed cancer

Dr. Martin Young

Physician

June 9, 2011

Dear “Robin,”

Nothing in my career in medicine has prepared me for being a friend to someone with such a terrible disease. As a doctor I dispense advice on a daily basis, but those interactions remain strangely impersonal. With you, cancer has invaded our inner circle, and we all share your shock and despair.

No one can know exactly what it feels like …

Prices should be readily available to save hospitals money

Happy Hospitalist, MD

Physician

June 9, 2011

Hospital costs are out of control. We have an aging population living longer with more complicated presentation of disease. We have an insurance driven platform instead of a health driven accountability. The long term sustainability of that architecture is one of guaranteed insolvency.

One way or another hospitals are going to find their lifeline cut off. Medicaid is bankrupt. Hospital profit margins …

Budget cuts to NICU admissions will have a ripple effect

Linda Burke, MD

Physician

June 8, 2011

What is wrong with the state of Texas? Have they no heart? Why is it that at the time of fiscal crisis, it’s always the “little” people whose services are eliminated first?

The “little” people in this case would be babies who are either born sick or premature. The New York Times article, In Search of Cuts, Health Officials Question NICU Overuse, was shocking. The Texas state officials have …

What it means to be sick as a medical student

Jessica Gold

Medical Education

June 8, 2011

For the first time since I have been in medical training, I got sick.

Not just the kind of sick where its a cold, or you know that its stress, but the kind of sick that does not go away and randomly comes up just to make you mad when you just want to have fun (like …

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