KevinMD.com

October 17, 2010Oct 17, 20102

I had been running late on another busy summer day. The type of day where you gain one step and lose two. Meetings and paperwork had filled up another summer morning. Baseball games, swimming practices, and soccer scrimmages had filled up another summer afternoon. And for this particular summer evening, I was scheduled to work an odd emergency room shift from eight p.m. to four a.m.

While driving to work, I …

Conditions and diseases

Common throat problems that sleep apnea sufferers face

Steven Y. Park, MD

October 17, 2010Oct 17, 2010

If you wake up every morning needing to hack up lots of thick mucus or have throat pain, hoarseness, or a chronic cough, you're not alone. You may think it's the beginning of a cold, but a cold doesn't continue…

If you wake up every morning needing to hack up lots of thick mucus or have throat pain, hoarseness, or a chronic cough, you’re not alone. You may think it’s the beginning of a cold, but a cold doesn’t continue for weeks to months without progressing into full-blown viral symptoms.

Instead, these symptoms are the beginnings of the most common throat problem sleep apnea sufferers face. And as I explain below, …

Patient voices

How working in the White House breaks down your body

Keith Humphreys, PhD

October 17, 2010Oct 17, 2010

When my friend Paul Costello left the Carter Administration, he wrote a funny New York Times article suggesting a special course for departing staffers: There ought to be an "outward bound" course for White House employees facing exile. Must we…

When my friend Paul Costello left the Carter Administration, he wrote a funny New York Times article suggesting a special course for departing staffers:

There ought to be an “outward bound” course for White House employees facing exile. Must we face this cruel and unusual punishment cold turkey?

Maybe people were tougher back then – I personally would have collapsed five minutes into the first day of the course. My experience …

Real physician voices, twice a week

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Medical education

Advice for a second year medical student

Skeptical Scalpel, MD

October 16, 2010Oct 16, 201017

A rising second year medical student read some of my posts and wrote me a kind note asking if I would write something for students. I taught students and ran surgical clerkships at community teaching hospitals for my entire career…

I also was prompted to address this subject after reading a recent New York Times story about a new admissions policy at Mt. Sinai …

Physician voices

How a tyranny of health is bad for both patients and physicians

Jan Henderson, PhD

October 16, 2010Oct 16, 201021

Something happened to the public perception of health and medicine in the 1970s. People began to adopt — and financial interests and the media began to profit from – “healthy lifestyles.” This was not without consequences. • Americans became increasingly…

Something happened to the public perception of health and medicine in the 1970s. People began to adopt — and financial interests and the media began to profit from – “healthy lifestyles.”

This was not without consequences.

• Americans became increasingly preoccupied with diet, exercise, and health habits.

• There was a big uptick in the use of alternative “medicine” and stress reduction practices – acupuncture, chiropractic, herbalism, naturopathy, nutritional therapies, yoga, massage, biofeedback.

• …

Conditions and diseases

MKSAP: A 70-year-old man with a history of a systolic murmur presents with exertional dyspnea

mksap

October 16, 2010Oct 16, 2010

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 70-year-old man with a history of a systolic murmur presents for further assessment of exertional dyspnea. He has had dyspnea his entire life,…

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

A 70-year-old man with a history of a systolic murmur presents for further assessment of exertional dyspnea. He has had dyspnea his entire life, but has noted a recent deterioration in his exercise capacity. He has no other medical conditions and is on …

Patient voices

Searching for solace while balancing the care of patient

Brian McMichael, MD

October 16, 2010Oct 16, 2010

The NEJM recently published an interesting case in the ongoing series: " A Request for Retrieval of Oocytes from a 36-year old Woman with Anoxic Brain Injury." Usually these cases are diagnostic dilemmas. This one focused on an ethical dilemma…

The NEJM recently published an interesting case in the ongoing series: “ A Request for Retrieval of Oocytes from a 36-year old Woman with Anoxic Brain Injury.” Usually these cases are diagnostic dilemmas. This one focused on an ethical dilemma at end-of-life.

The Case

A 36-year-old woman, in overall good health taking oral contraceptive pills (OCPs), was on a prolonged international flight, and collapsed. A physician …

Health policy

Is healthcare is a right? A balanced opinion

Patrick W. Hisel, MD

October 15, 2010Oct 15, 2010178

Chris Mathews had Ron Paul on his show, Hardball, earlier this year to discuss Social Security and the new health care bill. Mr. Mathews pointed out that people get old and no longer have an adequate income source to take…

Chris Mathews had Ron Paul on his show, Hardball, earlier this year to discuss Social Security and the new health care bill.

Mr. Mathews pointed out that people get old and no longer have an adequate income source to take care of their basic needs, and pointed to this as a reason to force working Americans to save for our retirement through a government program as a sort of …

Drugs and prescribing

How drug reps increase drug sales by influencing physicians

Daniel J. Carlat, MD

October 15, 2010Oct 15, 201011

An excerpt from Unhinged: The trouble with psychiatry- a doctor’s revelations about a profession in crisis. Copyright © 2010 Daniel Carlat. Excerpted with permission by Free Press, a Division of Simon & Schuster, Inc. It may be hard for people…

An excerpt from Unhinged: The trouble with psychiatry- a doctor’s revelations about a profession in crisis. Copyright © 2010 Daniel Carlat. Excerpted with permission by Free Press, a Division of Simon & Schuster, Inc.

It may be hard for people to imagine that drug reps can get us to prescribe a particular drug by simply giving us a meal or being nice to us. The process is subtle, …

Conditions and diseases

Breast cancer and understanding your breast type

Therese B. Bevers, MD

October 15, 2010Oct 15, 20103

What does your breast type say about your cancer risk? Quite a bit, actually. Whether you have large, small or lumpy breasts, self-awareness is very important. Getting to know how your breasts look and feel can help you recognize possible…

What does your breast type say about your cancer risk? Quite a bit, actually.

Whether you have large, small or lumpy breasts, self-awareness is very important. Getting to know how your breasts look and feel can help you recognize possible red flags.

Large vs. small breasts

When it comes to cancer risk, size really doesn’t matter. But, size can affect your mammogram and clinical breast exam.

For example, women with large breasts may need …

Patient voices

Protecting kids in the world of social media, a Cybersafe excerpt

Kevin

October 14, 2010Oct 14, 2010

An excerpt from CyberSafe: Protecting and Empowering Digital Kids in the World of Texting, Gaming and Social Media. by Gwenn Schurgin O’Keeffe, MD, FAAP Screen Time and Childhood Have you ever tried to go “screen-less”? I often tell the story…

An excerpt from CyberSafe: Protecting and Empowering Digital Kids in the World of Texting, Gaming and Social Media.

by Gwenn Schurgin O’Keeffe, MD, FAAP

Screen Time and Childhood

Have you ever tried to go “screen-less”? I often tell the story of taking my girls to New York City on an April vacation, looking forward to Turnoff Week. This is a semiannual event that encourages families to flip off the …

Health technology

Challenges facing patients adopting personal health records

MedPage Today

October 14, 2010Oct 14, 20104

by Kristina Fiore They're still there. Rows upon rows of number- and color-tagged manila charts, packed in so closely together that Fiore sometimes sticks to Fiori, or hides behind it. None of my physicians has yet converted to electronic health…

by Kristina Fiore

They’re still there. Rows upon rows of number- and color-tagged manila charts, packed in so closely together that Fiore sometimes sticks to Fiori, or hides behind it.

None of my physicians has yet converted to electronic health records. I dream of the day when my PCP can pull up my chart on her iPad, accessing all of the important information (allergies, family history) before …

Health policy

Tips for questioning costs in today’s health care system

Joanna Fief

October 14, 2010Oct 14, 201015

by Joanna Fief About two years ago in the wee hours of the morning, I found myself in a local emergency room with severe stomach pain, incessant vomiting and dehydration. It wasn’t pretty, and I was desperate for something –…

by Joanna Fief

About two years ago in the wee hours of the morning, I found myself in a local emergency room with severe stomach pain, incessant vomiting and dehydration. It wasn’t pretty, and I was desperate for something – anything – to ease my pain and stop my vomiting.

Gratefully, within minutes of receiving an IV with medications for pain and nausea, my symptoms subsided. After a couple of blood tests …

Drugs and prescribing

Finasteride, fruit, and the matter of prostate health

Arnon Krongrad, MD

October 14, 2010Oct 14, 20104

by Arnon Krongrad, MD The noose was loose on its neck. At first I worried, but then I relaxed. This was a bottle of pomegranate juice, the antioxidant superpower. As the billboard implied, it could cheat death. Perhaps if I…

by Arnon Krongrad, MD

The noose was loose on its neck. At first I worried, but then I relaxed. This was a bottle of pomegranate juice, the antioxidant superpower. As the billboard implied, it could cheat death. Perhaps if I consumed pomegranate juice, I could cheat death.

Last week, the Federal Trade Commission charged POM Wonderful, LLC, makers of pomegranate products, with deceptive advertising. …

Physician voices

What makes an e-Doctor?

Dr. Martin Young

October 13, 2010Oct 13, 20107

The rise of the e-Patient movement has the potential to change the practice of medicine, in my opinion, for the better. e-Patients demand to be taken seriously, to be “equipped, enabled, empowered, engaged, equals, and emancipated.” My recent post on…

My recent post on KevinMD.com suggested the need for e-Doctors as well, in response to the growth of the e-Patient movement.

So how do you become an e-Doctor? I believe you, and I, need to be equally …

Read more…

What makes an e-Doctor?

Health policy

Selecting health insurance requires free choice for individuals

William Bayer

October 13, 2010Oct 13, 201010

Buying health insurance across state lines and health savings accounts are good - but they do not resolve the core issue. The core issue is that the employer is making the main choice for the employees, leaving them essentially with…

Buying health insurance across state lines and health savings accounts are good – but they do not resolve the core issue.

The core issue is that the employer is making the main choice for the employees, leaving them essentially with a choice between small, medium or large. That may satisfy the most important needs, but it does not encourage competition because the consumer is …

Drugs and prescribing

HIV sufferers benefit from the FDA’s unapproved drugs initiative

Gary Puckrein, PhD

October 13, 2010Oct 13, 20103

by Gary Puckrein, PhD Unapproved drugs have never been tested by the Food and Drugs Administration for safety and efficacy. Prescribed by the million every year in the United States, these products pose a potential danger to all patients, but…

by Gary Puckrein, PhD

Unapproved drugs have never been tested by the Food and Drugs Administration for safety and efficacy. Prescribed by the million every year in the United States, these products pose a potential danger to all patients, but HIV/AIDS patients who suffer weakened immune systems are at an even higher risk as they are more vulnerable to injury due to their disease.

That’s why we …

Drugs and prescribing

Narcotic use is rampant in workers compensation

Joseph Paduda

October 12, 2010Oct 12, 20105

Just in case you thought the problems with abuse of powerful prescription drugs have been overstated, here's a wake-up call. The CDC's Director is taking this very seriously, saying: "Overdose with prescription drugs is one of the most serious and…

Just in case you thought the problems with abuse of powerful prescription drugs have been overstated, here’s a wake-up call.

The CDC’s Director is taking this very seriously, saying: “Overdose with prescription drugs is one of the most serious and fastest-growing problems in this country.”

The problem is showing up in a doubling of emergency room admissions due to prescription drug abuse, driven primarily by oxycodone, methadone, and hydrocodone.

Narcotic use is rampant

…

Health policy

Making health care better, faster, and cheaper with collective innovations

Joe Flower

October 12, 2010Oct 12, 20105

The country seems to have shifted in less than 18 months from a slogan of “Yes We Can!” to “Oh, well…” and a shrug, then back to “Cool! I think. What was that, really?” Hopes for a true rebirth of…

The country seems to have shifted in less than 18 months from a slogan of “Yes We Can!” to “Oh, well…” and a shrug, then back to “Cool! I think. What was that, really?”

Hopes for a true rebirth of health care turned into the Year of Screaming Inanely, then took that long slide from what we might hope for to what we might settle for. Yet suddenly it seems like …

Real physician voices, twice a week

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