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Open-angle glaucoma: To screen or not to screen?

Conditions

June 23, 2022

In a published statement in JAMA Network on May 24/31, 2022, the U.S. Preventive Services Task Force found that there was insufficient evidence for screening for primary open-angle glaucoma in adults. They could not find a way to balance harms versus benefits for screening in general. But is this reasoning faulty?

It is well known that Black and Hispanic populations suffer a greater incidence and severity of glaucoma, …

Every intern encounters moments of patient care that become poignant memories

Alexandra Highet, MD

Physician

June 23, 2022

“I am so sorry …”

My apology diffused as I stood adjacent to the IV pole, triangulated between Ms. S, her husband, and her daughter. Ms. S, who was congenitally deaf and capable of lip-reading save for my N95, nevertheless immediately caught the sadness in my eyes. My pulse raced, and my heart sank as her face fell. She knew that her transplant – for which her family had paused their …

Confronting weight bias in health care

Hannah T. Todd, PT, DPT

Conditions

June 23, 2022

One day, working as a floater PT, I walked into the rehab gym, and every single therapist looked at me with the same pitying expression. The rehab manager took me into her office.

“I’m so sorry to put you in this position. One of your new patients today is a really large man. His BMI is 103. It took 12 people to move him from the stretcher into the bed last …

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Confronting weight bias in health care

Healthy patients and healthy physicians: Is it possible? [PODCAST]

The Podcast by KevinMD

Podcast

June 22, 2022

“Lifestyle medicine is part of regular medicine but stands apart in that it is health care that directly benefits patients through the restoration of vitality and health, primarily by lifestyle interventions.

And its healing capacity does not stop there. Because it unlocks the door to health and well-being, its effects reach …

Private practice is the best defense for burnout

Brett Levine, MD

Physician

June 22, 2022

Most physicians choose medicine to care for others. The essential premise balances this selfless, optimistic objective that the physician is healthy and happy with enough knowledge, experience, and abundance to heal their patients.

Unfortunately, our health care system thwarts us at every turn, with continual devaluation and reduction in reimbursements, paralyzing insurance and government regulations, and demoralizing lack of control.

Ballooning student debt and declining reimbursements, and the perception of greater stability …

What feelings stir up inside us when we hear of a child’s death?

Rashmi Bhopi, MD

Physician

June 22, 2022

I wondered if this post needs a trigger warning. Maybe it does. I don’t know now. What feelings stir up inside us when we hear of a child’s death?

My first experience with a child dying in front of me was soon after medical school graduation. I was an inexperienced 24-year-old working in a government hospital in Bangalore. I don’t remember many details, but I remember his face and his father’s …

Who do we become when we love work more than we love ourselves?

Tracey O'Connell, MD

Physician

June 22, 2022

On June 4, 2022, CNN.com published an Opinion piece written by Carolyn Chen: “Why ‘do what you love’ is the worst graduation advice.” As a mother of a recent college graduate, with two others close behind, I read it to garner insights into which encouraging words to use with my own babies entering the adult workforce. The target audience is college graduates, narrowing the relevance to those privileged to …

Strategies to help you prepare for multiple mini interviews (MMIs) [PODCAST]

The Podcast by KevinMD

Podcast

June 21, 2022

“The bottom line is that while you can’t predict exactly which MMI prompt you’ll be given, you can absolutely start preparing for the MMI. Become familiar with the format, practice your delivery, start reading about issues in health care, and start thinking about major points to discuss around these issues. While …

Cognitive dissonance in the medical profession

Claudia Finkelstein, MD

Physician

June 21, 2022

Since writing a cathartic post about being burned out, I’ve received supportive messages as well as concerned calls from friends and former colleagues. Some were worried about my well-being. Others agreed with the sentiments.

One note in particular resonated. It named cognitive dissonance as part of the problem. This dissonance is pervasive in society. The gap between what we say we stand for and what we actually do …

7 high performance habits for physicians

Tomi Mitchell, MD

Physician

June 21, 2022

When it comes to developing healthy habits, there’s no one-size-fits-all approach. However, certain habits are particularly effective when working as a physician. These are what we refer to as high-performance habits.

Being a physician is one of the most challenging jobs out there. I know this because I am one. It takes many years of schooling to become a physician. But, it takes even more than that. It takes …

The body is the gateway to the Original Blueprint

Rebecca A. Ward

Conditions

June 21, 2022

An excerpt from The Paper Tiger Syndrome: How to Liberate Yourself from the Illusion of Fear.

Your Original Blueprint is the part of you that knows abundance is your natural state. It’s the inner voice, which says, I am full. I am satiated. I am content. I am peaceful. …

Primary care’s inevitable reboot [PODCAST]

The Podcast by KevinMD

Podcast

June 20, 2022

“The tech giants of Silicon Valley – love them or hate them – have put incredible personal technology tools into homes and pockets of our patients and their caregivers. Now, we must activate those instruments for our own sustainability, and for our patients’ benefit.

If the neighborly primary care practice is going …

Doctors are not the bad guys

Steven J. Cyr, MD

Physician

June 20, 2022

An excerpt from Cutthroat: A Surgeon’s Fight against Big Government, Corrupt Businessmen, and a Broken Healthcare System.

The media, the business world, insurance companies, and even the government have done an amazing job of portraying doctors as the culprits for the exorbitant costs of health care.

They’ve been able to …

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Doctors are not the bad guys

Precision medicine: the rifle vs. shotgun approach to cancer treatment

Hirva Mamdani, MD

Conditions

June 20, 2022

Why does one person respond favorably to lung cancer treatment while another does not?

The answer lies in their DNA.

Just 20 years ago, lung cancer was broadly categorized into two groups: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Relatively recently, the treatment of NSCLC shifted from chemotherapy as a single treatment option to treatment with precision medicine, which is positively impacting survival rates.

Utilization management is medicine’s great conspiracy theory

Arthur Lazarus, MD, MBA

Physician

June 20, 2022

So-called “evidence-based guidelines” are slowly destroying the practice of medicine, and companies that develop these proprietary guidelines are guilty of conspiring with payers to deny individuals necessary medical treatment.

Guideline developers, health plans, and their benefit managers contend that utilization management (UM) programs based on medically proven guidelines will reduce unwarranted clinical practice variation and improve care quality and cost. But real-world evidence paints an entirely different picture. A recent Read more…

Utilization management is medicine’s great conspiracy theory

Why is there a formula shortage?

Michelle Haggerty, DO, MPH, Jessica Madden, MD, Sonal Patel, MD, and Nithya Natrajan, MD

Policy

June 20, 2022

This is a complicated answer with a complex history.

The most recent factor contributing to the formula shortage is COVID-19 and the pandemic’s effect on supply chains. With the start of the pandemic, people began stockpiling supplies from toilet paper, bottled water, to formula. Concurrently, birth rates decreased due to fear of the virus and its unknown effects on pregnant patients, fetuses, and newborns. Formula consumption was low, decreasing …

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Why is there a formula shortage?

Art as a tool to manage pain [PODCAST]

The Podcast by KevinMD

Podcast

June 19, 2022

“I had also used arts and crafts previously in my own experience to help with healing. Including the previous year when I had a breast cancer recurrence did many crochet projects and took classes in mosaics making as I navigated from victim to survivor. However, following my catastrophic accident, I didn’t …

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Art as a tool to manage pain [PODCAST]

A difficult conversation with my mother’s oncologist

Roxanne Almas, MD, MSPH

Physician

June 19, 2022

The silence felt heavy on the other end of the phone line. I waited a few seconds, and it dawned on me: He wasn’t ready. This moment, each in our own worlds was a defining point in our journey.

Twenty seconds earlier, I had just shared the following with him, “We are ready for hospice.” But he clearly wasn’t. Or maybe he was and just couldn’t verbalize it. He paused after …

5 reasons physicians are afraid to leave medicine

Anonymous

Physician

June 19, 2022

At age 33, I got my first job as an outpatient pediatric attending. With great pay, nice coworkers, and exceedingly better hours than in training, to everyone around me, I had finally “landed.” Soon after I began working, however, I woke up with trepidation every morning, forcing myself to get out of bed.

Why wasn’t I relishing the fruits of my labors? After all this time, I no longer trailed the …

Supporting a new mom: my experience and some helpful tips

Sirosh Masuood, MD

Physician

June 19, 2022

I recently came across a number for the National Maternal Mental Health Hotline. It took me back to my first pregnancy and postpartum experience.

I belong to a traditional family where there is an expectation of bearing a child after a year of marriage. No one prepares the couple for it. No one talks about any challenges during pregnancy and after the child is born.

It was no different …

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