What does a cardiologist think of the keto diet?

Conditions
November 8, 2019

Being a cardiologist, the most frequent question coming my way for the last few years is “Doc what do you think about the “keto” [ketogenic] diet.”

All foods contain both micronutrients and macronutrients that are essential for the body to function optimally. The human body requires macronutrients in large amounts, which include carbohydrates, proteins, and fats. These nutrients provide energy for your body in the form of calories. Micronutrients are nutrients …

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A poem for the pediatrician on a Monday

Physician
November 8, 2019

It’s Monday, I recall as I step into work;
“Preparing for battle,” I say with a smirk.
Surviving all weekend with a sick kid in tow,
the parents’ relief as they waited to show
you their child with fever, diarrhea and sneezing,
the one who is too hot, too cold or is freezing,
the one who forgot that a helmet is needed,
the one who is eating too much, they conceded.
The one who still haunts you when …

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How illusions impact how we practice medicine

Physician
November 7, 2019

We can learn a lot about ourselves by looking at, and thinking about, perceptual illusions and our biases.

Look at the image above. The classic, Muller-Lyer illusion.

We know that the two lines are the same size. But no matter how much we intuitively “know” this to be true, we see the top line as bigger. We can’t unsee it — even if we …

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How compensation can affect physician burnout

Finance
November 7, 2019

Burnout in medicine has reached epidemic proportions. A recent systematic analysis found that the prevalence of burnout was as high as 80.5%. All medical specialties are affected, although prevalence rates of burnout vary widely between specialties.

Classically, burnout is defined as a triad of emotional exhaustion, depersonalization, and inefficacy. Recently, moral distress or moral injury has also been recognized as a potential component of Read more…

Why diverticulitis can be an elusive diagnosis

Conditions
November 7, 2019

I have been treating diverticulitis for 30 years the same way. When I suspect that a patient has this diagnosis, I prescribe antibiotics. This has been the standard treatment for this disorder for decades. I have found that diverticulitis is a slippery entity that has two trap doors waiting for physicians to fall through.

It is an easy task to miss the diagnosis. Every physician has done this.

The diagnosis can be …

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What rushed patient encounters are doing to patients and physicians

Physician
November 5, 2019

Research shows that as many as 50 percent of physicians report some level of burnout that manifests as depression, dissociation, indifference, and even substance use disorders. Medicine has become focused on monetary gains by large corporations, major hospitals, and insurance companies. As much as doctors want to focus on quality patient care, they are forced to focus on electronic medical records that are cumbersome, seeing multiple patients with quick assessments …

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MKSAP: 28-year-old woman follows-up after a pre-employment physical examination

Conditions
November 2, 2019

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

A 28-year-old woman undergoes follow-up consultation regarding a pre-employment physical examination. She reports feeling well, with no recent illness. Medical history is notable for gastroesophageal reflux disease. Her only medication is omeprazole. She is black.

On physical examination, vital signs and other examination findings are normal.

A peripheral blood smear shows …

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Our healers need healing

Physician
October 30, 2019

I woke up to him, pacing the bedroom.

Within an hour, I was pacing the ER at his bedside.

Our experience at one of the country’s best-ranked hospitals lasted only three days before we were discharged home. What led us there will last a lifetime in our minds. When faced with your own mortality (or that of your husband’s), you are forever changed. We are grateful for his continued recovery from myopericarditis. …

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Patients: Be proactive in your health care

Conditions
October 30, 2019

If you’ve ever been in the hospital for a surgery, you probably had a resident speak to you about the procedure; you were presented a laundry list of risks, the benefits mentioned, asked if everything was understood. And finally, you initial in several spots before signing your name on the dotted line. You looked at the wall clock and noted that the conversation took a mere six minutes.

Is this proper …

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Why your doctor may be concerned about prescribing benzodiazepines

Meds
October 29, 2019

As an academic psychiatrist who treats people with anxiety and trauma, I often hear questions about a specific class of medications called benzodiazepines. I also often receive referrals for patients who are on these medications and reluctant to discontinue them.

There has been increasing attention into long-term risks of benzodiazepines, including potential for addiction, overdose, and cognitive impairment. The overdose death rate among patients receiving …

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A guide to couples matching

Physician
October 29, 2019

I consider myself one of the lucky ones because my wife and I couples matched to the same institution for residency. At the time we put our residency match lists in, we were just boyfriend and girlfriend, and the decision to couples match felt like a bigger leap forward for our relationship than deciding to ask her to marry me about a year later. It was the right decision for …

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The stigma of motherhood in medicine

Physician
October 28, 2019

STAT_Logo Women who become doctors must often choose between motherhood and medicine. I’m a mother and a surgeon. I never thought of choosing between the two, even though my employers often asked me to.

Today I work as a trauma surgeon in a busy practice. It’s been a long journey since the day five years ago when I …

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Should there be a disqualifying upper age limit to become president?

Conditions
October 28, 2019

The health challenge recently faced by Sen. Bernie Sanders has brought two issues to the forefront of the 2020 presidential election. Should there be a disqualifying upper age limit to become president, and should an existing health issue preclude a candidate from running for president?

As scientists in the field of aging, we cannot tell the voting public how to answer these questions. What we can do is inform you about …

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Patients are used to seeing physicians who are not their doctors

Physician
October 27, 2019

Nowadays, patients are used to seeing physicians who are not their doctors. Often, patients may be seeing a nurse practitioner, a highly trained professional for their medical care, instead of a physician. A generation ago, patients nearly always saw their own physician, including if a patient was hospitalized. Imagine that: Your own primary care doctor sees you in the hospital, an event that occurred when dinosaurs roamed freely.

The medical universe …

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When we walk into a patient’s room, we are entering a story

Physician
October 27, 2019

The doctor opened the door after a gentle knock. He was greeted with warmth, offered a seat by Mary, and promptly sat down on the end of the hospital bed. As he sat, the family stood to greet him. They discussed the grandkids, the trips taken since they last saw each other. The room felt peaceful. Time slowed down.

Walking in behind my attending, I had been ruminating about the lengthy patient list, the work to be done. Then …

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Don’t use stimulants to cram for exams. It ruins sleep and doesn’t help test scores.

Meds
October 26, 2019

Along with a steeper financial burden and an increasingly competitive academic environment, this year’s incoming freshman university class will likely be confronted with the pressure to take a little pill that some popular culture references say will make you “awesome at everything.” Or they may eschew the temptation and rely on the standard practice of study, sleep, repeat.

Welcome to #GenerationAdderall, the …

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How best to support, honor, and show gratitude for your mentors

Physician
October 26, 2019

I recently had the amazing opportunity to both witness and participate in an event where my Children’s Hospital of Philadelphia (CHOP) pediatric mentor received a lifetime achievement award for her many years of exemplary service to the pediatric community of Southern New Jersey.

My mentor’s leadership, compassion, and dedication to serving the Latino community have set an example — not only for patients and their families but for generations of pediatricians …

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