Learn about Salter-Harris fractures with a Medcomic

Conditions
January 13, 2018

Pediatric physeal fractures have traditionally been described by the five-part Salter-Harris classification system.

Type I fractures occur through the growth plate. These injuries may present with normal radiographs, and the diagnosis is often made clinically when tenderness is palpated over the growth plate.

Type II fractures occur through the growth plate and metaphysis. Type II injuries are the most common physeal fractures.

Type III fractures occur through the …

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20 anecdotes that describe the world of female medical students and physicians

Education
January 13, 2018

I recently collected anecdotes from women in medicine who have noticed the same thing I’ve noticed: We’re not as comfortable here as our male counterparts. Despite progress, medicine remains a patriarchy — an “old boy’s club” — and the women in this world are frequently reminded of this status quo. In collecting these anecdotes, I’ve noticed two main themes for the type of advice and comments women receive.

The first one speaks …

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Health care and the airline industry have a lot in common

Policy
January 10, 2018

There are many apt comparisons to be made between aviation and health care. As a (lapsed) instrument-rated pilot, I may have some insight about the system in which planes function on a daily basis in the United States. It is truly an impressive system which is (to paraphrase Don Berwick) well-designed to achieve the safety results that it does. However, the kind of statement that some health care safety leaders …

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A physician lurked on Facebook mom groups. Here’s what she found.

Physician
January 9, 2018

In my off time, as a mom and a physician, I spend a decent amount of time lurking in a rather strange environment, even for the internet. A place so filled with anxiety, stories of ill-chosen spouses and little glimpses of unbridled joy, that you’d think you were somehow inside a taping of the Real Housewives of This-crying-baby-makes-me-hope-that-I-end-up-having-a-dissociative-fugue. You know, *that* place.

Online mommy groups on Facebook.

And, there I am, lurking …

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15 minutes aren’t enough for a primary care visit

Physician
January 9, 2018

Have you bought a new memory foam mattress recently? Many come vacuumed in shrink bags. Once air gets in the bag, the mattress expands to its normal size. It is fascinating to watch how they expand.

It is not so fascinating to watch a patient expand to their actual size, when they are forcefully squeezed into an enclosed time space like an office …

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A physician’s love-hate relationship with dividends. And what he does about it.

Finance
January 9, 2018

When I described my drawdown strategy in early retirement, I stated we will “sell from the taxable account first.” I also plan to collect quarterly dividends from my index funds, but if Vanguard were Burger King and I could have it my way, I’d hold the dividends and take bites out of my account only as needed.

When I discuss the downsides of dividends, note that I …

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Learn about Clostridium difficile infection with a Medcomic

Conditions
January 8, 2018

Clostridium difficile is a gram-positive anaerobic bacillus which secretes toxins (A and B) that cause diarrhea and pseudomembranous colitis. C. difficile is the most common infectious cause of nosocomial diarrhea. Transmission of C. difficile can occur from contact with contaminated humans and fomites. The organism contains endospores that can survive the acidity of the stomach and reach the large intestine.

C. difficile colonizes the intestinal tract after the normal …

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The non-difference between MDs and DOs

Education
January 8, 2018

“What’s a DO?” is something virtually every osteopathic medical student and physician have been asked at some point in their training. There is this public misconception that professionals who carry MD after their names are the only qualified people to medically treat their ailments. Any other degree is categorized as “alternative medicine” in their mental schema. Truth be told, DOs, or doctors of osteopathic medicine are just as qualified as …

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Please change the culture of surgery

Education
January 8, 2018

It is December 2017. I have been on the road for the last five months, completing my five months of elective rotations. I am a fourth-year medical student aspiring to specialize in family medicine. I also want to learn procedures, so I did two months of surgery, three months of family practice electives. At the beginning of this process, I had wanted to be a general surgeon, but I ended …

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Why published trading strategies rarely work

Finance
January 8, 2018

When you browse finance-related websites, it doesn’t take long for you to see ads that claim that they can help you make money, fast.

“I’VE BEEN ABLE TO WIN ON 90% OF MY TRADES WITH THIS PROVEN STRATEGY.” – TYPICAL AD #1

“LET ME SHOW YOU HOW TO EARN 25% RETURNS, GUARANTEED.” – TYPICAL AD #2

“SIGN UP FOR MY NEWSLETTER AND I’LL SHARE WITH YOU THREE STOCKS THAT ARE READY TO EXPLODE.” …

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Lessons from the psychiatric ward

Education
January 7, 2018

The specter of the psych ward looms large in popular culture: video games, horror movies, novels — the concept of a locked inpatient psychiatric ward is shorthand for a variety of terrors. This perception is driven by a complex cocktail of factors. Psych ward patients have struggled with historical and current abuses, which are compounded by misunderstanding and ignorance around mental illness.

During third year, I spent a six-week rotation in …

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Do physicians make the best politicians?

Physician
January 4, 2018

Even though we have probably 20 years of work remaining as physicians, like a lot of you, I like to think about how we will spend our retirement years. After all, in twenty years we will still only be in our early fifties, hopefully with no dependents and a lot of financial security. Of course, my wife and I are interested in traveling, spending time with grandchildren (hopefully), gardening and …

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Why the social history is important

Physician
January 3, 2018

From the notes I read, it seems that other medical specialties limit “social history” to whether or not someone uses tobacco, drinks alcohol, or uses drugs.

“Social history” is meant to get a sense of the context in which people live. Where do they live? Who do they live with? How did they come to live there? Where did they grow up? What sort of work do they do? How much …

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Why are so many doctors doing multi-level marketing?

Finance
January 3, 2018

My goal with this post is to try to answer some of the more popular questions that we get asked about multi-level marketing (MLM). Why write about it? Besides the fact that my wife and I are involved in one, and it’s made a significant impact on our income, the number of physicians getting involved these days is huge.

My goal is not for everyone to go out and …

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Relative risk reduction is a troublesome way to convey the benefits of treatments

Meds
January 1, 2018

How excited would you be about a medication that lowered your risk of cardiovascular death, heart attack or stroke by 1.5%? Excited enough to spend a few thousand dollars a year on the drug? I expect not.

What if, instead, the drug reduced those same terrible outcomes by 20%? That’s probably enough benefit to interest some in the drug.

Well, those statistics come from the same clinical trial, evaluating the same drug. …

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