How diabetes education programs can help busy primary care physicians

Conditions
April 26, 2019

Busy primary care physicians have a lot on their plates. But when it comes to helping people with diabetes learn how to improve their health, they don’t have to do it all themselves. Diabetes self-management education and support (DSMES) programs, led by a diabetes educator, can provide vital assistance by helping people with diabetes maintain a healthy weight, quit smoking, begin an exercise routine and integrate other self-management behaviors into …

Read more…

What are the best student loan repayment plans for medical students and residents?

Finance
April 26, 2019

If you’ve ever tried to learn about student loan repayment plans, you might have felt overwhelmed and confused. Instead of spending days researching information — as I did — here’s a summary of the different repayment plans to help you choose the right one.

1. What is the standard repayment plan?

With the standard repayment plan, you will pay off your student loans in 10 years by making “fixed” monthly payments. The …

Read more…

The truth and challenges of being a doctor mom

Physician
April 25, 2019

Being a doctor mom is a beautiful paradox of feeling like a badass one moment and a frazzled I-don’t-know-what-the-heck-I-am-doing mess of a person. Being a female physician, the majority of us feel there is a societal and cultural pressure to be perfect all the time in every sphere of our life: as a professional, parent, and person. Obviously, expecting perfection is a bit unrealistic.

Among doctor moms, there are some common …

Read more…

Every doctor needs to monitor their online reviews

Physician
April 25, 2019

We’ve had several articles from various sources over the years on grooming your social media. Most of them advise paying attention to your physician ratings, but not acting on anything specifically. “Don’t engage” is the mantra. Let’s take a fresh look at this.

Like probably everyone in medicine, I have my share of physician rating site reviews. Most are good, some are bad, but all of them I pay attention to. …

Read more…

The obscene price of insulin: This is what happens when health care is for profit

Meds
April 25, 2019

I recently had a patient whose blood sugar was well controlled until he lost his health insurance. He purchased his diabetes pills because they’re cheap, but he couldn’t afford the insulin. His diabetes had been well controlled. Now, almost a year later, his hemoglobin A1C was 14, or double what it should be. The HbA1C measures sugar control over the last three months.

The bee sting kit or EpiPen cost hike …

Read more…

Medical workplace bullying: We just want it to stop

Physician
April 25, 2019

Health care is increasingly complex. Objective peer review, constructive feedback, and robust debate are essential to continually improve the quality of patient care.

But doctors don’t always disagree well. One of the contributing factors to bullying in medicine is the complex interplay of different personality types in very stressful situations. Some doctors have personality traits that predispose them to have interpersonal conflict and being unable to see the view from the …

Read more…

Why didn’t your doctors tell you the truth?

Conditions
April 24, 2019

Here’s what they should have told you: “We found cancer in your lymph nodes, your liver, your lungs, and your brain. It explains your weight loss, your difficulty breathing and your loss of appetite. This wasn’t just your depression like you thought. It started in your lungs, and now it’s everywhere. This cancer has been growing for quite some time. You cannot, even with the strongest medications and the longest …

Read more…

A patient that reminded me of the first man I ever witnessed dying

Conditions
April 24, 2019

He struggled to breathe, progressing from deep breaths with wet sounds reverberating in his lungs, to guppy breathing — opening the mouth like a fish, contorting the entire face. His heart rate slowly decreased, from 150 beats a minute — a pace attempting to keep up with the oxygen demands of the body — to 50 beats, to 40 beats, to that which is incompatible with life. The nurse pushed …

Read more…

USMLE Step 1 tips that may surprise you

Education
April 21, 2019

To reach my current position as a general cardiologist, I have taken nine board exams. I have also been teaching medical students for over ten years with several colleagues who write questions for the USMLE Step 1 exam. Through this experience, I have observed a number of themes about what works and does not work for board preparation. I share these with you now in the hopes they may help …

Read more…

A nurse’s downfall was telling the truth

Conditions
April 21, 2019

These events happened over 18 years ago. Some content has been changed to protect the innocent and the guilty. Searching for positive changes in the health care industry. We are not a number, and the patients are not a number.

I’m not good at lying. My eyes go to the left or look downward, and I start to stutter and pause. There is no eye contact, and I fall deep into …

Read more…

The powerful phrase that’s ruining medicine

Physician
April 20, 2019

Within the clinics, hospital corridors, and halls of medicine, a new phrase has emerged and taken hold of the practice of medicine. Whenever confronted with the challenging, inconvenient, undesirable, underinsured or maybe when just overwhelmed, health care personnel have begun to utter the phrase “I’m not comfortable with …”

Upon the utterance, all responsibility to the patient, institution or the honorable practice of medicine is immediately and completely discharged until the …

Read more…

MKSAP: 39-year-old woman with fatigue, intermittent rectal bleeding, and abdominal pain

Conditions
April 20, 2019

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

A 39-year-old woman is evaluated for fatigue, intermittent rectal bleeding, and abdominal pain over the past 2 months. She reports that the bleeding is not accompanied by anal pain or itching. She has experienced an unintentional 2.3-kg (5.1-lb) weight loss since her symptoms started. She has no personal or …

Read more…

ADVERTISEMENT

What physicians should know about investing in real estate

Finance
April 19, 2019

As someone who can’t stop talking about passive income investments, I inevitably end up having a lot of conversations about investing in real estate.

I’ve heard countless stories of how real estate investing has helped people achieve their goals, but from those who don’t invest, I often hear this objection commonly voiced, “I don’t want to be called in the middle of the night to unclog a toilet.”

What I …

Read more…

8 things to watch for if you, or a family member, is hospitalized

Physician
April 18, 2019

Hospitals are busy, hectic, and unpredictable places. Professionals who work in health care are highly trained and competent individuals, and if you are receiving acute care in America — the standard of your treatment and access to high-quality tests and an array of specialists, is unparalleled (take it from someone who has worked in different countries). Nevertheless, the hospital experience itself, despite our best efforts, often falls short. Here are …

Read more…

What distinguishes good physicians from truly seasoned medical professionals?

Physician
April 17, 2019

One thing that gastroenterologists know about is stool. But, I’m not referring to that kind of stool in this post. Follow along.

When we do a colonoscopy, for example, we are relying upon stool, or more accurately a stool, as in a three-legged stool. This metaphor illustrates that the three legs must be equally strong or the stool will not stand. The three pillars of support that a colonoscopist needs include:

How physicians and administrators can get to a place of greater trust

Policy
April 16, 2019

Recently, I wrote about some key findings from a 2018 survey of U.S. physicians by The Physicians Foundation. It’s no surprise to anyone working in health care today that the survey found alarming levels of professional dissatisfaction, burnout, and pessimism about the future of medicine among respondent physicians. Sadly, it appears that much of that pessimism is directed toward hospitals and their leaders: 46 percent of survey respondents viewed …

Read more…

Was she a doctor? Or was she a hack?

Physician
April 14, 2019

Separating fact from fiction had once been her favorite activity. Going over research with a fine-toothed comb, she caught the inaccuracies that riddled popular culture like unruly strands of hair. It came down to this simple algorithm: there were things that could be proven and things that could not. In other words, there were things that would happen consistently given the same set of conditions, while other things were random. …

Read more…

MKSAP: 62-year-old woman with a sun allergy

Conditions
April 13, 2019

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

A 62-year-old woman is evaluated for a “sun allergy,” manifesting as a rash on her scalp, eyelids, upper back, and knuckles. This started 2 years ago, but is less pronounced over the winter months. Medical history is unremarkable. Her only medication is hydrocortisone cream.

On physical examination, vital signs are …

Read more…

610
pages