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How you can show patients you are listening

Physician

February 8, 2020

Being a physician is an important role. It’s easy to forget the impact that you have on a patient just by being at their bedside.

It’s huge.

Have you ever been a patient? It’s an incredibly vulnerable experience.

You’re not really sure what’s happening and what is going to happen next.

People are really putting their faith in you to understand their needs and to ease their suffering. It’s a powerful thing to ease …

Doctors: Take a sick day

Ariela Marshall, MD and Alexandra Wolanskyj-Spinner, MD

Physician

February 8, 2020

Every winter, flu season descends upon the hospital. The most consistent reaction among any of our physicians — trainee and attending alike — who succumb to this nasty virus is one of guilt. Even the thought of “calling out sick” leads to such extreme guilt that many colleagues choose to come to work sick instead.

Several trainees have admitted to suffering from flu-like symptoms but pushing themselves to come to the …

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Doctors: Take a sick day

MKSAP: 32-year-old woman with loose stools, bloating, and weight loss

mksap

Conditions

February 8, 2020

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

A 32-year-old woman is evaluated for a 6-month history of loose stools, bloating, and a 3.2-kg (7-lb) weight loss. Her medical history is otherwise unremarkable. Her brother has type 1 diabetes mellitus, and her mother has autoimmune thyroid disease. She reports no other symptoms and takes no …

Goodbye, Benadryl: It is time for you to retire

Roy Benaroch, MD

Meds

February 7, 2020

Sometimes, old ideas and time-tested treatments remain the best. Newer doesn’t always mean better. Except in the case of one of our oldest antihistamines, tried-and-true Benadryl. It is time for that old drug to be retired, sent off to pasture, and never used again. Goodbye, Benadryl. Fare thee well, adieu, and don’t let the door hit you on the way out.

Benadryl (diphenhydramine) was introduced in 1946. The top single that …

A case for nephrology

Nupur Gupta, MD

Physician

February 7, 2020

In recent times, physician burnout has rightfully surfaced as a social concern for the medical fraternity. Physician burnout is a thing, and lately, I was thinking about it related to nephrology.

Many national physician organizations and local hospital systems are developing strategies to reduce work-life stress and improve the engagement of the workforce. In November 2018, I represented the Renal Physician Association at the interim meeting of the American Medical Association …

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A case for nephrology

Reconciling consent culture and bodily autonomy with pediatric care

Jennifer Bevacqua, CPNP-AC/PC

Conditions

February 6, 2020

Every day, children are cared for in clinics and hospitals. And every day, some of them are unhappy about it; some of them deeply unhappy about it.

The contemporary practice of nursing and medical care includes health care providers having to touch their patients. This may include an abdominal exam, listening to their lungs with a stethoscope, or even slightly invasive maneuvers, such as having to put an otoscope into their …

How to build trust and therapeutic relationships in 15-minute office visits

Hans Duvefelt, MD

Physician

February 5, 2020

It is well known by now that a physician’s demeanor influences the clinical response patients have to any prescribed treatment. We also know that even when nothing is prescribed, a physician’s careful listening, examination, and reassurance about the normalcy of common symptoms and experiences can decrease patients’ suffering in the broadest sense of the word.

This has been the bread and butter of counselors for years. People will faithfully attend and …

Stressed is desserts spelled backward

Jasmine Toor, MD

Physician

February 5, 2020

Tiramisu, chocolate mousse, red velvet cake, freshly baked cookies, and warm brownies topped with ice cream. These are some of my favorite desserts and the things I start thinking about when I am under intense stress. I often gaze at the bakery section at the grocery store just to take a look when I feel overwhelmed with stress at work or home. It is the classic description of what we …

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Stressed is desserts spelled backward

The doctor who avoids answering your questions

Christopher Johnson, MD

Physician

February 3, 2020

Most of us are, to some degree, procrastinators. We avoid or postpone doing unpleasant things. In this sense, physicians who are avoiders are no different from anyone else. For a doctor, however, avoiding things often leads to poor, or at least less than frank, communication with parents.

One kind of avoidance behavior is when the doctor avoids answering your questions. These doctors do not behave this way because they are poor …

The questions people ask medical students

Menachem Gurevitz, DO

Education

February 3, 2020

Wow, you’re in medical school? So you are going to be a doctor? What year are you? When are you going to finish? What are you going to go into?

You should become a skin doctor, what do they call them again? It doesn’t matter, but they do good. But they are not real doctors, so maybe it’s not worth it.

You should become a doctor that gives vaccines. Are vaccines real? …

A medical student’s advice for clinical rotations

Ton La, Jr., MD, JD

Education

February 2, 2020

As a rising fourth-year med student, these are my words of wisdom for all students who are on their clinical rotations.

Your mental health is paramount; do not neglect how you are feeling!

There is not one med student that I know of who hasn’t felt anxiety, paranoia, or depression. Some of your peers may even be diagnosed with psychiatric disorders and take medications. And that is OK! As a mentor of …

Black Man Syndrome: in memory of Bryce Gowdy

Earl Stewart, Jr., MD

Physician

February 1, 2020

He came to the office in search of help as many patients do, but the circumstances that compelled him to seek medical attention were all too similar to me. I’ve seen it time and again. He said that he couldn’t sleep at one visit. At another, his blood pressure was high.

At a visit after that, he’d share more information, and his wife would attend with him. He wasn’t making enough …

Black boxes: health warning or profit warning?

Martha Rosenberg

Meds

February 1, 2020

“Boxed warnings” or “black boxes” are the strictest FDA label warnings. They appear on cigarettes, fluoroquinolones (for tendon rupture), Lamictal (for SJS and TEN), Accutane (birth defects), and other products with well-known risks.

The industry obviously dislikes black boxes since they reduce sales (though their lobbyists charge the boxes “confuse” and “unnecessarily alarm” patients).

So it was no surprise that when the Read more…

Black boxes: health warning or profit warning?

Doctors, a tech revolution is coming

Osmund Agbo, MD

Tech

January 31, 2020

What if I told you just a few years ago that Amazon — a budding e-commerce startup — would come to disrupt the multi-billion dollar retail industry.

I seriously doubt that anyone could have given it a serious thought. At least not in the magnitude that will force a slew of big-box retailers to shut their doors for good.

I am sure the same response would have been elicited about Uber and …

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Doctors, a tech revolution is coming

Nurses are sick of being treated like hotel workers

Rachel Basham, RN, CCRN

Conditions

January 31, 2020

“Compassion fatigue” is a phrase thrown around easily when talking about the health care professions. It is often spoken in the same breath as “burnout” and “turnover” while discussing the crisis of a diminishing workforce and increasing demand in health care.

The phrase brings to mind the burnt-out nurse who doesn’t have the emotional energy to care anymore. I can see her: deep frown lines, flat facial expression, dimmed eyes.

The light …

There is no such thing as medical swag

Nina Shapiro, MD

Physician

January 30, 2020

A recent excellent piece by Dr. Karen Sibert, an experienced anesthesiologist at my institution, raised some critical issues regarding how physicians are thought of by non-physicians, and how misguided that thought process is. Indeed, our stress levels associated with the moves we make and the decisions we contemplate, some of which are made and done in milliseconds, do not come with a price tag, but do …

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There is no such thing as medical swag

Here are the common ways that doctors can practice medicine

Smart Money, MD

Physician

January 29, 2020

When I finished my training, I wish that I had known all of the options I could practice medicine. Most of us categorized our options as either “academic” practice or “private practice,” but in reality, these two options only cover the tip of the iceberg. Was my limited understanding a shortcoming of my medical training? Perhaps. I doubt that many medical schools back then actually had seminars on practicing medicine. …

Are you happy with your decision to go into medicine?

Erin O'Laughlin, DO

Physician

January 28, 2020

On a rare Sunday morning, I woke and had the time to make breakfast for my kids and their cousin, who’d stayed the night. My nephew said, “Thanks, Aunt Erin, I feel like I never see you.”

To which my oldest (10) stated very matter-of-factly, with no ill-intent: “That’s because she’s never home.”

Being a full time, private practice physician and mom to 5 kids, with a healthy social life, it’s extremely …

How do you know if you have hypertension and need medication?

Peter Ubel, MD

Conditions

January 27, 2020

High blood pressure is the silent killer. It puts people at risk for heart attacks, strokes, vascular disease, kidney failure. It is basically really bad to have longstanding, undertreated high blood pressure.

But it is also harmful to be told you have high blood pressure when you don’t, and to be treated for high blood pressure when that treatment won’t benefit you. So when your doctor diagnoses you with high blood …

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