The challenge of evidence-based medicine to the new physician

Education
May 31, 2015

Evidence-based medicine (EBM) has been classically described as “the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.”  At first look, this well-accepted approach to clinical medicine appears not only completely reasonable, but also somewhat obvious given the immense amount of research available for academic consumption.

EBM has been repeatedly preached as the gold standard of clinical care across all medical …

Read more…

A neurosurgeon teaches us about degenerative disc disease

Conditions
May 31, 2015

shutterstock_105328079

No one wants to hear that they have a disease. And yet everyone will develop some degree of degenerative disc disease (DDD) — or degenerative spine disease — over the course of a lifetime. DDD refers to a combination of age-related and wear-and-tear-related changes that occur within the spine over time. It is very common and a natural part of aging.

Most …

Read more…

So you failed maintenance of certification. What now?

Physician
May 25, 2015

shutterstock_205431067

What is it like for physicians to fail their ABMS Maintenance of Certification® (MOC) program examination? How does the largest member board of the ABMS, the American Board of Internal Medicine (ABIM), respond to doctors who fail their secure examination?

As I continue to confidentially collect information from physicians who have failed their MOC examination, I thought it would be important to publish …

Read more…

Leaving medical school for a startup. And with no regrets.

Education
May 20, 2015

shutterstock_277822496

There he stood at our beach party, the family doctor I grew up admiring. I timidly approached his circle of friends to announce I had gotten into medical school and would start in the fall. He stopped to attention. His friends stood watching. I couldn’t conceal my smile. I thought, “He is going to be so excited for me!”

“Get out now.” …

Read more…

The top 10 lies of doctors

Physician
May 19, 2015

shutterstock_118623196

I’ve been a doctor for more than 20 years, and I hate to break it to you, but it’s time I came clean: We lie. Doctors lie. Not always. Not necessarily on purpose. But we do.

Sometimes the lies are to our patients. Sometimes, the lies are to our families. And sometimes the lies are to ourselves.

But, nonetheless, we lie. A lot. …

Read more…

Casual Fridays don’t have a place in medicine

Physician
May 16, 2015

shutterstock_82606081

A disclaimer before I even get started on this post.

Some of you who know me or work with me will think that by writing this post I am talking about you or even attacking you. I am not. If you’re especially sensitive, don’t read any further.

I am simply writing something that has been kicking around in my head for a long …

Read more…

So your child swallowed a button battery. Here’s what you need to know.

Conditions
May 13, 2015

shutterstock_174096008

Each year children ingest an array of foreign bodies including coins, magnets, and a new subset of batteries known as button batteries. Awareness of this small yet very dangerous foreign body is important for parents to understand so they can act quickly if their child is suspected of ingestion.

What is a button battery?

A button battery is a cylindrically shaped object measuring …

Read more…

ADVERTISEMENT

Back pain during pregnancy: Advice from a neurosurgeon

Conditions
May 12, 2015

shutterstock_146442830

For many women, pregnancy is a wonderful experience. There are, however, many changes and challenges the mom-to-be can expect, and back pain is one of them. The good news for pregnant women is that the development of severe or debilitating low back pain is very rare.

The incidence of symptomatic low back pain that is severe is about 1 to 2 percent. …

Read more…

Tips to avoid medical errors in the emergency department

Physician
May 12, 2015

shutterstock_263483609

Emergency medicine physicians: Could these be your cases?

  • A 35-year-old presents with shortness of breath and numbness to the legs. CXR and EKG are normal. She is discharged to see her doctor in two days, but is found dead at home. Autopsy reveals a dissecting aortic aneurysm.
  • A 15-month-old is triaged to fast track and seen by a physician assistant for fever, lethargy, …

    Read more…

Order your own lab tests. What could go wrong?

Physician
May 7, 2015

shutterstock_132480524

LabCorp, one of the largest outpatient lab providers in the USA, is soon going to let you skip the tedium of a doctor’s visit to get lab work done. Want some tests? Come on down!

I’ve got mixed feelings about this. While there are some tests that seem reasonable for people to do on their own — pregnancy and HIV tests come …

Read more…

ADVERTISEMENT

A surgeon who wasn’t God in the OR after all

Physician
May 4, 2015

shutterstock_3101394

Do you know the difference between a surgeon and God? God doesn’t think he’s a surgeon.

Everyone who goes into the study of surgery has ideas about what they’re going to be. I would imagine that each individual has different expectations of what the future holds, though few find their future at all resembles those expectations.

I recall when I started my surgery …

Read more…

MKSAP: 30-year-old woman is evaluated for a 1-year history of fatigue

Conditions
May 3, 2015

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

A 30-year-old woman is evaluated for a 1-year history of fatigue, headaches, poor sleep, depression, intermittently blurred vision, and weakness when climbing stairs. She takes no medication. Following a physical exam and lab studies, what diagnostic tests should be performed next?

On physical examination, vital signs are normal. Bilateral ptosis and diplopia are …

Read more…

ADVERTISEMENT

543
pages