KevinMD.com

Avoiding late-stage dementia with advance directives for stopping eating and drinking

Conditions

October 6, 2019

On October 1, 2019, Nevada began allowing individuals to avoid living in late-stage dementia. The new statute recognizes the legitimacy of an advance directive that instructs health care providers to stop hand feeding food and fluid by mouth. Individuals have already been completing such directives in New York and Washington. The Nevada law is the first that explicitly authorizes such instructions.

Growing …

MKSAP: 54-year-old woman with flushing of the face

mksap

Conditions

October 5, 2019

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

A 54-year-old woman is evaluated for flushing of the face of 1 year’s duration. These episodes occur two or three times per week and last about 30 minutes. She went through menopause at age 50 and is on estrogen and progesterone hormone therapy. She also experiences episodes of anxiety, …

What it means to be an attending physician

Mary Braun, MD

Physician

October 4, 2019

Dr. Ryme had been retired at least thirty years from medicine when he met me, his last pupil. I was a freshly minted doctor, and he became the first teacher of a new course at my new school called “Life as an Independent Doctor.”

At our first office visit, after telling me his life story, he quizzed me, “And furthermore, Dr. Braun, you’re an attending physician now. You are no longer …

20 minutes isn’t long enough for an office visit

Fred N. Pelzman, MD

Physician

October 3, 2019

As many of you know, if you’ve read my columns regularly, once a year the whole family escapes from the city, and we travel up to New Hampshire to stay at the lake house that’s been in my wife’s family for over 100 years.

A modest wooden house perched out over the water, situated just right for sunset viewing, for a few …

Using low-dose naltrexone to treat pain

Alex Smith

Meds

October 2, 2019

Lori Pinkley, a 50-year-old from Kansas City, Mo., has struggled with puzzling chronic pain since she was 15.

She has had countless disappointing visits with doctors. Some said they couldn’t help her. Others diagnosed her with everything from fibromyalgia to lipedema to the rare Ehlers-Danlos syndrome.

Pinkley has taken opioids a few times after surgeries, but they never helped her underlying pain, she said.

“I hate …

Read more…

Using low-dose naltrexone to treat pain

How we got from 18th-century tinctures to the opioid crisis

Mike Magee, MD

Meds

October 2, 2019

Americans have always loved their medicines and sought them out actively to cure whatever ailed them. Their interest ranged all the way from “staying well” to “feeling better.” Productivity in this hard-charging, pull yourself up by the bootstraps society required activity, and it’s hard to be active when you’re sick.

In the 18th-century in Germany, England, France, and Switzerland, men practicing pharmacy saw their retail operations as the …

An expensive treatment may be a victim of its own widening use

Julie Appleby

Meds

October 1, 2019

Medical treatment has knocked down tumors in 6-year-old Easton Daniels’ brain, but the drug used also wiped out his immune system.

To bolster his immune function and help keep him healthy, he has visited a hospital for intravenous infusions of immune globulin about every month for the past year and a half.

But in early July, his family was stunned by a letter from Cincinnati Children’s Hospital: “All of Easton’s appointments canceled …

Do physicians really need such extensive training?

Erin Wildermuth

Education

September 30, 2019

Last year the American Association of Nurse Practitioners announced a $2 million campaign to further expand independent practice, which they already have in 22 states. The relatively new doctorate of nursing (DNP) has led to a confusing scenario where nurses are indeed doctors, just not the kind you think of when you see a white coat. The profession (well, its money-making institutions) has fought hard to keep people confused.

Doctors are …

This doctor defines himself as a Christian, not a physician

Jeffrey McWilliams, MD

Physician

September 29, 2019

What is life? It’s the cumulation of the daily processes all wrapped up into one, filling the void of each day. These processes coalesce hour by hour, filled with demands, expectations, current crisis, and bills to pay. Life is a full-contact sport, each hour brimming with all-encompassing activities, expectations, and trivial pursuits. We live every second to its fullest, squeezing every ounce of information and productivity only to repeat it …

4 reasons why physicians should hire a financial advisor

Wall Street Physician, MD

Finance

September 27, 2019

I’m a big proponent of do-it-yourself investing. In the age of index funds, many investors can manage their own investments at very low cost.

And fees you pay to a financial advisor could be used to invest and grow your nest egg.

But that’s not to say that I believe that no one should have a financial advisor. There are many situations where it can be beneficial to hire a financial …

The mystery illness of Kim Kardashian West

Michele R. Berman, MD and Mark S. Boguski, MD, PhD

Conditions

September 27, 2019

Reality star and meta-celebrity Kim Kardashian West made the rounds on the network news and talk shows last week to promote her new line of shapewear. But she also talked about the recent health scare that was revealed on the latest episode of “Keeping Up with the Kardashians.”

Talking to Savannah Guthrie and Hoda Kotb on Today, …

The keyboard is the sworn enemy of physicians

Fred N. Pelzman, MD

Tech

September 26, 2019

During one long ago very hot Washington, DC summer, at the suggestion of my parents, I enrolled in a typing course that was given at our elementary school.

This was the summer between sixth and seventh grades, and there were lots of things I would’ve preferred to have been doing, but my dad, who started out in advertising, felt that touch-typing …

Who actually owns your medical records?

Linda Girgis, MD

Physician

September 25, 2019

I was in a discussion with a group of patients about how difficult it is for patients to get access to their own medical records. It was initiated after one of my patients was refused copies of her recent hospitalization. There is much confusion out there about who actually owns the record and how it is allowed to be accessed. Most people are aware of HIPAA, the regulation set into …

Read more…

Who actually owns your medical records?

Black market pharmaceuticals target immigrants

John M. Glionna

Policy

September 25, 2019

The bootleg medications were smuggled across the border and sold to mostly Latino immigrants in public spaces throughout Los Angeles — at swap meets, parks, beauty salons and makeshift stands outside mom-and-pop grocery stores.

The drugs were cheap, and the customers — mostly from Mexico and Central America — did not need prescriptions to buy them. Some of the products featured brand names and colorful packaging that immigrants knew well from …

In medicine, find the beauty in what is common

Andrew Ross, MD

Physician

September 25, 2019

“The value of experience is not in seeing much, but in seeing wisely.”
– Osler, “Aequanimitas”

Recently, my family and I were leaving a restaurant, and in so doing, we crossed a large parking lot filled with a seemingly endless number of pebbles. My youngest daughter, whose hand I was holding, suddenly pulled away from me. I stopped short, about to reinforce with her the importance of holding hands in the parking …

How pneumatic tubes symbolizes our health system

Fred N. Pelzman, MD

Physician

September 24, 2019

About once or twice a day, everyone on our hospital’s computer network gets an emergency message that scrolls across the bottom of our screens, highlighted in the colors of danger and warning.

They include things like a notification that a particular data system is down and that a backup on paper will have to be used for documentation, or the hospital …

To extinguish burnout, bring back physician autonomy

Christina Dewey, MD

Physician

September 24, 2019

In his article, “Medical education needs to stop burning out students — now,” Augustine Choi suggests the culture of medical education is responsible for increasing numbers of depression and burnout among medical students, and suggests that more programs are needed to address self-care and wellness in order to build resilience.

While I agree that mental health treatment should be readily available and easily accessible to those in …

Made mistakes? How to spin them for your medical school applications.

Michelle Finkel, MD

Education

September 24, 2019

Despite more than a dozen years in medical school admissions consulting, I still clearly recall a bright advisee who had improved her grades considerably throughout her college career. But I, unfortunately, had a less than stellar freshman transcript. After calculating her AMCAS GPA with me, she lamented, “I feel like my grades are a criminal record.” In a twisted way, she was right — she couldn’t erase the grades.

But she …

Seniority is the worst metric for health care leadership

Travis Bias, DO and Ashley Ramirez, CPNP-AC

Physician

September 23, 2019

Health care delivery in the United States is being led by practitioners who have ascended to leadership roles primarily through years of loyalty to their organizations. But as burnout worsens and affects the youngest clinicians to the detriment of the system, is this the appropriate cadre to shepherd us towards necessary system transformation?

We share two stories that …

Hair is undoubtedly the politician’s crowning glory

Joe D. Haines, MD

Physician

September 23, 2019

It all started with John F. Kennedy’s campaign for the presidency. After eight years with President Eisenhower’s baldness and Vice President Nixon’s receding hairline, the American public was ready for a change. Kennedy had great hair, which he flaunted by appearing bareheaded at his inauguration. A new political maxim was established that day; to win in American politics, it’s not what’s in your head, but what’s on your head that …

Most Popular

Past Week

Past 6 Months

Recent Posts

Subscribe to KevinMD and never miss a story!

Most Popular

Past Week

Past 6 Months

Recent Posts