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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 …

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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 …

It’s OK if doctors can’t memorize everything

David Mann, MD

Tech

September 22, 2019

The storage capacity of the human mind is amazing. One estimate of the size of the brain’s “RAM” is as high as 2.5 petabytes (a million gigabytes). The number is based on the total number of neurons in the brain and the total number of possible connections per neuron. I suspect it is an overestimate, given the vagaries and innate inefficiency of biological systems. Nevertheless, the true figure …

An American doctor in Rome

Susan Levenstein, MD

Physician

September 21, 2019

An excerpt from Dottoressa: An American Doctor in Rome.

When I migrated from the banks of the East River to the Tiber shores the path was strewn with bureaucratic boulders, land-mines, and pitfalls. I offer the tale of my odyssey as an object lesson to would-be fellow cosmopolites in that …

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An American doctor in Rome

The orthopedic objectification of women

Stephanie Atkinson, MD

Physician

September 21, 2019

A recent uproar in Twitterverse regarding the publication of certain images has sparked further debate after the response from publishers. The images represent scantily clad women with socially “ideal” body-types, seductively eyeing the camera and would, unfortunately, be commonplace in glossy magazines meant to sell products using these women’s sexual appeal. Body positive activists in society, for some time now, have been campaigning industry to stop this damaging and exploitative …

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The orthopedic objectification of women

Is it physician burnout or perimenopause?

Beverly Joyce, MD

Conditions

September 20, 2019

I am an experienced OB/GYN, well-versed in obstetrics, infertility, gynecology, surgery and — yes — menopause, or so I thought. So why was I so blindsided by my own menopause transition?

I thought I was going through burnout, with anxiety, anger, mood swings, irritability, and depression. I was at a point in my career as an OB/GYN of 20-plus years that patients flocked to me because of my reputation and expected …

Clearing up the confusion surrounding Medicare for all

Caroline Poplin, MD, JD

Policy

September 18, 2019

The Democratic debates this summer demonstrated massive confusion around Medicare for all. Does it mean Medicare for all who want it? Medicare Advantage? A “public option” on an Affordable Care Act (ACA) exchange?

Democrats need to get their story straight.

The confusion is understandable. Medicare for all has been an aspiration since at least the New Deal, but since 1965, when Congress …

A psychiatrist closes his practice

Michael Dorfman, MD

Physician

September 18, 2019

After practicing psychiatry and behavioral health for nearly 25 years, I’m done. I feel sick, and especially sicker from my occupation. Not merely burned out, but ill. Primarily mentally.

I’ve always had complex post-traumatic stress disorder. And depression and generalized anxiety, and many other diagnoses from the DSM. But, I’ve covered my illnesses so I could go to work and help so many people. Least of all myself.

My mother had chronic …

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A psychiatrist closes his practice