About half of all children in the United States with an autistic spectrum disorder are diagnosed at age five or older, according to a May 2012 NCHS (National Center for Health Statistics) data brief. However, many parents are suspicious much sooner. As part of autism awareness month, we bring you clues into toddler development that can alert you to a potential issue.
Pediatricians often use a questionnaire called the M-CHAT (Modified …
Over the past twenty years, Wall Street business has covertly taken over the medical profession while doctors have been distracted by a deluge of procedural, financial, and legal paperwork. A strategic plan was launched to extract exorbitant profit benefiting business, and is now mainstream without challenge from our profession nor the public.
Legal boardrooms were abuzz in the 1990s as a blueprint assault was made against organized medicine, redirecting a profession into a …
As chairman of the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) Work Group on Attention Deficit Hyperactivity Disorder (ADHD) and Disruptive Behavior Disorders, I read the article on ADHD that appeared on the front page of The New York Times on April 1, 2013, with interest and also dismay, which was shared by my colleagues in the work group. We recognize the effort involved …
Radiologists care about their patients, even though most diagnostic radiologists don’t meet and greet their patients the same way direct-care clinicians do.
Some people have the erroneous perspective that radiologists and pathologists don’t care about the welfare of their patients. It is possible for us to understand that view if we look at radiologists and pathologists as isolated workers who work …
I would like now to delve into what I consider critical elements of patient-centric care. They all involve technology to various extents.
1. There must be buy-in from providers. I am including payers, healthcare systems as well as clinical providers in this category. While I realize that much of healthcare is devoted to satisfying legal and regulatory mandates, there is great opportunity to improve the care experience (and dare I say …
The use of ultrasound has had a large impact on health care in resource poor countries. This article details some of the research that has been done overseas to look at the impact on bedside ultrasound by caregivers to deliver more appropriate care for injured and ill patients in Africa, Asia and Mexico.
Using an ultrasound to determine how dehydrated a child …
In recent times, it seems as though every newspaper or magazine with a dedicated health section has a focus on the perils of gluten and the benefits that come along with adhering to a gluten-free diet. Or better yet, each week brings a new celebrity touting the dangers of gluten, and how it is an unhealthy ingredient that should be avoided religiously. Is this truly sound advice?
As a practicing academic …
Text message: “John, This cough and congestion is killing me. It’s turning thick and green. Can you write me a Z-pak? It always works for me.”
If you write a blog on medical decision-making and heart rhythm matters, it seems an incredible omission not to opine on the FDA warning concerning the commonly used antibiotic azithromycin (the drug in a Z-pak). Quoting directly from the FDA warning:
[Azithromycin] can cause …
Watching my grandfather pass away changed my life. It wasn’t sudden and it shouldn’t have been unexpected. Yet it seemed unnatural, mysterious, and incredibly uncomfortable. I can still remember receiving the phone call from the hospital, my mother letting out a distraught cry that my grandfather was no more. My initial reaction was shock and confusion: I just couldn’t understand what had happened. Looking back, he had been under intensive …
When I came to medical school, I was certain I wanted to do primary care. Despite the forces that steer many of us off the path – how many times have we heard, “but you’re too smart to do primary care!”? – after three years of medical school, I was still committed to primary care.
But I struggled with which type of program would be best for me. I applied to both …
An article from Sweden was recently published showing that in a very large group of women, over 60,000 of them, followed for 19 years as part of an also very interesting study of the effectiveness of mammograms, women who get more calcium, in their diet or as supplements, had a higher risk of dying of anything, but especially of heart attacks. It is …
Next in a continuing series.
Inside the belly, everything is slippery. The peritoneum is a glistening layer of self-moistening plastic wrap, enveloping the surfaces of all the organs, and the inner aspect of the abdominal wall. Undisturbed, the intestines coil and slither, reptilian. Watching waves of peristalsis makes me smile: there’s something always entertaining about those moving contractions, following one upon another, gurgling, surprisingly tight bands of tension moving …
A crunchy friend of mine on Facebook re-posted something from an even crunchier friend of hers who was shocked to find that many naturopaths sell supplements. Actually, she feels that selling them is okay; so is prescribing them. But selling what they prescribe apparently tips her ethics meter over into “unacceptable”.
As I read her screed against the ND who conducted a cursory history and exam before checking off $750 worth …
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For over a decade, I have advised pre-meds on how to maximize their chances of getting into medical school. During this time, as I witnessed thousands of anxiety-ridden pre-meds wade doggedly through the murky waters of medical school admissions, I have noticed pre-med difficulties often pale in comparison to those of pre-meds parents. It’s often much easier to be the athlete on the field than the coach on the sidelines. …
A city is free. A town is celebrating.
I sat and watched the local news station announce that the second suspect in the 2013 Boston Marathon bombings had been taken into custody and was being transported to a nearby hospital.
I am relieved. And thankful.
Then I wonder. I wonder about the hospital that this suspect is being transferred to, and I wonder about my colleagues. What are the nurses, the doctors, and …
A little over a year ago, I found myself burning out and realized that my worklife was unsustainable.
I’d been working at an FQHC clinic, and had become the site’s medical director a few months before. I was practicing as a primary care doc, trying to improve our clinical workflows, problem-solving around the new e-prescribing system, helping plan the agency’s transition from paper charts to electronic charts, and working on our …
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Yesterday I had office hours: 26 patients at 15-minute intervals, followed by 3 new patients for one-hour visits, interspersed with 4 emergencies and 33 phone calls. An active normal day. However, the 1:30, 1:45, 2:00 patients all arrived at 2:15 and suddenly I was looking at an afternoon that would run deeply into eve. I really hate it when patients are late.
Now, I have to admit this is a unique …
When I was young and foolish and just starting out in my career, I found it very hard to take “no” for an answer. If a patient needed radiation therapy, and he or she didn’t want to have it, I did my very best to talk that patient into it. I have always been a very persuasive person—if I didn’t get the go ahead on the first formal consultation, there …
As I walk onto any one of the locked psychiatric units at our hospital I am immediately struck by the hum of intense activity. It’s like the startling feeling of stepping out of an air-conditioned apartment into the steamy height of a New Haven summer. Across from the nurses’ station, a psychologist interviews a patient retelling the story of constant childhood molestation as rivulets of mascara run down her cheeks. …
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New research just out in the journal Psychology and Aging says pessimists live longer and healthier lives. If this is true, then contemplating the future of anesthesiology ought to make us immortal, because our professional prospects don’t look bright. As we teach residents to do what we’ve always done, shouldn’t we ask ourselves honestly if we’re training them for a future that doesn’t exist?
Especially here in California, it seems …
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