KevinMD.com

The rewards of being a designated airman medical examiner

Physician

December 21, 2018

For the last 25 years, I have had the privilege of being a designated airman medical examiner by the Federal Aviation Administration. To earn that privilege, it required flying to FAA headquarters and taking a one-week training course followed by refresher training material every three years.

The FAA grades medical examiners annually by our judgment and decision-making. The nature of the questions we are required to ask the pilot candidates, and …

Diagnosed with prostate cancer? You must ask these 10 questions.

Naeem Rahman, MD

Conditions

December 20, 2018

Prostate cancer often presents unique challenges to patients and physicians alike. It can be indolent and non-aggressive — or life-threatening and everything in between. Unlike most cancers that have a dedicated roadmap for treatment for prostate cancer revolves around opinions and biases.

To help patients navigate the landmine of prostate cancer, I’ve compiled a list of 10 basic questions to ask when diagnosed with prostate cancer. Here they are:

1. “What is …

How physicians can play the credit card reward game

Smart Money, MD

Finance

December 19, 2018

We’ve all heard about credit card points and miles by now—put enough of your expenses on plastic and you’ll be flying first class airlines all the time, right? We are actually fortunate in American (sorry for those of you residing in, let’s say Japan, who still are stuck in a mostly cash-based society) to be able to have incredible amount of credit card options to squeeze out every penny.

While the …

A clinician’s guide to microbiome testing

Alexander Khoruts, MD

Conditions

December 17, 2018

The intestinal microbiota, also commonly known as the ‘‘gut microbiome’’ is integral to human physiology and has wide-ranging effects on the development and function of the immune system, energy metabolism and even nervous system activity. There is a lot of excitement around the potential of targeting the microbiome therapeutically to promote health and to prevent or treat medical conditions. Further, as DNA sequencing technologies and computational methods …

How to foster and encourage genuine, curious learning in a medical student

Jamie Katuna

Education

December 16, 2018

I just had a conversation with a physician and faculty member at my school. He started the conversation like this: “It’s alright if you disagree with me, and I can disagree with you too. Good academic discourse should allow people to disagree with each other.”

He then allowed me to question him and explain my perspectives for over an hour as he explained his answers, helped clarify some points, and gave …

The key to successful rounding

Robert Centor, MD

Physician

December 15, 2018

A wonderful senior resident helped me understand the goal of rounding. Rounds should focus primarily on understanding the key problems and the diagnostic and therapeutic approaches to those problems. She suggested that some rounds spend too much time on “minutia” that the resident could handle, and not enough on understanding the big issues. According to her, rounds work best when we spend our time addressing the problems that the patient …

Read more…

The key to successful rounding

6 ways to ensure you’re not accepting a terrible health care job

Health eCareers

Physician

December 15, 2018

This article is sponsored by Careers by KevinMD.com.

What makes any particular job a “bad” one? Maybe the pay is too low. Perhaps the hours don’t work with your other commitments. It could be the commute is too long, or the opportunity for advancement is too little. A job might be bad because it has a poor …

The fight to save Howard University College of Medicine

Vicky Li and Naveen Balakrishnan

Education

December 13, 2018

Our country is at risk of losing an iconic institution that has played a pivotal role in the history of medical education. A school, which has produced some of the boldest pioneers in medicine, could lose accreditation upon the opening of a new hospital that will shunt away 40 percent of their current patients. Scores of our brightest potential medical students will be ripped away from the communities that desperately …

How social media leads to a loss of creativity

Edwin Leap, MD

Social media

December 12, 2018

I use social media. Specifically, I use Facebook, Twitter, and LinkedIn. In the beginning, I did so for utilitarian purposes. As a columnist and aspiring writer of books, these were (and indeed are) useful marketing tools.

I have, in the past, carried around a note-pad to jot down ideas. I was never without my note-pad. I always wanted a small legal-pad with a blue or black gel-ink pen. It was my …

The day when the white coat can be worn with no hesitation at all

Shadi Ahmadmehrabi

Education

December 11, 2018

It was my first day of orientation at medical school. In a hallway stood a coat rack overflowing with white garments. I set down my accumulated papers, reached for a hanger and — for the first time ever — shrugged first one arm and then the other into a white coat.

It was too large, but I had no other options. The unisex coats ran from XXS to XXL, but the …

The Wild West approach to PICU practice

Christopher Johnson, MD

Policy

December 10, 2018

I spent my early and mid-career years working in a pediatric intensive care unit (PICU) at a large academic center. We did almost everything except for a few things esoteric at the time — small bowel transplants, a few kinds of experimental surgery. I’m now in my late career (but have no plans to quit anytime soon!) and work in a smaller PICU. I am frequently confronted with the issue …

Read more…

The Wild West approach to PICU practice

Disability can be a devastating outcome to a doctor’s career. Here’s how handle it.

Smart Money, MD

Finance

December 9, 2018

Disability can be a devastating outcome to a doctor’s career and self-image. Think about it: You busted your butt to learn how to do a Whipple procedure, end up getting into a skiing accident that ends your career right there. No worries, because you purchased the appropriate coverage of own-occupation disability insurance, right?

Having disability insurance certainly provides a protective cushion, especially you are the sole breadwinner. This is a no-brainer, …

Why mentors are so important in medicine

Health eCareers

Physician

December 8, 2018

This article is sponsored by Careers by KevinMD.com.

After spending a decade in college and medical school, followed by internships and residency, seeking additional guidance at the beginning of your career may seem excessive. You’ve already taken direction from dozens of leaders; isn’t it time to cut your own path?

Yes and no. You’ll make plenty of your …

The power of the tincture of time

Philip A. Masters, MD

Physician

December 6, 2018

A guest column by the American College of Physicians, exclusive to KevinMD.com.

I distinctly recall during residency a much older and well-respected clinical teacher periodically opining that what was needed in a particular patient case was “a dose of the tincture of time.”

For those less familiar with more historic terminology, a tincture is an alcoholic …

Read more…

The power of the tincture of time

How physicians can get started with passive income

Passive Income, MD

Finance

December 4, 2018

It’s been a little over two years since I started this journey of blogging about passive income, and I’ve learned so much along the way. The term “passive income” has come to mean something very different to me over these years.

I used to think that passive income was simply earning money in a way that isn’t proportional to the time you put in. And while this is …

There’s no room for ego in health care

Suneel Dhand, MD

Physician

December 4, 2018

I was recently seeing a rather complicated medical patient in the hospital. We were treating both a heart and kidney condition, and things were not going so well. To spare anyone non-medical who is reading this the scientific details of the bodily processes involved, we were essentially balancing hydrating, with the need to get rid of excess fluid. After seeing the patient, I spoke with the nurse, went over the …

Read more…

There’s no room for ego in health care

You must make a good first impression with patients

Andrea Lauffer, MD

Physician

December 4, 2018

First impressions are critical. We are taught early in our careers that first impressions truly matter. Whether interviewing for medical school or a residency program, our goal is to make a positive first impression in hopes of making the cut at each checkpoint in our early careers.

These processes in our academic lives and careers are exhausting. As residencies and medical schools are becoming more competitive, the importance of first impressions …

A physician’s letter to his wife

Anonymous

Finance

December 3, 2018

To my wife,

Let’s just start at the beginning.

When we first met, you thought I was arrogant and prideful. For two and a half years we would rarely talk while we walked past each other in our small college town. At the time, we never could have imagined that one day we would get married. In a twist of irony, two weeks before we started dating you still didn’t know as …

Read more…

A physician’s letter to his wife

A surgeon mistakes a kidney for a tumor. How can this happen?

Skeptical Scalpel, MD

Conditions

December 3, 2018

A number of media outlets recently featured a story about a Florida general surgeon who removed a normal kidney from a woman who was undergoing spine surgery. How could this have occurred?

The 51-year-old patient who had been injured in a car crash was scheduled for an anterior lumbar interbody fusion (ALIF) of the fifth lumbar to the first sacral vertebra. The general surgeon’s role was to provide …

Here’s what the corporatization of medicine is doing

Naeem Rahman, MD

Policy

December 2, 2018

Have you ever been to a doctor’s office and felt that your evaluation was rushed? Have you been seen in the emergency room and felt that you were just a number in a long series of patients? Have you ever seen the same doctor for years and felt like the doctor just met you for the first time each visit?

Chances are we’ve all experienced this as patients. If we’re honest, …