When President Obama turned 50 last year, he made an “informed patient request” for a PSA (prostate specific antigen) test. This is the blood test routinely used to screen men over 50 for possible prostate cancer. The President received his PSA test. But under ObamaCare, you may not be able to.
Now that ObamaCare has been upheld by the Supreme Court, all of its major provisions will be in force, …
Across the country, newly minted doctors have started their internships. The first night on call there won’t be an intern – anywhere in the country – who will sleep. Every new intern is absolutely convinced that the beeper is going to go off and they won’t know what to do. (You get over this by about the 2nd or 3rd call night, by the way).
Graduating from medical school …
Student loan debt is at an all-time high at a little over 1 trillion dollars, a figure that now, for the first time ever, exceeds our nation’s credit card debt. Higher education has never cost more, the rate of rise of college tuition having exceeded in recent years the rate of rise of many other services. Perhaps as a result of this, as well as of the difficulty in obtaining …
A recent economic analysis concluded that patients with metastatic cancer value their treatments significantly more than regulators recognize, with many expensive new therapies looking like veritable bargains to most patients. Yet the study ignored the values really driving oncology spending—the warped incentives oncologists have to promote their own bottom line by prescribing expensive treatments.
Let’s start with the economic analysis, another in a series of studies by a USC team of …
One of the most intense moments of my third-year of medical school was during my internal medicine clerkship when a code blue was called.
It was our responsibility as medical students on the inpatient service to report to every code blue while we were on our calls every 4th night. This time was no different, and my call partner and I ran to the code. When we arrived, I recognized the …
Everybody knows that some medications can cost a lot of money. I always try to take the cost to my patients into account when prescribing a medication- after all, if someone can’t afford it, they are not going to take it. When it’s appropriate (and 9 times out of 10 it is), I try to prescribe a generic medication. They are much cheaper and work just as well as the …
In a pediatrician’s office, summertime is teen check-up time.
And, I love it.
Annual checkups are a time for me to catch up on the school year, brag about amazing extra-curricular accomplishments, and swoon over summer vacation plans. It is also a time for anticipatory guidance, private conversations, and facing the often sobering reality of teen life.
Throughout this past year, I have had the privilege of being involved in the lives of many …
My boys and I suffer from tree pollen allergies. More than birds chirping or flowers blooming, I have come to associate boogery sleeves and sneezing with the onset of spring. But these are the typical symptoms, which are easily recognizable as allergy-induced.
What I’d like to address in this post are some lesser known symptoms of seasonal allergies, which may also be rearing their ugly heads this spring. Red eyes and …
My mom always told me she gave me the “doctor name” (apparently my name looks good with an MD after it), so in some ways I knew from an early age that this was going to be my profession. Though I toyed with the idea of being a bank teller in kindergarten, I realized after a while that this was really not the job I thought it was (no offense …
All of us hate waiting in lines. Our society breeds a “me-first” attitude. Often the lines in which we wait are slow to move and, we become irritable and angry. Somehow there is always someone who is able to outsmart the system and get served ahead of their place in the queue. In the typical queue at the grocery store, (or at the apple store genius bar) we become impatient because …
June in the United States heralds the month when residencies end and new ones begin. While much will be written soon about the dangers of entering hospitals this time of year (this story never seems to tire with mainstream media), I would like to step back and reflect on why doctors should consider attending residency graduations. I had the pleasure of doing so recently.
Excitement. With all of the dreary news of …
“What about combined psychiatry-family medicine-neurology-internal medicine programs? Should I try to do a triple board program in psychiatry-child psychiatry and pediatrics?”
Every April, I field such questions from a slew of rising fourth year students who have become, to their surprise (and sometimes dismay), passionately interested in psychiatry. Psychiatry is a shortage specialty and psychiatric issues rank high among the challenges facing medical care systems here and around the world. For …
Professor James Reason is the intellectual father of the patient safety field. I remember reading his book Managing the Risks of Organizational Accidents in 1999 and having the same feeling that I had when I first donned eyeglasses: I saw my world anew, in sharper focus.
Reason’s “Swiss cheese” model, in particular – which holds that most errors in complex organizations are caused not so much by …
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The year is 2012. A 58-year-old veteran Family Physician who has just finished a day with more human heartaches than clinical triumphs settles down among the pillows with his wife in front of his MacBook to watch a movie, delivered wirelessly over the Internet:
“The year is 1969. A 62-year-old veteran general practitioner who has just seen his health threaten to fail him, speaks passionately to a group of doctors about …
Does your doctor have something on the wall that starts with “American Board of … “?
The terms “board certified” and “board eligible” are confusing to people not in the medical profession. It doesn’t help that more than a few doctors blur the distinctions to their own benefit. This post gives you a brief rundown of the distinctions at stake.
The first thing to understand is that anybody who has graduated from …
Recently our department of medicine grand rounds was on the subject of asthma. It began with a clinical vignette about a child with asthma, lasting three minutes, and, was followed by 47 more of intracellular cascades. The talk was like many others this year, and the speaker, who was introduced as a physician scientist, lived up to the part.
As someone who works in an academic hospital, I know many physician-scientists. …
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Now more than ever, the growing consensus among many is that doctors should avoid seeing pharmaceutical sales representatives, otherwise known as drug reps. A position statement from the AAMC, the head organization of all US medical schools and residency programs, recommends that all academic health centers avoid having drug reps on their campuses, hospital and clinics. Many medical institutions including the VA and Kaiser have also enacted similar policies banning …
Recently, as I finished up a visit with one of my patients who has migraine, she asked me the following: “My 10 year old daughter gets headaches. Is it possible that she has migraines too? I had headaches as a child and was always told it was nothing to worry about, but now I have headaches several times a month. Is there anything I can do to prevent this from …
At the end of long days I often stand gazing out my window at the beautiful, timeless Rocky Mountains in Colorado Springs and am taken by their sense of permanence. I recently returned from Nampa, Idaho, where I presented hospital Grand Rounds on Accountable Care Organizations.
The parallels between the timeless mountains and the physicians I met in Nampa struck me. Strange, you say? Maybe, but I am accustomed to the …
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I recently learned the sorry news that my childhood pediatrician has died. Not only was he my pediatrician, but he was also my father’s pediatrician. Our family became rather close to him over the years.
He came from a different generation of doctors, one that made house calls, that served in wars abroad, and that learned how to diagnose patients in the days before MRIs and CT scans. Even though I …
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