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The best medical specialty you’ve never heard of

Physician

May 22, 2018

The most common response when I introduce myself as a preventive medicine resident is an interjection, “You mean family medicine?” I have come to realize that the majority of the healthcare field has never heard of preventive medicine as a unique medical specialty. It’s a shame, because preventive medicine is truly the best medical specialty you’ve never heard of.

Preventive medicine practices at the intersection of public health and clinical medicine …

Everyone needs someone to be a safe harbor

Loice Swisher, MD

Physician

May 21, 2018

I met David on the internet. It was to become on of the closest, most intense relationships of my life. For you see, a few months before he crossed my path his daughter finished the same protocol for the same type of brain tumor that my daughter just had started. They had successfully traversed the waters that to me were completely unknown — and frankly terrifying. On the pediatric brain tumor listserv, …

Medical residents and academic due process: Know your rights

Todd Rice, MD, MBA

Education

May 20, 2018

I recently received a call from a physician resident in the Northeast U.S. who had been notified that she would be terminated from her residency program for a “weak knowledge base.” There would be no contract offered to her for the coming academic year. She reports that her scores are no worse than several of her colleagues and that her accredited program has a history of arbitrarily dismissing residents. She …

I was accidentally accepted to an Ivy League medical school at 17

Eliza

Education

May 20, 2018

Want to hear a crazy story?

Typical medical school students can relate tales of a college experience that includes summer research or hours spent reviewing for the MCAT. I didn’t even take the MCAT. Read on for the oddest medical school acceptance story you’ve ever heard.

I was driven in high school. I’d heard for years about smart kids going off to the Ivy League, and I wanted that experience — to …

Personal finance lessons from Shaquille O’Neal

James M. Dahle, MD

Finance

May 18, 2018

I’m always intrigued by those who earn millions of dollars per year or even per month. Some manage to blow all that money and then some. Others, like a select few NFL players, choose to spend wisely and save prodigiously.

Today’s Saturday Selection highlights the habits of one athlete who was among the highest paid NBA stars for many years. The headlines sadly feature athletes with similar …

Too many things need physicians’ signatures

Fred N. Pelzman, MD

Physician

May 18, 2018

Just sign here.

How many times a day are we asked to do this? “Just sign here.” “Just put down your license number.” “We need a stamp with your doctor’s info on it.” “Give us your NPI.” “Initial here, here, and here.”

If we took the time to read all the things we’re signing, we wouldn’t have time to do any doctoring.

The other day I was asked to hand-write the date on …

Why some physicians thrive and some struggle to survive

Praveen Suthrum

Policy

May 15, 2018

I’m sitting in the waiting area across the endoscopy room of a major hospital. Mindless talk show TV runs in the background. Patients are waiting patiently. They anxiously look up every now and then from their phones towards the reception desk.

It’s a scene I’ve experienced for years while working in health care while waiting for doctors.

But there’s something different in the air now.

Patients, like those around me, will encounter a …

How this physician became a financial advisor

Blake McGowan, MD

Finance

May 14, 2018

Growing up with a father who is a physician made for a natural draw to medicine. However, as young people are prone to do, I did my best to rebel. Early into my undergraduate career I proudly announced to my father that I had decided to go to law school. And perhaps to dig the needle a little deeper, I told him I planned on going into medical malpractice, on …

10 reasons why doctors spend too much money

James M. Dahle, MD

Finance

May 13, 2018

Once every couple of years I have medical students from the local medical school over for dinner. At some point, the conversation usually turns to finance, and I commiserate with them about their loan burdens. I typically toss them a few pearls of wisdom, wish them good luck, and we move on to something else. They always think it’s funny when I say, “If you can’t live on $200K, you …

To Paxil, with love

Jennifer L. Barkin, PhD

Meds

May 12, 2018

In 1994, Penguin Books published what would become a national bestseller titled, Listening to Prozac written by Dr. Peter Kramer, a Clinical Professor of Psychiatry at Brown University at the time. Throughout the book, he debates the ethics of “cosmetic pharmacology” a term associated with the transformation of personality traits through medication. Kramer describes several patients as becoming “better than well” on Prozac — more socially adept, less inhibited, and …

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To Paxil, with love

Health care is not a service commodity

Peter Spence, MD, MBA

Policy

May 12, 2018

As we continue to attempt to restructure how health care is measured, reimbursed and organized, we must hold true to the idea that health care is simply not a service commodity.

“A commodity is any good or service (“products” or “activities”) produced by human labor and offered as a product for general sale on the market.” Our health care delivery model continues to evolve as we move away from the fee-for-service (FFS) model …

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Health care is not a service commodity

MKSAP: 35-year-old woman is evaluated for intermittent fever

mksap

Conditions

May 12, 2018

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

A 35-year-old woman is evaluated for intermittent fever, sweats, fatigue, and dull midchest pain of 2 weeks’ duration. Medical history is significant for liver transplantation 6 months ago for primary biliary cirrhosis; she was seronegative for cytomegalovirus and Epstein-Barr virus, and her donor was positive for both. Results of pretransplant testing for tuberculosis …

What makes you an effective change agent in health care?

Ashwini M. Zenooz, MD

Physician

May 11, 2018

Change and health care are closely interconnected. Health care organizations are continually faced with the need to adapt to change, whether it be advances in medical care or technology, growing demand for care delivery, a patient population that is increasingly active and involved in their own health and well-being, or evolving reimbursement and cost models. By recognizing that change is inevitable in the health care sphere, organizations can focus on …

A physician’s guide to getting more time with family

Nana Korsah, MD

Physician

May 10, 2018

Do you ever feel like time is always slipping away? Do you feel like you hardly get time to enjoy the things you love? For example, do you feel like you get enough time in your day to spend with your kids? If your answer is “no,” welcome to the club. You are not alone! I am a physician mom of young kids who used to feel like I never …

When someone is not dead but not alive

Deep Ramachandran, MD

Physician

May 9, 2018

May lay in a hospital bed, her wrinkled skin covered with sensors that monitored her every breath and heartbeat. Her husband sat at her bedside gently stroking her withering gray hair as her chest moved slowly up and down accompanied by the soft whoosh-whoosh of the ventilator that breathed for her.

He stared expectantly at her face as if at any moment she would rise and free herself from the multiple …

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When someone is not dead but not alive

An emergency physician makes the case for circumcision

Paul Blackburn, DO

Conditions

May 9, 2018

Whether to circumcise a newborn male child is not the simple, binary “yes/no” question it appears to be. Rather, the choice is affected by an astonishing array of issues: religion, culture, health and hygiene, sexually transmitted infections, expense, pain and medical recommendations. Some cite ethical concerns regarding usurpation of a child’s free choice. Others claim an equivalency between neonatal male circumcision and the practice of female genital mutilation.

As a practicing …

Never undermine the work of a nurse

Nabeela Patail, MD

Physician

May 9, 2018

A few months ago a nurse I know vented her frustration at a misperception she had received several times, unfortunately. She recalled a conversation in which someone had asked her in a condescending manner if she does anything else at work besides “handing out pills.”

I became visibly irritated at this, not only was this person purposely making disrespectful comments to bring her down but was also perpetuating her own biased …

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Never undermine the work of a nurse

What could be worse than being sued for malpractice? Prison.

Skeptical Scalpel, MD

Physician

May 6, 2018

Kang Se-hoon, a surgeon in South Korea, operated on a popular rock singer and song writer in October 2014. According to reports, Shin Hae-chul had abdominal pain, and the surgeon performed laparoscopic lysis of adhesions. Without having obtained consent, he decided to also do a weight reduction procedure.

The patient was discharged a few days after surgery but returned a day later with fever and severe abdominal pain. Kang did not …

Internet support forums for benzodiazepine withdrawal: the good, the bad, and the ugly

Christy Huff, MD

Physician

May 5, 2018

Since the advent of the internet and rise of social media, patients can connect and compare their experiences with prescribed drug withdrawal. A problem that was once considered rare is a worldwide epidemic that is finally getting noticed. A recent New York Times article discussed the problems many have discontinuing antidepressants, and more than 8,800 readers responded about their difficulty stopping …

When a physician gets yelled at

Jordan Grumet, MD

Physician

May 4, 2018

It was not so much the words as the overall tone of the interaction. The doctor-patient relationship had been generally affable. There was the usual exchange of pleasantries over the years. Questions about family, children, and grandchildren. It was a good relationship — until Harvey got sick, that is.

Originally, there was weight loss and fatigue. The initial physical exam and slew of testing showed nothing but a frail, cachectic, middle-aged …

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When a physician gets yelled at