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Clinical plagiarism: the problem of copy and pasting in EMRs

Tech

March 26, 2018

It is all too common for a section in a progress note to look something like this:

# Aspiration pneumonia:

Continue vancomycin 1 g bid

Continue Zosyn 3.325 g q6h

Follow-up blood cultures

Follow-up sputum cultures

MRSA nares screen negative

Blood cultures negative

Discontinue vancomycin

Yesterday, a version of this note (lines 1 to 5 to be precise) had my name on it. Today, it is signed by someone else. Read it …

Learn typical community acquired pneumonia with a Medcomic

Jorge Muniz, PA-C

Conditions

March 26, 2018

Community-acquired pneumonia (CAP) is an acute infection of the lung parenchyma acquired outside of the hospital or less than 48 hours after hospital admission. CAP is classified into typical and atypical subtypes, differentiated by their presentation and causative pathogens. This illustration focuses on the classic features of typical CAP.

The most common cause of typical CAP is Streptococcus pneumoniae. It is an encapsulated, gram-positive, …

The medical student who cries

Orly Farber

Education

March 25, 2018

I’m a default crier. I happy-cry, stress-cry, romantic-comedy-cry, regular-comedy-cry and, apparently, I even doctor-in-training-cry.

Crying is a tough response, especially for someone who wants to take care of sick patients. My default reaction poses challenges for my future career. I had my first taste of this when a patient actor brought me to tears. An actor? That’s ridiculous, you might think. It was all pretend and yet, I broke down. I’m …

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The medical student who cries

A physician is often the only person that sets the tone of hope, or despair

Joshua S. Jolissaint, MD

Physician

March 24, 2018

It was mid-afternoon in the ever-bustling surgical intensive care unit (ICU). The nurse, one of those experienced, battle-hardened savants of human symptoms, called me into one of the patient rooms. He was tachypneic on the ventilator with labored breathing and declining oxygen saturations; with each inspiration, his diaphragm would paradoxically elevate, his stomach bulge and the ventilator alarm with the dyssynchrony. Intubated, sedated and unaware, he was fighting for his …

Using marijuana 2 times a month cost this doctor his license

J. Wesley Boyd, MD, PhD

Physician

March 23, 2018

If a physician has a substance use or mental health problem, it is in everyone’s interest — the physicians themselves, their patients and their families — for them to get treatment. And if they go for treatment, they deserve to be treated fairly, but given my six years of experience as an associate director in one state physician health program (PHP) and in working with physicians from all across the …

5 ways to build a relationship with hospital administrators

Amy Baruch, MD

Physician

March 23, 2018

My desire to write this piece stems from my recent realization that I wasted a good part of my early career in medicine. While I was happily working in my pathology “bubble,” I was completely oblivious to the great untapped potential I had to affect change not just within, but also outside of, my department. In an effort to encourage other physicians to find ways to make an impact, I …

What you should know about colon polyps

Frederick Gandolfo, MD

Conditions

March 22, 2018

When it comes to colon cancer prevention, the polyp is the key player to know. Colon polyps, called adenomas, are precancerous growths originating from the inner lining of the colon wall. There are other types of polyps in the colon which are not considered precancerous, but for our purposes in this article, we will consider the terms colon polyp and adenoma to be …

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What you should know about colon polyps

The difficult conversations physicians have with patients

Uzma Khan, MD

Physician

March 21, 2018

A 60-year-old lady came for follow-up after a recent stay in the hospital. She was diabetic — horribly uncontrolled — the result of which was that she had already been on dialysis for four years. She ended up in the emergency room with chest pain. Diabetic patients are at higher risk than the general population of having heart attacks.

She underwent studies to evaluate for blockages in her heart. The cardiologist …

This medical student scored a 281 on the USMLE Step 2 CK. You can, too

Alyssa Ehrlich

Education

March 21, 2018

Once a minor hurdle on the road to Match Day, the USMLE Step 2 CK is now required by many residency programs before ranking applicants. For those with low Step 1 scores, Step 2 CK is even more critical, as it represents a student’s only opportunity to compensate for Step 1 performance. I was happy with my Step 1 score but planned to take Step 2 CK well before applying …

What do you do when your loved one becomes suddenly ill?

Natalie Santiago, MD

Physician

March 21, 2018

When someone you love who has always been healthy and a go-getter suddenly takes ill, it can be very scary and confusing for both of you. It can be particularly scary and confusing for your loved one. Your loved one, while healing, is also experiencing grief/loss, and not just over the loss of health. Even as adults, we can sometimes feel like bad things won’t ever happen to us. Feeling …

10 tips to help patients through benzodiazepine withdrawal

Christy Huff, MD

Meds

March 20, 2018

As physicians, we are experts at prescribing medications. However, we often fail miserably when it comes to recognizing adverse reactions and tapering medications. It’s something that is simply lacking in our medical training. I have become a victim of this with benzodiazepines, as I detailed in a prior blog post. Benzodiazepines, in particular, are very difficult drugs to taper. I would like to share with you …

Enjoy financial freedom by reaching the land of critical mass

Live Free MD

Finance

March 20, 2018

If you’re doing investing right, you’re saving a large percentage of your income every month (like 25-50%) and stuffing it into stocks, bonds, and real estate investments.

At first, even with a high savings rate, your net worth will be low, and the money made by your investments will also be low, like maybe a few hundred dollars a month. However, as your net worth increases, your investments will make more …

How inflation will affect our health system

Robert Pearl, MD

Policy

March 19, 2018

All eyes are on interest rates as investors look for more signs of trouble ahead.

If their concerns over higher-than-expected inflation prove accurate, many players in the U.S. economy will suffer the burden of higher costs. But perhaps no sector would feel the strain more than health care. Higher costs would be just the start of many problems to come for providers, insurers and, eventually, patients.

Surging inflation would create a vicious …

The public’s unrealistic expectations about CPR

Skeptical Scalpel, MD

Physician

March 19, 2018

A survey of 1,000 volunteer adults found 71% regularly watched medical television dramas, but only 12% said the shows “were a reliable source of health information.”

The participants were given some brief vignettes describing scenarios where CPR was administered: a 54-year-old who suffered a heart attack at home and received CPR by paramedics, an 80-year-old with a postoperative cardiac arrest in the hospital after surgery, and a post-traumatic arrest in an …

Communication skills: a tale of 2 doctors

Suneel Dhand, MD

Physician

March 18, 2018

There are two doctors working at the local hospital. They are both around the same age, been in practice for several years, and in the same specialty.

Dr. Cooper grew up in Ohio and went to medical school in California, before moving to New York after his residency training. Dr. Steele grew up in Michigan, where he also went to medical school, before completing his residency in Florida, and then ending …

The truth about plastic surgery chains

Jennifer Greer, MD

Physician

March 17, 2018

Over 17 million cosmetic surgery and minimally invasive procedures were performed in the U.S. in 2016. With the increasing popularity of cosmetic procedures, it seems nearly everyone is out to get a bite of the apple.

Cosmetic surgery chains are growing in size and popularity in an attempt to cash in on this market. Examples include: LifeStyle Lift in the U.S., which declared bankruptcy in 2015 …

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The truth about plastic surgery chains

Intern year is still universally hard. Intern year is also universally great.

Grace Faith Chao, MD

Physician

March 17, 2018

4:00 p.m. Right on time.

I am walking down the street with my brother on his first visit to me in residency; I’m only two weeks in.

I turn to him: “Wait a second.”

I place my hand on the cement wall next to us, and I start to heave.

“Um … are you OK?”

“Yeah. No worries. My body’s just adjusting.”

I go on to describe how every day at 4 p.m. after a 24-hour …

How to have a life in residency

Angela Seabright, DO

Physician

March 16, 2018

Medical students and residents become accustomed to living life in year increments. Four years for medical school, three to five years for residency, a couple years for fellowship, research, and so on. While many of us like to think we are putting our life on “pause” as we complete our medical training this just isn’t possible. Life is happening all around us every day. Many physicians look back on their …

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How to have a life in residency

The implicit biases of gender stereotypes in medicine

Jenny Hartsock, MD

Physician

March 15, 2018

I was lucky to be raised in a place and time where I have not had any significant barrier in my way because I am a woman. I have been allowed to make my own choices and pursue my own path in life. My gender never deterred me from achieving what I set out to do. Can you imagine being a woman a hundred or two hundred years ago or …