Want to enhance medical education? Use spaced repetition.

Education
June 4, 2015

We’ve all heard it said that learning medicine is like drinking from a firehose. Yet many students and schools don’t use one of the most effective study techniques available to them. Spaced repetition is a powerful, evidence-based study technique that can enhance learning and long-term retention of medical knowledge. Medical students and schools could both benefit from understanding and using spaced repetition to produce more knowledgeable and better-informed doctors.

Over a …

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The problems with a low salt diet

Conditions
June 3, 2015

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One of my favorite physician sayings is, “Don’t just do something, stand there!” Which means that it’s better to do nothing than to do something that doesn’t help. As I move through my career, I find myself agreeing. I am endlessly amazed at the number of things we do for no good reason, and that patients come to expect, also for …

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Doctors: Be sure to thank the case managers

Physician
June 1, 2015

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As someone who has practiced hospital medicine up and down the East Coast for the last several years, I’ve had the fortune of working with some absolutely terrific colleagues. The hospital environment is by its very nature a busy and hectic one — where we all put our heads down and work tirelessly at the coalface for hours on end. Doctors …

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The challenge of evidence-based medicine to the new physician

Education
May 31, 2015

Evidence-based medicine (EBM) has been classically described as “the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.”  At first look, this well-accepted approach to clinical medicine appears not only completely reasonable, but also somewhat obvious given the immense amount of research available for academic consumption.

EBM has been repeatedly preached as the gold standard of clinical care across all medical …

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A neurosurgeon teaches us about degenerative disc disease

Conditions
May 31, 2015

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No one wants to hear that they have a disease. And yet everyone will develop some degree of degenerative disc disease (DDD) — or degenerative spine disease — over the course of a lifetime. DDD refers to a combination of age-related and wear-and-tear-related changes that occur within the spine over time. It is very common and a natural part of aging.

Most …

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So you failed maintenance of certification. What now?

Physician
May 25, 2015

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What is it like for physicians to fail their ABMS Maintenance of Certification® (MOC) program examination? How does the largest member board of the ABMS, the American Board of Internal Medicine (ABIM), respond to doctors who fail their secure examination?

As I continue to confidentially collect information from physicians who have failed their MOC examination, I thought it would be important to publish …

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Leaving medical school for a startup. And with no regrets.

Education
May 20, 2015

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There he stood at our beach party, the family doctor I grew up admiring. I timidly approached his circle of friends to announce I had gotten into medical school and would start in the fall. He stopped to attention. His friends stood watching. I couldn’t conceal my smile. I thought, “He is going to be so excited for me!”

“Get out now.” …

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The top 10 lies of doctors

Physician
May 19, 2015

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I’ve been a doctor for more than 20 years, and I hate to break it to you, but it’s time I came clean: We lie. Doctors lie. Not always. Not necessarily on purpose. But we do.

Sometimes the lies are to our patients. Sometimes, the lies are to our families. And sometimes the lies are to ourselves.

But, nonetheless, we lie. A lot. …

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Casual Fridays don’t have a place in medicine

Physician
May 16, 2015

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A disclaimer before I even get started on this post.

Some of you who know me or work with me will think that by writing this post I am talking about you or even attacking you. I am not. If you’re especially sensitive, don’t read any further.

I am simply writing something that has been kicking around in my head for a long …

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So your child swallowed a button battery. Here’s what you need to know.

Conditions
May 13, 2015

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Each year children ingest an array of foreign bodies including coins, magnets, and a new subset of batteries known as button batteries. Awareness of this small yet very dangerous foreign body is important for parents to understand so they can act quickly if their child is suspected of ingestion.

What is a button battery?

A button battery is a cylindrically shaped object measuring …

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Back pain during pregnancy: Advice from a neurosurgeon

Conditions
May 12, 2015

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For many women, pregnancy is a wonderful experience. There are, however, many changes and challenges the mom-to-be can expect, and back pain is one of them. The good news for pregnant women is that the development of severe or debilitating low back pain is very rare.

The incidence of symptomatic low back pain that is severe is about 1 to 2 percent. …

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Tips to avoid medical errors in the emergency department

Physician
May 12, 2015

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Emergency medicine physicians: Could these be your cases?

  • A 35-year-old presents with shortness of breath and numbness to the legs. CXR and EKG are normal. She is discharged to see her doctor in two days, but is found dead at home. Autopsy reveals a dissecting aortic aneurysm.
  • A 15-month-old is triaged to fast track and seen by a physician assistant for fever, lethargy, …

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Order your own lab tests. What could go wrong?

Physician
May 7, 2015

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LabCorp, one of the largest outpatient lab providers in the USA, is soon going to let you skip the tedium of a doctor’s visit to get lab work done. Want some tests? Come on down!

I’ve got mixed feelings about this. While there are some tests that seem reasonable for people to do on their own — pregnancy and HIV tests come …

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