I had a patient once who wanted an exercise stress test even though he had neither symptoms nor risk factors to suggest the presence of coronary artery disease (such as chest pain with exertion). I argued vociferously against it. However, extenuating circumstances (not relevant here) prompted our mutual decision to go ahead with it anyway. To our surprise and dismay, it came …
Here are the three most useful words for a doctor: “I don’t know.”
A close second would be “I’m not sure,” another three that have got me out of trouble more times than I can remember. The older I get, and more experience I have, the more useful it becomes.
Pattern recognition is essential in effective medical practice. So often patient complaints are vague and nondescript, and in the absence of physical …
Armed with tools I have never used or seen before I entered a physical exam practice room for the first day of learning.
Having finished history-taking practices last semester, we were now beginning a new chapter, learning to take a head-to-toe physical exam. Before class began, we were told to read a book and …
I love running.
I typically run 3-4 miles a day 5 to 6 days per week. It’s only about a half hour of time, and it’s well worth it. I get ‘in the zone’ when I run, and I can tune out the rest of the world and enjoy just being. It feels great physically and mentally each time. It’s helped me immensely to stave off the obesity issues that have …
If you develop a swollen knee, please don’t consider it a normal occurrence.
If there was a clear cause, such as a fall to the knee, or some twisting injury to the knee, it’s likely that the cause is due to some mechanical damage. An easily recognized example would be a football or rugby player sustaining such an injury on the playing field. In that case, its typically serious and when …
by George H. Northrup, PhD
No one becomes a mental health professional—in my case, a clinical psychologist—for the financial rewards.
With comparable (or less) education, far more lucrative careers exist in law, business, or other health care specialties. Psychotherapy tends to draw practitioners who are fascinated by the mysteries of the mind and who find satisfaction helping others in distress. Money has typically been a …
Private practices are organized in a corporate model where the physicians are shareholders, or where one or more physicians own the practice and employ other physicians or providers. Private practices are almost exclusively for-profit. Physician practices are organized into corporations for the tax benefits as well as protecting the owners from liability judgments.
Hospitals can be for-profit, not-for-profit …
Lying on the backboard, a frail little old lady moaned with discomfort.
She had fallen beside her bed in the nursing home and was then tightly bound by straps onto the backboard, a cervical collar pushing her chin up and holding her immobile. A person not familiar with modern medicine might think the ensemble looked like a torture device. Indeed, it can …
by Joe F. Lau, MD and Jeffrey W. Olin, MD
Physicians who perform percutaneous endovascular procedures encounter a multitude of vascular diseases that may masquerade as obstructive atherosclerotic arterial disease. While atherosclerosis is clearly the most common condition seen, complex inflammatory, genetic or structural processes may either not be amenable to an endovascular approach or actually be harmful and thus lead to outcomes that are not …
On May 15, 2011, 147 students embarked on their careers as doctors as they graduated from the University of Pennsylvania School of Medicine.
One student, Jenny Rowland, who will pursue a career in Radiology and continue her training at Penn, shared her personal thoughts and emotions as she prepared to graduate.
by Jenny Rowland, MD
I’m not a typical PennMed student.
I’m 31 years old, and I …
Most of us are uncomfortable talking about our waste products, urine and feces. However, changes in the color and odor may signify disease that can be treated or prevented. This article will review causes of discoloration of urine and when there is a change in the odor of urine.
For hundreds of years doctors have looked at urine as a barometer of what is happening in the body. The urine can …
I recently had the opportunity to go to the anatomy lab and help the first years go through the pelvic anatomy. What a blast! There is nothing like dissecting a cadaver to tune up one’s surgical anatomy skills, and helping young eager medical students through it is a great experience.
Prior to going into the lab, I spent many hours going through Netter’s atlas to brush up on the anatomy so …
“Code Blue ICU … Code Blue ICU”
I was greeted by the PA system as I walked into the hospital this morning. A shiver ran down my spine as I quickened my pace . The days of running to codes are long gone. But since I have a patient In the ICU I was curious and just a little bit worried.
As I walked through the sliding doors I passed the room …
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As if medical practices don’t have enough to worry about with EMR implementation, now they have to decide what kind of EMR system to get: a client-server-based system or a web-based system. The former is the kind that most of us are familiar with. You purchase a computer server, buy a license for the EMR software, install said software on your server, …
As 30-year-old New Yorker Carrie Donnelly began her bachelorette party in her new black open-toe five-inch heels, she fell, her foot going one way and her ankle the other.
“When I woke up the next day, my ankle was throbbing and had become extremely swollen,” she said. It was a month before her wedding—the last thing she wanted to do was to walk down the aisle in a cast.
Super-high heels like …
Becoming a doctor is a long and arduous process. Between taking pre-med courses, taking the MCAT, applying to medical schools, matriculating, then taking test after test after test until you take the big one (USMLE Step 1) before which you did questions all day long for weeks from a good USMLE question bank …
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I was in practice about five years and was about to do a radical nephrectomy on a patient.
I met with the patient and his son in my office and the son informed me that he and his father were Jehovah’s Witnesses and that he didn’t want his father to receive any blood or blood products before, during, or after surgery. I asked the father if that was his wish and he …
If you need laser eye surgery in the state of Kentucky, or a little cosmetic work around the eyelids, it now behooves you to ask your prospective surgeon the following question before signing the operative consent form:
“Say doc, did you go to medical school?”
Kentucky joined the company of Oklahoma earlier this year as the second state to conflate optometrists and ophthalmologists. Only ophthalmologists are the sort of doctors who graduated …
Your current thought patterns are likely what keep you trapped in the prison of social anxiety.
To unlock yourself from this prison, you will likely need to have to rewire your brain with new thoughts that take time to cement in the brain, but if you try this as a start, it will lead you up the correct path.
1. The change cannot happen …
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A failed treatment, a surgical complication, a medical error, a patient death. When the going gets tough, even the toughest clinicians should get help.
Physicians and nurses who feel personally responsible for a medical error or a patient’s injury face an immediate quandary—their next patient. In the midst of your angst and guilt, do you suck it up and soldier …
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