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The slow death of private practices

Emily Dalton, MD
Physician
June 13, 2017

Doctors have been bemoaning changes in the practice of medicine for years and with good reason. It’s harder and harder to make a go of it in private practice. In recent years our area has lost several small practices — Hal Grotke’s Redwood Family Practice closed, Dr. Garcia retired, Teresa Marshall’s solo office shut its doors, Eureka Internal Medicine transitioned to Humboldt Medical Specialists (which then became St. Joseph Hospital …

Read more…

The slow death of private practices

Stop asking doctors for free advice

Anonymous
Physician
June 12, 2017

My husband is a doctor. Similar to any other career, this is what he spends most of his time doing. It’s also our family’s livelihood — how we pay our mortgage, our bills and send our daughter to preschool.

He went to through seven years of training after college, often working all night or even 24-plus hour calls. He’s had to miss family dinners, birthday parties, nights of putting our daughter …

Read more…

Stop asking doctors for free advice

Doctors: You have a PR problem

Kaci Durbin, MD
Physician
June 12, 2017

Over the last few decades, public perception of physicians has been on the decline. Many issues are to blame, but a largely overlooked contributing factor is the media. Physicians are often portrayed negatively, with stories of narcotic abuse, greed and medical mistakes dominating the news. Rather than fight back, physician organizations have stood silently and allowed their reputations to be tarnished. On the other hand, nursing organizations have been busy …

Read more…

Doctors: You have a PR problem

Better care: Private practice or academic center?

Dads Dollars Debts, MD
Physician
June 12, 2017

Throughout training, I had an idea. And that idea was — I would be a great academic physician. I had the right training. I had done research from college through fellowship. I had received research grants from medical school through fellowship, published numerous papers and started defining a niche. Everything was going great.

Academia — here I come!

Then attending-hood arrived. I looked for positions in academic centers. I was limited by …

Read more…

Better care: Private practice or academic center?

How a one-time bridging prescription became an every time refill

Fred N. Pelzman, MD
Meds
June 11, 2017

At what point, we have to ask ourselves, does a medical error that we do over and over again cease to be an error, and simply become business as usual?

At one of the patient safety conferences this week, where we reviewed sentinel events that occurred in the hospital and in the outpatient setting, one of the cases was about a patient who developed an abnormal cardiac rhythm as a result …

Read more…

How a one-time bridging prescription became an every time refill

MKSAP: 37-year-old man with low libido and fatigue

mksap
Conditions
June 10, 2017

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

A 37-year-old man is evaluated for a 2-year history of low libido, loss of morning erections, fatigue, and decreasing muscle mass. His medical history is otherwise unremarkable. He takes no medications.

On physical examination, vital signs are normal. BMI is 35. The remainder of the examination, including genital examination, is normal.

Laboratory studies:

Luteinizing hormone 10 …

Read more…

MKSAP: 37-year-old man with low libido and fatigue

This is what it’s like to be a military physician

Demis N. Lipe, MD
Physician
June 7, 2017

After another long shift of patients with colds, bug bites, ankle sprains and sore throats I eagerly looked through the wine selection at the local grocery store. It was my wedding anniversary and nearing 9 p.m. at the beginning of a holiday weekend. While at the checkout line, an elderly woman in front of me thanked me for my service. At that moment, I realized that I was wearing my …

Read more…

This is what it’s like to be a military physician

A nurse was raped and tortured at her hospital. Here’s what you can do to help.

Admin
Video
June 6, 2017

A inmate, while a patient at Delnor Hospital in surburban Chicago, escaped and took two nurses hostage.  One of nurses was raped and tortured at gunpoint.  There is little mention of this horrific story in mainstream media.  Violence against health care workers cannot remain silent.

ZDoggMD recently spoke with this individual, who shared her story. #silentnomore

Please send your notes of support to her:

Delnor Nurse
PO Box …

Read more…

A nurse was raped and tortured at her hospital. Here’s what you can do to help.

MD vs. DNP: 20,000 hours make a difference

Niran S. Al-Agba, MD
Physician
June 6, 2017

As Southern states entertain legislation granting nurse practitioners independent practice rights, there are some finer details which deserve careful deliberation.  While nurse practitioners are intelligent, capable, and contribute much to our healthcare system, they are not physicians and lack the same training and knowledge base.  They should not identify themselves as “doctors” despite having a doctor of nursing practice (DNP) degree.  It is misleading to patients, as most do not …

Read more…

MD vs. DNP: 20,000 hours make a difference

Overweight patients are not necessarily lazy

Cory Michael, MD
Conditions
June 4, 2017

My nurse practitioner was pleased to see me at my annual physical this year. “So how does it feel to be 20 pounds lighter?”

“It feels terrible,” I replied.

Allow me to explain.

Weight has been an issue my entire life. Raised on a standard Midwest diet of complex carbohydrates and the best processed delicacies that government assistance could buy, I spent most of my childhood socially segregated by my peer group due …

Read more…

Overweight patients are not necessarily lazy

How can relationships survive medical school applications?

Sarah Epstein
Physician
June 4, 2017

Medical school applications can raise big hairy questions about the long-term potential and trajectory of your relationship as well as the question of whether you get a say in where the applicant applies and attends medical school. For some, the timing of these questions arises in synchrony with the relationship’s natural progression that is at a time when you and your partner are beginning to discuss your long-term prospects. Other …

Read more…

How can relationships survive medical school applications?

It’s time for graduating medical students to celebrate their dream

Pamela Wible, MD
Education
June 3, 2017
YouTube video

A transcript of the Loyola Stritch School of Medicine 2017 commencement speech, Saturday, May 20, 2017.

Angela Jiang: Good morning! As the class vice president, it is my pleasure to welcome Dr. Pamela Wible to our graduation. Dr. Wible is a family physician and a pioneer in the ideal medical care movement. After completing a family medicine residency and working in different family practices for over ten years, Dr. Wible …

Read more…

It’s time for graduating medical students to celebrate their dream

Why it’s hard for physicians to order fewer tests

Chad Terhune
Policy
June 2, 2017

It’s common knowledge in medicine: Doctors routinely order tests on hospital patients that are unnecessary and wasteful. Sutter Health, a giant hospital chain in Northern California, thought it had found a simple solution.

The Sacramento-based health system deleted the button physicians used to order daily blood tests. “We took it out and couldn’t wait to see the data,” said Ann Marie Giusto, a Sutter Health executive.

Alas, the number of orders hardly …

Read more…

Why it’s hard for physicians to order fewer tests

Here’s the place where burned out physicians go

Sarah Kwon
Physician
June 2, 2017

Burned out cardiac surgeon seeks opportunities or empathy,” one message reads. “I feel stuck,” another confides. A third says simply, “I don’t want to be a doctor anymore!”

The posts come in from across the globe, each generating its own thread of commiseration and advice. “I just wanted to reach out and let you know I feel your pain,” a doctor-turned-MBA replies to one surgeon. “Your story is so similar to …

Read more…

Here’s the place where burned out physicians go

A retired physician asks: Am I still a doctor?

Robert Baker, MD
Physician
June 1, 2017

Monday morning and no place to go. After 35 years of practicing medicine and GI, including a year of eager anticipation, the day had arrived when there were no patients in my schedule. Nor would there be tomorrow. Nor the next day.

I was happily accustomed to a scheduled life. For me it had been decades of awakening early, working out, assembling a breakfast to inhale in the car, kissing the …

Read more…

A retired physician asks: Am I still a doctor?

The abscess that surprised this emergency physician

Raj Waghmare, MD
Conditions
June 1, 2017

I carried it around with me the entire shift. I showed it to my E.R. colleagues, the internists, and even a couple of surgeons. I’d tell them the story. “Never,” one of them said. “Not in twenty-eight years. Never seen that before.”

One of them held the small urine jar up to a light and began unscrewing the lid.

“Don’t!” I said.

“Why not?”

“It stinks. You wouldn’t believe how much it stinks. We …

Read more…

The abscess that surprised this emergency physician

CSF is soap for your brain

Jason Lee, TCRN, CCRN
Conditions
May 31, 2017

Recently after pulling a couple 20-hour shifts, people kept encouraging me to sleep on my break. They were obviously concerned for my well-being but it got me thinking more about the role sleep plays in our lives. If the average life expectancy is 78 then we spend 30 percent of our lives asleep which is also the same amount we spend in our cars commuting, and a meager 0.16 percent …

Read more…

CSF is soap for your brain

6 tricks that pharmaceutical marketers use

Martha Rosenberg
Meds
May 30, 2017

Long before the Internet and direct-to-consumer advertising, the medical profession tried to reassure people about their health concerns. Remember “take two aspirins and call me in the morning?”

Flash forward to today’s online “symptom checkers.” They are quizzes to see if someone has a certain disease and exhortations to see their doctor even if they feel fine. Once drug makers discovered that health fears and even hypochondria sell drugs, there seems …

Read more…

6 tricks that pharmaceutical marketers use

Listen up GEHA: Vaccines should not be an out of pocket cost

Niran S. Al-Agba, MD
Policy
May 29, 2017

In a little piece of legislation known as the Affordable Care Act, preventive services are mandated to be covered with no out-of-pocket expense to consumers. According to the Healthcare.gov website, approved insurance plans must cover a “list of preventive services for children without charging a copayment or coinsurance.”

Number 18 on that preventive care list is childhood immunizations for children from birth to age 18, acknowledging regional variation in the standard …

Read more…

Listen up GEHA: Vaccines should not be an out of pocket cost

Is there a medication that can combat rigid and robotic thinking?

Michael Kirsch, MD
Meds
May 29, 2017

I had an interesting conversation with a patient in the office some time ago.

He was sent to me to evaluate abnormal liver blood tests, a common issue for gastroenterologists to unravel. I did not think that these laboratory abnormalities portended an unfavorable medical outcome. Beyond the medical issue, he confided to me a harrowing personal tribulation. Often, I find that a person’s personal story is more interesting and significant than …

Read more…

Is there a medication that can combat rigid and robotic thinking?

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  • Most Popular

  • Past Week

    • Evidence-based medicine vs. clinical judgment: a medical student’s perspective

      Jay Pendyala | Education
    • The controversy over Maintenance of Certification for grandfathered physicians

      Bernard Leo Remakus, MD | Physician
    • How hindsight bias distorts clinical medicine

      Olumuyiwa Bamgbade, MD | Physician
    • When side effects are actually a cry for help with medication costs

      Shuchita Gupta, MD | Physician
    • Proactive monitoring can prevent emergencies by catching heart signals early [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why clinician education must prioritize nutrition training

      Beata Pasek, EdD | Conditions
  • Past 6 Months

    • The dangers of vertical integration in health care

      Stephanie Waggel, MD | Policy
    • Why does sex work seem like a more viable path than medicine in 2026?

      Corina Fratila, MD | Physician
    • The 9 laws of health care quality: Why metrics miss the point

      Constantine Ioannou, MD | Physician
    • Politics and fear have replaced science in U.S. pain management [PODCAST]

      The Podcast by KevinMD | Podcast
    • From Singapore to Canada: a blueprint for primary care transformation

      Ivy Oandasan, MD | Policy
    • How board certification fuels the physician shortage crisis

      Brian Hudes, MD | Physician
  • Recent Posts

    • Proactive monitoring can prevent emergencies by catching heart signals early [PODCAST]

      The Podcast by KevinMD | Podcast
    • Health care affordability crisis: lessons from the NYC nursing strike

      Marc Henry Estriplet, MD, MPH | Physician
    • How wearable technology is changing the role of physicians

      Jeffrey Junig, MD, PhD | Tech
    • Workplace violence against nurses: a crisis of systemic failure

      Amanda Dean, RN | Conditions
    • Ignored DNR hospital policy: a family’s tragic end-of-life story

      Amanda Cutshall | Conditions
    • Why measuring muscle mass matters more than tracking your weight [PODCAST]

      The Podcast by KevinMD | Podcast

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