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Why not make antibiotics over the counter?

Meds

June 27, 2016

Bacteria are rapidly becoming resistant in our antibiotic-loving society. This statement is a fact. We are facing a threat not only to our country, but to the world.

I have a proposal to make: over-the-counter antibiotics.

(Insert tongue-in-cheek here.)

Will this help us deal with the falsely popular notion that antibiotics are a cure-all? I don’t know, but here’s something I do. I’ve had patients storm out because I’ve said no, and I …

How do you define success after residency?

Kelly G. Elterman, MD

Physician

June 27, 2016

Residency is a time of immense learning. You learn from your attendings, your patients, and your colleagues. Of all the teaching moments during my residency, one that frequently stands out in my mind now is the day when one of my co-residents told me about the “post-training phenomenon.” He had previously completed a different residency and practiced in that field for a decade prior to switching to our specialty.

“Once you …

Physicians have a duty to respond to emergencies if they can

Niran S. Al-Agba, MD

Physician

June 27, 2016

“Someone else will lend a helping hand,” a physician told me once, when asked to help with an emergency in public. As a PALS instructor for more than a decade, I have always responded when possible. In the last decade, there have been three in-flight emergencies, two elderly individuals who passed out in church, and a host of other less serious maladies. A week ago, I discovered the best reason I …

If you are admitted to the hospital, will a specialist see you?

Gene Uzawa Dorio, MD

Physician

June 23, 2016

Most primary care physicians (PCPs) who admit patients to a hospital are family practitioners or internists. Since medicine becomes more complex each day, PCPs must remain up-to-date on the latest treatment related to drugs, surgery, procedures, risks, complications, and costs. This might require your PCP to be a quarterback bringing together a team of consulting specialists to guide you through your hospital stay.

The economics of hospitalization are changing, and since …

The death of a child is an abomination

Olubunmi Ode, MD

Physician

June 23, 2016

When, aged thirteen, my best friend died of complications from sickle cell disease, her parents could not attend her funeral or find out where she was buried. My mom explained to me that in the Yoruba culture because parents are not expected to survive their children, it is considered an abomination for a parent to know where their child is buried. So, the young adults in the extended family attended …

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The death of a child is an abomination

How can patients accept cash-based practices?

Steven Reidbord, MD

Physician

June 22, 2016

A primary care physician named Ashley Maltz recently discussed advantages and disadvantages of a cash-based practice. I appreciate her evenhanded tone: She prefers this model yet expressed concern for patients who can’t use it. In the comments section, several physicians extolled the virtues of cash-pay, but patients were mixed. It’s attractive for those who can afford it, while it worries, and maybe angers, those who can’t.

I enjoy the personal and patient benefits of a mostly cash-pay psychiatric practice (I …

Don’t do these 5 things with your medical school personal statement

Dr. Dale

Education

June 21, 2016

Your medical school personal statement is one of the most important components of your application. This short essay can be the deciding factor as to whether or not you will spend the remainder of your life practicing medicine.

To be honest, most personal statements will be similar enough that they’ll fit right in with the rest. There will be a handful that stand out above the majority, and if you can …

When doctors and patients secretly record each other

Skeptical Scalpel, MD

Physician

June 20, 2016

A JAMA Viewpoint suggests that doctors should be aware that patients may be surreptitiously recording their conversations. The author, a neurosurgeon, takes a very benign view of this issue and recommends that if a doctor suspects that patient is recording a conversation, “the physician can express assent, note constructive uses of such recordings, and educate the patient about the privacy rights of other patients so as to avoid any …

My attending is throwing scalpels. What do I do?

Pamela Wible, MD

Physician

June 16, 2016

PamelaWiblePostcard283-copy

Dear Dr. Wible,

Thank you for the work that you do. I have been following your push for humane medical education for several months now. I finally decided to contact you after reading your article about how “burnout” is actually abuse. I am a med student entering my third year. I have been consistently hearing horror stories from other students about the …

I’m a physician assistant. It’s time to stop the bitterness.

Wes Johnson, PA-C

Physician

June 13, 2016

I like to read. I always have, and I’m sure I always will. I read almost everything that I come across. I often find myself reading the articles on this site. Some I agree with and some I don’t, but I like that part of the site too. I read, and I learn and I’m informed, and I gain knowledge, but then something always seems to happen. I always wind …

This doctor was remembered for his devotion to patients. Was it enough?

Sudha Prasad, MD

Physician

June 12, 2016

Recently I attended the funeral of a prominent gastroenterologist in my community whom I knew socially as the father of my son’s friend. It was an untimely and rapid death due to pancreatic cancer. He left behind a young wife and four children, two of whom are in college. I would see him periodically at school functions; he would sneak into an event at the last minute and often struggle …

Physicians are society’s scapegoats

Kevin Haselhorst, MD

Physician

June 12, 2016

Dad had taken a turn for the worse, but my family was not ready to give up on him and consider end-of-life care. Nevertheless, choices had to be made. Would Dad be allowed to pass while in assisted living or have his life prolonged in a skilled-nursing facility? What kind of a doctor am I? When perceiving that a patient is dying, what type of physician neglects to intervene and …

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Physicians are society’s scapegoats

7 tips for doctors to be successful in telemedicine

Geeta Arora, MD

Physician

June 11, 2016

In early 2014 I decided to use the six state licenses I had obtained as a locum tenens physician to start practicing telemedicine. Since then I have worked with several telemedicine platforms. I use telemedicine to keep up my outpatient skills. I have found that telemedicine companies differ dramatically in their overall ease of use for the provider.

Here are my top 7 tips for deciding which telemedicine company to work …

The story of a man who did not feel well

Mark E. Williams, MD

Physician

June 9, 2016

Once upon a time, not that long ago, there was man who lived an uncomplicated life. One morning he awoke and did not feel well. He could not really describe his malaise, but he definitely was not his usual self. Nothing particularly noteworthy had happened to him except that his dog had recently died of old age. William, a scruffy little terrier, was 17 years old, and the man knew …

The question doctors should ask before ordering a test

James C. Salwitz, MD

Physician

June 8, 2016

Doctors have several bad habits. They order piles of tests just to get a vague, unfocused view of a patient’s health. They order expensive and invasive tests to rule out the unlikely or extraordinarily rare. The worst “bad test habit” is when doctors order a test, which, no matter what the result, will not change what they are planning to do.

Why do doctors over order? These same people thought a …

Are you the physician who yells?

Edwin Leap, MD

Physician

June 7, 2016

I’ve never been the doctor who yells. However, if you work in medicine, you’ve met him or her. I’ll call this physician “Dr. Barkus Yellby.” Dr. Yellby is angry. A lot. In the old days (and not so old days), he threw instruments in the OR when they weren’t what he wanted. Or if the charts and labs weren’t ready for rounds, he slammed things on the desk and berated …

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Are you the physician who yells?

Physicians as innovators: 6 ways we help and hurt ourselves

Nicole Van Groningen, MD

Physician

June 6, 2016

The U.S. health care system is the world’s top in health care spending per capita, but in terms of performance, we’re dead last among developed countries. As a young physician embarking on a career in this landscape, it’s glaringly obvious that we need disruptive innovation to create better health at a lower cost. Physicians are uniquely positioned to make critical contributions to medical innovation, but even among …

MKSAP: 32-year-old man with a rash on his face and midchest

mksap

Conditions

June 4, 2016

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

A 32-year-old man is evaluated for a 2-week history of a rash on his face and midchest. He describes the rash as consisting of small, reddish “lumps” that are intensely itchy; they develop and begin to resolve with development of new lesions. He otherwise feels well.

Medical history is significant for a recent diagnosis …

How marriage affects men’s colonoscopy rates

Frederick Gandolfo, MD

Conditions

May 31, 2016

Did you know that married men have a lower colorectal cancer mortality when compared to unmarried men? What about the fact that married men have higher rates of colorectal cancer screening? Interesting, right? In fact, studies showing the association between marriage and favorable behavior regarding colon cancer screening have been published as early as 2010.

More recently, a study published in the journal Preventive Medicine found that married men are …

Hyperbole is seldom helpful. Especially when it comes to medical errors.

Dr. Saurabh Jha

Physician

May 29, 2016

Josef Stalin famously said: “One death is a tragedy; one million is a statistic.” Perhaps 250,000 preventable deaths from medical errors, according to an analysis by Makary and Daniel in the BMJ, maketh a Stalin.

The problem with Makary’s analysis, which also concluded that medical errors are the third leading cause of death, isn’t the method. Yes, the method …

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