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So you failed maintenance of certification. What now?

Wes Fisher, MD

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 …

A medical student on her obstetrics rotation: Behind the scenes

Freida McFadden, MD

Education

May 23, 2015

An excerpt form Baby City: An Inside Look into Labor & Delivery.

I am going to make this medical student cry.

I don’t know how I know it, but somehow I can sense it. I know it the second she walks into the resident room on labor and delivery at Cadence …

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

Gina Siddiqui

Education

May 20, 2015

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.” …

The top 10 lies of doctors

Starla Fitch, MD

Physician

May 19, 2015

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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The top 10 lies of doctors

Casual Fridays don’t have a place in medicine

Greg Smith, MD

Physician

May 16, 2015

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 …

She took Zofran and her son had a heart defect. Here’s why she’s not suing.

Jennifer Gunter, MD

Conditions

May 15, 2015

I suffered from extreme nausea during my pregnancy; I had triplets, and I’m pretty sure I had a triple dose. I never threw up, but you know how your mouth salivates the moment right before you vomit, that sensation that sends you running to the bathroom? I had that. All. Day. Long. For four weeks.

By day four or five I was …

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

Timothy Hadley, DO

Conditions

May 13, 2015

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 …

Being a patient is tough. Here are 3 reasons why.

Starla Fitch, MD

Physician

May 13, 2015

A while ago, I wrote about “The secret lives of doctors.” The post must have struck a nerve because it went viral, maybe because it helped patients to realize that doctors are human.

We doctors can’t really know how human we are until we become a patient.

That happened to me recently. And it wasn’t pretty. You need to know the …

Back pain during pregnancy: Advice from a neurosurgeon

Matt Ammerman, MD

Conditions

May 12, 2015

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. …

Tips to avoid medical errors in the emergency department

Roneet Lev, MD

Physician

May 12, 2015

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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Tips to avoid medical errors in the emergency department

Order your own lab tests. What could go wrong?

Roy Benaroch, MD

Physician

May 7, 2015

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 …

Counting 80 hours: The life of a pediatric resident

Katie Lockwood, MD

Education

May 5, 2015

At a recent block party, neighbors asked me questions about the life of a resident. It amazed me how little the general public still knows about the hours a resident works. Over the years, TV shows have shed some light on what the experience of a resident is like, although none are quite realistic, but it is hard to appreciate from …

A surgeon who wasn’t God in the OR after all

Hope Amantine, MD

Physician

May 4, 2015

Do you know the difference between a surgeon and God? God doesn’t think he’s a surgeon.

Everyone who goes into the study of surgery has ideas about what they’re going to be. I would imagine that each individual has different expectations of what the future holds, though few find their future at all resembles those expectations.

I recall when I started my surgery …

MKSAP: 30-year-old woman is evaluated for a 1-year history of fatigue

mksap

Conditions

May 3, 2015

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

A 30-year-old woman is evaluated for a 1-year history of fatigue, headaches, poor sleep, depression, intermittently blurred vision, and weakness when climbing stairs. She takes no medication. Following a physical exam and lab studies, what diagnostic tests should be performed next?

On physical examination, vital signs are normal. Bilateral ptosis and diplopia are …

Fellowship training, as viewed by a physician’s spouse

Ashley Mast

Physician

May 1, 2015

As a wife and mother, I have days that are very difficult, especially since my husband is in training. I go several days in a row where I only see him right before bedtime, and some days he is unable to see our son at all. I often feel like I have no control of our schedule, and am lucky to …

End-of-life care: What I learned from a pet’s death

Abigail Schildcrout, MD

Physician

April 30, 2015

It has taken me almost two years to be able to write this. We said goodbye to our beloved dog in early May of 2013. I grieved for well over a year.

About a month-and-a-half prior to his death, we had a big medical scare with him. I wrote at that time about how dealing with a veterinary emergency can provide us with some insights and practice parallels to dealing with …

We’re going to need more medical chaperones. Here’s why.

Edwin Leap, MD

Physician

April 29, 2015

For my entire life as a physician, from medical school, through residency and now until this 22nd year in practice, I have subscribed to the idea that I should have a chaperone when performing breast, pelvic or rectal exams on women. I was taught to do this from the beginning, and I still do it.

Why is this? On some level, the …

Our time on this earth is finite

Jordan Grumet, MD

Physician

April 27, 2015

Everything eventually expires.

I looked down at the bottle of natural spring water in astonishment. It had an expiration date. Scanning the empty hospital cafeteria on an early Sunday morning, I wondered what on earth about spring water could go bad? It had no living parts, Nothing that serves as nourishment for wayward bacteria or fungus. The container was sealed. Pristine.

I figured it was another fiscal hoax, perpetrated on unsuspecting consumers. …

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Our time on this earth is finite

When a CT scan misses cancer

Michael Kirsch, MD

Conditions

April 26, 2015

A female patient came to see me with some difficulty swallowing, a very routine issue for a gastroenterologist. I performed an scope examination of her esophagus and confronted a huge cancer occupying the lower portion of her esophagus.

I expected a benign explanation for her swallowing issue. She was relatively young and not particularly ill. She had seen my partner years in the past for a similar complaint, which he …

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When a CT scan misses cancer

Who gets to call themselves family physicians?

Lucy Hornstein, MD

Physician

April 26, 2015

Who is a PCP? (And does that second “P” stand for “physician” or “provider”?)

Who gets to say? Does it matter?

Perhaps we should start with some basic qualifications: The degree of MD or DO, the satisfactory completion of an accredited residency in family medicine, and successfully passing the written examination of the American Board of Family Medicine (ABFP, an organization distinct and independent of the AAFP). Hard to argue with those.

How …

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