Ear infections (or, what we like to call “acute otitis media”) are one of the staple diagnoses of pediatrics. Most kids have at least one before their third birthday. And most pediatricians see at least one every day by 11. You would think we would always get it right. But I have a confession — we don’t. In fact, children are misdiagnosed and over-treated at an alarming rate.
There are several reasons for …
Why is diagnosing ear infections so hard?
Doctors have a difficult time adjusting to other cultures and because of this flaw, patients, and the medical profession suffer. By culture, I do not mean religious or philosophical background, socio-economic difference, country of origin, nor even the silence created by language and education barriers. I am referring to the communication and comprehension chasms that exist between different occupations and physicians.
What …
Why other professions can’t relate to medicine
ESPN sportscaster Stuart Scott’s recent death has given the American public a chance to reflect on what it means to live with a cancer diagnosis. His speech at the ESPY awards in the summer of 2014 was widely hailed as an inspiration to people with cancer. Obviously, the Jimmy Valvano Award for Perseverance with the ties to cancer research (Jimmy V Foundation) and Scott’s public image as someone being …
Stuart Scott and his fighting words
Dangerous ingredients, like toxins, antifreeze, and mercury, are touted by many as reasons to decline vaccination against influenza. However, toxin is an inaccurate term regarding vaccines (a toxin is a poisonous substance made by cells or organisms and is definitely not in any vaccine), mercury is a non-issue (see below), and there is no antifreeze in vaccines (although some contain propylene glycol, …
Scared of the flu vaccine? Let’s see what’s really inside it.
What defines a competent psychiatrist? To staunch critics of the field, perhaps nothing. Some believe psychiatry has done far more harm than good, or has never helped anyone, rendering moot the question of competency. What defines a competent buffoon? A skillful brute? An adroit half-wit? Having just finished Robert Whitaker’s Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, a reader might easily conclude that psychiatric competency is …
What does it mean to be a competent psychiatrist?
If F. A. Hayek were alive today, he would support the revival of labor unions in general and professional labor unions in particular. Towards the end of the Second World War, Hayek wrote a book warning us all that allowing governments to engage in extensive central planning of economic activities is nothing more than a road to serfdom for humanity. F.A. …
Physicians must unionize. Here’s why.
While the electronic medical record (EMR) has advantages, it also has introduced liability risks. EMRs can lead to lawsuits or result in a weak defense by casting the physician in an unfavorable light.
For example, examine these exchanges in a recent malpractice trial:
EMRs can hurt physicians during lawsuits. Here’s how.
A while ago, I wrote about a medical student whose school tried to dismiss him just prior to graduation for unprofessional behavior.
A judge ruled that the school could not do so because it had tolerated some similar behavior earlier in his medical school career and had not considered it important enough to mention in his letters of recommendation.
In that post, I said, “‘Professionalism’ is difficult to define, especially when trying to …
Why is it so hard to define what professionalism is?
New York Post reporter Susan Edelman revealed the name of the unfortunate anesthesiologist allegedly present on August 28 at Yorkville Endoscopy, during the throat procedure that led to the death of comedian Joan Rivers. She is reported to be Renuka Reddy Bankulla, MD, 47, a board-certified anesthesiologist from New Rochelle, NY.
Having her name made public will be a nightmare for Dr. Bankulla, as …
Joan Rivers: What should the anesthesiologist have done?
You might think of bacon, that thing of gustatory beauty that is salted, cured pork, as just pleasure for your taste buds. However, one of the first medical facts I learned in 2015 was that bacon has medicinal purposes (apart from making you feel better after eating it). With this new knowledge at hand, the time just seemed right for a …
3 ways to use bacon as medical treatment
You’ve made it. Four years of college, four years of medical school, and three years (sometimes four or five) of residency, depending on the specialty you chose. You’ve earned a prestigious title.
You are a doctor.
But wait, you are not done yet.
Want to be a cardiologist, oncologist, or gastroenterologist? Add another three years to the eleven spent to become an independent practitioner. Another three years of interest accruing on that six-figure …
What I learned after going through the fellowship match
Is it medically professional for a non-profit organization to use physician testing fees to “choose wisely” a $2.3 million luxury condominium complete with a chauffeur-driven BMW 7-series town car? In my view, obviously not. To most people, such an action would conjure up images of hypocrisy, waste, and corruption.
After a review of public and tax records, it appears to me this is exactly what has happened.
Background
In 1999 for reasons that …
A physician investigates the American Board of Internal Medicine
One of the things that I love about my job as a hospitalist is the ease with which we can develop friendships with colleagues from other disciplines. Since I am an inpatient physician, it’s not surprising that some of my good friends are cardiologists, nurses, endocrinologists, physical therapists and, of course, other hospitalists. In fact, I met my neurosurgeon husband while co-managing his patients at the hospital. While thinking about …
Why can’t more hospitalists and emergency physicians be friends?
Colonoscopy is the most effective test for the detection and prevention of colorectal cancer, the second leading cause of cancer death in the United States. An estimated 14 million colonoscopies are performed in the United States every year. About 20 to 40 percent of these colonoscopies have inadequate bowel preparation according to multiple studies.
Inadequate bowel preparation is costly to the patient, the health care system, and society.
In one study, poor …
The hidden costs of an inadequate bowel preparation for colonoscopy
Home health care is in many ways a fantastic service, especially for those Medicare beneficiaries who are essentially homebound due to frailty or illness.
But it often feels surprisingly hard to synergize with home health care.
The main problem, as I see it, is that home health care agencies have set themselves up to provide only administratively required communication with the ordering doc. (There are rules governing home health care, you know!)
Now, …
The problem with home health care communication
My brother wears a scar around his neck. It represents his second surgery for papillary thyroid cancer. The first started off the same way. Ugly, red and angry. Curving like an ominous smile around his neck, like a noose. That’s how it felt too — the lump in his throat growing as he sat quietly, alone in a doctor’s office. It’s interesting how physical scars are a visual manifestation of …
The hardest and often worst part of medicine: The waiting
In the United States, we train health care providers on poor people. This is no secret — most medical schools and residencies are in lower income areas. If you have Medicaid or no insurance, you are more likely to find care in an office or hospital where medical students, residents, nursing students, and other trainees rotate; Blue Cross patients don’t let interns watch their childbirth. Even though my residency emphasized …
A prescription to treat polyprovider syndrome
Have you ever eaten a healthy meal, maybe some brown rice and stir-fried veggies, and found yourself ready for another meal just a short while later? Or, more often couldn’t overcome a hankering for a satisfying dessert to top off (and undermine the healthiness of) that meal?
As it turns out, this lack of satiety is not merely a function of the …
You could get fat from eating healthy foods. Here’s how.
There once was a kind, humble physician who worked for years in an office building across the street from the hospital, toiling day to day to take exceptional care of his patients. He was open and deliberate, calm and thoughtful. He himself hired every secretary and medical assistant, every nurse, and biller. His staff formed a protective family who fiercely advocated …
How the kind, humble physician met his demise
Dear HMO,
As I prepare to #getcovered or #staycovered, I realize that as a physician, I have an advantage in that I know what specific types of insurance plans would best fit my needs. Unfortunately, this is not the case for many Americans. Most importantly, I know to avoid signing up for certain health maintenance organizations (HMOs). Although I am a strong …
Dear HMO, I don’t want your money
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