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Medical school drug testing is a moral and scientific failure

Anonymous

Education

May 11, 2014

Before the 1980s, drug testing was uncommon. It was widely viewed as an invasion of privacy and an infringement on fourth amendment rights. Today, a medical student is likely to be drug tested before entering medical school, before clinical rotations, and/or before residency. If preventing drug use among medical students is the goal of these tests, they have failed miserably. Urinalysis drug tests are ineffective. But more importantly, they are …

The relatively low compensation of infectious disease specialists

Paul Sax, MD

Physician

May 9, 2014

MD-Compensation-Report

Now a median of $174,000 per year is hardly chump change, so I don’t expect much in the way of sympathy on these data. On the other hand, someone has to to be last, and note that our income hasn’t increased a bit since the last time I commented on this survey three years ago.

So it’s worth taking a few moments listing …

The risks of being a physician advocate

Amol Utrankar

Policy

May 9, 2014

As a future doctor, I believe that digital dialogue affords medicine a powerful responsibility to educate and engage. I believe physicians have a responsibility, as daily witnesses to the gaps and failures of public policy, to advocate for social justice and policy reform. I believe that medicine should extend beyond the proximate effects of illness and injury to address their root social etiologies.

I’ve always held these beliefs with firm conviction. …

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The risks of being a physician advocate

Pay me like a French doctor. You know you want to.

Kevin Pho, MD

KevinMD

May 8, 2014

cost of medical school

Whenever new physician salary data is released, reporters and policy experts often compare doctor salaries in the United States to those of other countries: most notably, France.

And on cue, Vox’s Sarah Kliff — normally an excellent health care writer, by the way — is uncharacteristically lazy in framing physician salaries through a biased lens.

After presenting the data, …

When patients secretly record their doctor visits

Deep Ramachandran, MD

Physician

May 5, 2014

“Doctor, can I record this conversation?”

It’s happened to me a couple of times already. But the question above was never asked. Rather I was informed later on that my conversation with a patient or family was recorded without my knowledge. Smartphones have made it all too easy for patients to secretly record conversations with their health care providers. Simply hit a button, lay it innocently down by your side in …

To medical students: We’re all in the same boat

Serena Zhou-Talbert, MD, MPH

Education

May 4, 2014

I am an imposter in a white coat. I’m not sure if anyone knows yet, I hope I am good at hiding it. It’s a well-kept secret amongst all medical students. In the hospital, I am at the bottom. I know the least and have the least power. Most patients don’t realize this and look up to me like I’m an all-knowing, wise muse or something of that nature. Sometimes, …

Table manners for physicians: 30 tips for better dining etiquette

Karen Hickman

Physician

May 2, 2014

knife-and-fork

A few years ago I was engaged by the director of a residency program in my community to teach the program residents table manners. Now, you may wonder why medical residents need to know how to navigate a dining table gracefully. But good table manners are a must for professionals in any arena.

The director of the program stated that she felt some …

Why doesn’t everyone have a pocket ultrasound machine?

Janice Boughton, MD

Tech

May 1, 2014

For about 2 years now a tiny ultrasound machine has been part of my standard physical exam tools as I take care of patients in the hospital and in the outpatient clinic. In November 2011, I first picked up an ultrasound transducer in a continuing medical education course on bedside ultrasound for emergency physicians. I am an internist, not an emergency physician, …

Quality of life: We say it, but do we mean it?

Tamara Kile, MD

Physician

April 30, 2014

One of my most treasured stories as an ED physician belongs to a lovely couple who valued quality of life. It was a routine day in the ED when an elderly woman rolled through the ambulance doors on a cold, narrow stretcher, unaccompanied by family. She was placed in bed 5, which is where we met. She was frail and her memory was poor. The EMS run sheet reported “change …

The key to physician job satisfaction: Being valued

Lumi St. Claire, MD

Physician

April 29, 2014

It’s been almost two years since returned to medicine after a three-year hiatus from practice. I recently finished the longest week of work I have had since starting this job. I had a family emergency and a conference all converge around the same week, and ended up cramming two makeup days into an already full schedule. It was long. It was incredibly tiring. I was very glad when I finally …

Do medical scribes threaten patient privacy?

Joel Sherman, MD

Physician

April 27, 2014

Medical scribes are a burgeoning field with many institutions and practices exploring their use while the many commercial enterprises who lease out scribes are pushing for their widespread acceptance. There is no accepted definition of what scribes do or what their background or training should be. There is no mechanism for licensure of them in any state. They are poorly defined medical assistants. The field is in its infancy and …

Should BMI be used to measure obesity in children?

Roy Benaroch, MD

Conditions

April 25, 2014

Stephanie wrote in about a very common problem:

My daughter is 4 years old. She isn’t the tallest cat in town (she is about the 15th-25th percentile for height), and her BMI always ends up being in the high range (like over 85%). I worry about it. I am very health conscious for myself and my family. We live by all of the “rules.” And yet.

The family doctor doesn’t worry — …

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Should BMI be used to measure obesity in children?

The Medicare spending we should be concerned about

Leslie Kernisan, MD, MPH

Policy

April 24, 2014

“Do patients care about how much money their doctors make?”

This is the headline of a recently published post by Trudy Lieberman, and was written in response to the recent New Your Times’ coverage of Medicare disclosing payments to individual providers.

Now, I found the Times story fascinating on many levels, but I’ll admit it hadn’t occurred to me that the main value of this data release is that patients can …

The deadly consequences of media distortion in health and medicine

David L. Katz, MD

Physician

April 24, 2014

The recent concentration of misleading media hooey about health has been excruciating, but the problem is perennial. I trust I needn’t make the case that you are under constant assault by distorted, contorted, titillating, and insipid headlines. This is certainly true in my domain of health and medicine; it may well be true more generally, but I tend to limit my commentary to the realm of my actual expertise. But to …

Sluggish cognitive tempo is a dangerous diagnostic idea

Allen Frances, MD

Conditions

April 23, 2014

Sluggish cognitive tempo may possibly be the very dumbest and most dangerous diagnostic idea I have ever encountered.

And I have seen some beauts during my forty years of shooting down crazy new diagnostic dream lists. The wild suggestions are usually created by “experts” brim full with diagnostic exuberance — sometimes well meaning, sometimes influenced by extensive drug company affiliations — and always ungoverned by simple common sense, a respect for …

What do European doctors say about our guidelines for statins?

Janice Boughton, MD

Meds

April 23, 2014

In November of last year the American Heart Association released to recommendations on who should be taking statins (drugs like Lipitor/atorvastatin), the most common medicines we use to control cholesterol levels. High cholesterol levels are associated with higher risk of heart attacks and strokes, and taking statins, which lower cholesterol, can reduce those risks. The drugs have pretty significant side effects, though, and not everyone with high cholesterol or …

Doctors and nurses are being overloaded with menial tasks

Jordan Grumet, MD

Physician

April 22, 2014

I’m no economist. In fact, I have never taken any business or accounting classes in my life. But it doesn’t take a formal education to get this. We are speeding down the wrong path.

The call at three in the morning woke me from a deep sleep. I fumbled and strained to hear the whispered voice of the apologetic nurse. Apparently Mrs. …

Physician suicide letters

Pamela Wible, MD

Physician

April 21, 2014

I asked why physicians were dying by suicide. Here’s what they told me:

“I definitely graduated from med school with PTSD. It has changed me forever. My mom’s friend that I have known since I was born saw me for the first time since I went to med school and she [told my mom], “She has changed so much. Was it worth …

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Physician suicide letters

Real men don’t leave their wives right after birth

Justin Morgan, MD

Physician

April 20, 2014

News broke recently that Daniel Murphy, second baseman for the New York Mets, recently took two days off for paternity leave, causing him to miss Major League Baseball’s opening day and the season’s second game to be with his wife and child.

Mike Francesa, a popular New York sports radio personality, devoted about 20 minutes of his Wednesday broadcast on WFAN to a rant against paternity leave. According to him, a …

Can one have a voice without vocal cords?

James P. Thomas, MD

Conditions

April 20, 2014

I have a set of wind chimes hanging from an arbor that catch my attention whenever I am out in the garden and the breeze kicks up. They were given to me by Mrs. Mary Marlboro’s niece. Mary had purchased them while in hospice with instructions for her niece to give them to me after she passed on. I had cared for Mary for several years after I removed her …

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