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Violence and severe mental illness: 6 questions to ask

Physician

March 17, 2013

Recently one of our readers posted this comment:

“If any Shrink Rapper ever has the time and inclination it would be interesting to read about what you would do to fix the mental health system, particularly the issue of involuntary hospitalization, if you had unlimited funds and political resources. You’ve been in the trenches, it would be great to hear your thoughts.”

Over on Peter Earley’s blog I see that …

How to avoid becoming a gunner in medical school

Wayfaring MD

Education

March 15, 2013

gunner: a pre-med or medical student who is ambitious to a fault. They often throw other students under the bus, put their accomplishments and grades on display, and generally make life miserable for any student who they perceive to be a threat to their own success. In short, they are what Hermione would be if she was a Slytherin.

On my blog, I am fairly vocal about my disdain for gunners. They …

The act of incising human flesh is never routine

Sid Schwab, MD

Physician

March 15, 2013

Next in a continuing series.

The preliminaries are over. Sponges, needles, and instruments have been counted and checked, their number recorded on a whiteboard on the wall, as well as a clipboard. The checkoff is a comforting hum of words; the tuned machinery of the workplace. As the bottle of local is opened and poured into a sterile bowl on the …

My workflow for going through old paper charts

Leslie Kernisan, MD, MPH

Physician

March 14, 2013

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A few months ago I wrote a post about the 159 page digital fax that I received, containing records for a patient’s recent lengthy hospitalization.

I’ve now discovered something even more time-consuming and annoying: a 202 page paper record mailed to me by a major medical system. (I won’t name names right now; suffice to say this system uses Read more…

My workflow for going through old paper charts

Doctors: Pronounce the names of your patients correctly

Deep Ramachandran, MD

Physician

March 13, 2013

I have it on good authority that it’s not easy being green. But I’m willing to wager that it’s a whole lot easier when you have a lovable name like “Kermit.” Imagine being green (or brown) with a name like “Ramachandran”? Growing up with a name like mine certainly had its disadvantages. While most neighborhoods have a local bully who kicks ass and takes names, in my case, he would …

Working in an urgent care center: An assault on the soul

Richard Young, MD

Physician

March 12, 2013

I recently received this email message from one of my residents who has moonlighted in a local commercial urgent care center. This message is reprinted with his permission just as I received it, except I removed the brand name.

Hey Dr. Young, I’m looking for some basic mentoring advice. I’ve been moonlighting at ZZZ Urgent Care for about a year. Not my favorite work, but oh well. I don’t routinely prescribe antibiotics …

Read more…

Working in an urgent care center: An assault on the soul

Let no broken hip go unfixed: When a surgeon fails to communicate

John Schumann, MD

Physician

March 10, 2013

She was 94-years old with advanced Alzheimer’s. She thought it was 1954 and asked if I wanted tea. Not a bad memory for someone in a hospital bed with a broken left hip.

She’d fallen at her assisted living facility. It was the second time in as many months. She’d broken her collarbone on the previous occasion.

Over the past year, she’d lost 30 pounds. This is natural in the progression of …

When it comes to medical residents, patients have a choice

Shirie Leng, MD

Education

March 8, 2013

A resident is a person who has an MD, meaning they have completed 4 years of school, but they are not yet qualified to actually do anything. An MD is just a piece of paper saying you did your time in the lecture hall/lab. Residency is where you learn how to be a doctor. The term “resident” originates from the old days in which newly-minted doctors were actually living at …

You may be surprised at what family physicians do

Aaron George, DO and Dennis Gingrich, MD

Physician

March 7, 2013

There are surprising misconceptions about what family physicians actually do in practice.

Americans maintain a fond respect for the classic image of the family physician, making house calls with black handbag in tow. They admire the Marcus Welbys of the world. While this classic image is endearing, it should not be confused with the 21st century family doctor. The modern family physician is trained to engage in the adaptable world of health …

Medical journals that accept stories and essays from physicians

Louise Aronson, MD

Physician

March 6, 2013

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Health and health care are hot topics lately, and not just for journalists and bloggers debating Obamacare. Suddenly – or so it seems; in fact the trend has been building for years – people from all walks of life want to read about medicine.

Within medicine, a majority of journals now have essay, viewpoint, or perspectives sections. Not only are such sections frequently …

When doctors dissociate themselves from the stories of their patients

Raminder Nirula, MD, MPH

Physician

March 6, 2013

As trauma surgeons we often have to disassociate ourselves from the stories that surround our patients so that we can focus on their life-threatening injuries. It’s also how I personally cope with the devastating injuries to the patient and the aftermath left for the family. Sometimes, though, I am caught off guard and my defenses aren’t strong enough.

A middle-aged man was brought in one evening after being hit while riding …

5 reasons why you shouldn’t go into medical school

Brian J. Secemsky, MD

Education

March 2, 2013

The gall, you might think to yourself as you click on this link in disgust.

Before you write that brutal retort which I may/may not deserve, some simple disclaimers before we tackle this subject:

This is not a ruthless attempt to crush your dreams and passions
This is not an op-ed on our current healthcare system
This is targeted towards individuals who are considering medical school in order to practice clinical medicine
This is being …
Read more…

5 reasons why you shouldn’t go into medical school

Why energy drinks should be considered stimulant drugs

Kevin Pho, MD

KevinMD

March 2, 2013

A version of this column was published on February 3, 2013 in USA Today.

I’m seeing more patients than ever consume so-called “energy drinks,” a rapidly emerging class of beverage which promise to increase energy, improve alertness, and boost attention span. The energy drink business is booming, with more than $12 billion sold last year, eclipsing established beverage categories like iced tea …

The baby had a seizure: Why was the mother smiling?

BirdStrike, MD

Physician

March 1, 2013

My first night shift in a stretch of 7 was almost over. It was 6:15am and I had to keep moving otherwise the minute I would stop, my eyelids would drop like two ton shades and I’d fall asleep. That never makes for a good drive home after a night shift.

“Got time to see one more?” asked Jenny the nurse.

“Do I have …

What can nurses learn from doctors?

Meaghan O'Keeffe, RN

Physician

March 1, 2013

There’s a lot nurses can learn from doctors.

There I said it.

But I’m not talking about clinical ability or medical knowledge. I’m talking about expectations. I’m talking about basic behaviors that dictate a predictable response.

Nurses don’t feel valued. Much of this is warranted, but I argue that some of it is self-inflicted. I said this once to a colleague and she responded, “But that places the blame on the nurse.”

I disagree. …

Read more…

What can nurses learn from doctors?

Sending your child to the chiropractor: Be very careful

Roy Benaroch, MD

Physician

February 28, 2013

There are plenty of things we don’t know about health and illness. Sure, we know a lot more than we did fifty or a hundred years ago—but every day, still, I have questions that aren’t yet answered. I read a dozen or so journals each month. (I know. Nerd.) Each one has at least ten or so good quality studies—good, …

5 reasons why mobile health apps fail

David Lee Scher, MD

Tech

February 24, 2013

There are an estimated 15,000 medical apps presently on the market and is expected to grow 25% per year according to one study. There are issues which are common in the development of these apps and other categories of apps. However, some technical and non-technical issues are unique to the sector. As someone who does not design apps, …

Read more…

5 reasons why mobile health apps fail

Toradol in sports: A culture change is needed

Michele R. Berman, MD

Meds

February 23, 2013

Former Boston Red Sox closing pitcher Jonathan Papelbon may have opened up a can of worms with his remarks about his frequent use of the injectable anti-inflammatory drug Toradol (ketorolac) during his time with the Red Sox.

Papelbon, who now plays for the Philadelphia Phillies, told ESPNBoston.com that several Red Sox players were frequently injected with the drug:

“It was kind of …

Read more…

Toradol in sports: A culture change is needed

Why physicians tend to decline CPR and other heroic measures

Maria Yang, MD

Physician

February 22, 2013

Radiolab recently aired a show called “The Bitter End” that discusses the end-of-life care preferences of physicians and non-physicians. Physicians are much more likely to decline “heroic” measures, such as CPR, mechanical ventilation, feeding tubes, etc. This comes as a surprise to the hosts and, presumably, to other non-physicians. It’s a good show. I recommend it. (Full disclosure: I like Radiolab.)

In the show, Ken Murray argues that …

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