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The male gynecologist: Tips to connect with female patients

Physician

April 12, 2013

With all due respect to the many caring, compassionate, and skilled male OB/GYN physicians out there, we’d be amiss in ignoring the research showing a near majority of younger women preferring a female gynecologist. Some call this reverse discrimination in gynecology. I’d more simply call it patient preference. The bigger question is, “Where does this leave the male gynecologist?”, especially in a current marketing climate promoting the “female only” OB/GYN …

Increasing the role of nurse practitioners in the inpatient setting

Gene Uzawa Dorio, MD

Physician

April 12, 2013

We are fortunate in our country to have the best medical technology in the world. Unfortunately, delivery of this technology, reflected in a worldwide healthcare ranking of 37th, is a disservice to the American people and must be rectified especially when Cuba is ranked 39th.

As provisions of the Affordable Care Act are put in place, a daunting factor is the shortage of doctors who will be needed to provide this …

Beauty in surgery: Traction and counter-traction

Sid Schwab, MD

Physician

April 11, 2013

Next in a continuing series.

Traction and counter-traction: along with maintaining excellent exposure, that is one of the fundamental principles of operating. It’s Newtonian: equal and opposite. In nearly all forms of surgical dissection, there’s a need for some pull in the opposing direction: tissues that are a little stretched-out, that are under some tension, fall open more easily when dissected. Plus, it’s a form of stabilization, another obligatory …

Roger Ebert did not lose his battle with cancer

Michael A. Wosnick, PhD

Conditions

April 11, 2013

Roger-Ebert_612x451

I was very saddened to learn of the death of Roger Ebert. I, like so many around the world, was impressed and inspired at how he handled himself in the aftermath of his cancer surgery years ago that left him disabled and disfigured and unable to eat, drink or speak. And yet, despite his struggles he remained a dominant force in film …

A memorable introduction to the family

StorytellERdoc, MD

Physician

April 10, 2013

Although I rarely get sick with the numerous strains of “bugs” that seem to go around our community this time of year, the week prior to my return to work for my next scheduled string of four shifts was spent mainly in bed, coughing and aching and whining about how miserable I felt. Fully recovered, though, I was excited to return to the emergency department to do my fair share …

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A memorable introduction to the family

The real reason to be cautious about Z-Paks and azithromycin

Albert Fuchs, MD

Meds

April 10, 2013

The FDA issued a warning about the antibiotic azithromycin (Zithromax). The media stories have some patients terrified and some of them are calling me convinced that azithromycin is poison, a reliable agent for suicide.

What’s the hubbub about?

Azithromycin is in a family of antibiotics called macrolides, which also includes erythromycin and clarithromycin (Biaxin). Erythromycin and clarithromycin have long been known to very rarely cause fatal abnormal heart rhythms. It …

Doctors and nurse practitioners: We’re failing the reality test

Yul Ejnes, MD

Physician

April 9, 2013

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A guest column by the American College of Physicians, exclusive to KevinMD.com.

Over the past several months, I have covered some controversial topics, such as electronic health records and the overuse of diagnostic testing. For this month’s column, I will address a less provocative topic: the role of non-physician providers …

The best doctors teach their patients

James C. Salwitz, MD

Physician

April 8, 2013

The Oxford English Dictionary (OED) identifies the first use of the term “doctour”, as the year 1303 AD, shortened to “doctor” in the 1557 addition of the Geneva Bible. The OED first defines doctor not as a caregiver or healer, not as a science researcher or expert and not even as one with an advanced educational degree. The OED, the world’s foremost English language dictionary, defines “doctor,” 700 years ago …

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The best doctors teach their patients

4 ways asynchronous learning can benefit medical students

Karan Chhabra

Education

April 6, 2013

Dr. Chris Nickson recently asked, if a Martian landed on Earth and looked at how we do medical education, what would she think?

Could it really be true that so many dedicated, brilliant people with the same objectives could be doing exactly the same thing at the same time without sharing their resources? … That they could put so much work put into teaching sessions that so few actually …

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4 ways asynchronous learning can benefit medical students

Blaming others for their health problems helps no one

Jennifer Middleton, MD

Physician

April 5, 2013

I inherited motion sickness from my father’s side of the family. I can’t sit in the back seat of a car for more than 10 minutes without becoming sick. I take meclizine before every plane flight.

I inherited asthma from my mother’s side of the family. Exposure to perfume, 90+ degree temps with 90+% humidity, or even a good laugh will all prompt me to cough.

These two maladies of mine have …

The only thing that truly separates doctors from nurses

Shirie Leng, MD

Physician

April 3, 2013

Academic Medicine, a journal of the American Association of Medical Colleges, has sent out a recent call for articles addressing the 2013 question of the year: “What is a doctor? What is a nurse?” Thirty years ago this would have been an absurd question. Not only would it have been absurd for doctors and nurses, but for patients too. Roles were …

5 essential concepts to know about code status

Brian J. Secemsky, MD

Conditions

April 3, 2013

Full Code. Do not resuscitate. Do not intubate.

Ask anyone without a personal or family history of a hospitalization on the implication of these terms and you’d likely get a blank stare in response.

Unfortunately, this incomprehension often rings true with those who need to know it most: the hospitalized patients themselves.

Many clinical reports (see here and here) have demonstrated that most physicians are not only inadequate in discussing code status with …

Writing your medical school personal statement: Tips and myths

Jessica Freedman, MD

Education

April 2, 2013

“I have no idea what to write.”

“I want to stand out.”

“I want to be different.”

“I want to have a theme.”

These are all comments I hear from medical school applicants as they start thinking about what topics to include in their medical school personal statement. I find that applicants often feel pressured to be unique and to write something the medical school admissions officer has never read before. But if you …

Questions to ask when considering new medical technology

Leslie Kernisan, MD, MPH

Tech

April 2, 2013

“Hey doctor, what do you think about this product/solution/service?”

These days, I look at a lot of websites describing some kind of product or solution related to the healthcare of older adults. Sometimes it’s because I have a clinical problem I’m trying to solve. (Can any of these sleep gadgets provide data — sleep latency, nighttime awakenings, total sleep time — on my elderly patient’s sleep complaints?)

In other cases, it’s because …

Are physicians more afraid of death than the general population?

Benjamin Corn, MD

Physician

April 1, 2013

The cavernous hospital amphitheater in Tel Aviv, normally used to screen videos and new surgical procedures, was illuminated only by tea candles floating in decorative dishes of water on a recent Wednesday in January. Hundreds of doctors, nurses and other medical personnel filled the seats, as usual. But we had not come to learn the latest life-saving technique.

Dr. Ofira Ben-Tal, one of Israel’s leading hematologists, had lost her battle with …

Am I smart enough for family medicine?

Raymond Tsai, MD

Education

April 1, 2013

I’m not sure why my parents were surprised when I told them that I was applying to go into family medicine. It seemed like a logical transition after spending six years working in public health and primary care before medical school, but from the perspective of Taiwanese immigrant parents, I couldn’t have made a more absurd career choice. I was confronted with comments such as, “Most people choose careers to make …

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Am I smart enough for family medicine?

Clinical pearls that you don’t learn during medical training

David Sack, MD

Physician

March 29, 2013

Al Franken, the humorist-turned-senator, once published a book that was titled “Oh, the Things I Know!” Indeed, by the time we reach parenthood, it is truly amazing what we keep up there in that attic of a brain.

Here is a brief selection of things about the practice of medicine that I have had to discover for myself or never quite figured out, including clinical pearls, aphorisms, dictums, platitudes, mysteries and …

Where can doctors publish literary writing?

Louise Aronson, MD

Physician

March 29, 2013

There are many ways to write about health, medicine, and health care. And there are many people – patients, caregivers, policymakers, pundits, thought leaders, and health professionals – in a position to do so.

Fortunately, the world also offers a similar and growing diversity of places in which to publish this sort of work.

My focus today is more, well, literary.

I know the word “literary” often …

Why coroners should fill out death certificates

WhiteCoat, MD

Physician

March 27, 2013

I happened to read an article in the Columbus (Ohio) Dispatch where Ohio coroners are complaining because some doctors, including emergency physicians, are refusing to sign death certificates listing a patient’s cause of death. The coroners are concerned because they are being “burdened” with hundreds of extra cases every year that they must handle. And if other doctors don’t sign off on the cause of death, sometimes it takes two …

The resurrection of coenzyme Q10: It’s all about the money

David L. Katz, MD

Meds

March 26, 2013

A recent meta-analysis published in the American Journal of Clinical Nutrition suggests that coenzyme Q10 is of benefit in congestive heart failure. For those who like the idea that food and nutrients can be excellent medicine, this paper is interesting at the very least. But there is a case to be made that it is far more than that. There is a case to be made …

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