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Is it necessary for a doctor to examine you on each visit?

Physician

March 5, 2012

A tug-of-war is going on in medicine right now between the past and the future. The present is confused and very unsure of itself.

Though I could be writing about health care in the U.S and the looming Supreme Court battle over the new health care law, I’m actually raising a much more intimate issue: Whether your doctor touches (examines) you or not.

Many pundits have weighed in on whether the …

Are anesthesiologists the last true generalists?

Karen S. Sibert, MD

Physician

March 3, 2012

There’s been a great divide between the medical and surgical specialties ever since I can remember. Surgeons believe internists perseverate too much when decisions need to be made. Internists consider themselves the true intellectuals of medicine. I suppose anesthesiologists like me fall somewhere in the middle–we work in surgery, but have to take care of all the medical problems the patient brings to the OR table. Does that make us …

Residency interview tips from a Chief Resident

Gopi J. Astik, MD

Education

March 2, 2012

I never realized before how much work goes on behind the scenes to prepare and conduct these interview days, but I sure do now. As a Chief Resident, I schedule residents to attend the applicant dinners, lunches, and tours, and to spend time with the applicants our lounge. This makes the actual interview days go by much smoother, because two of us are present at all times to speak to applicants and answer any …

A sick care system instead of a health care system

Stephen C. Schimpff, MD

Policy

March 1, 2012

An excerpt from The Future of Health Care Delivery.

We Americans like to pride ourselves on having the best health care system in the world, but unfortunately that is not the case. We have a medical (that is, sick) care system—a system that waits until we become ill before it kicks into action—instead of a health care system focused on helping us stay healthy. We give lip service to prevention and, …

6 reasons why applicants fail to get into medical school

Jessica Freedman, MD

Education

February 28, 2012

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Every year medical school applicants feel confused and in the dark about why they have been rejected by medical schools. They do not understand what they did wrong or what they need to do differently when they reapply. Whether you are a premedical student trying to make sure to “do everything right” or a medical school applicant who has not yet …

Taking care of patients is a great honor

Elizabeth Breuer, MD

Physician

February 26, 2012

As my husband and I try and make a long term financial plan for paying off my almost $200,000 in loans from medical school, I sit here wondering, why did I pay 200 grand so that I can get peed on, pooped on, bled on, screamed at and sworn at? I’ve delivered a baby without gloves on (it was an emergency). I’ve been kicked so hard I almost fell off …

Doctors need to stop being so complacent

Anonymous

Physician

February 24, 2012

Four brutally honest declarations:

1. I can perfectly decide what is best for myself, my family, my patients, and my practice. I don’t need outside guidance telling me how to lead.

2. I decide what works best on my terms to practice the best medicine.

3. I will succeed and lead because I am focused on my goals just as much (if not more) than my patient’s goals.

4. My goal is to make …

Why maintaining a distance is necessary for doctors

Michelle Au, MD, MPH

Physician

February 24, 2012

You would think that for doctors, who work with life and death issues every day, the issues of our own frailties or the tenuous line between health and sickness for our own families would be, if not accentuated, then at least more immediate than to those who, say, do investment banking for a living. But the strange thing is that despite our easy familiarity with human mortality, it is not …

Impersonal communication on the Internet fuels cyberbullying

Dominic A. Carone, PhD

Tech

February 22, 2012

In the old days, bullying used to consist of name calling or physical aggression from someone in a position of power over another, typically from a roughly similarly aged peer group. The bullying could be mild such as occasional name calling and having one’s books knocked down when walking in the hallway. This does not mean the effects of the bullying were mild but comparatively speaking, this is generally not …

Why are labor and deliveries closing?

Vivian E. von Gruenigen, MD

Policy

February 18, 2012

Labor and deliveries are slowly closing across the United States: California, Pennsylvania, and Ohio. In regional areas where there have been no closures, conversations in hospital boardrooms are probably questioning whether they should be. But why? Because of health care reform, increasing medical expenditures, hospitals are making less money due to reduced reimbursement, and because of the financial margin of obstetrics. To explain the complex answer further, we need to …

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Why are labor and deliveries closing?

A Grammy artist with Tourette Syndrome

Michele R. Berman, MD

Conditions

February 17, 2012

Would you consider a career as a singer if you had involuntary tics from Tourette Syndrome?

Well, it apparently didn’t stop 20-year-old Contemporary Christian musician Jamie Grace.

In fact, Grace attributes singing with helping her cope with her disease.

And now she is being rewarded with a Grammy nomination for best contemporary Christian music song, Hold Me. The song features TobyMac, who is a Grammy winning Christian recording and hip/hop artist. He …

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A Grammy artist with Tourette Syndrome

Reward or punishment in medical training

Christopher Johnson, MD

Education

February 17, 2012

Like many of my colleagues, I teach and supervise students, residents, nurses, and respiratory therapists. I’m also the medical director of a PICU. Overall, I’ve been teaching and doing administration for over 30 years. And, like most of my colleagues, I never received any formal instruction at all in how to do these things. To some extent I got help from my own mentors, primarily by watching what they did, …

Plastic surgery is part of the ENT surgeon repertoire

Mike Armstrong, MD

Physician

February 16, 2012

Do ear surgeons perform facelifts? Absolutely!

And we perform nose surgery and throat surgery, too!

A recent article in the New York Times presented a scathing editorial on complications caused by poorly trained surgeons. However, the implication of the title “Ear surgeons performing facelifts,” is misleading and overlooks the fact that a large portion of training in the specialty of ear, nose and throat surgery includes plastic and reconstructive surgery of …

Why we need truth in labeling of medical conditions

Toni Bernhard, JD

Conditions

February 16, 2012

Labels matter. We quickly form judgments based on them. If we hear someone called lazy, the label “lazy person” attaches in our mind even though we may not have even met the person. The same is true for labels given to various medical conditions. If the label for an illness uses language such as “fatigue,” we abstract from our experience and think we know what it’s like to suffer from …

The psychological basis of Morgellons disease

Dominic A. Carone, PhD

Conditions

February 15, 2012

If you are like most people, you have probably never heard of Morgellons disease or Morgellons. The first reason you have likely never heard if it is because it is so bizarre and uncommon. Most of what is known about it is based on rare case reports or anecdotal stories. The second reason is because it is not recognized in the medical community as a legitimate medical disease. It is …

Why an anesthesiologist would be needed for organ donation

Anesthesioboist T., MD

Physician

February 13, 2012

I’ve only had to declare death a couple of times. Once in a three-year-old and once in an adult. In each case the heart had stopped beating. Death was clear.

Brain death is tougher to cope with, both clinically and psychologically. I imagine it would make anyone want to say, at some point, “Are you sure? Are you really sure? How do you know? How can you be sure?” Some times …

5 ways to avoid a misdiagnosis

Evan Falchuk

Physician

February 13, 2012

Billionaire Teddy Forstmann had been diagnosed with a serious form of brain cancer. There’s a tragic twist to the story: according to Fox Business News, Forstmann believes that for more than a year, he had been misdiagnosed with meningitis.

ABC News wonders, “How could such a misfortune befall a billionaire —- a man able to afford the best doctors, best technology and the most sophisticated diagnostic tests?”

They’re missing the point. …

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5 ways to avoid a misdiagnosis

6 things I wish I had known at the beginning of medical school

Rick Pescatore, DO

Education

February 9, 2012

It’s amazing how quickly you can lose track of time as you power through the books. Once everything is setup — coffee to the left, pens and highlighters to the right, Grooveshark playlist perfectly tuned — you can suddenly look up and realize that three weeks have flown by and there are 123 multiple choice questions to be answered in the morning.

Over the past year and a half, I’ve learned …

Why we should eliminate the diagnosis of ADHD

Steve Balt, MD

Conditions

February 8, 2012

I’m reluctant to write a post about ADHD. It just seems like treacherous ground. Judging by comments I’ve read online and in magazines, and my own personal experience, expressing an opinion about this diagnosis—or just about anything in child psychiatry—will be met with criticism from one side or another. But after reading L. Alan Sroufe’s article (“Ritalin Gone Wild”) in the New York Times, I feel compelled to write.

If …

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