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Physicians should be concerned about malingering

Conditions

January 15, 2012

Malingering is the intentional production of false or grossly exaggerated physical or psychological symptoms motivated by external incentives such as avoiding military duty, avoiding work, obtaining financial compensation, evading criminal prosecution, or obtaining drugs. The word “malingering” comes from the French word “malinger” meaning “poor or weakly” as these are the characteristics feigned or exaggerated by the malingerer. Malingering has been documented as far back as in the Bible when …

MKSAP: 25-year-old with diffuse muscle and joint pain

mksap

Conditions

January 14, 2012

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 25-year-old woman is evaluated during a follow-up visit for a 6-month history of diffuse muscle and joint pain above and below the waist, fatigue, and difficulty sleeping. She has a 2-year history of hypothyroidism treated with levothyroxine. Her only other medication is hydrocodone-acetaminophen, which has …

A guide for entrepreneurs to get a doctor’s attention

Rebecca Coelius

Tech

January 12, 2012

I’ve had the luck to attend medical school in the city of San Francisco during what will be looked back on as the start of transformational change in our health care system. My growing interest in technology and new business models as the disruptive forces behind this change, as well as marriage to a technology entrepreneur, has me frequently rubbing elbows with movers and shakers in the digital health space. …

How patients can remember their doctor’s name

Anthony Breu, MD

Physician

January 8, 2012

“Do you remember my name?”

Like a broken record, I repeat this question again and again as I make rounds in the hospital. My patients’ universal answer, given with furled eyebrows and an apologetic look is “uh, no, I don’t remember”.

My response: “Don’t worry. It’s Dr. Tony Breu, but call me Tony.” Theirs’ (again with furled brow, but also a smile): “Oh, okay.”

In a busy teaching hospital, it is not uncommon …

The 3 types of residents that medical students will encounter

Nonmaleficence

Education

January 6, 2012

Every medical student is a bit apprehensive when he/she knows they will be assigned a new resident. The same questions always come up. Will the resident be nice? Will they understand my busy schedule? Will they make me do a ton of scutwork? Will they make me write all of his/her progress notes? And maybe most importantly, will they let me leave early to study for boards or enjoy the …

Doctors: Don’t be ashamed about going bankrupt

Kevin Pho, MD

KevinMD

January 5, 2012

Are doctors really going broke?

According to this piece from CNN Money, some are: “Doctors list shrinking insurance reimbursements, changing regulations, rising business and drug costs among the factors preventing them from keeping their practices afloat. But some experts counter that doctors’ lack of business acumen is also to blame.”

That’s all entirely true.

Pressure on reimbursement, combined with a lack of …

Our healthcare system is unfair and unbalanced

Mark Ryan, MD

Policy

January 5, 2012

About six weeks ago, while in clinic, I developed pain in my stomach — specifically, in my right upper quadrant, just below the ribs. I had experienced this a few times before, but this time it seemed more persistent than usual. Following the rule that physicians make the worst patients, I kept working through it until my nurse told me I looked poorly, and made me see my own primary …

Requiring doctors to give orders on patients they have not seen

Steven Reznick, MD

Physician

January 4, 2012

To meet Federal patient satisfaction goals, our hospital administration is requiring community based physicians to give patient admission orders before we have a chance to see the patient. Patients who self-refer themselves to the emergency department, are evaluated by the emergency room staff, and who are determined to require admission must be admitted by their community physician within 20 minutes of receiving a call from the ER staff advising the …

Should healthcare providers hug their patients?

Dominic A. Carone, PhD

Physician

January 3, 2012

Imagine this scenario. You are a male health care provider and you complete an evaluation of a woman close to your age. You establish good rapport as you always do, she laughs at some of the same jokes you make with all patients, and she expresses delight that you are listening to her problems (unlike those other providers she says she has seen), feels you are helping her, and is …

Advice for doctors who want to change careers

Franz Wiesbauer, MD

Physician

January 2, 2012

An interview by MedCrunch with Ashley Wendel, MA, CMC, PDC, a Physician Executive Coach and Healthcare Organization Consultant dedicated to helping physicians create meaningful and sustainable change that positively impacts their professional lives.

MC: Thank you so much Ashley for your time!

Ashley: Thank you, I’m really happy to share anything I can.

MC: You are a physician coach, what are the most common problems you encounter in your practice?

Ashley: Well, for many …

What kind of shoes should you wear in the hospital?

Mary L. Brandt, MD

Physician

January 1, 2012

I got home recently after a 14 hour day in the operating room with (predictably) a pair of really tired feet, which lead me to think about shoes, foot rubs, and the fact that no one ever talked to me about this in my training.

What kind of shoes should you wear in the hospital?

There’s a lot of walking in the hospital, but there’s even more standing. Running shoes don’t provide …

Is ethical for parents to refuse surgical treatment for their child?

Christopher Johnson, MD

Physician

December 27, 2011

The principle of autonomy is one of the four guiding principles of medical ethics, the others being beneficence, nonmaleficence, and justice. It means that patients have the right to decide what is done to their own bodies. For children under eighteen, the age of majority, this means their parents decide for them. What happens when parents refuse a treatment that their child’s doctors recommend? (The right of a minor child …

The 7 types of medical students you’ll meet

Collin Creange

Education

December 24, 2011

The third year of medical school is definitely an interesting one. You leave the classroom and enter the big bad world of medicine, and you quickly realize that much of what you’ve learned is for naught. You also realize that the medical student next to you could become your best friend, or the bane of your existence — or fall anywhere along that spectrum. Here is a list of the …

Conflict between physician and nurse

Sarah Beth Cowherd, RN

Physician

December 19, 2011

When it comes to doctor- nurse interactions, when is enough, enough?

Recently, I dealt with an upsetting situation involving a physician and nurse. A little background: The nurse has been working on our unit for years (since it first opened). She is very smart and savvy when it comes to nursing. She constantly gets feedback from the patients as being one of the kindest, most thorough nurses. I look up to …

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Conflict between physician and nurse

Did hospital politics lead to physician suicide?

Skeptical Scalpel, MD

Physician

December 17, 2011

What causes a doctor to commit suicide?

A story about a radiation oncologist from Springfield, IL brought this strange case to my attention. Dr. Thomas G. Shanahan committed suicide by cutting his throat in November of 2011. He was respected in his field, having published many research papers and traveled the world helping to set up brachytherapy clinics in several countries. He also had been an acting alderman in his …

How political correctness interferes with healthcare

Dominic A. Carone, PhD

Physician

December 14, 2011

Political correctness and sensitivity training are interfering with medicine and healthcare. In a recent article published in the journal, Pediatrics, a group of researchers published their findings regarding parental perceptions of the terminology that doctors use to describe childhood obesity (ages 2 to 18). The researchers found that it was undesirable to use the term “fat,” “obese,” or “morbidly obese” because they were stigmatizing, blaming, and the least motivating to …

Saying no to your oncologist is sometimes the right thing to do

Lucy Hornstein, MD

Physician

December 11, 2011

Cancer is a dreadful disease. Just dreadful. Make no mistake: I have tremendous respect for the awesome doctors who treat patients afflicted with it day after day. Still, paradoxically, I can’t help but notice that some of them have just as hard a time as do other doctors with caring for patients at the end of their lives. I believe a large part of their difficulty stems from the ridiculously …

MKSAP: 42-year-old woman with lymphadenopathy, fatigue, and edema

mksap

Conditions

December 10, 2011

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 42-year-old woman is evaluated for a 3-month history of progressive cervical lymphadenopathy, fatigue, night sweats, bilateral lower-extremity and abdominal wall edema, and a 4.5-kg (10.0-lb) weight gain. History is significant for three episodes of weight gain and facial and lower-extremity edema lasting 4 weeks in …

The difference between a child psychologist and child psychiatrist

Roy Michael Stefanik, DO

Physician

December 8, 2011

What exactly is the difference between a child psychologist and child psychiatrist? The two terms are frequently mistakenly interchanged, but the requirements for the two are considerably different.

To become a child psychologist, many programs require that you get an undergraduate degree in psychology, although some graduate programs will only require that you take the prerequisite sciences courses (biology, physical and social sciences, statistics, mathematics, etc.) before applying for the graduate …

Young doctors don’t see value in primary care careers

John Schumann, MD

Physician

December 5, 2011

In my new role as one of the directors of an internal medicine training program, I help select new interns out of medical school for the three year training stint of residency.

At the end of residency, many graduates go on to subspecialty fellowships, another two to four year period of intensive training in fields like cardiology, nephrology, critical care etc.

For those that don’t choose a subspecialty, one choice remains: traditional …