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ABIM Maintenance of Certification (MOC) internal medicine exam tips

Kevin Pho, MD

KevinMD

June 10, 2011

This past spring, I took the American Board of Internal Medicine (ABIM) Maintenance of Certification (MOC) exam.

7 weeks later, I received my results. Thankfully, I passed.

This was not entirely a surprise, as the pass rate for first-time test takers was 88%. But it definitely requires some studying. It’s not a gimmie.

Considering that I last took my board exam in …

A doctor’s letter to a patient with newly diagnosed cancer

Dr. Martin Young

Physician

June 9, 2011

Dear “Robin,”

Nothing in my career in medicine has prepared me for being a friend to someone with such a terrible disease. As a doctor I dispense advice on a daily basis, but those interactions remain strangely impersonal. With you, cancer has invaded our inner circle, and we all share your shock and despair.

No one can know exactly what it feels like …

Prices should be readily available to save hospitals money

Happy Hospitalist, MD

Physician

June 9, 2011

Hospital costs are out of control. We have an aging population living longer with more complicated presentation of disease. We have an insurance driven platform instead of a health driven accountability. The long term sustainability of that architecture is one of guaranteed insolvency.

One way or another hospitals are going to find their lifeline cut off. Medicaid is bankrupt. Hospital profit margins …

What it means to be sick as a medical student

Jessica Gold

Education

June 8, 2011

For the first time since I have been in medical training, I got sick.

Not just the kind of sick where its a cold, or you know that its stress, but the kind of sick that does not go away and randomly comes up just to make you mad when you just want to have fun (like …

Cultural attitudes influence the benefit from stem cell therapy

Stephen C. Schimpff, MD

Meds

June 8, 2011

Embryonic stem cells are present after a fertilized egg divides for two or three days. They have the seemingly miraculous ability to turn into any of the tissue types in the body—whether brain neurons, beating heart cells, bone, or pancreatic islet cells. It is important to understand just where these cells come from.

Those used in science are …

What will be your legacy as a physician?

Francine Gaillour, MD

Physician

June 6, 2011

I’ve heard some physicians wonder out loud if their career has been “wasted” – either because they were on a path that wasn’t a good fit or they spent years focusing on accumulating and worrying rather than on contributing and enjoying. The question is one of personal value: Am I measuring up? And by whose metrics?

How do you measure the value of your physician career? Dollars earned? Lives saved? Honors …

How to minimize the costs of surgery

Christopher Chang, MD

Policy

June 5, 2011

Surgery is expensive, there are no doubts about that. However, there are a few things a patient without insurance who desires surgery can do to minimize the costs as much as possible. Before going into cost-cutting measures, you first need to understand where the costs come from.

In rank order, the costs of surgery come from (highest to lowest):

Hospital Charges …
Read more…

How to minimize the costs of surgery

5 easy steps to become a better medical student

Aaron George, DO

Education

June 1, 2011

I recently had quite a long conversation with a college senior that was just accepted into medical school for this coming fall.

As a rising fourth year medical student myself, I would like to think that I have navigated the waters of academia and figured out both efficient paths to success and avoidance of roadblocks and setbacks. …

Pain control in a patient with rib fractures and a spinal cord transsection

Ralph Gordon, MD

Physician

June 1, 2011

When I was called to see the patient after a motorcycle accident I expected the worst. The patient sustained a thoracic spine injury with cord transsection at T5 level as well as significant chest wall injury on the right side.

Multiple ribs were broken; some with a significant displacement. Managing patients with a significant chest wall trauma could be a nightmare. Pain control is only one of the challenges.

Practical advice for medical students starting clinical rotations

Mary L. Brandt, MD

Education

June 1, 2011

Here’s some advice to think about before starting clinical rotations during the third year of medical school.

Don’t sit in the back of the plane

The basic sciences are important to learn the vocabulary and grammar of medicine. Clinical rotations are different – it’s where you actually learn to be a physician. If you use the analogy of learning to fly, …

The legal issues of doctors and chiropractors working together

Kevin

Physician

June 1, 2011

by Jeffrey L. Cohen and Albert R. Meyer

Chiropractors and medical doctors (or D.O.s) have had a long and somewhat complex relationship.

Though they approach healthcare issues differently, there are many instances where they share care or even work together. Such “M.D./D.C.” relationships are legally complex, but often prove to be rewarding in many respects. Properly constructing the arrangements is critical, especially since government regulators and payers tend …

What happened inside the hospital during the Joplin, MO tornado

Kevin J. Kikta, DO

Physician

May 31, 2011

joplin hospital tornado

Dr. Kevin Kikta was one of two emergency physicians on duty at St. John’s Regional Medical Center in Joplin, MO on Sunday, May 22, 2011, when an EF-5 tornado struck the hospital.

You never know that it will be the most important day of your life until the day is over. The day started like any other day for me: …

Should doctors be addressed by their first name?

Jennifer Middleton, MD

Physician

May 29, 2011

I was sitting next to a resident in the preceptor room yesterday. He was calling a patient to discuss lab results, and introduced himself on the phone by his first name and last name … but not with “Doctor.” (e.g., “Hi, this is John Smith from the Family Health Center.”)

I occasionally see the residents’ patients for urgent visits. When I ask them who their regular PCP is at the office, …

Why doctors can’t screen patients for every disease

Alex Lickerman, MD

Physician

May 26, 2011

I had a patient once who wanted an exercise stress test even though he had neither symptoms nor risk factors to suggest the presence of coronary artery disease (such as chest pain with exertion). I argued vociferously against it. However, extenuating circumstances (not relevant here) prompted our mutual decision to go ahead with it anyway. To our surprise and dismay, it came …

The three most useful words for a doctor

Dr. Martin Young

Physician

May 26, 2011

Here are the three most useful words for a doctor: “I don’t know.”

A close second would be “I’m not sure,” another three that have got me out of trouble more times than I can remember. The older I get, and more experience I have, the more useful it becomes.

Pattern recognition is essential in effective medical practice. So often patient complaints are vague and nondescript, and in the absence of physical …

Doing the physical exam for the first time as a medical student

Jessica Gold

Education

May 26, 2011

Armed with tools I have never used or seen before I entered a physical exam practice room for the first day of learning.

Having finished history-taking practices last semester, we were now beginning a new chapter, learning to take a head-to-toe physical exam. Before class began, we were told to read a book and …

A psychiatrist on the compulsion behind running and exercise

Jeffrey Knuppel, MD

Physician

May 25, 2011

I love running.

I typically run 3-4 miles a day 5 to 6 days per week. It’s only about a half hour of time, and it’s well worth it. I get ‘in the zone’ when I run, and I can tune out the rest of the world and enjoy just being. It feels great physically and mentally each time. It’s helped me immensely to stave off the obesity issues that have …

Why you shouldn’t ignore a swollen knee

Dr. Irwin Lim

Conditions

May 24, 2011

If you develop a swollen knee, please don’t consider it a normal occurrence.

If there was a clear cause, such as a fall to the knee, or some twisting injury to the knee, it’s likely that the cause is due to some mechanical damage. An easily recognized example would be a football or rugby player sustaining such an injury on the playing field. In that case, its typically serious and when …

Read more…

Why you shouldn’t ignore a swollen knee

How managed care caused the mental health care crisis

Kevin

Physician

May 24, 2011

by George H. Northrup, PhD

No one becomes a mental health professional—in my case, a clinical psychologist—for the financial rewards.

With comparable (or less) education, far more lucrative careers exist in law, business, or other health care specialties. Psychotherapy tends to draw practitioners who are fascinated by the mysteries of the mind and who find satisfaction helping others in distress. Money has typically been a …

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