How managed care caused the mental health care crisis

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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How managed care caused the mental health care crisis

Pros and cons of private or hospital owned practice

Physician
May 24, 2011

Private practices are organized in a corporate model where the physicians are shareholders, or where one or more physicians own the practice and employ other physicians or providers.   Private practices are almost exclusively for-profit.  Physician practices are organized into corporations for the tax benefits as well as protecting the owners from liability judgments.

Hospitals can be for-profit, not-for-profit …

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Pros and cons of private or hospital owned practice

Why confused, weak elderly patients are subjected to aggressive care

Physician
May 23, 2011

Lying on the backboard, a frail little old lady moaned with discomfort.

She had fallen beside her bed in the nursing home and was then tightly bound by straps onto the backboard, a cervical collar pushing her chin up and holding her immobile. A person not familiar with modern medicine might think the ensemble looked like a torture device. Indeed, it can …

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Why confused, weak elderly patients are subjected to aggressive care

Vascular diseases that present as obstructive atherosclerotic arterial disease

Conditions
May 23, 2011

by Joe F. Lau, MD and Jeffrey W. Olin, MD

Physicians who perform percutaneous endovascular procedures encounter a multitude of vascular diseases that may masquerade as obstructive atherosclerotic arterial disease. While atherosclerosis is clearly the most common condition seen, complex inflammatory, genetic or structural processes may either not be amenable to an endovascular approach or actually be harmful and thus lead to outcomes that are not …

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Vascular diseases that present as obstructive atherosclerotic arterial disease

The difficult road to becoming a doctor

Education
May 20, 2011

On May 15, 2011, 147 students embarked on their careers as doctors as they graduated from the University of Pennsylvania School of Medicine.

One student, Jenny Rowland, who will pursue a career in Radiology and continue her training at Penn, shared her personal thoughts and emotions as she prepared to graduate.

by Jenny Rowland, MD

I’m not a typical PennMed student.

I’m 31 years old, and I …

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The difficult road to becoming a doctor

Pay attention to the color and smell of your urine

Conditions
May 20, 2011

Most of us are uncomfortable talking about our waste products, urine and feces. However, changes in the color and odor may signify disease that can be treated or prevented. This article will review causes of discoloration of urine and when there is a change in the odor of urine.

For hundreds of years doctors have looked at urine as a barometer of what is happening in the body. The urine can …

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Pay attention to the color and smell of your urine

Going through Netter’s to teach medical students pelvic anatomy

Education
May 20, 2011

I recently had the opportunity to go to the anatomy lab and help the first years go through the pelvic anatomy.  What a blast!  There is nothing like dissecting a cadaver to tune up one’s surgical anatomy skills, and helping young eager medical students through it is a great experience.

Prior to going into the lab, I spent many hours going through Netter’s atlas to brush up on the anatomy so …

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Going through Netter’s to teach medical students pelvic anatomy

How real life medicine is less glamorous than residency

Physician
May 18, 2011

“Code Blue ICU … Code Blue ICU”

I was greeted by the PA system as I walked into the hospital this morning. A shiver ran down my spine as I quickened my pace . The days of running to codes are long gone. But since I have a patient In the ICU I was curious and just a little bit worried.

As I walked through the sliding doors I passed the room …

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How real life medicine is less glamorous than residency

Pros and cons of cloud based or web based EMR systems

Tech
May 18, 2011

As if medical practices don’t have enough to worry about with EMR implementation, now they have to decide what kind of EMR system to get: a client-server-based system or a web-based system. The former is the kind that most of us are familiar with. You purchase a computer server, buy a license for the EMR software, install said software on your server, …

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Pros and cons of cloud based or web based EMR systems

Prevent foot fractures while wearing heels

Conditions
May 17, 2011

As 30-year-old New Yorker Carrie Donnelly began her bachelorette party in her new black open-toe five-inch heels, she fell, her foot going one way and her ankle the other.

“When I woke up the next day, my ankle was throbbing and had become extremely swollen,” she said. It was a month before her wedding—the last thing she wanted to do was to walk down the aisle in a cast.

Super-high heels like …

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Prevent foot fractures while wearing heels

Transfusing a Jehovah’s Witness during surgery

Physician
May 13, 2011

I was in practice about five years and was about to do a radical nephrectomy on a patient.

I met with the patient and his son in my office and the son informed me that he and his father were Jehovah’s Witnesses and that he didn’t want his father to receive any blood or blood products before, during, or after surgery. I asked the father if that was his wish and he …

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Transfusing a Jehovah’s Witness during surgery

Why the ophthalmologist and optometrist conflict should concern patients

Physician
May 10, 2011

If you need laser eye surgery in the state of Kentucky, or a little cosmetic work around the eyelids, it now behooves you to ask your prospective surgeon the following question before signing the operative consent form:

“Say doc, did you go to medical school?”

Kentucky joined the company of Oklahoma earlier this year as the second state to conflate optometrists and ophthalmologists. Only ophthalmologists are the sort of doctors who graduated …

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Why the ophthalmologist and optometrist conflict should concern patients

Physicians coping after a medical error

Physician
May 10, 2011

A failed treatment, a surgical complication, a medical error, a patient death. When the going gets tough, even the toughest clinicians should get help.

Physicians and nurses who feel personally responsible for a medical error or a patient’s injury face an immediate quandary—their next patient. In the midst of your angst and guilt, do you suck it up and soldier …

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Physicians coping after a medical error

Recovery may be predicted with a perception of the inner pulse

Physician
May 6, 2011

An excerpt from The Inner Pulse: Unlocking the Secret Code of Sickness and Health.

by Marc Siegel, MD

The Pulse of Recovery

People are like stained-glass windows.  They sparkle and shine when the sun is out, but when the darkness sets in their true beauty is revealed only if there is light from within.
–Elisabeth Kübler-Ross

The inner pulse can keep beating—loudly—long after doctors, researchers, and their monitors predict …

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Recovery may be predicted with a perception of the inner pulse

Cooperation between patient and doctor is essential today in health care

Physician
May 4, 2011

There are many aspects to being a doctor. Just as important are the many aspects that go into being a patient. Of course, the difference is that one has been perceived as being a position of power and the other one has not. I don’t believe this distinction is useful or true in today’s world.

Patients and doctors work …

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Cooperation between patient and doctor is essential today in health care

Explaining why belief in pseudoscience is often evidence resistant

Conditions
May 4, 2011

What links belief in tarot cards, UFOs and vaccine rejectionism? Yes, they are all forms of superstitious or magical thinking, but are there characteristics that predict who will believe in such nonsense? That’s one of the questions that psychologists Marjaana Lindeman and Kia Aarnio seek to answer in their paper, Superstitious, magical, and paranormal beliefs: An integrative model.

Lindeman and Aarnio postulate that believers in superstition, paranormal phenomena and pseudoscience make …

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Explaining why belief in pseudoscience is often evidence resistant

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