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 …
What it means to be sick as a medical student
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 …
Cultural attitudes influence the benefit from stem cell therapy
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 …
What will be your legacy as a physician?
There have been a couple of widely-publicized cases recently of physicians divulging patient information in social media. I’m sure the doctors involved did not intend to violate patient privacy.
While there are several excellent guidelines and policies on this topic, there isn’t a whole lot of practical advice, so here are my tips to help you avoid privacy violations (I hope this is the beginning of a conversation …
7 tips to avoid HIPAA violations in social media
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):
How to minimize the costs of surgery
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. …
5 easy steps to become a better medical student
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.
Read more…
Pain control in a patient with rib fractures and a spinal cord transsection
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, …
Practical advice for medical students starting clinical rotations
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 …
The legal issues of doctors and chiropractors working together
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: …
What happened inside the hospital during the Joplin, MO tornado
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, …
Should doctors be addressed by their first name?
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 …
Why doctors can’t screen patients for every disease
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 …
The three most useful words for a doctor
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 …
Doing the physical exam for the first time as a medical student
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 …
A psychiatrist on the compulsion behind running and exercise
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 …
Why you shouldn’t ignore a swollen knee
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 …
How managed care caused the mental health care crisis
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 …
Pros and cons of private or hospital owned practice
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 …
Why confused, weak elderly patients are subjected to aggressive care
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 …
Vascular diseases that present as obstructive atherosclerotic arterial disease
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