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An orthopedic surgeon analyzes presidents’ skeletal maladies

Conditions and Diseases

January 21, 2020

I, along with some others, take Presidents Day as an opportunity to celebrate the lives and contributions of all U.S. presidents. Amid the praise, however, perhaps I alone feel compelled to describe their skeletal maladies. I have gleaned the following information from several websites and books that carefully detail the reported injuries, diseases, bad habits, and addictions experienced by U.S. chief executives throughout their lives, starting with George Washington’s …

Is obesity self-inflicted?

Anonymous

Physician

January 21, 2020

“Aren’t you happy for me?” asks the patient smiling from the exam chair in my office. I say yes, but that’s not entirely true.

Happiness isn’t the right word. Conflicted might be it. How do I reconcile my feelings when this patient, who I am not sure is deserving, reports that he was awarded Social Security disability?

Sure, he has severe arthritis, wildly uncontrolled diabetes, and a massive skin breakdown of his …

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Is obesity self-inflicted?

A physician’s 6-step money challenge for the New Year

Altelisha Taylor, MD, MPH

Physician Finance

January 21, 2020

As we embark upon this new decade, many of us are committed to improving our finances. We may have vowed to stick to a budget or have a general goal to live below our means. While these are noble goals, let’s challenge ourselves to do even more. Here’s my six step-money challenge for 2020:

1. Buy 1 or 2 finance books to read. There are many different ways to …

How to manage the side effects of prostate cancer treatment

Miles J. Varn, MD

Conditions and Diseases

January 21, 2020

Prostate cancer is the second most common type of cancer diagnosed in men in the U.S. According to statistics gathered by the American Cancer Society, approximately 191,930 new cases of prostate cancer will be diagnosed in this country in 2020, with one in nine men at risk of being diagnosed with this cancer during his lifetime. While advanced or aggressive disease can lead to death from prostate cancer, most men …

What to do if your doctor is excessively egotistical

Christopher Johnson, MD

Physician

January 20, 2020

Egotism is a common trait among doctors, although most of us keep it under adequate control when dealing with patients. The ideal doctor-parent encounter has been described as a collaboration among equals, each of which brings expertise to the exchange; the doctor knows medicine, the parent knows the child. This is the ideal, although sometimes the reality falls short of it. The way our medical system is now structured gives …

Why sometimes you need to be your family’s doctor

Karen Yeter, MD

Physician

January 20, 2020

My uncle died last year. As physicians, we are all too familiar with death. Even if we are practicing primary care, we are touched by death and the line between life and death. That patient who had what statistically should’ve been acid reflux, but who you found to have stomach cancer. That breastfeeding mom who thought a little lump was a clogged milk duct, when it actually turned out to …

Your grocery cart on WIC

Hanna Saltzman

Health Policy

January 20, 2020

Karen smiled nervously, her swollen belly peeking out from under her stretched silver tank top. Six months pregnant with her first child, the eighteen-year-old had come to the WIC (Women, Infants, and Children) office for help with getting enough to eat. As a medical student with a background in nutrition advocacy and a future in pediatrics, I had asked to observe the WIC enrollment process.

Karen and …

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Your grocery cart on WIC

The power of peer mentorship in medicine

Stephanie Lovinsky-Desir, MD

Physician

January 20, 2020

If you asked me five years ago what my career goals were, I may have said something about getting more grant funding and writing more manuscripts so I could eventually become an independently funded physician-scientist. But honestly, at that time, I had no concept of the nitty-gritty details and emotional support that it would take to accomplish those goals. My primary research mentor was a notable figure in our field …

The one word that carries so much weight in the cancer experience

Anne Katz, RN, PhD

Conditions and Diseases

January 19, 2020

The patient was well over 6 feet tall and looked like he had recently lost weight. When he took off his winter coat and hung it over the back of the chair, I could see his scapulae like wings under his sweater. He folded himself into the chair and carefully crossed his legs. He sighed softly as he arranged his …

Why experience and skills are not enough

Neil Baker, MD

Physician

January 19, 2020

Experience and skills are not enough to assure the highest levels of success and sustainability with improvement initiatives in healthcare. The reason this is true has to do with … quicksand.

When I was a kid, quicksand seemed to show up in movies quite a bit. People would be on the beach or in the jungle walking on what seemed like solid ground and suddenly get stuck. In quicksand, you lose …

Only Biden, Bloomberg, and Buttigieg have health plans that have a realistic chance of becoming law

Robert Laszewski

Health Policy

January 19, 2020

In an earlier post, I pointed out that there is no better chance of passing a Medicare for all health care plan through Congress in the coming years than there was in 1977, or 1993, or 2009.

Then Elizabeth Warren showed us just how politically unrealistic single-payer health care is when she released her funding plan and then quickly backtracked to the public option …

Finding meaning in the intersection between marriage and medicine

Charles Feng, MD

Physician

January 19, 2020

When I first saw Jea-Hyoun, in a medical meet-cute straight out of a romantic comedy, she was being evaluated for thyroid cancer. I was an allergy/immunology fellow harried by a pile of paperwork. She was a patient, in the same building where she saw patients of her own as a psychiatry and family practice resident, preparing to see the specialist. We made awkward small talk in the hallway before she …

Telemedicine overprescribes antibiotics: Are you really receiving the best care over the phone?

Roy Benaroch, MD

Physician

January 18, 2020

You’ve seen the ads, and you may have even gotten a flyer in the mail directly from your insurance company. Use an app to make a quick video call to get the medical care you need. No waiting rooms, no appointments, no having to be touched, or even sit in a room with a physician – just the magic of the internet, and you’ll get what you want.

But will you …

Can a unique boarding home save my patient?

Raymond Abbott

Conditions and Diseases

January 18, 2020

James is a tall, lanky Caucasian man, well into his 40s. He has brown curly hair and is not a bad looking fellow except for the vacant look in his large brown eyes. He is a pacer, which is a manifestation of his illness, and a consumer of excessive amounts of water.

You have to talk right at James to be understood. I try to make eye contact. Sometimes he doesn’t …

MKSAP: 23-year-old woman with 2 weeks of painful lumps on her legs

mksap

Conditions and Diseases

January 18, 2020

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

A 23-year-old woman is evaluated for 2 weeks of painful lumps on her legs. The lumps persist for several days and make it difficult for her to go to work as a waitress. She is a college student in Ohio where she has lived her whole life. …

Stop the war on PAs and NPs

Brent Lacey, MD

Physician

January 18, 2020

I think it’s time for physicians to end the assault on the clinical practices of PAs and NPs.

Are you worried about PAs and NPs taking your job? If you’re a good doctor, you should stop worrying. Great PAs and NPs are everywhere, and I think it’s time physicians embraced them.

PAs and NPs have excellent skills

My first rotation as a third-year medical student was in the emergency department. There was a …

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Stop the war on PAs and NPs

Keep insulting doctors, and good luck finding a physician in 10 years

Karen S. Sibert, MD

Physician

January 17, 2020

If physicians are “muggers” and co-conspirators in “taking money away from the rest of us,” then journalists and economists are pontificating parasites who produce no goods or services of any real value.

I don’t think either is true, but the recent attacks on physicians by economists Anne Case and Angus Deaton, and “media professional” Cynthia Weber Cascio, deserve to be called out. You …

Watching is incredibly important. I know this as a physician.

Edwin Leap, MD

Physician

January 17, 2020

I sometimes work as a church security volunteer. And when I do it, I get to simply stand and watch. Watch for someone sick or injured (we have defibrillators and wound care equipment). Watch for someone coming to cause harm. Watch in order to call the police. Watch to keep the children safe.

And it occurs to me, when I do it, that watching is incredibly important. I know this as …

Changes are coming to health care in 2020. Are you ready?

David Conejo

Health Policy

January 17, 2020

Of the nation’s 3.5 trillion in annual health care spending, 90 percent is for people with chronic and mental health conditions. How long can this continue? Can health care institutes afford not to engage in the 2020 wave of preventative care health care disruption? For those riding the disruption wave, the answer is simple. CMS alone is providing more than 80 billion in reimbursements for preventive care …

What Karl Marx can teach doctors about burnout

Farid Alsabeh

Conditions and Diseases

January 17, 2020

Professional burnout is widely identified using the Maslach Burnout Inventory, which defines it along psychological lines: emotional exhaustion, a feeling of depersonalization and cynicism, and a low sense of personal accomplishment.

Accordingly, the phenomenon of physician burnout is often framed as a personal problem to be solved by means of self-care. While this approach is undoubtedly helpful, it doesn’t sufficiently address the structural factors that contribute to burnout in the first …

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