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Physicians: Why you need a personal board of directors

Physician Finance

December 31, 2019

Why do you need professional advisors?

If you were the CEO of a company pulling in $15 million in top-line revenue, you wouldn’t be managing that organization by yourself, right?

You’d have a team of trusted professional advisors in your “C-suite” to help you manage the business. You would have a director of human resources, a chief operations officer, a chief financial officer, and probably ten other people to manage different parts …

Happiness has become a selfish pursuit

Hans Duvefelt, MD

Physician

December 30, 2019

Earlier this month Ross Douthat wrote a piece in The New York Times titled “The Age of American Despair” where he posed the question “Are deaths from drugs and alcohol and suicide a political, economic or spiritual crisis?”

Douthat writes:

The working shorthand for this crisis is “deaths of despair,” a resonant phrase conjured by the economists Anne Case and Angus Deaton to describe the sudden rise in …

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Happiness has become a selfish pursuit

Treat the whole patient and do the right thing

Marc Rothman, MD

Physician

December 30, 2019

Sometimes what makes truly great catchphrases, mission statements, and movie titles so powerful is that they are true, always necessary, and sometimes sufficient. I was reminded of this a few months back when a patient called into our telephonic urgent care triage line worried about a drug overdose. I was in my office typing or talking away, as I am prone to do, when the registered nurse who took the …

When a medical facility isn’t equipped to handle profound mental health issues

Matt Dayer, RN

Conditions and Diseases

December 30, 2019

A person rolls into an outpatient clinic. A pleasant bleach smell emanates from freshly scrubbed chairs. Happy chatter about people’s lives, and this week’s health issues are dimmed by the local radio station playing in the background.

The person who just rolled in for the first time has a confoundingly complicating diagnosis. It’s not the first sized holes in their body under their urine-soaked shorts they initially refuse to take off. …

CBD oil: Natural does not mean it is safe

Sarah Fraser, MD

Medications

December 30, 2019

At the age of three months, Charlotte Figi had her first seizure. She was later diagnosed with Dravet Syndrome, a rare form of epilepsy. Her seizures continued, increasing in both frequency and severity. In a CNN interview, Charlotte’s mother Paige said that at the age of three, Charlotte was having up to 300 seizures per week. They could last for up to four hours.

After all other medical treatments had failed, …

Stand up and be heard. But don’t hate your doctor.

Linda Girgis, MD

Physician

December 29, 2019

“I don’t know.”

That is an answer patients hate to hear. It is also an answer doctors hate to utter, and in truth, many of us fail to say those words when it would be proper to say them. Doctors spent long hours over many years of training, sacrificing personal time and family life. Most of us are perfectionists, and not knowing a medical diagnosis often feels like failure. Perhaps, the …

A nurse won’t let this patient die

Anonymous

Conditions and Diseases

December 29, 2019

The sun sets a cascade of pink and yellow in the window of an ICU room. The slow hum of ventilation dampens the buzzes and beeps from machines. I stand in a room inundated by equipment. A machine to monitor vital signs with purple, green, blue, and red on a black background displays peaking and rolling waveforms. Two IV poles with twelve pumps click and murmur sounds of fluid migration …

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A nurse won’t let this patient die

There is a global anesthesia crisis

Berend Mets, MD

Physician

December 29, 2019

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

There is a global anesthesia crisis: too few people trained to give anesthetics for surgery and obstetrics worldwide. The Lancet launched a commission to look at the needs for global surgery, which identified the issues starkly. While international disease control efforts have …

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There is a global anesthesia crisis

Give your psychiatric patients a reason to trust

Anonymous

Medical Education

December 29, 2019

I had been diagnosed three days prior, given lithium to stabilize and a benzodiazepine to sleep. I went home. Things did not get better.

I had been admitted just that morning after a long, confusing night in the ED. I did not yet understand the severity of what had happened — or even what had happened. The mania was still mostly euphoric and speckled with bursts of joy, but between these …

Physicians should never underestimate the power of their words

Suneel Dhand, MD

Physician

December 28, 2019

It’s no secret that America (and indeed a lot of the western world) faces an unhealthy lifestyle crisis. Shocking statistics suggest that over 70 percent of the United States population is overweight or obese (defined as a BMI over 25). The consequential health effects are well known, and don’t need further explaining. As a country and health care community, we simply cannot allow ourselves to get to a place where …

The continuing battle between the emergency department and radiology

Cory Michael, MD

Physician

December 28, 2019

I overheard a disappointing phone call while supervising a radiology resident recently. I could tell that the resident was struggling in a conversation with an emergency department physician, so I asked him to switch over to speakerphone. Eventually, I heard the emergency physician say, “Listen. This is how it works. A patient points to what hurts. Then I have that part scanned, and you tell me what is wrong.”

Disheartening as …

How setting healthy boundaries can help you regain control in a demanding world

Dimitrios Tsatiris, MD

Physician

December 28, 2019

Advancements in technology have blurred the lines between work and home life. This is because modern technology, such as the smartphone has made it easier for others to reach us. Time and location no longer serve as barriers. It is not uncommon for work-related matters to reach us via email or text after hours. People are continuing their work from home rather than enjoying precious time with loved ones.

Physicians are …

MKSAP: 59-year-old man is evaluated during a routine examination

mksap

Conditions and Diseases

December 28, 2019

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

A 59-year-old man is evaluated during a routine examination. He feels well and has no symptoms. Medical history is significant for hypertension. He does not smoke, and he does not have diabetes mellitus. He is active, performing aerobic exercise for 20 to 30 minutes four times per …

The excitement of clinical rotations: Not just learning medicine but doing medicine

Orly Farber

Medical Education

December 27, 2019

The first time a woman went into the final stage of labor, I watched from a corner of the room. As a third-year medical student, I was on my six-week clinical rotation in obstetrics and gynecology, and it was day one of the two-week portion on the labor and delivery floor. As a loudspeaker announcement projected over the woman’s screams, and nurses and doctors rushed in response, I instinctively clasped …

A physician who has her name butchered on a daily basis

Lisa Sieczkowski, MD

Physician

December 27, 2019

“S as in Sam, I, E, C as in Charlie, Z as in zebra, K, O, W, S as in Sam, K, I.”

“A, O, W?”

“No. K, as in kite. K, O, W.”

“Is that your married name?”

“Nope. This is my maiden name. I kept it.”

“What is that? Polish?”

“Yes. Yes, it is.”

“Wow! I definitely wouldn’t have gotten that one right!” Chuckle.

Sigh. Then move on to my next task knowing that this interaction …

For students with test stress, medical schools leave a void

Steve Blatt, MD

Medical Education

December 27, 2019

I’m writing this for my tribe of worriers and self-doubters, people for whom ever-present test stress is inextricable to the med school experience. Sure, every medical student becomes preoccupied fretting over exams to some degree. That’s part of what you sign up for. But our preoccupation is something greater than that—it towers over us and bullies us. It makes us cower in the corner, begging to be spared from harm.

We’re …

10 things you need to know about strangulation and domestic violence

Dan Field, MD

Conditions and Diseases

December 27, 2019

Having recently testified in several legal cases involving strangulation, here are some facts we all need to know about this extreme form of domestic violence (DV). I invite other subject matter experts to share their personal opinions on what is important.

1. Strangulation is assault with a deadly weapon – an act with known potential lethal consequences. Formally defined, strangulation is an external force applied to the neck cutting off blood …

Why this primary care physician still rounds at the hospital

Steven Reznick, MD

Physician

December 26, 2019

I have been fortunate in that I have not had to hospitalize any patients in the past four weeks. This means I have an extra 60 minutes or more to prepare for the workday in my office. The streak ended this weekend when my associate, taking his rotation of being on call, hospitalized one of my patients with pneumonia.

In many cases, pneumonia is treated as an outpatient. You receive an …

Why this medical student is pursuing a dual MD/JD

Ton La, Jr., MD, JD

Medical Education

December 26, 2019

I am frequently asked: “Why are you pursuing a dual MD/JD?” Neither profession is a family business; no one in my family is a doctor or a lawyer — but I’ve always dreamt big. I always wanted to get the most possible out of my education. Beginning in elementary school, I knew I wanted to be a doctor, but it was not until college that I …

Alexithymia: patient satisfaction, doctor burnout and health care costs

Dina D. Strachan, MD

Physician

December 26, 2019

My next patient was a healthy man in his early 20s following up for eczema. His case had not been severe, so I had anticipated that the prescription strength steroid cream I had given him would have addressed his symptoms faster than I had promised. His chief complaint had been itch—a symptom—something that he was experiencing. He hadn’t even noticed the rash. It was what one would call “bread and …

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