KevinMD.com

The uphill battle for scholars in elderly care

Harsh Moolani

Conditions and Diseases

July 18, 2019

Cognitive decline in older adults has been accepted as a normal part of aging. Recall, episodic memories, processing speed, and divided attention are all expected to decrease with time, but the implications of this decay are rarely discussed. Elderly scholars, or individuals who have sought to learn about the world or facets of the world through books, articles or newspapers, often are devastated by this cognitive decay. But, what if …

Rest is not enough for a busy physician

Stephanie Wellington, MD

Physician

July 18, 2019

After years of being busy taking care of critically ill and recovering neonates in the neonatal ICU, then coming home to take care of my children, I’m making new decisions. One of them is to learn how to relax and be still. It’s a new experience for me. It’s taken years and many shifts to get to this place. And it’s becoming a self-care practice that I really enjoy.

For the …

Read more…

Rest is not enough for a busy physician

Do substituted decisions break the Golden Rule?

Ron Louie, MD

Physician

July 18, 2019

The way I learned the Golden Rule was: “Do unto others as you would have them do unto you.” Basically, it’s from the New Testament, but the concept goes way back to pre-Christian ancient civilizations in Babylonia, Egypt, India, and China.

So here I am, just trying to do my best as a spousal caregiver, and I started to realize that if I were to take the Golden Rule literally — …

I will not stop sacrificing for my medical career

Anonymous

Medical Education

July 18, 2019

At the moment, I should be studying for my first round of boards, but there is something I can’t get off my mind: sacrifice.

If you ask a medical student what they have had to sacrifice to study medicine, the list could go on for days. It could be small things like watching their favorite teams play or being caught up on current events. But more than likely we will list …

What Ocasio-Cortez and Cruz get right about birth control

Kyle Varner, MD

Health Policy

July 18, 2019

I think we can all agree that women have a lot more hoops to jump through when it comes to contraception. If a woman wants to go on the pill, she has to go through the bureaucratic process of seeing a doctor and getting a prescription.

This is why I am so happy to see Alexandria Ocasio-Cortez and Ted Cruz agreeing to support a bill …

Doctors die. But the good ones leave a legacy.

Jaime B. Gerber, MD

Physician

July 17, 2019

In family medicine residency back in the early 2000s, we had a then-novel curriculum in narrative medicine. During inpatient rounds, we would sometimes get a few minutes to write down our thoughts about a patient’s experience. I remember how cathartic even refreshing at times that felt, to write my feelings about my first patient on the wards with severe heart failure or that sweet toddler I had to put an …

Here’s what I wish I knew as a resident

Irene Tien, MD

Physician

July 17, 2019

When I decided to become a doctor, little did I know that medical school and residency would be like a hazing for future physicians. We are broken down mentally and physically and then remade in the image of the “strong” doctor and to admit to being sick is equivalent to being weak. We are publicly shamed for admitting we don’t know the answer to daily pimping on morning rounds. We …

Read more…

Here’s what I wish I knew as a resident

The risk physicians take when going on social media

Anonymous

Social Media in Medicine

July 17, 2019

I am at a conference that is encouraging physicians to engage in social media. This is something I was always a proponent of. I felt strongly that as physicians, we help set the tone of accurate medical information. Especially now in this age of disinformation and “alternative facts,” our voices are crucial.

I used to be an active Twitter user. I had 21,000 followers and was verified — with a blue …

Should physicians stay in their lane on abortion?

Nina Shapiro, MD

Physician

July 17, 2019

Now more than ever, it seems that medicine, politics, social justice, and societal mores have become intertwined. There are so many “lanes” that the 405 to the 10 freeway splits seem like country roads in comparison. Perhaps we have social media to thank for this multitude of lanes. Or maybe it’s to blame.

When doctors were publicly berated (on social media, primarily) soon after we became outspoken about the issue of …

Be Bowser, not Mario in your medical practice

Phil Boucher, MD

Physician

July 17, 2019

Anyone familiar with Nintendo’s Mario franchise is probably very confused by the title of this blog but stay with me here.

My kids have recently become obsessed with Mario. It’s brought back great memories from my childhood of playing Super Mario World on the Super Nintendo Entertainment System way back in the day and “Super Mario Bros.” before that.

As I’ve assisted my kids in defeating a boss here or there, I …

Are benzodiazepines “the worst thing that’s ever happened to people”?

Nicole Lamberson, PA

Medications

July 17, 2019

Although Arnold Knutsen and I “met” virtually five years ago, we only first spoke on the phone recently when he called to share his story. He’s the eldest member of the online benzodiazepine support group we cohabitate. His posts in the group always reeked of desperation, and there was a palpable sense of urgency to his pursuit of a cure for his situation. It was clear …

How technology ruined, and can save, the doctor-patient relationship

Robert Pearl, MD

Health Technology

July 16, 2019

Each year, Medical Economics surveys physician readers to find out what irks them most. Topping the latest list: insurance paperwork, followed closely by electronic health records (EHRs).

The reason is the same for both. Insurers and EHRs get between doctors and their patients.

When it comes to medicine’s computer problem, the obstacle is literal. Doctors sit behind a screen, focused on the EHR and not the patient. …

Why an asthma action plan is so important for children

Christopher Johnson, MD

Conditions and Diseases

July 16, 2019

Asthma is a common childhood condition. Estimates are that around 8 percent of all children have it. The incidence had been steadily increasing for many years, but some recent data suggest the burden of the disease in children may have leveled off over the past couple of years. That’s encouraging, but the number of children with asthma is still huge. The peak age group is 5 to 14. The …

Patients: Take back your health information. Here’s how.

David M. Mitchell, MD, PhD

Health Technology

July 16, 2019

Have you ever wondered why your personal health information essentially belongs to your health care provider or institution? I mean: why do they keep your information under lock and key, and you have to sign a release to get it? After all, it’s your blood that they just pulled out and tested, it’s your body they just shot up with X-rays or operated on — and you paid for these …

Why a gap year will make this medical student a better physician

Yoo Jung Kim, MD

Medical Education

July 16, 2019

Whenever someone asks me what year of medical school I am currently in, I answer that I am a “four-out-of-five.” To those outside the milieu of Stanford Medicine, this is an odd response — four-out-of-five of what? But at Stanford, this is common parlance to refer to students taking a gap year after our third year of medical school.

Some would reasonably bemoan my choice to take a research year as …

Workplace violence in the health care setting is a public health emergency

Amy Costigan, MD

Physician

July 16, 2019

Health care providers may have one of the most dangerous jobs out there — and it is only getting worse. Nearly 74 percent of workplace assaults occur in the health care setting, and health care accounts for almost as many serious violent injuries as all other industries combined. The statistics are alarming. Seventy-eight percent of emergency physicians report being targets of workplace violence in the …

Considering locum tenens? Think about these factors first.

Cory Fawcett, MD

Physician Finance

July 16, 2019

Locum tenens is a great way to make a living or earn some extra income. But frankly, there are some groups of physicians who should not even consider doing locums work. When you pair the right person with the right job, you can get employment bliss. But when the wrong person takes a job, both the employer and the employee are often unhappy.

I believe everyone should enjoy the work they …

A hidden cancer success story: declining deaths from melanoma

J. Leonard Lichtenfeld, MD

Conditions and Diseases

July 15, 2019

Here is some news about cancer that isn’t widely known and is hiding in plain sight: Deaths from melanoma — a skin cancer that has lethal potential — have declined dramatically over the past several years. And while that fact alone is surprising, so is the reason behind the drop.

Let’s make something clear at the outset: too many people die from melanoma. It is not the …

A psychiatric hospital in Uganda: a medical student’s reflection

Brian Rosen

Medical Education

July 15, 2019

I excel at intellectualization. It is a fickle defense mechanism, allowing the observer to fully comprehend the situation in front of them without fully engaging in the emotional context. Throughout my medical training, intellectualization has aided me at many patient bedsides and through emotionally charged family conferences. I am reminded of many moments on neurology wards when a patient’s emotionally charged question was reinterpreted and deflected through a purely intellectual …

Our medical training has been outsourced

Katie Klingberg, MD

Physician

July 15, 2019

Reflexively, I often feel my breath catch, and my eyeballs roll ever-so-slightly when a patient leads with, “I saw on the internet …”

The precious minutes available to connect, inspect, and direct the management of their Google search are suddenly squandered by backtracking to reassure the bug bite will not turn into the bubonic plague!

Our medical training has been outsourced to Wikipedia and WebMD.

Today we all stand guilty believing we are …