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Physicians who don’t play the social media game may be left behind

Xrayvsn, MD

Social Media in Medicine

February 25, 2019

The internet truly is a wondrous invention.

It has evened the playing field with a wide swath of people now having access to information that used to be possessed in the hands of only the elite few not too long ago.

However, as with most things, there can be downsides associated with any tool of progress.

Yelp

Yelp is a powerful social tool that allows individuals to share experiences, good or bad, so that …

Doctors and patients should be wary of health care mega-mergers

Linda Girgis, MD

Health Policy

February 24, 2019

Over the past year, multiple mega-mergers were announced in health care. The four largest ones being:

1. On March 18, 2018, Cigna announced that it was acquiring Express Scripts for $68 billion in cash and stocks. The deal was closed on December 20, 2018.

2. On December 3, 2017, CVS announced that they were acquiring Aetna for $69 billion in cash and stocks. The deal was officially closed on November 28. …

Government shutdowns show the importance of an emergency fund

Cory Fawcett, MD

Physician Finance

February 24, 2019

It’s interesting, but not surprising, to hear that numerous government employees are crippled by the delay of a single paycheck. This is precisely the reason everyone needs an emergency fund. When an unexpected financial catastrophe pops up, we need to be able to weather the financial storm.

Many people consider a car breakdown, a sick pet, or a roof leak to be an emergency. These are not emergencies. These are things …

Political correctness and the taboo topics in medicine

Edwin Leap, MD

Physician

February 24, 2019

I write for several publications, and I’m always pitching to new venues. Recently I pitched an idea to an editor. I wanted to write about gun research from the perspective of a rural physician. In particular, I wanted to ask what might physicians say if researchers found answers that were uncomfortable. What if they found that intact families, strong fathers, religious engagement or familiarity with guns were factors that reduce …

Is financial independence selfish?

DocG, MD

Physician Finance

February 24, 2019

Reaching financial independence is no small feat. One has to turn inward and explore personal habits, goals, and rebalance value systems. These are somewhat introspective topics. Indeed, they require quite a bit of self-focus. This, I believe, is good. If we don’t continuously re-evaluate our beliefs and actions then how are we going to grow? On the other hand, such thinking leads to another critical question. Is financial independence selfish?

Are …

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Is financial independence selfish?

How mundane health findings can be prettied up with PR magic

Mary Chris Jaklevic

Conditions and Diseases

February 23, 2019

As all researchers know, science is a grinding parade of failure and dead ends. But as we’ve often written, news release writers sometimes seem hell-bent on making the public believe otherwise.

Like expert makeup artists, they can add sparkle to lackluster findings, mask blemishes in study designs, and smooth over unimpressive data.

One thing I won’t miss much about my job at HealthNewsReview.org is reading the daily churn of PR releases.

Every weekday morning …

Physicians should take their time with big purchases

James Turner, MD

Physician Finance

February 23, 2019

While at a gathering during residency, I found myself talking to an older physician. He graduated from the same residency ten to fifteen years prior. He was a natural leader and a good storyteller. He was also a good teacher because he was about to teach me a lot about delayed gratification.

In the midst of our discussion, I told him that my wife and I intended to move …

How a medical student can help the team during clinical rotations

Ton La, Jr., MD, JD

Medical Education

February 23, 2019

Based on my clinical experiences, there are ten pieces of advice I would give to any medical student starting their rotations that will maximize productivity and lead to a robust and thriving work environment (your interns will thank you).

1. Do as complete of a workup on your assigned patients as you can. Be thorough with your admission H&P. Think of all the tests, labs and imaging studies you want ordered. …

MKSAP: 75-year-old man with progressive dysphagia

mksap

Conditions and Diseases

February 23, 2019

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

A 75-year-old man is evaluated for progressive dysphagia of 8 months’ duration for both solid food and water, and the necessity to induce vomiting several times each month to relieve his symptoms. He also has experienced chest pain and heartburn symptoms. He has lost approximately 6 kg (13 lb) …

A disturbing study about children and guns

Christopher Johnson, MD

Health Policy

February 22, 2019

Children are relatively healthy overall. Although 25% of the American population is under the age of 19, only 2% of annual deaths occur in this age group. There was a time when the contributions of diseases to pediatric death rates were much higher. Declines in deaths from infectious disease or cancer, the result of early diagnosis, vaccinations, antibiotics, and medical and surgical treatment, have given way to increases in deaths from …

How opioids can destroy the most beloved of personalities

Ashley McMullen, MD

Medications

February 22, 2019

“I feel like a caged animal” — My patient offered me this lens through which to view his life seeped in chronic pain. For him, pain dictated his entire sense of being — it was something that simply could not be distilled down to a single value on a 10-point scale. The cage represented the restriction of life and the boundaries within which he was allowed to experience, let alone …

Fixing physician burnout means changing the culture of medicine

Marschall S. Runge, MD, PhD

Physician

February 22, 2019

A talented young physician was concerned about her job at Michigan Medicine, where we both work. She thought she might have to leave the organization because she could not meet mandatory early-morning start times for procedures or outpatient visits. She was especially discouraged by colleagues who said her attitude reflected a lack of commitment and “was emblematic …

8 ways to go broke as a doctor

James M. Dahle, MD

Physician Finance

February 22, 2019

So much of personal finance and investing isn’t about winning; it’s about not losing. That’s because investing is a single-player game; it’s you against your goals, not you against your neighbor or your partner or some yahoo on an internet forum. However, there are precious few whose ultimate financial goal is to be broke and if you can avoid doing that, well, that’s one mark of success. There aren’t that …

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8 ways to go broke as a doctor

Patients turn to GoFundMe when money and hope run out

Mark Zdechlik

Patient

February 21, 2019

Tammy Fox wanted to help after a friend took ill with a rare and difficult-to-diagnose autoimmune disorder that required many trips to the Mayo Clinic.

Although Fox couldn’t do anything medically, she knew there was a way to ease some of the burden of medical bills and costs associated with doctor visits. She turned to the website GoFundMe and set up a site for her friend.

“You’ve got meals; you’ve got hotel …

The culture of permission in medicine

Lauren Joseph

Medical Education

February 21, 2019

During the recent winter break, I went home and visited my yearly slew of doctors for check-ups: vision, dental, gynecology, etc. In the exam room, my new gynecologist instructed me to put my feet up in the stirrups. I had recently learned in a seminar at school that new guidelines on Pap smears suggest spacing them every three years for women at my age, and I wondered, “Do I even …

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The culture of permission in medicine

A shortage of Kayexalate leads to an ER visit

Hans Duvefelt, MD

Medications

February 21, 2019

Last week I had a patient with mild kidney disease and a high potassium. I thought that it would be easy to take care of. We called around to all the pharmacies from Bangor to Ellsworth to Belfast, and nobody had Kayexalate, the time-tested antidote, in stock.

It happened to be on a Tuesday night with my Suboxone group starting at 5 o’clock. The patient had been there since 4; his …

Health care organizations have to take better care of their employees

Suneel Dhand, MD

Physician

February 21, 2019

Anybody who has even a passing interest in health and wellness knows the sobering fact that a large number of medical problems that plague society today are the result of unhealthy living habits. Conditions such as heart disease and diabetes, which are reaching epidemic proportions, are directly linked to poor eating and inactivity. Official statistics show that around 70 percent of Americans are overweight or obese. We live …

How can doctors address patients’ expectations?

Linda Girgis, MD

Physician

February 20, 2019

No one wants to be sick, especially when no one can tell them what is wrong. In the U.S., we live in a culture where we want instant results; we want easy answers for complex problems. However, in medicine, there are often no easy fixes. Adverse medical events happen, despite our best efforts. For example, a young child was recently diagnosed with Type 1 diabetes mellitus. While he and his …

An emergency physician with no friends

Rada Jones, MD

Physician

February 20, 2019

Every time I call a friend, all I have for them is more work. I’ve never yet called to say: “I hope you’re having a great day. Why don’t you take a break and have some fun? You’ve worked enough.”

Nope. I only call to give them extra work. Whether it’s 2 a.m. or 2 p.m., I need you to get away from your bed/lover/high horse and come take my patient. …

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An emergency physician with no friends

The questions clinicians never think to ask

Maria Yang, MD

Conditions and Diseases

February 20, 2019

The chief complaint was belly pain. He described the pain as both dull and crampy. It came and went, but bothered him the most on the same night of each week.

The notes from the primary care doctor show a thoughtful search for the underlying cause. There were comments about activity logs, blood tests, and imaging studies. Months later, it remained a mystery: He still had belly pain. The investigations did …

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