A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.
Chronic pain is a silent epidemic
Chronic pain is a significant public health burden, but one that is not talked about enough. In 2011, the Institute of Medicine estimated that approximately 100 million Americans suffer from chronic pain. But chronic pain is not just …
Education as an intervention for the chronic pain epidemic
Noticing.
If you think about it, that’s really a lot of what we do a lot of the time. As clinicians, we are trained as observers to notice, to use our eyes, our ears, our hands. To notice.
We notice that our patients seem different today. More tired. A little pale. Notice a change in their gait. Notice they are in pain.
We notice swelling in their legs, a new heart murmur, a …
We need the time to apply our noticing skills to our patients
Attend any biotech or health informatics conference and one thing becomes clear: the scarcity of physicians. Entrepreneurs, businessmen, angel investors, and software engineers swarm these conferences — and their encompassing companies — all the while the imperative persona in this realm remains tied up behind a dysfunctional EHR or in an overbooked operating room. Why?
Certainly, inculcating these dynamic players in the health care space is integral to the successful evolvement …
Why more physicians should enter industry
An excerpt from The Choice: Medicine vs. Nursing.
An extensive amount of data now exists in the science of choice. Social researchers such as David Kahneman and Dan Ariely have conducted numerous experiments which suggest a number of ways in which humans are led astray when making choices. An understanding some of these pitfalls is critical as you embark on the process of …
The choice between medicine and nursing
These recent weeks have been hard for me, and I suspect for a lot of other people as well. Not because I spent it in a board review course listening to lectures for 12 hours a day, and not because I drank enough coffee to practically burn a hole in my stomach, but because the world lost two amazing people all too soon.
I didn’t know either Kate Spade or Anthony …
Celebrity suicides make the irony of our era clear
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 70-year-old man is admitted to the hospital with a 1-hour episode of left arm and left leg weakness. He is diagnosed with a transient ischemic attack. The patient has a history of hypertension and type 2 diabetes mellitus and a 30-pack-year history of smoking. Family history is noncontributory. His medications are metformin and lisinopril.
On …
MKSAP: 70-year-old man with a transient ischemic attack
How do I balance my home life with physician life?
I really want to do a research study. How do I start?
How do I get involved in my specialties society?
I am overwhelmed with clinical duties. How do I negotiate for nonclinical time?
My manuscript was rejected. What should I do next?
I had a bad clinical outcome, and I can’t seem to recover. How do I move forward?
Joining this committee will be a …
10 tips every young physician should read
That statement from a recent patient was a summary to me of what is bad in our health care “system.” It’s a terrible summary of what is seen all over this country with people who must make the choice between financial solvency and health.
Here’s what happened: It was a new patient I saw, who is a veteran who owns two businesses. He went out on his own when he “kept …
A patient is left with a choice: financial devastation or blindness
A few days ago I received a message: “Any advice for incoming med students?”
As an old, wise, seasoned, now-second year medical student, I know everything. Just kidding — I fumbled my way through first year like everyone else, and just like you will too. No piece of advice allows you to opt out from the challenges of medical school year one.
My advice isn’t the “normal” recommendations incoming medical students receive. You …
Advice for first-year medical students
Timeshares, for those who might not know, are a way to own the right to use a vacation resort. It comes in two forms, owning points or owning a specific room in a complex for a specific week. It’s like a partial ownership of a condo at a resort. These units can be traded for other timeshares all over the world. If you own a week, it can be traded …
A physician on timeshares: Who are they right for?
He spoke with an aura of superiority, in a slightly nasal voice, and his topic was migraines. It was in the late 70s, a time when there were few options to treat migraines.
“Most people who claim to have migraines just have simple tension headaches,” he scoffed. And in a move that seemed unorthodox at the time, he disclosed that he suffered from “real migraines,” so he knew all about this …
The art of medicine is needed to prevent migraine headaches
Written by George Kamajian as told by Bob Fedor.
I’m an old family doctor. I’ve seen much and forgot more. Life has taught me that we touch our patients’ lives for a moment, a season or a reason — and sometimes with unforeseen consequences.
I grew up in Erie, Pennsylvania. In 1968, when I was 19, the Tet Offensive in Vietnam caught the American military off-guard, and the Pentagon began frantically drafting …
How basic training changed me as a doctor
I remember reciting a phrase during my childhood that goes something like this, “Step on a crack, break your mother’s back.” So as I would walk back and forth to school, I would make a conscious effort to avoid any and all cracks in the sidewalks for fear of bringing unwarranted harm to my mother. This was a pretty difficult task to accomplish since in my small hometown, cracks in …
Don’t let fear harm your health
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It is easy to look at someone’s net worth and ooh and ahh. The response from my monthly income reports is fairly telling. People see the numbers and wonder how I accumulated so much. They peruse the Rockstar Finance’s Net Worth Tracker and daydream. To capture these dreams, there are countless blog posts about how to become a millionaire. If you just follow these three simple steps! The headlines are alluring and the answers are …
Financial independence requires sacrifice
Every small community has a unique but similar cast of characters. Our small Southern Utah town was no different. From a young boy’s perspective, the cops and docs were feared but cautiously idolized, the mayor was respected, the athletic coaches were immortalized, and of course, we had the homeless man in town, whom we feared. We will call ours Stu.
Stu had greasy disheveled hair and a gray beard. He wore …
A physician-father who made a lasting impression
I have written previously about the raging opioid epidemic in Ohio. Attacking and reversing this tidal wave will require many weapons, resources and time. Opioid addiction is a crafty and elusive adversary that will be difficult to vanquish. Our battle plan will have to be nimble and adjusted over time, much as military leaders must do in actual armed conflict.
Here in Ohio and elsewhere, physicians must abide by new …
Restricting opioid prescribing: Some error has to be tolerated
“Some data is better than no data at all.” Do you believe that?
I heard it frequently when the infamous ProPublica’s Surgeon Scorecard first appeared three years ago. Back then I blogged about it saying “To me, bad data is worse than no data at all.”
A recent study in BJU International confirmed my thoughts about this type of publicly posted data and identified a previously unreported issue. The paper attempted to …
The risks of publically reported surgical outcomes
It has become a sign of legitimacy to call a personal problem “medical.” This aims to distinguish the problem from those of morality or character. It implies both that the problem is serious, and that it is unbidden and largely out of the sufferer’s control. Unfortunately, it isn’t clear what exactly qualifies as “medical,” so this label serves more as a rhetorical device than a scientific finding.
Alcoholism is …
When does a condition become a medical issue?
Fair and just societies protect children. The Trump administration’s unconscionable practice of separating children from their families at the border between Mexico and the United States is making me rethink what kind of society I live in.
The images and the stories are heartbreaking.
In an effort to deter families from migrating to the United …
Separating children at the border is a danger to their health
In an era where health information is freely flowing thanks to the internet and Dr. Google, I’ve come to expect that patients who see me for the first time will have done their homework — about their cancer, treatment options, and yes, even about me. To be frank, it’s not uncommon for patients to mention they’ve …
Accept the decisions patients make
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