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This primary care physician does all his work through conversation

Physician

March 30, 2018

One of the ways a doctor can document the value of an office visit is by keeping track of the number of symptoms the patient has and the number of items included in both the review of systems and the physical exam of the patient.

This way, for example, we can get paid more if we do an extensive evaluation of a dizzy patient by looking for both inner ear, cardiovascular …

This National Doctors’ Day, conquer the physician shortage one mentor at a time

Heather Smith, MD, MPH

Physician

March 30, 2018

March 30th is National Doctors’ Day, a day set aside to recognize physicians, their work, and their contributions to society and the community. Though we are used to thinking of the profession of physician as something many parents hope their children aspire to, the reality is that fewer and fewer students are choosing that path.

According to a March 2017 report by the Association of American Medical Colleges, the U.S. will …

How to become debt free without sacrificing anything

Cory Fawcett, MD

Physician Finance

March 30, 2018

One of the biggest complaints I hear when I discuss becoming debt free is the dread of living on a shoestring. We did enough of that in medical school, and we don’t want to do it again. Let me make something perfectly clear right up front, you absolutely do not need to scrimp and sacrifice to get out of debt and live debt free, but if you choose to, it …

How silence can help us learn from our patients

Anne Katz, RN, PhD

Conditions and Diseases

March 29, 2018

As the patient talked, I found myself nodding my head. In so many ways, she was just like me. Highly educated, a professional, a woman who had worked hard and long to get where she was. And then cancer took it all away, or at least that’s the way she described it. She was diagnosed with metastatic cancer one year …

The health insurance industry is like a house of cards

Linda Girgis, MD

Health Policy

March 29, 2018

You go to your doctor because you are suffering pain, fatigue, or some equally debilitating ailment. Your doctor examines you and is worried there may be a serious underlying medical reason for your symptoms and orders a test. But, before you can have that test done to determine the cause of your symptoms, the insurance company must agree that you need it in order for them to cover the cost …

What this medical student learned from running a marathon

Shoshana Weiner

Medical Education

March 29, 2018

“4 ounces water every mile, half an electrolyte ‘gu’ pack over 2.5 miles, ¼ energy bar every 6 miles” — a.k.a. how did you manage training for a marathon while in medical school? The simple truth: I decided to run a marathon, so I did. Longer story: months of rigorous training, more moments of doubt than I care to recall, and insights already positively impacting my medical training.

Training for and …

Are there too many female OB/GYNs?

Jennifer Gunter, MD

Physician

March 29, 2018

The Los Angeles Times recently published a piece on the lack of men in OB/GYN. Only 17% of new trainees (residents) in OB/GYN are men and the male OB/GYN physicians who weighed in worried that this “lack of diversity could weaken the field.” Apparently, it sends a “horrible message to men,” and with the lack of men we might “lose the next person who is going to find a cure …

Read more…

Are there too many female OB/GYNs?

What is the perfect fee-for-service system?

Matthew Hahn, MD

Health Policy

March 29, 2018

It is wildly popular to say that the chief culprit in the U.S. health care system is the traditional fee-for-service payment system, which rewards physicians for volume but not quality, leading to high-cost, low-quality health care. It supposedly follows that the fix is a system of “value-based” payments.

Despite the popularity of these arguments, both aspects have been shown to be wrong. Studies show that the rising cost of American health …

How this doctor teaches his kids about money

DocG, MD

Physician Finance

March 29, 2018

We shop a lot.

Now I didn’t say we buy a lot. But we spend countless hours on the weekend walking through malls and shopping centers. I’m not sure exactly why. It may be that there is enjoyment in the visualizing without actually having. Or, more likely, as a family of four with two growing children, we have many items on our purchase list to check off.

Inevitably, repeatedly, our kid’s eyes …

What should physicians look like? Should it matter?

Maria Yang, MD

Physician

March 28, 2018

I don’t remember her name, but I do remember her light brown hair, the simple nose ring that looped out of her left nostril, and the calm and centered presence she had with patients. She came across as unassuming, professional, and caring. We were both in medical school, though she was two years behind me. I admired how she treated people.

I don’t remember his name, but I do remember that …

How do you tell your child’s doctor that you’re a physician?

Joelle Borhart, MD

Physician

March 28, 2018

My son is 16 months old, and I’ve never told his pediatrician I’m a doctor.

More than a decade after becoming an MD, I still struggle with the “reveal” of my identity as a physician when a family member or I am a patient. On one hand, I want the treating doctor to know my background to allow for a more sophisticated (but not too sophisticated!) conversation. On the other hand, …

The evolving meaning of the body mass index

J. Leonard Lichtenfeld, MD

Conditions and Diseases

March 28, 2018

A recent news story in the Journal of the American Medical Association (JAMA) reminds me that lots of things in our lives are changing these days, not the least of which is the shape of our bodies.

Oh, my. This aging thing isn’t so easy, and that is really the message behind Rita Rubin’s timely piece about shifting body mass and muscle as we age and its implications. Although focused …

Too much testing: Are patients to blame?

Kevin Lomangino

Conditions and Diseases

March 28, 2018

Our health care system in the United States is notorious for providing a lot of unnecessary medical care — something we’ve written about extensively.

Doctors may provide that unnecessary care because they perceive that patients are expecting or requesting it.

If health care professionals don’t provide the aggressive care that patients believe they require, the thinking goes, patients won’t be satisfied, and the doctor-patient relationship will suffer. Plus, the patient will just go …

What this doctor decided to do about physician suicide

Natalie Newman, MD

Physician

March 28, 2018

My physician advocacy began in February of 2017. I was reading a Medscape article about a doctor who was discussing the issue of physician suicide. She had her own website and newsletter.

After discovering the staggeringly high number of physician suicides, of which I was unaware, I signed up for the newsletter because I wanted to learn more. One day I received her newsletter; within it was a story about an emergency medicine (EM) physician …

The problem of misunderstanding 23andMe genetic test results

Susan Domchek, MD

Conditions and Diseases

March 28, 2018

Home delivery for everything from fresh produce to custom-selected clothing has become a way of life for many Americans. While most home-delivery conveniences are generally changing our lives for the better — giving us more time and choices — at-home genetics kits that reveal information about the risk of developing certain cancers represent a risky step in …

Physicians: Shape your career around the life that you want

Nisha Mehta, MD

Physician

March 27, 2018

There are lots of things we get right about medical training, but one thing that I’ve always found to be lacking is discussion of the logistics of life in medicine: how to shape your career around the life that you want, instead of vice versa. Through my writing and speaking, I often have people reach out to me for advice in this regard. I love providing my input, but also …

Crippling drug costs: the role of insurers

Janice Boughton, MD

Medications

March 27, 2018

Drug costs in the U.S. are higher than in in any other industrialized country in the world. Our cost for an insulin glargine (long-acting insulin) pen is $76.80 and in Canada, so very few miles away, it costs $19.60. The latter price is reasonable. The former price can make the difference between being able to afford a life-saving drug and dying. It is illegal, however, for a U.S. citizen to …

The data is in: Vaccines don’t “overload” children’s immune systems

Melvin Sanicas, MD

Physician

March 27, 2018

There is so much out there about vaccines — endless opinions and recommendations from doctors, experts, friends, family, celebrities, politicians — it can be challenging to identify who to trust and what to believe. Every parent’s only goal is to protect his or her child as best as they can. One of the most frequently asked questions is: “There are so many more vaccines than when I was a kid, …

The real cost of not having health insurance

Jen Baker-Porazinski, MD

Health Policy

March 27, 2018

I was behind schedule (again). My next patient was Helen, a non-compliant diabetic that hadn’t been into my office in over two years. Her blood sugars weren’t controlled at her last visit when I’d tried to impress on her the serious health problems that could develop if she didn’t take better care of herself.

Clearly, I’d failed. Maybe I’d even chased her away? No pill I prescribed would help her diabetes …

An emergency physician delivers a baby, and realizes that it isn’t for him

Edwin Leap, MD

Physician

March 27, 2018

I’m an emergency physician. In common parlance, an ER doc. Which means, like a little kid who will eat dirt on a dare, there’s not much I won’t try in the practice of my profession. Many of my colleagues have had far more challenging careers than me, I assure you. But I have some stories to tell. Cyanide overdose while moonlighting as a resident. Patient nearly dying from bite by …

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