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How to care for patients who are personal health researchers

Physician

October 25, 2017

The ability to access health information via the Internet is creating a generation of empowered, informed patients. While this is almost always beneficial to both patients and the patient-physician relationship, it does call for changes to traditional counseling methods. Widespread access to myriad health information sources has divided patients into two subsets: those who prefer traditional counseling and those who become “personal health researchers” or PHRs.

While some patients will continue …

Fixing the American health care system is simple. Here’s how to do it.

Matthew Hahn, MD

Health Policy

October 25, 2017

If we listen to the president, fixing the American health care system is too complicated. It is not actually that complicated. The number one issue is cost. Even with many millions of people unable to access care, we already spend close to twenty percent of every dollar in the U.S. on health care. If we hope to include everyone in the health care system, then we need to lower health …

An interview with an American doctor working in Canada

Suneel Dhand, MD

Physician

October 24, 2017

A couple of weeks ago I visited Canada. It was my first visit in a very long time. We were in Ontario, spending most of the time in the Toronto area, and also getting to visit the majestic Niagara Falls for the day. I’ve heard so much over the years about the differences between neighbors USA and Canada, and in even just a few days there, agreed that there are …

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Beware of online retailers selling designer benzodiazepines

Abraham M. Nussbaum, MD

Medications

October 24, 2017

One of Max’s friends taught him an easy way to buy shady drugs. What he learned almost killed him, and it opened my eyes to a hiding-in-plain-sight source of dangerous drugs that is amplifying the opioid epidemic.

When Max (not his real name) developed pancreatitis a decade ago, his physicians prescribed opioids to ease his extreme …

We shouldn’t be surprised that there is an opioid crisis when medicine is operated as a business

Jenny Hartsock, MD

Physician

October 24, 2017

Future generations will look back on the opioid epidemic as the greatest tragedy of modern medicine. The recent 60 Minutes special about drug distributors really highlights that manufacturing and prescribing opiates was never about the best interest of patients. The pharma companies saw a business opportunity that could be exploited by offering patients a little pill to take their pain away. What person, given the chance, would …

Are we medicalizing everything?

Kjell Benson, MD

Physician

October 24, 2017

“A condition counts as a disease independently of whether there is safe and effective treatment.”
– Journal of Medicine & Philosophy, August 2017

What is a disease anyway? Mrs. Jones is 90 years old and frequently experiences episodes of chest pain. She has numerous partially blocked coronary arteries, and her physician has told her to come to the emergency room because she might be having a “heart attack.” …

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Are we medicalizing everything?

You can pick any two, but only two: conversations about health care costs

Darrell E. White, MD

Health Policy

October 24, 2017

My wife Beth and I had a rather spirited discussion about how we in the U.S. might be able to pay for the health care of our citizens. Being ever practical, and also owning the job of writing the checks that pay for the health insurance our company offers its associates (including us), Beth in effect is arguing for a national consensus on something we might describe as a baseline …

Lessons in doctoring from Paul McCartney

Robert Baker, MD

Physician

October 24, 2017

I learned a good lesson in doctoring from Paul McCartney. Sir Paul, if we want to get formal about it. My wife and I went to one of his shows, and aside from re-living the soundtrack of our lives, we also were struck by how fresh and personal the concert felt. If you consider how many times he’s played those songs and that there were eighteen thousand people in the …

Think of the person behind the cells: the motivations of biomedical research

Samuel Falkson

Conditions and Diseases

October 23, 2017

Born in 1920, Henrietta Lacks lived in Virginia and Maryland, worked as a tobacco farmer, and mothered five children. At age 31, her life was unfortunately cut short by cervical cancer. Since her death, she has helped catalyze numerous biomedical discoveries.

Upon treatment at Johns Hopkins, Henrietta’s physician obtained a tumor sample. To his amazement, her cells survived and divided in a petri dish. Today, her cells are still used in …

A place for music in the emergency department

Thomas Scary

Medical Education

October 23, 2017

The emergency department is a place of unpredictability. Some days are a whirlwind, others drag, but both can be interesting. On a calmer day, I found myself, a fourth-year medical student, working with a physician I will call Dr. Smith. We discovered that we shared a common love for music, and between patients, we discussed everything from opera, to banjo, to Indian music. I am a composer and amateur classical …

Respiratory syncytial virus: Are we making any progress?

Christopher Johnson, MD

Conditions and Diseases

October 23, 2017

It’s fall in the PICU, and we just saw our first severe case of respiratory syncytial virus (RSV) of the season. RSV is by far the most common cause of bronchiolitis in infants. To scientists, RSV is a fascinating virus with several unique properties. One of these is its behavior in the population. When it’s present, RSV is everywhere. Then it suddenly vanishes. There are exceptions to everything in medicine …

See what happens when you give a doctor a user-friendly EMR?

Hans Duvefelt, MD

Health Technology

October 23, 2017

I’ve finally found my groove with our EMR. Maybe I’m even starting to like it.

A few weeks ago I got a new iPad, this time a Mini, which lets me type with two thumbs the way some people text on a smartphone, and the voice transcription is good enough as long as you avoid fancy jargon and unusual generic drug names. Yesterday as I sat next to a patient and …

What would it be like if we said hello to everyone in our communities?

Maria Yang, MD

Physician

October 23, 2017

My first memory of encountering a person who appeared to have no place to live was during my first year of college at UCLA. A man was sitting outside a mini-mart, his legs crossed and his hair long. He looked tired, and his clothes had stains on them. Feeling pity for him, I went into the mini-mart and purchased a turkey sandwich on wheat.

“Here,” I said as I handed him …

Choose your tribe wisely

Sasha K. Shillcutt, MD

Physician

October 23, 2017

One of the most important things my mother taught me was to choose my friends intelligently. From a very young age, I remember my mother quoting Proverbs to me and telling me this, “Choose your counsel wisely.” The older I get, the more I believe who I allow to influence me plays an enormous part in the place I find myself in today.

Research has shown you become like the five …

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Choose your tribe wisely

The flu vaccine doesn’t cause the flu. Period.

Jennifer Gunter, MD

Conditions and Diseases

October 22, 2017

Flu vaccines are available, and so that means that the anti-vaccine brigade is out in force.

The Daily Mail published an anti-vaccine op-ed by a former reality TV contestant named Katie Hopkins. It was followed by a shorter counter argument by a doctor, but when you are given less than half the word count and are at the bottom of the page it is hard to mount an effective response. …

Feel over-boarded by MOC? Fight back.

Niran S. Al-Agba, MD

Physician

October 22, 2017

According to recent Ohio statistics, 1.3 million people have limited or no access to primary care physicians. Based on the 2015 Ohio Primary Care Assessment, 60 of 88 Ohio counties have medically-underserved populations. The Patient Access Expansion Act (HB 273), co-sponsored by Representative Theresa Gavarone (3rd District) and Representative Terry Johnson (90th District), specifically addresses health care access by prohibiting physicians from being required to comply with maintenance of certification …

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Feel over-boarded by MOC? Fight back.

Dos and don’ts for patients who consult Dr. Google

Uchenna O. Njiaju, MD

Physician

October 22, 2017

Dear patient,

I meet people several like you on a daily basis. It is always a pleasure to meet you since you come much more prepared compared to the average patient. I have seen you with several sheets of paper or even a notebook, a list of questions and an extra sheet of paper on which to write recommendations. You may even have printed research papers and articles off the Internet.

I …

The first day of my ER rotation is one that this doctor will never forget

Zahir Basrai, MD

Physician

October 22, 2017

Text message:

Me: “Mom you alright? I just heard that there was an explosion at the Pepsi Center.”

Mom: “What are you talking about? I am fine, everything is OK over here.”

Earlier that day:

It’s the first day of my first ER rotation as an intern.

I had endured months on medicine, neurosurgery and the medical ICU. I am finally home back in the ER. I am hoping that today will be a somewhat …

Let your patients know that motherhood is more than giving birth

Andrea Eisenberg, MD

Physician

October 21, 2017

For days on end, she looked out of the bedroom window, rocking her baby back and forth on her glider. The maple tree waved at her daily as the breeze came through its branches. Gradually, the leaves made their annual change from green to red and orange and yellow. She watched as the leaves transformed, jealous of their seamless change as she struggled to make her own transition to motherhood.

Eventually, …

Different perspectives but the same goal: providing the best possible care to patients

Yul Ejnes, MD

Physician

October 21, 2017

A guest column by the American College of Physicians, exclusive to KevinMD.com.

For this column, my 61st for the American College of Physicians (ACP), I thought it would be interesting to look back at the first 60 and review the trends and topics that inspired me to write 800 to 900 words every month. Rather …

Real physician voices, twice a week

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