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This pediatrician doesn’t fear fevers and neither should you

Conditions and Diseases

September 9, 2017

As a pediatrician in training, I’ve seen countless instances in which parents, in both the ED and inpatient/outpatient care settings, have presented with deep concern regarding their child’s fever. It’s an age-old concern. But why exactly does fever cause so much distress in a parent’s world?

As a medical student, I distinctly remember rotating with an attending physician who had strong feelings regarding fever. He became angry with me when I …

I vow not to call my patients “difficult.” Here’s why.

Weisheng Mao, MD

Medical Education

September 9, 2017

I am not a doctor. (Yet.) I am a novice third-year medical student, somewhat able to perform and document a physical exam on a sleeping child, to dial the correct number to call a consult and to make wild guesses about chest X-rays (“I see a consolidation?”). I write about medicine not from a position of experience, but of malleability. I want to become like the best doctors I see.

Towards …

MKSAP: 46-year-old man with fever, dysuria, and urinary frequency

mksap

Conditions and Diseases

September 9, 2017

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

A 46-year-old man is evaluated for fever, dysuria, and urinary frequency of 1 day’s duration. He also notes a sensation of deep pelvic pain near the rectum. He has no urethral discharge or testicular pain. He states that he felt well before the current illness and has no other symptoms. Medical history …

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Am I the first user of the Hospice Compare website?

Franziska Rokoske

Health Policy

September 8, 2017

In a terrible twist of fate, the very day that the Centers for Medicare & Medicaid Services (CMS) Hospice Compare website went live, I found myself in a pulmonologist’s office with my parents, taking in the news of my mother’s advanced cancer and malignant pleural effusion. The shock of it, and the uncanny timing are beyond comprehension. You see, I’ve been leading research at RTI International and …

A reminder that physicians are artists

Shannon Tapia, MD

Physician

September 8, 2017

Anyone entering medical training is taught that medicine is an art, one that combines scientific knowledge, discovery and application with its practice. It is both art and applied science. It should never become nor has it ever been only all one or the other.

To be medicine at all, the noble vocation that so many brilliant minds sacrifice to pursue in service to their fellow humans, the practice must balance art …

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A reminder that physicians are artists

Natural disasters in a time of telemedicine

Amy Fan, MD

Physician

September 8, 2017

My significant other is a physician working in Houston, and he missed Hurricane Harvey over the weekend, being out of town for a conference. The hospital sent out an S.O.S. asking faculty to do their best to come in. As the Houston airports continued to be closed Monday and Tuesday, he and his colleague, also a physician and a native of Houston, flew to another airport and drove a few …

3 ways to better communicate with patients via signposting

Edward Leigh

Patient

September 8, 2017

Imagine driving through an unfamiliar area, and there are no street signs. How would you feel? Frustrated? Scared? Angry? You would feel these emotions because you had no direction or guidance. Patients need direction when they enter the health care system. Signposting is a tool to provide direction.

On the streets, there are posts that have signs. They provide direction; they tell us where we are going. Hence, the name, “signposting.” …

A cancer survivor embraces the light of going to medical school

Shekinah N. Elmore, MD

Medical Education

September 8, 2017

This article was originally presented as student remarks at the 2015 Harvard Medical School commencement.

At the end of medical school, I always return to a musing, a zen koan of sorts from Dean Jeffrey Flier. At my white coat ceremony, a close friend and current resident, Dr. Nina Gold was chatting with the dean about the heft of our newly bestowed bright white coats. He asked her, in one beautiful …

7 ways for doctors to stay safe at work

Jenny Hartsock, MD

Physician

September 7, 2017

Being a health care provider has always come with personal risk. We care for all patients, which includes patients agitated due to psychiatric issues, dementia, acute medical illness, alcohol or drug intoxication or just anger. Patients can be extremely volatile and lash out unexpectedly causing physical injury to their doctor, nurse or another provider. Besides the physical risk, patients can be emotionally and verbally abusive as well- and both types …

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7 ways for doctors to stay safe at work

Did doctors know best in the Charlie Gard case?

Dr. Saurabh Jha

Physician

September 7, 2017

For American conservatives, Britain’s NHS is an antiquated Orwellian dystopia. For Brits, even those who don’t love the NHS, American conservatives are better suited to spaghetti westerns, such as Fistful of Dollars, than reality.

The twain are unlikely to meet after the recent press surrounding Charlie Gard, the infant, now deceased, with a rare, fatal mitochondrial disorder in which mitochondrial DNA is depleted — mitochondrial depletion disorder (MDD). In this condition, …

For a long, happy career, be more than just a doctor

Passive Income, MD

Physician Finance

September 7, 2017

“You’re a doctor; focus on being a doctor.”

This piece of advice was recently given to me by my own father, in regards to my multiple ambitions outside of the medical field. He himself only recently retired from a long career as a surgeon, so his opinion is the result of years of experience.

His advice got me thinking.

What makes for career longevity in our field? Statistics show that more than half …

Co-production of care: A different kind of health care than we’re used to

Sylvester Jones and Laura C. Leviton, PhD

Health Policy

September 7, 2017

More than anything, Willie needed a place to pee.

Elaine needed help walking.

Willie is homeless; Elaine is affluent. They both needed someone to listen to them and help them find solutions to their most pressing everyday challenges. That’s called “co-production of care.”

When Willie found out he had congestive heart failure, his doctor put him on beta blockers with diuretics.

The medications made Willie feel better, but there was one problem: Because of …

Putting down the scalpel: The aging surgeon

John C. Hagan III, MD

Physician

September 7, 2017

In the early epoch of human development, mankind learned to shape and sharpen wood, stone and metal objects to facilitate plunging them deep into other humans’ chests, abdomens, skulls and eyes in the ultimate form of conflict resolution.

Over tens of thousands of years, other less pugilistic and more compassionate humans crudely — but later artfully — insinuated an increasingly sophisticated array of implements into the human corpus to cure diseases, …

Can we slow the aging process?

Stephen C. Schimpff, MD

Conditions and Diseases

September 7, 2017

Part of a series.

Can we slow the aging process? The answer is a definite yes. It’s not easy and requires some real diligence, but aging can be slowed.

When thinking about a car we all know “old parts were out.” It is equally true for the human body. But less appreciated is the fact that we can either slow or speed up the process, just as good preventive …

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Can we slow the aging process?

Are CTE headlines overblown? A radiologist investigates.

Dr. Saurabh Jha

Conditions and Diseases

September 6, 2017

A study published in JAMA looking at the brains of former football players donated to a brain bank, a highly selective sample, found signs of chronic traumatic encephalopathy (CTE) — a degenerative neurological disease — in nearly all deceased players examined.

The mainstream media converged towards numerical consensus.

Fox News reported players in a study had CTE.”
CNN reframed the headline, “CTE found …
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Are CTE headlines overblown? A radiologist investigates.

Being a resident and a parent is hard when your child gets sick

Adam D. Langenfeld, MD , PhD

Physician

September 6, 2017

One of the most difficult situations for a parent is one in which your child is sick. To be in a situation where you cannot control how the child responds to interventions is very challenging. Under normal circumstances, you follow your normal daily routine: up in the morning, breakfast, get dressed, off to school or daycare or activities for the day, a nap in the afternoon, pick up from school …

New technology might help us become more empathetic to others’ suffering

Shirie Leng, MD

Health Technology

September 6, 2017

Tele-empathy is not being empathetic over the phone. It is not crying in the sad parts of your favorite TV show. It is not beaming empathetic thoughts magically across time and space. No, tele-empathy is a technology. I should rather say, it’s a group of technologies recently being created to increase the empathy of health care providers. “This is rich,” you might say coming from an industry that brought us …

After 8 years, this doctor is finally treating his pancreatic tumors

Mark A. Lewis, MD

Conditions and Diseases

September 6, 2017

I’ve known that I’ve had tumors in my pancreas since 2009. Until now I’ve done nothing about them.

This might sound like a counter-intuitive, even foolhardy strategy, especially for an oncologist, who should surely know better than to let his disease gain an advantage through his own inaction. But I don’t have the “usual” type of pancreatic cancer, the kind that claimed the life of Patrick Swayze and has sentenced …

The surprising way that architecture and the art of healing intersect

Betty Yibrehu, MD

Conditions and Diseases

September 6, 2017

Cold, sterile and well … clinical. Three words that neatly describe hospitals as many of us know them. In books, on TV and in movies, we see and experience hospitals as impersonal, solemn and sterile institutions — designed only to treat disease.

Interestingly enough, while our society has begun shifting away from thinking of health as just the treatment of disease, our hospitals fail to reflect these changes. This is particularly …

3 unconscious things you might be doing that affect your patients

Nisha Cooch, PhD

Conditions and Diseases

September 6, 2017

Patient psychology is increasingly recognized as an important contributor to health outcomes. What patients believe about their health and their providers can significantly affect their initiative and their adherence.

It is important to recognize that factors that appear to be unrelated to medical care can influence feelings about that care, as well as outcomes. The reason this occurs is that the brain is not designed to parse out each element of …

Real physician voices, twice a week

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