KevinMD.com

August 5, 2017Aug 5, 2017

I told you so. I also told the POTUS in my open letter, but he did not read it. Who could honestly believe the nation would support dumping coverage for 22 million people? As David Leonhard wrote recently op-ed in…

I told you so. I also told the POTUS in my open letter, but he did not read it.

Who could honestly believe the nation would support dumping coverage for 22 million people? As David Leonhard wrote recently op-ed in the New York Times: “They [Republicans and President Trump] had only one big weakness, in fact: They weren’t dealing in reality.” When faced with reality, it is interesting what a few good …

Physician

How long should I take antibiotics? Exploring the Goldilocks problem.

Robert Centor, MD

August 5, 2017Aug 5, 2017

Antibiotics save lives, but antibiotics can have negative effects. When patients have bacterial infections, we want to treat them to prevent complications of the bacterial infection, but not treat them for an excessive duration. So we have a Goldilocks problem…

Some clinical conditions have adequate research to define the Goldilocks duration. Community acquired pneumonia only …

Health Policy

Bridges and roads are also important to your health

Korydon Smith, EdD

August 5, 2017Aug 5, 2017

Two seemingly unrelated national policy debates are afoot, and we can’t adequately address one unless we address the other. Health care reform has been the hottest topic. What to do about America’s aging infrastructure has been less animated but may…

Two seemingly unrelated national policy debates are afoot, and we can’t adequately address one unless we address the other.

Health care reform has been the hottest topic. What to do about America’s aging infrastructure has been less animated but may be more pressing.

Yet even as cracks in America’s health system and infrastructure expand, political divides between parties and within parties have stalled efforts to develop policies and implement solutions. Problematically, debates …

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Conditions and Diseases

MKSAP: 67-year-old woman who takes diclofenac

mksap

August 5, 2017Aug 5, 2017

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 67-year-old woman is evaluated during a routine examination. She has a history of hip and knee pain related to degenerative joint disease. The…

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

A 67-year-old woman is evaluated during a routine examination. She has a history of hip and knee pain related to degenerative joint disease. The joint pain is now well controlled with diclofenac, which was started 3 months ago. A previous trial of high-dose acetaminophen was not effective. She does not have any …

Physician Finance

Am I using money, or is money using me?

Dave Denniston, CFA

August 4, 2017Aug 4, 2017

I get on the phone with a physician. She is stressed. Her tone is exasperated. Her frustration has been building and building. I hear the stress in her words. She feels like she has been juggling ball after ball after…

I get on the phone with a physician. She is stressed. Her tone is exasperated. Her frustration has been building and building. I hear the stress in her words.

She feels like she has been juggling ball after ball after ball. Living her circus of a life. Taking care of her patients. Pulling extra shifts and doing locums.

Somehow, fitting in a little bit of time when she can for her caring …

Read more…

Am I using money, or is money using me?

Physician

Inappropriate patient behavior is not OK

Sanghamitra Sadhu, MD

August 4, 2017Aug 4, 2017

"OK, one more patient to go," I said to myself with my eyes quickly scanning the patient list in my hands. I was in the elevator, going up the spanking new glass tower in the giant tertiary care hospital I…

“OK, one more patient to go,” I said to myself with my eyes quickly scanning the patient list in my hands. I was in the elevator, going up the spanking new glass tower in the giant tertiary care hospital I call my workplace. Today was turning out to be a better Monday than usual. I had worked over the weekend, so I knew the patients. And there were no major …

Health Policy

Would single payer work? The real devil is in the details.

Matthew Hahn, MD

August 4, 2017Aug 4, 2017

When I began my career as a physician in the late 1990s, I was relatively apolitical. Since then, as our health care system has crumbled, and as its demise (and our repeated failure to fix things) has increasingly affected my patients and my practice, I have become very political. In 2008, I began giving lectures in the community in support of a single-payer health reform model. My political leanings tend …

Physician

Here’s how being a parent changes you as a physician

Sehyr Imran, MD

August 4, 2017Aug 4, 2017

I sit in my living room at the end of a long day. I open my laptop to complete the day’s clinic notes. I look up to see my daughter busy painting (she’s two years old, so less than half…

I sit in my living room at the end of a long day. I open my laptop to complete the day’s clinic notes. I look up to see my daughter busy painting (she’s two years old, so less than half the paint is going on the coloring book and most is being smeared over her hands and feet). I hear the distant clatter of dishes as my husband loads the …

Medical Education

3 reasons why July 1st should be a day to celebrate

N. Bande Virgil, MD

August 4, 2017Aug 4, 2017

Fireworks, champagne toasts, sparkly hats, and the ball drop are all items that we conger up in our minds as we think of the New Year. For the majority of the world, January 1st represents the transition from one year to another on the calendar. New resolutions are made, and there is a global fresh start. However, for those of us in the medical field, there is another new year …

Medical Education

How a blanket changed the way I thought about medicine

Anika Morgado

August 4, 2017Aug 4, 2017

My sister calls my name three times before I hear her. I am so distracted by the palm trees and the ocean view that I don’t feel her put the car in park. I look up at the “Physician Parking…

My sister calls my name three times before I hear her. I am so distracted by the palm trees and the ocean view that I don’t feel her put the car in park. I look up at the “Physician Parking Only” sign straight ahead.

“Hurry up and get out. We’re running late, and I don’t want to have to stay after my shift ends,” she says.

“Don’t you always stay like two …

Physician Finance

10 reasons why being a doctor is a privilege

Dads Dollars Debts, MD

August 3, 2017Aug 3, 2017

I feel privileged to be practicing medicine. Many people consider doctor careers and imagine how great it may be. Is it the right thing for you? Yes there are days of frustration, exhaustion, and utter defeat, but at the end…

The fact that I alleviated one individual’s anxiety or …

Physician

Being a camp doctor is the most rewarding physician job I’ve ever had

Dara Kass, MD

August 3, 2017Aug 3, 2017

Even after all this time, the phone calls aren't always easy to make. “Hi, Mrs. Smith, this is Dr. Kass at camp, don’t worry, everything is OK.” I usually get that out in one breath, then immediately transition to concrete…

Even after all this time, the phone calls aren’t always easy to make.

“Hi, Mrs. Smith, this is Dr. Kass at camp, don’t worry, everything is OK.” I usually get that out in one breath, then immediately transition to concrete details. “It’s a finger. It might be broken.” It doesn’t matter if I’m calling about a cough, a fever or a bite from the camp pet pig — I know that …

Physician

New health policies must cover our most vulnerable

Bruce Campbell, MD

August 3, 2017Aug 3, 2017

Cancer treatment delays are sometimes inevitable. Here is a story, though, that haunts me. Years ago, long before the Affordable Care Act, I was asked to evaluate a very pleasant man with hoarseness in a local free clinic. He struggled…

Cancer treatment delays are sometimes inevitable. Here is a story, though, that haunts me.

Years ago, long before the Affordable Care Act, I was asked to evaluate a very pleasant man with hoarseness in a local free clinic. He struggled to make himself heard. “Things have been getting worse and worse,” he said.

“When did you start losing your voice?” I asked.

“About six weeks ago,” he responded. “When it started getting more …

Physician

Scribes for physician burnout: How scribes help reconnect doctors with their patients

Diane W. Shannon, MD, MPH

August 3, 2017Aug 3, 2017

Recently, I had an opportunity to drop in on two of the foremost researchers in physician burnout, Sara Poplau and Mark Linzer of Hennepin County Medical Center in Minneapolis. We chatted about various aspects of the current burnout crisis and exciting new initiatives on the horizon. Then we spent some time contemplating a frustrating truth: leaders in health care often fail to acknowledge a reality that leaders in other industries …

Health Technology

Artificial intelligence in health care: Better studies are needed

Skeptical Scalpel, MD

August 3, 2017Aug 3, 2017

An article in Newsweek magazine says, “Artificial intelligence will cure America’s sick health care system” using data and automation to “drive down the costs of health care while increasing effectiveness.” According to Newsweek, it will work like this for diabetes.…

According to Newsweek, it will work like this for diabetes. A company called Virta Health has come up with a smartphone app that is like “a live-in doctor and diabetes coach.” Type 2 diabetics who enroll will enter data such as blood sugar …

Physician

How EMRs are making informed consent meaningless

Fred N. Pelzman, MD

August 2, 2017Aug 2, 2017

Recently, getting dressed after working out in the gym, the guy in the next locker decided to complain to me about his recent surgery. Having lockers next to each other had led over time to "What do you do for…

Recently, getting dressed after working out in the gym, the guy in the next locker decided to complain to me about his recent surgery.

Having lockers next to each other had led over time to “What do you do for a living?” After discovering that I was a physician he has occasionally asked some medical questions, and done what a lot of people do when they know you’re a health care …

Conditions and Diseases

Let’s talk about the ethics of breastfeeding

Jennifer Lincoln, MD

August 2, 2017Aug 2, 2017

In the spirit of World Breastfeeding Week, I want to highlight all we can about breastfeeding; why it’s great for you and your baby, some ways to make it easier, and how to manage common challenges. But one challenge that…

But one challenge that often gets ignored in the offices of doctors and lactation consultants is the issue revolving around the ethics of breastfeeding. That is, addressing uncomfortable questions like these:

Are moms who choose …
Read more…

Let’s talk about the ethics of breastfeeding

Conditions and Diseases

Dear Sen. McCain: 9 ways to live with glioblastoma

Adam Hayden

August 2, 2017Aug 2, 2017

Dear Sen. McCain, I was saddened to hear that you received a diagnosis of glioblastoma. I also live with this particularly aggressive type of brain cancer. On the surface, you and I are very different. I am a 35-year-old dad…

Dear Sen. McCain,

I was saddened to hear that you received a diagnosis of glioblastoma. I also live with this particularly aggressive type of brain cancer. On the surface, you and I are very different. I am a 35-year-old dad with three sons aged 5 and under. I have a beard and listen to indie rock. I hold …

Physician

Find the right doctor for you: Here’s what to look for

Linda Girgis, MD

August 2, 2017Aug 2, 2017

Many people love to vilify doctors. They think we are all greedy and we don’t listen. They say we perform procedures just for profit. We are not available when we need them. Sure, there are doctors that fit this stereotype. But, in my experience, most doctors do not and care about their patients trying to do the best for them.

I hear patients complain about other doctors and some of the …

Conditions and Diseases

A physician’s mixed feelings about clinical pathways

Christopher Johnson, MD

August 2, 2017Aug 2, 2017

As the kids say, it’s complicated. Practicing physicians are seeing an ever increasing list of protocols and pathways coming their way. These arrive in several forms -- order sets for medications, guidelines in how to proceed for various conditions, when…

As the kids say, it’s complicated. Practicing physicians are seeing an ever increasing list of protocols and pathways coming their way. These arrive in several forms — order sets for medications, guidelines in how to proceed for various conditions, when to do this, when to do that, and when not to do either one. They generally are the product of various committees trying to synthesize what these days we call …

Real physician voices, twice a week

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