KevinMD.com

July 8, 2017Jul 8, 2017

You've been swindled. At least that's the conclusion I've come to. It wasn't the hucksters or the snake oil salesman. It wasn't big business, big medicine, or some greedy hospital administrator. It was most likely pharma with a large dose…

You’ve been swindled.

At least that’s the conclusion I’ve come to. It wasn’t the hucksters or the snake oil salesman. It wasn’t big business, big medicine, or some greedy hospital administrator. It was most likely pharma with a large dose of helping from your doctor. Plain and simple.

I’ve learned quite a bit being a hospice medical director. Covering dozens of new admissions a week has given me much insight into doctor …

Physician

Her patients helped this doctor out of her despair

Jennifer Lycette, MD

July 8, 2017Jul 8, 2017

Recently I found myself sitting in my car in the parking lot of my clinic, unable to will myself to open the door. I didn’t want to head into the clinic that morning. Instead, I was filled with despair; overwhelmed…

Recently I found myself sitting in my car in the parking lot of my clinic, unable to will myself to open the door.

I didn’t want to head into the clinic that morning. Instead, I was filled with despair; overwhelmed with the events of the world.

How can I do it? I thought. How can I walk in there and summon the energy to see my patients?

An even worse thought: Why should …

Conditions and Diseases

MKSAP: 60-year-old woman with substernal chest pain

mksap

July 8, 2017Jul 8, 2017

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 60-year-old woman is evaluated for a 3-week history of substernal chest pain. The pain is dull, nonradiating, and unrelated to activities. Sometimes the…

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

A 60-year-old woman is evaluated for a 3-week history of substernal chest pain. The pain is dull, nonradiating, and unrelated to activities. Sometimes the pain is worse after eating spicy foods and can be occasionally triggered by emotional stress. She has not had shortness of breath or weakness. She is moderately active, …

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Physician

None of us should have to choose between MOC and DRexit

Karen S. Sibert, MD

July 7, 2017Jul 7, 2017

I wish I knew who coined the term “DRexit” so I could send flowers or a bottle of whiskey as a thank you gift. There couldn’t be a more perfect term to describe the growing exodus of physicians from our beloved profession, which is turning into a morass of computer data entry and meaningless regulations thought up by people who never touch a patient.

The one bright note on the horizon …

Medications

Behind the scenes of a detox scam

Britt Marie Hermes, ND

July 7, 2017Jul 7, 2017

It is surprisingly easy to sell snake oil. I know, because I’ve done it. In 2014, I helped create and sell The Right Detox. This was a bogus detoxification program that purported to improve anyone’s well-being and perhaps, cure disease. I was the face of the scam. I launched The Right Detox at a spring-time women’s health expo in Tucson, Arizona.

I kicked off my sales-pitch in front of a small …

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Behind the scenes of a detox scam

Health Technology

When your doctor’s computer crashes

Michael Kirsch, MD

July 7, 2017Jul 7, 2017

Earlier this week, as I write this, our office lost a skirmish against technology. It was my procedure day, where lucky patients file in awaiting the pleasures of scope examinations of their alimentary canals. A few will swallow the scope…

Earlier this week, as I write this, our office lost a skirmish against technology.

It was my procedure day, where lucky patients file in awaiting the pleasures of scope examinations of their alimentary canals. A few will swallow the scope (under anesthesia), but most will have back-end work done. We are a small private practice equipped with an outstanding staff. We do our best every day to provide them with the …

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When your doctor’s computer crashes

Physician

The obsession with diagnosing President Trump

Dr. Saurabh Jha

July 7, 2017Jul 7, 2017

When I first read about neurosyphilis in medical school, I became convinced that Mrs. Thatcher, who I detested intensely because it was fashionable detesting her, had general paralysis of the insane. The condition, marked by episodic bouts of temporary insanity, which indicated that the spirochetes were feasting on expensive real estate in the brain, seemed a plausible explanation why she had introduced the poll tax.

A little bit of medical knowledge …

Health Technology

5 ways to fix health IT immediately

Suneel Dhand, MD

July 6, 2017Jul 6, 2017

Following my latest article on health care information technology, and how tragic the situation has become for physicians, I received a lot of correspondence. As always with articles that express physicians’ frustrations with the current batch of IT systems, there’s typically a lot of sympathy and agreement (although I believe that just nodding our heads and saying how bad a situation is, doesn’t really mean that …

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5 ways to fix health IT immediately

Conditions and Diseases

Drowning in a sea of misinformation: Dry drowning and secondary drowning

Seth Collings Hawkins, MD, Justin Sempsrott, MD, and Andrew Schmidt, DO, MPH

July 6, 2017Jul 6, 2017

Recently, a young child died following days of vomiting. He had been in shallow water in a Texas dike about a week before his death. The story was picked up as an alleged case of a rare condition called dry drowning or secondary drowning. The media accounts went viral, spreading significant fear in parenting communities and among those learning about these alleged conditions from the news …

Medical Education

They said, “Third year of medical school is better.” It wasn’t nearly good enough.

Rohit Abraham

July 6, 2017Jul 6, 2017

Everyone says that medical school gets better, especially third year. The traditional four-year curriculum covers basic science in the classroom for the first two years. Then suddenly, third year plunges us into clinical rotations in the hospital, where we’ve all dreamed of working for so long. Third year is when we transition from learning how to be scientists; we finally learn how to become doctors — except for one critical, …

Physician

10 ways for doctors to think outside of the box

Danish Siddiqui, MD

July 5, 2017Jul 5, 2017

Thinking outside the box is a somewhat cliché way to illustrate thinking beyond the norm and imagining what “could be” with an innovative mindset. This imagery of being stuck in a box rings true for many physicians, given how many…

Physicians work hard to treat each patient individually, but this feeling of …

Medications

Pre-authorization is hell. Here’s why.

Matthew Hahn, MD

July 5, 2017Jul 5, 2017

This April, my turn to take the medical board exam rolled back around, necessary every ten years for maintenance of certification. I studied diligently for the better part of three months preceding the test (and I think I did well). It was actually pleasurable to go back over details that I had forgotten and to catch up on newer developments in the field. I realized that I don’t do nearly …

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Pre-authorization is hell. Here’s why.

Physician

My patient is dying, and I don’t know what to do

Jeremy Topin, MD

July 5, 2017Jul 5, 2017

The patient in front of me is trying to die. Elderly and frail, he is lying in bed. His ribs outlined under the skin that should be smooth. His temples are concave where they should be flat. Both are an outward display of internal damage from his lung cancer. More striking than his cachexia are the strained muscles in his neck and his pursed-lip breathing. He is working hard for …

Social Media in Medicine

A diabetes forum tried to lock down photo sharing. Twitter wasn’t happy.

Emily Kopp

July 5, 2017Jul 5, 2017

Attendees at the American Diabetes Association’s Scientific Sessions in San Diego this year — many of them young researchers who are active on social media — were surprised to be greeted with the following: “Thanks for joining us at #2017ADA!…

For many, the essence of gathering at conferences is the sharing of scientific information, a peek at …

Physician

Communication in health care should be better than it is

Fred N. Pelzman, MD

July 4, 2017Jul 4, 2017

A few days ago, just after dawn, while I was out walking the dog, our home phone rang and my wife answered it. She's used to my pager, cell phone, and home phone ringing at all hours, and so she…

A few days ago, just after dawn, while I was out walking the dog, our home phone rang and my wife answered it.

She’s used to my pager, cell phone, and home phone ringing at all hours, and so she was not all that surprised when an unidentified voice said,”We’re looking for the methadone dose for patient John Q. Smith.”

She told him I was out of the house at the moment, …

Physician

Laying the foundation for a lifetime of eye health

Andrea P. Thau, OD

July 4, 2017Jul 4, 2017

After life itself, it is said that God’s great gift is vision. 80 percent of what we learn is through vision. Babies are not born with perfect vision. They develop vision over time. A child who never developed good vision does not know what normal vision is — he or she assumes that however they see is normal. There is nothing like the overwhelming emotion I have each time I …

Medical Education

A new medical intern begins. These 2 mottos will serve him well.

Abraar Karan, MD

July 4, 2017Jul 4, 2017

I will walk into the hospital with a clean, ironed white coat buttoned to the top, dress shoes polished, a tie neatly knotted under my collar, my maroon stethoscope rearing to go -- and I will be largely unprepared for…

I will walk into the hospital with a clean, ironed white coat buttoned to the top, dress shoes polished, a tie neatly knotted under my collar, my maroon stethoscope rearing to go — and I will be largely unprepared for what lies ahead. Along with countless others across the country, I will begin my medical internship, a year considered by many to be the most important in a physician’s working …

Physician

These physicians are crying. Here’s why.

Christopher Bennett, MD

July 4, 2017Jul 4, 2017

I cried this morning. It wasn’t because of the patient who coded with a wide-complex tachycardia and died in front of me, and it wasn’t because of the patient who tried to spit on me for not giving her a prescription for narcotics. Nor was it my intoxicated 2 a.m. bar fight patient yelling at my other patients, including one whom I’d recently diagnosed with metastatic cancer. It was because …

Physician

A wealth of medical knowledge in a country that lacks resources

Yul Ejnes, MD

July 3, 2017Jul 3, 2017

A guest column by the American College of Physicians, exclusive to KevinMD.com. For many years, I've wanted to visit Cuba. When travel restrictions to Cuba were relaxed a few years ago, I hoped that I would get there before the…

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

For many years, I’ve wanted to visit Cuba. When travel restrictions to Cuba were relaxed a few years ago, I hoped that I would get there before the first Burger King opened in Havana. I had my chance in May, as a member …

Medications

Ask your physician tough questions about opioids

Anita Gupta, DO, PharmD

July 3, 2017Jul 3, 2017

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Alleviating pain has been a primary focus of my career as a physician anesthesiologist. Just as there are physicians who specialize in treating conditions such as cancer, heart…

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

Alleviating pain has been a primary focus of my career as a physician anesthesiologist. Just as there are physicians who specialize in treating conditions such as cancer, heart disease or allergies, there are specialists in treating pain. These physicians complete four years of …

Real physician voices, twice a week

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