KevinMD.com

June 29, 2017Jun 29, 2017

The “doctor-patient” relationship is tightly woven into the culture and history of medicine. But that special bond is under enormous pressure today. And to keep it from fraying, we need periodically to examine the fabric. Last month, the Council of Accountable Physician Practices (CAPP), representing 28 of the nation’s largest and best medical groups in the U.S., did just that.

Annually, CAPP sponsors a meeting in Washington D.C. where it invites …

Health Policy

A two-tier solution to the current health care quagmire

Brian C. Joondeph, MD

June 29, 2017Jun 29, 2017

Despite campaign promises from then candidate Donald Trump as well as from incumbent and new members of Congress to repeal and replace Obamacare, now almost six months into the Trump presidency, Obamacare is still the law of the land. Progress, albeit slow, was apparent this week as the Senate debated their version of a replacement, following the House doing the same two months ago.

Are either if these bills a true …

Physician

What a patient taught her doctor about defying death

Linda Girgis, MD

June 29, 2017Jun 29, 2017

The answer reflected off of her face, and I knew my news would be no surprise. Nonetheless, the lump in my throat grew as I hesitated to tell her the latest we found on her recent scans. The fact that…

The answer reflected off of her face, and I knew my news would be no surprise.

Nonetheless, the lump in my throat grew as I hesitated to tell her the latest we found on her recent scans. The fact that this was a recurrence of a previous cancer and she dealt with this inhumanity in the past also did not make it any easier.

It was then that Mrs. B spoke up, …

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Conditions and Diseases

A more careful examination would have saved her expensive procedure

Hans Duvefelt, MD

June 28, 2017Jun 28, 2017

“Noncardiac chest pain” was Laurie Black’s discharge diagnosis. Her chest CT angiogram didn’t show a pulmonary embolus, her troponins were negative for a heart attack and her nuclear stress test was negative for coronary ischemia. “So what do you think…

“So what do you think it was?” she asked while I read through her hospital discharge summary.

“I don’t know. Show me where the pain was,” I answered.

“It started on my back, on the left side, and …

Conditions and Diseases

How journalists help doctors fight the opioid epidemic

Sandeep Kapoor, MD

June 28, 2017Jun 28, 2017

One of the privileges of being a health care provider these days is having access to innovative technologies designed to help save lives. My colleagues and I were recently surprised to discover a powerful tool that could be useful in…

I am part of an interdisciplinary team that focuses on finding …

Conditions and Diseases

How to prepare your baby for the perfect poo

Bryan Vartabedian, MD

June 28, 2017Jun 28, 2017

An excerpt from Looking Out for Number Two: A Slightly Irreverent Guide to Poo, Gas, and Other Things That Come Out of Your Baby. Early bowel patterns | What's normal As we learned, the poo patterns of new babies don’t…

An excerpt from Looking Out for Number Two: A Slightly Irreverent Guide to Poo, Gas, and Other Things That Come Out of Your Baby.

Early bowel patterns | What’s normal

As we learned, the poo patterns of new babies don’t settle in until a week or two after birth.

And beyond the evolution of the early poo trifecta, you’ll likely find that poo is slow to get going if you …

Health Policy

Single payer is not a cure for a broken system

Marilyn M. Singleton, MD, JD

June 28, 2017Jun 28, 2017

California’s state senate’s unipartisan passing of a sweeping single-payer health care bill, the Healthy California Act, has drawn attention to single payer as a solution to the decaying Affordable Care Act. The ACA decreased competition and plan availability in health insurance and leaves patients holding the bag of unaffordable premiums, deductibles, and copays. It’s no surprise that a majority of state residents Read more…

Single payer is not a cure for a broken system

Health Policy

There’s good and bad news for millennials in the Senate’s GOP health bill

Anna Gorman and Kellen Browning

June 28, 2017Jun 28, 2017

Darlin Kpangbah receives free health insurance through Medicaid and is grateful for the coverage in case of accidents, such as when she tore a ligament in her leg a few years ago. “I feel like I’m injury-prone,” said Kpangbah, 20, who lives in Sacramento, Calif. Without insurance, she said, the injury “would’ve been huge to pay for.”

Young adults like Kpangbah were among the biggest beneficiaries of Obamacare, which helped reduce …

Social Media in Medicine

Physician engagement in social media is time well spent

Michael Patrick, MD

June 28, 2017Jun 28, 2017

Physicians have always been teachers, educating patients and families in the exam room, sharing handouts, hanging posters, and sometimes writing magazine articles and self-help books. Today, we have another communication tool, one that is far-reaching with significant impact: social media.…

Americans use social media to consume massive amounts of digital content. The problem is much of it is misinformation, which is why it’s important for physicians to jump in and lend …

Patient

When impossible pain is, in fact, possible

Angelika Byczkowski

June 28, 2017Jun 28, 2017

I had my first outpatient surgical procedure when I was still in high school and needed a plantar wart removed from the sole of my foot. As the doctor injected the area with a local anesthetic, he explained he did these procedures all the time, and I wouldn’t feel a thing. After a short wait, he began to dig out the deeply embedded wart with a hooked scalpel.

With the first …

Physician

11 ways to be an doctor and still live your travel dreams

Sightsee, MD

June 27, 2017Jun 27, 2017

So, you’re a physician with a love of travel — awesome! One week of your salary allows you to travel anywhere in the world (coach, at least) — double awesome! But, as you are acutely aware, there is a catch … a big one. As a full time doc, how do you possibly get the time off to explore new cultures, hike/bike amazing trails and eat/drink around the globe?

As physicians …

Health Policy

Overcoming trainee mistreatment to advocate for our patients

Falisha Gilman, MD

June 27, 2017Jun 27, 2017

“You’re a doctor. You’re a doctor. Goddammit, you’re a doctor, man! You’re a doctor, so say so, and that’s the message, and we’ll follow you,” Jon Lovett shouted to an audience member on Pod Save America. The listener was an internal medicine resident who, in early May, asked how young physicians could better advocate for their patients. I heard this before the House of Representatives voted on the American Health …

Physician

Let’s make our field welcoming to underrepresented minorities

Jose Rodriguez, MD and Jessica L. Jones, MD

June 27, 2017Jun 27, 2017

In response to recent national events, I have often reflected on privilege — what it means, and what I should do about it. Privilege is the freedom to have an advantage without the guilt of knowing that you have it, and not knowing that it is unfair. It is the freedom to say and do things that others cannot. Admittedly, I am male, which comes with certain privilege. I am …

Physician

A doctor’s place is in the exam room

Stuart L. Weinstein, MD

June 27, 2017Jun 27, 2017

An orthopedic surgeon and a neurosurgeon walk into a room … Unfortunately, this is not the start of a joke. While we would prefer to be sharing best practices and treating patients in our exam rooms, the fact is we’re…

An orthopedic surgeon and a neurosurgeon walk into a room …

Unfortunately, this is not the start of a joke. While we would prefer to be sharing best practices and treating patients in our exam rooms, the fact is we’re spending more time than we’d like in a courtroom. Because our medical liability system is broken, orthopedic surgeons, neurosurgeons, OB-GYNs and other specialty physicians continue to find themselves on the receiving …

Read more…

A doctor’s place is in the exam room

Physician

Pay off your medical school loans for free? Here’s how.

Robert A. Felberg, MD

June 27, 2017Jun 27, 2017

We are all panicked over student loan debt. The size of the loan can be worrisome — sometimes overwhelming. The average medical student debt is over $160,000, and it’s not unusual to owe $300,000 to $450,000! The compounded interest is growing every day and adding to your anxiety. Most early career physicians state the stress related to paying off these loans is their greatest emotional burden. Think about that — …

Health Policy

It’s time to advocate for our patients to politicians

Jonathan Kohler, MD

June 27, 2017Jun 27, 2017

As a physician, I often forget how much I know. But there are things that remind me just how different our own experience as doctors is from those who don’t spend their days and nights taking care of the ill.…

I do a lot of work for television, helping writers and directors to create medically plausible stories and scenes. I used to get worried that I might get the dose of …

Conditions and Diseases

Where should babies sleep? A pediatrician responds.

Roy Benaroch, MD

June 26, 2017Jun 26, 2017

A new study about the best place for babies to sleep -- in their own rooms, or sharing a room with their parents -- contradicts current AAP guidelines. But hopefully, in the long run, it will help more parents and…

A new study about the best place for babies to sleep — in their own rooms, or sharing a room with their parents — contradicts current AAP guidelines. But hopefully, in the long run, it will help more parents and babies get a better night’s sleep overall.

The most recent “safe sleep” guidelines were published in 2016. They stressed evidence-based recommendations for the safest way for babies …

Medications

To solve the overmedication problem, follow the physiatrists

Val Jones, MD

June 26, 2017Jun 26, 2017

Medical school prepares physicians to prescribe medications for prevention and treatment of disease, but little to no time is spent teaching something just as important: de-prescribing. In our current system of auto-refills, e-prescriptions, and mindless “checkbox” EMR medication reconciliation, patients may continue taking medications years after their original prescriber intended them to stop. There is no doubt that many Americans are over-medicated, and the problem Read more…

To solve the overmedication problem, follow the physiatrists

Conditions and Diseases

There is no place for blame in cancer

Jennifer Lycette, MD

June 26, 2017Jun 26, 2017

I recently read a post by oncologist Dr. Stephanie Graff on the experience of blame, from self and others, that people with cancer are subjected to: The talk about risk factors and early detection makes us think we can achieve…

I recently read a post by oncologist Dr. Stephanie Graff on the experience of blame, from self and others, that people with cancer are subjected to:

The talk about risk factors and early detection makes us think we can achieve perfection, and that cancer is somehow a personal fault … let us stop making accusations and blaming persons diagnosed with cancer. They are blameless.

Her post, “Read more…

There is no place for blame in cancer

Health Policy

What the Better Care Reconciliation Act says about America

Matthew Hahn, MD

June 26, 2017Jun 26, 2017

The Senate version of the Republican health care bill lays bare the priorities of America’s current political leadership. It is not pretty. The new bill demonstrates the Republicans’ entirely unbalanced view of government and fiscal policy, where monetary value trumps…

These are the new values of the Republican leadership as evidenced by the new bill. We once …

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