KevinMD.com

April 10, 2017Apr 10, 2017

My entire childhood I wanted to become a doctor. When asked by adults what I wanted to be when I grew up, it was always the same answer. Never did I consider being a fireman or policeman or professional athlete. It was always the same answer: doctor. You see, my father was a small-town, general practice doctor who was somewhat of a legend in town because of his unfailing dedication …

Read more…

Medicine comes in second for me

Physician

My prayers and my medical practice

Fredy El Sakr, MD

April 10, 2017Apr 10, 2017

"Help!" I yelled out of our open apartment door. I was seven years old, and my family had recently emigrated from Egypt to the U.S. We'd been feeling elated that week because, after months of interviews, my father had matched…

“Help!” I yelled out of our open apartment door.

I was seven years old, and my family had recently emigrated from Egypt to the U.S. We’d been feeling elated that week because, after months of interviews, my father had matched into a pediatric residency.

That morning, he’d awoke feeling nauseated. My mother and sister went to buy some soothing food. I noticed that he’d vomited in the bathroom; now he was feeling …

Read more…

My prayers and my medical practice

Physician

Who will be delivering babies in the United States in coming years?

Valerie A. Jones, MD

April 10, 2017Apr 10, 2017

The American Congress of Obstetrics and Gynecology (ACOG) estimates that the U.S. will have between 6,000 and 8,800 fewer OB/GYNs than needed by the year 2020. Additionally, there is a possible shortage of 22,000 by the year 2050. What is…

What is being done about this problem? Well, there are currently efforts to attempt to increase the number of residency positions. There is also talk of having nurse midwives take a greater role. While those are valid …

Real physician voices, twice a week

Free, and one click to unsubscribe.

Physician

Our responsibility to refugee children

Lacey Castellano, MD

April 9, 2017Apr 9, 2017

I am a pediatric resident working, like many residents, in a clinic that sees many of the most vulnerable children in our area. We see many refugees and immigrants coming through our clinic, including many from the countries named in…

These refugee children often suffer from afflictions we rarely see amongst our usual patient population: severe vitamin and nutritional deficiencies, intestinal parasites, malaria. They are often thin …

Read more…

Our responsibility to refugee children

Conditions and Diseases

How much health can you buy for $14,000?

Stephen Devries, MD

April 9, 2017Apr 9, 2017

Unparalleled reductions in cholesterol levels are now possible with a new class of cholesterol medicine, a PCSK9 antibody, reported in one of the large national cardiology meetings recently. But this latest example of high-tech cholesterol treatment comes with a staggering price-tag, $14,000 a year for the new genetically engineered injectable. As a preventive cardiologist, I began to wonder if this is the best way to spend our money.

A few caveats …

Physician

Fighting burnout: No is the wrong answer. It is not acceptable.

Fred N. Pelzman, MD

April 9, 2017Apr 9, 2017

Down in Baltimore for a meeting, long days full of plenary sessions and workshops, awards ceremonies and poster sessions. Recycled hotel air, bad coffee, great camaraderie. Lots of new ideas, lots of new ways of looking at things, lots of…

Down in Baltimore for a meeting, long days full of plenary sessions and workshops, awards ceremonies and poster sessions. Recycled hotel air, bad coffee, great camaraderie.

Lots of new ideas, lots of new ways of looking at things, lots of reinventing the wheel, lots of hope for change. Lots of sessions about how to improve the environment for learners, how to engage medical students, how to build a curriculum, how to …

Medications

How micropractices can help the opioid crisis

Mark Leeds, DO

April 9, 2017Apr 9, 2017

A confluence of events has occurred in the United States that could help to save the lives of many patients as well as the lives and careers of many physicians. The solution is to apply the use of micropractices to address the current opioid addiction crisis. A micropractice is a small medical practice that is run efficiently to keep overhead low and put the patient first. The patient is given …

Physician

This physician fights burnout by having a binder of successes

Erin Barnes, MD

April 9, 2017Apr 9, 2017

The hold music on the telephone cut off abruptly as the doctor I was trying to reach picked up the line. “Yes?” she said curtly. “Hi, this is Erin Barnes,” I said. “I’m calling from Temple University Hospital in regard…

The hold music on the telephone cut off abruptly as the doctor I was trying to reach picked up the line. “Yes?” she said curtly.

“Hi, this is Erin Barnes,” I said. “I’m calling from Temple University Hospital in regard to one of your patients. She was admitted last week with anemia. We were initially concerned …

Health Technology

Recognize the importance of the physical exam in the history of medicine

Rafid Rahman, MD

April 9, 2017Apr 9, 2017

A patient comes into the ER complaining about throbbing migraines after falling off her bicycle; thus, the physician quickly orders an X-ray, complete blood count, and asks the nurse to schedule the patient for an MRI of the head and neck in case both those tests come back inconclusive. As an ER scribe, I saw many conditions where the physician would quickly do a physical exam, and then use a …

Medications

Surviving opioids in the fentanyl era

Martha Bebinger

April 8, 2017Apr 8, 2017

There’s a clear culprit in the rising drug overdose death count in Massachusetts — the synthetic opioid fentanyl. More powerful and more deadly than heroin, fentanyl has sparked a new set of survival rules among people who abuse opioids. About…

About 75 percent of the state’s men and women who died after an unintentional overdose last year had fentanyl in their system, up from 57 percent in 2015. It’s a pattern cities …

Read more…

Surviving opioids in the fentanyl era

Conditions and Diseases

Bioterrorism: 10 facts about sarin gas

Tanu S. Pandey, MD

April 8, 2017Apr 8, 2017

As the civil war in Syria shows no signs of de-escalating, worrisome evidence points towards the deployment of chemical warfare with banned agents recently, resulting in almost a hundred deaths with more than a quarter of them children. Chlorine and…

1. Historically, Sarin was used for bioterrorism by members of Aum Shinrikyo, …

Read more…

Bioterrorism: 10 facts about sarin gas

Health Technology

Congressman Chaffetz: iPhones are the future of medicine

Kevin R. Campbell, MD

April 8, 2017Apr 8, 2017

Recently, Utah Republican Jason Chaffetz made comments concerning health care reform that illustrates just how out of touch Congress is with modern medicine. In a press conference addressing the ongoing debate over Obamacare repeal, he stated that Americans should make a choice between purchasing health insurance and an iPhone — in the Congressman’s own words “rather than getting that new iPhone that they …

Health Policy

Maybe mothers saved the Affordable Care Act

Claudia M. Gold, MD

April 8, 2017Apr 8, 2017

In striking contrast to the happenings in the U.S. Congress, Kate Middleton, future queen of England, spoke these words at London's Royal College of Obstetricians and Gynecologists on the occasion of a launch of educational films dealing with maternal mental…

In striking contrast to the happenings in the U.S. Congress, Kate Middleton, future queen of England, spoke these words at London’s Royal College of Obstetricians and Gynecologists on the occasion of a launch of educational films dealing with maternal mental health:

Nothing can really prepare you for you the sheer overwhelming experience of what it means to become a mother, It is full of complex emotions …

Read more…

Maybe mothers saved the Affordable Care Act

Physician

This is what every medical practice should have

David J. Norris, MD, MBA

April 8, 2017Apr 8, 2017

An excerpt from The Financially Intelligent Physician: What They Didn't Teach You in Medical School. Every practice should have a dashboard of financial and performance metrics that the physician leader studies on a regular basis. A good dashboard should include…

An excerpt from The Financially Intelligent Physician: What They Didn’t Teach You in Medical School.

Every practice should have a dashboard of financial and performance metrics that the physician leader studies on a regular basis. A good dashboard should include the financial analysis tools that are most important to the organization. Pick which ones you want …

Conditions and Diseases

MKSAP: 79-year-old man with right hip pain

mksap

April 8, 2017Apr 8, 2017

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 79-year-old man is evaluated for a 3-month history of right hip pain. He points to the center of his right buttock when asked…

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

A 79-year-old man is evaluated for a 3-month history of right hip pain. He points to the center of his right buttock when asked to identify the location of the pain. He has no radicular symptoms. He reports no focal trauma but believes his symptoms began after he stepped off a curb that …

Physician

I once made a promise to a young boy with half a heart. I could not keep it.

Eugene Gu, MD

April 7, 2017Apr 7, 2017

“Am I going to die?” There was a mixture of fear and pain in my patient’s eyes. He was a second grader but had already survived three major heart surgeries. Now he had pneumonia and was struggling to breathe. We…

“Am I going to die?”

There was a mixture of fear and pain in my patient’s eyes. He was a second grader but had already survived three major heart surgeries. Now he had pneumonia and was struggling to breathe. We were about to intubate him.

“You’re a strong guy,” I whispered to him as his mother held his hand and sobbed. “We’ll get you through this.”

He died two days later.

I drove home …

Health Policy

Health reform is dead. So what can we do now?

Matthew Hahn, MD

April 7, 2017Apr 7, 2017

Health care reform as it is typically discussed in America is dead for now. By “as it is typically discussed,” I mean broad “big picture” health care reform, which deals primarily with how we organize payments: government vs. free market, multi-payer vs. single payer, profit-based vs. not-for-profit. The Democrats tried. Obamacare’s shortcomings stem largely from the fact that neither President Obama nor the larger Democratic Party had the political power …

Medications

Drugs shouldn’t be this expensive

Michael Kirsch, MD

April 7, 2017Apr 7, 2017

Why are the costs of prescription drugs so high? While I have prescribed thousands of them, I can’t offer an intelligent answer to this inquiry. Of course, all the players in this game — the pharmaceutical companies, pharmacy benefit managers, insurance companies, consumer activists and the government — offer their own bromides, where does the truth lie?

While I don’t fully understand it, and I don’t know how to fix it, …

Read more…

Drugs shouldn’t be this expensive

Physician

What do you do when you know someone is going to die?

Jeremy Topin, MD

April 7, 2017Apr 7, 2017

What do you do when you know someone is going to die? I’m not talking about death when it comes at the end of a long protracted illness or a terminal diagnosis. Or the final act at the end of…

What do you do when you know someone is going to die? I’m not talking about death when it comes at the end of a long protracted illness or a terminal diagnosis. Or the final act at the end of a “good” life, when the body and mind have ultimately given way. I’m talking about when you realize the twenty-five-year-old woman in front of you, who you met five minutes ago, …

Physician

Have doctors become desensitized to gruesome realities?

Zahir Basrai, MD

April 7, 2017Apr 7, 2017

So it’s a Wednesday night, and I just got home after completing a shift. I’m beat. My beautiful sofa beckons to me, and my TV seduces me with brainless images and sound. I succumb to the temptation. I turn on Netflix. Too many movies, too many decisions. Screw this; I didn’t just finish up a shift to have to sit and make more decisions. I go to the suggested for …

Real physician voices, twice a week

The Podcast

Latest episodes

The Podcast

Latest episodes