KevinMD.com

April 7, 2017Apr 7, 2017

The next time your patient walks into the exam room try starting off your visit a little differently. Instead of asking them how their weekend was, why not ask them, “Out of curiosity do you know any scientists?" No matter…

At a time when scientific debate, and rational thought, all too often falls silent to …

Physician

3 hidden rewards of practicing oncology in a small community

Jennifer Lycette, MD

April 6, 2017Apr 6, 2017

There is a shortage of rural physicians in the U.S. My specialty, medical oncology, is but one of many specialties where the shortage is especially glaring. In oncology, I think there is perhaps a fear of practicing outside the walls of a large tertiary center and leaving behind the established framework and boundaries between the doctor and patient. I know it was a …

Medical Education

The gunner culture hurts the future of medicine

Kelsie Riemenschneider

April 6, 2017Apr 6, 2017

As graduation nears, I recall an away rotation that concerns me for the future of medicine. I remember eagerly boarding my plane, ready to work hard, learn as much as possible, and explore the unknown. My first day in clinic, I was excited to befriend the student I would rotate with. After seeing our first patient together, she asked me to share my clinical reasoning for the case. I happily …

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Medical Education

This one question changed how I thought about medicine

Jessica Celine Morgan

April 6, 2017Apr 6, 2017

It’s 4:00 p.m. on a Thursday: time to present at teaching attending rounds. I have prepared my presentation and know about the patient’s pathology, but I can never help myself from being incredibly anxious for these moments. I gather my…

“This is a 49-year-old undomiciled male with a past medical history significant for alcoholism, insulin dependent diabetes mellitus and chronic pancreatitis who presents with hematemesis.”

I take a breath. …

Physician

Can physicians be introverts? A introverted physician speaks her mind.

Aparna Iyer, MD

April 6, 2017Apr 6, 2017

I’ve known since I was very young that I just experienced life differently than did my extroverted family members and friends. During parties, they seemed to truly enjoy the loudness and chaos of get togethers and the seemingly endless small talk, while I would secretly yearn to return home so that I could read my latest novel in peace. An older family member once told me that I would eventually …

Conditions and Diseases

This is what heroin addiction looks like

Debbie Moore-Black, RN

April 6, 2017Apr 6, 2017

What can I tell you? It started out innocently. College exams were over. And that meant one thing — party time! Bubbly, shots, beer, cocaine and Percocet. Everyone was happy. It was a celebration. Pam came from a pretty strict…

What can I tell you? It started out innocently. College exams were over. And that meant one thing — party time! Bubbly, shots, beer, cocaine and Percocet. Everyone was happy. It was a celebration.

Pam came from a pretty strict religious family: no alcohol, no premarital sex and no crazy music in her house growing up. It was church every Wednesday and Sunday. And if you missed a Sunday, you were …

Medical Education

The infantilization of medical students

Jonathan Coleman

April 6, 2017Apr 6, 2017

I was sitting on hold in the resident room gearing up to beg the IT person that would soon come on the other line for enough authorization to be able to view the residents’ patient problem list, and I found myself thinking about what some of the old docs must think of us third-year students now. Talk to some of these older physicians and they’ll tell you their stories of …

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The infantilization of medical students

Medical Education

Why this medical student joined the National Health Service Corps

Asaad Traina

April 5, 2017Apr 5, 2017

Like many of my peers, I started medical school with idealistic dreams of providing compassionate care for poor patients. I thought being a physician was a noble profession and even discussing money, much less changing my career choices based on it seemed antithetical to that. A visit to the financial aid office quickly cured me of my naiveté. I was facing over $300,000 in debt and would be forgoing millions of …

Conditions and Diseases

What are the best uses of rehabilitation medicine in patients with cancer?

Val Jones, MD

April 5, 2017Apr 5, 2017

Rehabilitation medicine is one of the best-kept secrets in health care. Although the specialty is as old as America’s Civil War, few people are familiar with its history and purpose. Born out of compassion for wounded soldiers in desperate need of societal re-entry and meaningful employment, “physical reconstruction” programs were developed to provide everything from adaptive equipment to family training, labor alternatives and psychological support for veterans.

Physical medicine and rehabilitation …

Physician

5 ways physicians suffer by complaining

Maiysha Clairborne, MD

April 5, 2017Apr 5, 2017

There's a saying: "Pain is inevitable, but suffering is optional." However, some people thrive by complaining. These people, when presented with potential solutions to the problem, argue and invalidate all possibilities presented. Sounds familiar? Being a physician advocate in the…

There’s a saying: “Pain is inevitable, but suffering is optional.” However, some people thrive by complaining. These people, when presented with potential solutions to the problem, argue and invalidate all possibilities presented. Sounds familiar? Being a physician advocate in the battle to lower physician burnout and prevent suicide in doctors, I am disheartened to see this phenomenon in our community. While there are frontline physicians — even physician leaders — …

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5 ways physicians suffer by complaining

Physician

Will we solve health care by blaming doctors?

Thomas D. Guastavino, MD

April 5, 2017Apr 5, 2017

I started my career in the late 1980s and retired just recently. I am very grateful that I caught at least a few years of the "golden age" of medicine because those years made all the difference. Over my career,…

I started my career in the late 1980s and retired just recently. I am very grateful that I caught at least a few years of the “golden age” of medicine because those years made all the difference.

Over my career, I witnessed many different efforts at health care reform proposed, attempted and failed. DRGs, Hillarycare, private insurance capitation, “To Err is Human,” Medicare fraud crackdowns, Global and Bundled payments, general reimbursement …

Physician

We want a federal budget where the trade-offs support life, not death

Edward C. Halperin, MD

April 5, 2017Apr 5, 2017

When I entered college, I took a course in introductory economics. Human wants are unlimited, I learned, but resources are limited. Therefore, we have to make choices about what we spend money on. That, I was told, was what economics…

My economics textbook illustrated the point by quoting from Nazi Germany’s Propaganda Minister Joseph Goebbels who said: “We can do …

Physician

The metric, the dialectic, and the chart electric

Kjell Benson, MD

April 4, 2017Apr 4, 2017

"There is no document of civilization which is not at the same time a document of barbarism." - Walter Benjamin, Theses on the Philosophy of History It is 1940, and the Nazi horror is bearing down on Europe. France has…

“There is no document of civilization which is not at the same time a document of barbarism.”
– Walter Benjamin, Theses on the Philosophy of History

It is 1940, and the Nazi horror is bearing down on Europe. France has fallen, and refugees are streaming out, fleeing to safety through neutral states and America. Walter Benjamin, a Jew, and a German philosopher, joins a small group being guided through southern Spain with …

Physician

It’s OK for physicians to say they’re struggling

Kip Wenger, DO

April 4, 2017Apr 4, 2017

Physicians are trained to assess and care for patients who walk through their hospital or clinic doors. Few of us are prepared to watch for signs that one of our colleagues may need help. That changed for me with one…

Physicians are trained to assess and care for patients who walk through their hospital or clinic doors. Few of us are prepared to watch for signs that one of our colleagues may need help.

That changed for me with one trauma case. I came into the emergency department as the patient arrived — a 33-year-old female with multiple, self-inflicted stab wounds. I walked around the corner to the trauma bay and …

Health Policy

Quantifying quality doesn’t help patients

Kjell Benson, MD

April 4, 2017Apr 4, 2017

Two quality metrics walk into a bar. One demands, "Give me the best beer you’ve got!" The other says, "Give me the second-best beer you’ve got." The bartender pours the beers and states, "You can have them both for free…

Two quality metrics walk into a bar.

One demands, “Give me the best beer you’ve got!”

The other says, “Give me the second-best beer you’ve got.”

The bartender pours the beers and states, “You can have them both for free if you can tell me why this one is better than that one.”

Quality metrics were invented to quantify the ineffable, such as the taste of a fine lager or IPA. I see that …

Medical Education

We should teach medical residents health policy. Here’s why.

Sneha Tella, MD

April 4, 2017Apr 4, 2017

When the U.S. health care system began, physicians were largely autonomous in selection of medical treatments and their delivery. Patients were treated under a fee for service model. However, over time we began to notice an alarming incline in medical spending which ultimately lead to the development of health maintenance organizations (HMOs). At their inception, HMOs were intended to standardize medical treatment, reduce unnecessary use of resources, and encourage the …

Physician

Think we evolved to eat meat? Think again.

Shivam Joshi, MD

April 4, 2017Apr 4, 2017

Eating meat has been linked to cancer, high blood pressure, heart disease, diabetes, stroke, dementia and many other diseases. Nearly every modern lifestyle disease has been associated with meat. With so much emerging evidence against meat, it begs the question:…

Physician

8 things doctors secretly want to tell their patients

Brian C. Joondeph, MD

April 4, 2017Apr 4, 2017

As the repeal of Obamacare is debated in the halls of Congress and on cable TV, one common theme is: “What will happen to patients?” Questions loom about what might change with coverage, about cost, about whether you’ll still be…

But what about doctors? What about how they’re doing?

There are things doctors want to tell their patients, not only about …

Health Technology

10 signs that you may need a scribe

Ofor Ewelukwa, MD, Sarah Glover, DO, and Kevin Fennelly, MD, MPH

April 3, 2017Apr 3, 2017

When I began my tenure at the University of Florida, the departure of a colleague left a very large inflammatory bowel disease practice that involved a lot of work both in and outside of clinic, just as the electronic healthcare record became mandatory. One unanticipated consequence of EHR is that physicians have to review everything before it is final in a patient’s chart. Thus, I spent countless hours in the EHR …

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10 signs that you may need a scribe

Health Technology

This is what CPOE apps should look like

Suneel Dhand, MD

April 3, 2017Apr 3, 2017

Computerized physician order entry (CPOE) is something that every physician up and down the country will be familiar with. For anyone non-medical reading this, it’s the process by which physician orders are now placed in nearly all U.S. hospitals. As little as five years ago, most hospitals were still using pen and paper to place medication, laboratory, radiology and all other orders. Being able to do this now by computer …

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This is what CPOE apps should look like

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