KevinMD.com

January 31, 2017Jan 31, 2017

The problem with health care and drug prices in America isn’t that we spend too much money. The real problem is that we believe we are spending “other people’s money.” Yes, I was raised in Sweden, but no, I’m not…

The problem with health care and drug prices in America isn’t that we spend too much money. The real problem is that we believe we are spending “other people’s money.”

Yes, I was raised in Sweden, but no, I’m not a Socialist. The irony is that “free” health care there is more clearly understood to be directly financed by local(!) taxes that can go up if people in that region consume …

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Health care needs a moral wake-up call

Physician

I’m a U.S. doctor just back from Sudan, where hospitality from Muslims greeted me everywhere

Richard Gunderman, MD, PhD

January 31, 2017Jan 31, 2017

Many Americans have never visited a predominantly Muslim country and may know relatively little about the faith of Islam. This is relevant in light of the Trump administration’s recent executive order attempting to reduce terrorist threats to the U.S. by…

Having returned this month from Sudan, one of the countries affected by the ban, I wish to …

Conditions and Diseases

The story of a rare, serious complication of mononucleosis

Niran S. Al-Agba, MD

January 31, 2017Jan 31, 2017

Thirteen years ago, I received a call from the mother of a college freshman who was concerned because her son had been diagnosed with mononucleosis during finals week. She felt something was not quite right and asked me for advice.…

“Trust your instinct, go get him, and bring him home.”

She brought him to my clinic the following day. He looked mildly ill. His vitals were stable; he was fatigued, slightly dehydrated, …

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Physician

America’s veterans deserve the best, and safest, pain treatment

Ajit Rai, MD

January 30, 2017Jan 30, 2017

Pain is usually considered a symptom, not a life-threatening medical problem. But for Army veteran Richard Dejarnette, 52, constant excruciating pain in his right leg made his life intolerable, and he believes he wouldn’t be alive today if a physician…

Pain is usually considered a symptom, not a life-threatening medical problem.

But for Army veteran Richard Dejarnette, 52, constant excruciating pain in his right leg made his life intolerable, and he believes he wouldn’t be alive today if a physician anesthesiologist at the VA West Los Angeles Medical Center hadn’t been there to help him.

On December 14, the Department of Veterans Affairs announced the wise decision to keep physician anesthesiologists …

Medications

It would be disastrous if we reverse our impressive vaccine progress

Paul Sax, MD

January 30, 2017Jan 30, 2017

As an infectious diseases specialist married to a pediatrician, I am going to propose, in most unhumble fashion, that I have the ideal perspective to assess the worthiness of vaccines. So when Robert F. Kennedy Jr., a notorious anti-vaccine crusader,…

As an infectious diseases specialist married to a pediatrician, I am going to propose, in most unhumble fashion, that I have the ideal perspective to assess the worthiness of vaccines.

So when Robert F. Kennedy Jr., a notorious anti-vaccine crusader, announced that he was under consideration to head a government commission on vaccine safety and scientific integrity, and is planning to step away from his environmental job to take that post, I …

Physician

My top 5 wishes for health care in 2017

Suneel Dhand, MD

January 30, 2017Jan 30, 2017

Another year passed by, and I was going to write about my wishes for the New Year as a hospital doctor. But then, remembered that I did something very similar a couple of years ago. I went back and read over my wishes and found that they are identical to my wishes now! That’s not to say we haven’t made some great progress but — as anyone in health care …

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My top 5 wishes for health care in 2017

Medications

Let’s spend money on autism support, not conspiracy theories

Jessica Berthold

January 30, 2017Jan 30, 2017

I spent many sleepless nights in the months after my son’s autism diagnosis fretting whether I could have done something to prevent it. I recounted, in obsessive detail, the course of my pregnancy, the birth, and the two years of child-rearing that led to the moment when our pediatrician confirmed my fears — and life as I’d known it tilted off its axis. In my spare waking hours, I pored …

Physician

This is how doctors evolve

Jordan Grumet, MD

January 30, 2017Jan 30, 2017

You won't at first. But then, you will. It will start innocently. Probably even before medical school. You will have a morbid curiosity about passing ambulances and motor vehicle accidents. Your original empathy for the victim will disappear when you…

You won’t at first. But then, you will.

It will start innocently. Probably even before medical school. You will have a morbid curiosity about passing ambulances and motor vehicle accidents. Your original empathy for the victim will disappear when you begin to think of them as patients … as test cases.

The commodification accelerates during the early years of medical school. Anatomy, pathology and physiology provide you a vocabulary to replace human …

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This is how doctors evolve

Physician

Gun violence and the limits of human performance

Anonymous

January 30, 2017Jan 30, 2017

So let’s step outside our traditional arguments when discussing the health care problem of gun violence in this country. We all know the entrenched opinions of both sides: The second amendment is inviolable vs. there are over 30,000 deaths from guns per year in this country, and why on earth does anyone need an assault weapon? But the city with the strictest gun laws, Chicago, has the most gun deaths, …

Physician

Medicine is not destroying your marriage

Sarah Epstein

January 29, 2017Jan 29, 2017

Every medical couple knows that the lifestyle and career choice brings with it adjustments and sacrifices. Physician spouses and partners often take on more housework and childcare to accommodate long working hours. Physicians may work unusual hours that lead to late-night arrivals, missed bedtime tuck-ins, and less face-to-face time. This can lead many couples to blame medicine for their struggling relationship.

Take the example of a resident who has been working …

Health Policy

The Cancer Moonshot should not occur on class lines

Rachel Mintz

January 29, 2017Jan 29, 2017

Cancer. The ominous word instantaneously triggers fear and anxiety. According to the American Cancer Society, cancer is the second most common cause of death in the United States, accounting for one in four deaths. Despite the attention cancer has garnered, an inequality exists. Patients without Internet access may not learn about possible therapeutic interventions. As we proceed with the “Moonshot” to better control cancer, we must assure that all patients …

Medical Education

The difficulty of maintaining relationships throughout medical training

Farrell Tobolowsky, DO

January 29, 2017Jan 29, 2017

It was 1 a.m. on a Sunday night on call, and we were waiting patiently for admissions in the resident workroom. We were four near-perfect strangers, yet we had one thing in common: our challenges we faced in maintaining relationships. Was it truly because of our shared profession of medicine or because of our similar personalities that led us into the field? We realized we struggled preserving our current relationships …

Medical Education

A young black physician’s letter to future black doctors

Earl Stewart, Jr., MD

January 29, 2017Jan 29, 2017

Dear future colleague, What a tremendous thing it is to know you are becoming a physician! You are devoting your life and talents to the betterment of the health of your future patients, your local community, and our entire society.…

Dear future colleague,

What a tremendous thing it is to know you are becoming a physician! You are devoting your life and talents to the betterment of the health of your future patients, your local community, and our entire society. You have responded to the call to serve in a profession that is hundreds of years old, steeped in tradition but vehemently progressive, always changing, and vowing to remain abreast of …

Physician

Forget burnout. Let’s address physician dissatisfaction.

Karen Weiner, MD, MMM

January 28, 2017Jan 28, 2017

Burnout is a tragedy. It terminates careers, friendships, marriages and sometimes lives, prematurely. It threatens the well-being of individuals, families, patients, organizations and our society. The current media focus on the crisis of physician burnout is appropriate and timely, but the industry itself needs a reality check. While burnout is experienced by the individual, it is the manifestation of a dysfunctional environment that only we as physicians and leaders in …

Medical Education

Why it’s important to take the time and give feedback

Melanie Sulistio, MD

January 28, 2017Jan 28, 2017

I recently gave a teaching workshop focused on giving feedback. Thrilled to share my passion for medical education, I excitedly prepared my slides, ready to discuss tools that can help make someone a more effective educator. Despite the evidence and…

Despite the evidence and the recommendations from well-known educators I presented, there was an attendee that was dubious. The inevitable question arose, “But, why?” Why, this person asked, take the time to give feedback when …

Conditions and Diseases

Do patients with celiac disease need probiotics?

Maureen Leonard, MD

January 28, 2017Jan 28, 2017

One of the most common questions that I receive from patients diagnosed with celiac disease is if they should take a probiotic. The only available treatment for celiac disease, an autoimmune disease characterized by destruction of the absorptive surface of the small intestine which develops in genetically compatible individuals, is a gluten free diet. However, patients and providers often question whether supplementation with probiotics may hasten the healing process.

Probiotics are …

Conditions and Diseases

MKSAP: 68-year-old man with a right intertrochanteric fracture

mksap

January 28, 2017Jan 28, 2017

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 68-year-old man is evaluated in the hospital for a right intertrochanteric fracture sustained in a mechanical fall. He reports right hip pain but…

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

A 68-year-old man is evaluated in the hospital for a right intertrochanteric fracture sustained in a mechanical fall. He reports right hip pain but no other symptoms. He has hypertension and type 2 diabetes mellitus and was in his usual state of health prior to the fall. He checks his blood glucose level several times …

Physician

The real danger of maintenance of certification and what to do about it

Karen S. Sibert, MD

January 27, 2017Jan 27, 2017

In the interests of full disclosure, I acknowledge with delight that I have a non-time limited board certificate from the American Board of Anesthesiology (ABA), issued before the year 2000. I can just say “no” to recertification. The more I…

The more I learn about the American Board of Medical Specialties (ABMS) and its highly paid board members, the more disillusioned I’ve become. It’s easy to see why so many physicians today have concluded …

Physician

Men and women doctors versus correlation and causation

Ashish Jha, MD, MPH

January 27, 2017Jan 27, 2017

Our recent paper on differences in outcomes for Medicare patients cared for by male and female physicians created a stir. While the paper received broad coverage and mostly positive responses, there have also been quite a few critiques. There is no doubt that the study raises questions that need to be aired and discussed openly and honestly. Its limitations — which the paper highlights — are important. Given the …

Physician

Why this physician can’t be her family’s doctor

Karen Yeter, MD

January 27, 2017Jan 27, 2017

The day I got into medical school, my uncle said to me, “You are going to be a doctor! We finally have a doctor in the family. You are going to take care of your uncle in his old age.”…

The day I got into medical school, my uncle said to me, “You are going to be a doctor! We finally have a doctor in the family. You are going to take care of your uncle in his old age.” Other family members echoed the same sentiment. First doctor in the family. Now, we will all have free medical advice.

As I progressed through medical school, then internship and residency, then …

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