KevinMD.com

January 16, 2017Jan 16, 2017

Being sick is a horrible enough time without having to worry about how much it’s going to cost you. Unfortunately, the United States is unique among developed nations in not ensuring that the populace has a safety net that will protect them against exorbitant personal health care expenses. It’s a terrible thing to have to deal with as a physician. I went to medical school to learn how to take …

Physician

A day in the life of a radiologist

Samuel M. Chen, MD

January 16, 2017Jan 16, 2017

“Life is just a short walk from the cradle to the grave, and it sure behooves us to be kind to one another along the way.” - Alice Childress, American playwright, actor, author (1912-1994) I am awakened in the wee…

“Life is just a short walk from the cradle to the grave, and it sure behooves us to be kind to one another along the way.”
– Alice Childress, American playwright, actor, author (1912-1994)

I am awakened in the wee hours by the sound of rain. Ordinarily I would return to bed in hope of stealing more sleep from night, but this particular day I know I have to rise at 4:30 …

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A day in the life of a radiologist

Physician

A 3-question patient satisfaction tool for hospitalists

Rajil M. Karnani, MD

January 15, 2017Jan 15, 2017

About three years ago, our hospital was abuzz about patient satisfaction. Our HCAHPS scores were lower than expected, and there was a push by the administration to improve them. As a hospitalist, I wondered to myself, what could I possibly do to improve them? I already believed I was doing a very good job communicating effectively with patients.

Many years ago, I developed the habit at the end of each encounter …

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Health Policy

A solution to fix the chaos in Medicare

Kenneth Fisher, MD

January 15, 2017Jan 15, 2017

The concept of sickness insurance began in Germany in 1883. Chancellor Otto Von Bismarck initiated insurance for the poor. A decision about how these services were to be delivered is critical to understanding the contentious debates around health care. Could Bismarck have given vouchers for care as needed? Alternatively, should the government control the needed health care facilities?

Perhaps thinking the poor did not have the capability to manage their own health, he chose …

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A solution to fix the chaos in Medicare

Medications

How OTC medication labels are a lesson in health literacy

Subha Mohan

January 15, 2017Jan 15, 2017

Winter break back at home with my family may as well have counted as a preceptorship session or two. Ear infections, the common cold, the flu -- if you can name it, there's a good chance someone in my family…

Winter break back at home with my family may as well have counted as a preceptorship session or two. Ear infections, the common cold, the flu — if you can name it, there’s a good chance someone in my family caught it. We have never collectively consumed as much cough syrup, pain relievers, and antibiotics as we did over these last two weeks. Seriously, the quantity was awe-inspiring.

Even though each …

Physician

If you think fake news is bad for politics, you should try being a physician

Matthew Anderson, MD, MBA

January 15, 2017Jan 15, 2017

Much of the discussion surrounding the presidential election this year focused on fake news. There were countless stories in newspapers and on television news shows about these obviously biased and fictitious posts that might have affected the outcome of the election. I could not help thinking during this campaign season that if you think fake news is bad for politics, you should try being a physician.

As physicians, we are on the …

Medical Education

This patient reinforced a simple but important lesson

Stephanie Van, MD

January 14, 2017Jan 14, 2017

My first week on call, I got called in for a code blue. This patient happened to be the sickest patient on our unit. He had a tumor on his brain stem that was affecting his vision, hearing, swallowing, and breathing, so he had received a tracheostomy and gastrostomy tube as most palliative patients in his situation do. After a series of neurosurgeries, he was undergoing chemotherapy and radiation treatments. …

Medical Education

A medical school goes pass-fail: Why this change must happen everywhere

#LifeofaMedStudent

January 14, 2017Jan 14, 2017

Well, I'm officially that old, bitter resident. I had to walk uphill to medical school 10 miles there and back. “In my day,” medical school was fail, pass, high pass, or honors. I recently found out that the medical school…

Well, I’m officially that old, bitter resident. I had to walk uphill to medical school 10 miles there and back. “In my day,” medical school was fail, pass, high pass, or honors. I recently found out that the medical school I graduated from has changed the first two years of basic science courses to simply pass/fail (while retaining the honors/high pass grades in clinical rotations). I am so annoyed! Why …

Medical Education

The psychiatry rotation terrifies this medical student. Here’s why.

Anonymous

January 14, 2017Jan 14, 2017

Most third medical students look forward to their psychiatry block. After twelve plus hour days and six day weeks on internal medicine, OB/GYN and surgery, the reasonable hours on psychiatry seems like a dream. While my classmates viewed psychiatry as…

My world and fate forever changed when I was twelve years old. Sometimes depression is …

Conditions and Diseases

MKSAP: 26-year-old man with depressed mood and poor concentration

mksap

January 14, 2017Jan 14, 2017

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 26-year-old man is evaluated for a 3-month history of depressed mood, poor concentration, decreased energy, increased sleep, and weight gain. He reports missing…

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

A 26-year-old man is evaluated for a 3-month history of depressed mood, poor concentration, decreased energy, increased sleep, and weight gain. He reports missing many days at work and that his work performance has lagged. He has no suicidal ideation. He states that his current symptoms differ markedly from his usual state of being “highly …

Physician

This new year, a resolution to be grateful to the medical staff

Grace Cordovano, PhD

January 13, 2017Jan 13, 2017

While having coffee the other day, I came across a video called The Thank You Project. Watch it. I assure you, it’s worth 5 minutes of your time. In 2004, Kellie Haddock, her husband, and their 14-week-old son were involved…

While having coffee the other day, I came across a video called The Thank You Project. Watch it. I assure you, it’s worth 5 minutes of your time.

In 2004, Kellie Haddock, her husband, and their 14-week-old son were involved in a horrible car accident. Her husband was killed on impact, and their son was severely injured. In her heartbreaking tale, she recounts the roller coaster ride she endured …

Medical Education

Caring for someone else is not all about you

Brian Slayton, RN

January 13, 2017Jan 13, 2017

Incoming students, you need to hear this: it’s not all about you. Let me explain. My first hospital rotation was on an oncology floor. I answered a patient’s call light by myself. She asked if we had any extra tissues,…

Incoming students, you need to hear this: it’s not all about you. Let me explain.

My first hospital rotation was on an oncology floor. I answered a patient’s call light by myself. She asked if we had any extra tissues, I said yes, and as I turned to leave she said, “I just got a phone call from my mother’s nurse.” Her mother was in hospice care, and the nurse had …

Physician

The deadly risk of being treated by a male physician

Dr. Saurabh Jha

January 13, 2017Jan 13, 2017

Halfway through the “Bell Curve,” which is an analysis of differences in intelligence between races, I realized what had been bothering me about Charles Murray’s thesis. It wasn’t the accuracy of his analysis, which concerned me too. It was what he analyzed. The truth, I used to believe, was always beautiful, whether it was what happened in the multiverse at T equals zero or the historical …

Medical Education

Medical school applicants: Waitlisted? Want more interviews? Here’s what you can do.

Jessica Freedman, MD

January 13, 2017Jan 13, 2017

You submitted your application in July. You completed all of your secondary essays by mid-September. Other than one interview that resulted in a waitlist decision you’ve heard nothing but radio silence. What can you do? Whenever I work with medical…

Whenever I work with medical school applicants I emphasize that the application process is ongoing because the admissions process is fluid. It is not as if you submit your primary application and secondary essays and the …

Medical Education

Don’t laugh: I just want to help my patients

Benjamin Nguyen

January 13, 2017Jan 13, 2017

“And then he said, ‘I … I just want to help people you know?’” The table burst out laughing. I struggled not to spit out my breakfast burrito while chuckling. The laughter slowly died down, and I took another gulp of stale hospital coffee. My classmate was recounting the story of one of the pre-med undergraduates he had begun to mentor. I was too tired to think clearly about why …

Medical Education

My brain: In sickness and in health

Anonymous

January 13, 2017Jan 13, 2017

Chapter 1: Physiology “I am a brain, Watson. The rest of me is a mere appendix.” - Sir Arthur Conan Doyle Bound by flesh and bone, therein lies a mystery of undefined potential which the cosmos cannot even parallel in…

Chapter 1: Physiology

“I am a brain, Watson. The rest of me is a mere appendix.”
– Sir Arthur Conan Doyle

Bound by flesh and bone, therein lies a mystery of undefined potential which the cosmos cannot even parallel in mystery and in complexity beautiful and terrifying. It is that which allows movement to leave the study hall beneath the starry sky, professors to lull us to sonorous sweet slumber, to remember minute …

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My brain: In sickness and in health

Physician

There is a direct connection between inefficiency and burnout

Diane W. Shannon, MD, MPH & Paul DeChant, MD, MBA

January 12, 2017Jan 12, 2017

An excerpt from Preventing Physician Burnout: Curing the Chaos and Returning Joy to the Practice of Medicine. Mark Linzer’s research identified workplace chaos as one of the key predictors of physician stress, burnout, and intention to leave. A recent analysis…

An excerpt from Preventing Physician Burnout: Curing the Chaos and Returning Joy to the Practice of Medicine.

Mark Linzer’s research identified workplace chaos as one of the key predictors of physician stress, burnout, and intention to leave. A recent analysis of the data showed that physicians in clinics with chaotic work environments had …

Physician

Do surgery checklists really work?

Skeptical Scalpel, MD

January 12, 2017Jan 12, 2017

A before and after study at the University of Vermont Medical Center found that a 24-item operating room checklist did not significantly reduce the incidence of any of nine postoperative adverse outcomes. More than 12,000 cases were studied, and outcomes…

More than 12,000 cases were studied, and outcomes included: mortality, death among surgical inpatients with serious treatable complications, sepsis, respiratory failure, wound dehiscence, postoperative venous thromboembolic events (VTE), postoperative hemorrhage or hematoma, transfusion reaction and …

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Do surgery checklists really work?

Physician

Is it a stroke or a secret?

Raj Waghmare, MD

January 12, 2017Jan 12, 2017

Seconds after I arrive at the ER on a Sunday afternoon, I'm called to see an elderly woman who can't breathe. She's ninety-four, and gurgling for air. On my way, I pass two middle-aged women. They are hovering outside a…

Seconds after I arrive at the ER on a Sunday afternoon, I’m called to see an elderly woman who can’t breathe. She’s ninety-four, and gurgling for air. On my way, I pass two middle-aged women. They are hovering outside a nearby room, trying to get my attention. One gestures like a traffic guard as she tries to wave me into the room. The other throws up her hands as I …

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Is it a stroke or a secret?

Physician

Stop pushing doctors out of practice!

Suneel Dhand, MD

January 12, 2017Jan 12, 2017

Since finishing my residency several years ago, I’ve worked in almost every type of hospital up and down the East Coast, from big urban academic medical centers to more rural community outposts. Although I primarily practice hospital medicine, working with both smaller private groups and being a hospital employee, I empathize a lot with my independent practice colleagues and brethren. I almost certainly would have gone down the route of …

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Stop pushing doctors out of practice!

Real physician voices, twice a week

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