KevinMD.com

January 12, 2017Jan 12, 2017

Running has been a constant in my life, and it always will be. I’ve gone on runs in snowstorms and 100-plus degree heat waves, Christmas mornings and birthdays. That hour or so dedicated to running is sacred, reserved for a few minutes to clear my head, a sort of reset button to each day. I’m surrounded by nothing but the sound of shoes hitting the pavement and gasps of heavy …

Physician

I’m sorry your mom died, but I cannot help you now. Here’s why.

Jordan Grumet, MD

January 12, 2017Jan 12, 2017

Dear Mrs. J, I would like to express my deepest condolences on the passing of your mother. She was a magnificent woman, and I had the pleasure of being her doctor for almost a decade. It was a pleasure. During…

Dear Mrs. J,

I would like to express my deepest condolences on the passing of your mother. She was a magnificent woman, and I had the pleasure of being her doctor for almost a decade. It was a pleasure. During our short visits, she regaled me with stories of childhood and often gently sprinkled in advice gleaned from years of experience. Even as she began to decline, we would sit together …

Physician

Let’s make vaccines great again

Niran S. Al-Agba, MD

January 11, 2017Jan 11, 2017

Robert Kennedy, Jr. is an activist, author, and attorney specializing in environmental law. He is the son of Robert "Bobby" Kennedy, a former U.S. attorney general, and the nephew of former President John F. Kennedy. Kennedy is president of the…

Robert Kennedy, Jr. is an activist, author, and attorney specializing in environmental law. He is the son of Robert “Bobby” Kennedy, a former U.S. attorney general, and the nephew of former President John F. Kennedy. Kennedy is president of the board of Waterkeeper Alliance, a non-profit focused on protecting and enhancing waterways worldwide. He has written a book about the damaging effects of vaccinations due to thimerosal, and to round …

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Let’s make vaccines great again

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Physician

We must tell sad medical stories too

Richard Young, MD

January 11, 2017Jan 11, 2017

This post is based on a "friend of a friend" situation. Important details have been changed to protect anonymity, but not the basic realities I want to discuss. A 49-year old man was diagnosed with a rare form of lung…

This post is based on a “friend of a friend” situation. Important details have been changed to protect anonymity, but not the basic realities I want to discuss.

A 49-year old man was diagnosed with a rare form of lung cancer about a year and a half ago. This sad situation is compounded by the fact that he was in a stable marriage with a wife and two children, ages 10 …

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We must tell sad medical stories too

Medical Education

The one lesson I learned working in a psych unit

Anonymous

January 11, 2017Jan 11, 2017

I was incredibly nervous going into my first day in the inpatient child/adolescent psychiatry unit. “Was this where the truly psychotic kids are? Am I going to be safe here?” I wondered as I casually introduced myself to the staff on the floor. After a morning of sitting in on group therapy led by psychologists and occupational therapists, I calmed down. Against the backdrop of the soothing soft pastel colors, …

Medications

Many think the Cures Act will halt progress. They’re wrong.

Linda Girgis, MD

January 11, 2017Jan 11, 2017

Recently, the U.S. Senate passed the 21st Century Cures bill with an overwhelming vote of 95-4 and was approved by President Obama. Yet, the controversy continues. Some people worry that this act is destroying our scientific process and sacrificing patient safety issues. Others proclaim that this is a win for the big pharmaceutical companies, who are already winning by a landslide. And then, there are the voices shouting out with …

Physician

Why is my medical oncologist never on time for my appointment?

Prateek Mendiratta, MD

January 11, 2017Jan 11, 2017

My daughter's biggest fear before starting kindergarten was would she have enough time to finish her lunch in the time allotted. Luckily, she is not a busy medical oncologist in clinic. A medical clinic is not set up for those…

My daughter’s biggest fear before starting kindergarten was would she have enough time to finish her lunch in the time allotted. Luckily, she is not a busy medical oncologist in clinic. A medical clinic is not set up for those who take their time. Modern medicine is predicated that within a fifteen-minute visit, you are expected to see the patient, address their issues, place orders, and come up with a …

Conditions and Diseases

Pubic hair grooming means more sexually transmitted infections. Why?

Jennifer Gunter, MD

January 11, 2017Jan 11, 2017

Anyone who knows me, knows I have long been skeptical of the safety of pubic hair removal. We evolved to have pubic hair, and we have no data to say that we have outgrown that need as we have wisdom teeth. The current thinking is that pubic hair plays a role in protecting the more delicate/sensitive tissues of the labia and the vaginal opening. Basically, pubic hair is a mechanical …

Medical Education

Hope: Where can I fill a prescription for that?

Jacob Chevlen

January 11, 2017Jan 11, 2017

“I mean, ever since it happened, I just don’t feel safe anymore … they come out of nowhere … my heart will be pounding and pounding … they can get me at night, even if I’m in my mom’s house.…

Ms. Smith is a young white woman who is presenting with panic attacks.

“Doctor, the pain is so bad …

Health Policy

Repealing Obamacare faces these 7 challenges

Deep Ramachandran, MD

January 10, 2017Jan 10, 2017

Republicans have been waiting a long time for this moment. After sixty previous attempts to repeal the Affordable Care Act, commonly known as Obamacare, their moment has arrived. President-elect Trump and Speaker Ryan believe that they can repeal Obamacare and…

1. Millions will lose health insurance. Pre-Obamacare, nearly 20 percent of Americans went uninsured, and this disproportionately affected lower-income levels. Those are …

Physician

America needs more Michelle Obamas

Keith Pochick, MD

January 10, 2017Jan 10, 2017

As a presidency draws to a close, it is natural to consider the legacy it etches upon the pages of history. For the most part, a first lady's legacy is a sidenote. There are a few exceptions, of course. Eleanor…

As a presidency draws to a close, it is natural to consider the legacy it etches upon the pages of history. For the most part, a first lady’s legacy is a sidenote. There are a few exceptions, of course. Eleanor Roosevelt, Jackie Kennedy, and Nancy Reagan come to mind. I believe that Michelle Obama’s legacy will be one of the more notable of the modern era.

For better or worse, race …

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America needs more Michelle Obamas

Physician

The double meaning of despair in the hospital

Kjell Benson, MD

January 10, 2017Jan 10, 2017

How can a doctor resist an essay entitled, "The Sickness Unto Death?" Kierkegaard, the darkest of the bleak existentialists, begins by asking, “Is despair an excellence or a defect?” Can despair be an excellence? It is December in Oregon, the…

How can a doctor resist an essay entitled, “The Sickness Unto Death?” Kierkegaard, the darkest of the bleak existentialists, begins by asking, “Is despair an excellence or a defect?” Can despair be an excellence?

It is December in Oregon, the rain comes down in sheets, with only a few hours daily of half-light. Kierkegaard’s winters in 1840 Denmark must have felt a lot like this, so I press on.

“In despairing over …

Medications

Not everything is terrible in the U.S. health care system

Janice Boughton, MD

January 10, 2017Jan 10, 2017

A couple of weeks ago I started taking medicine to lower my blood pressure and another to reduce my cholesterol. This was a controversial move, given my deep distrust of the practice of medicine, when it is practiced on me,…

I know that, as a woman of 55 with a very active and healthy lifestyle, no chronic diseases and, most importantly, as a nonsmoker, I am at …

Physician

What a radiologist learned about a thoracentesis from a pulmonologist

Cory Michael, MD

January 10, 2017Jan 10, 2017

It was 1989. While alternating between NCAA basketball tournament games on broadcast television, reruns of an older version of the game show Wipeout on cable, and the 8-bit Nintendo game Top Gun, a child sat in a hospital bed in the middle of rural America wondering why he was there. All he knew was that he had a sharp pain in the left side of his chest and that couldn’t …

Physician

How this doctor went from meek to confident

Geoffrey Rubin, MD

January 10, 2017Jan 10, 2017

At 5:07 p.m. on July 27 of last year, my pager's beep pierced the bustle of the hospital hallway: "CARDIAC ARREST. 6GS room 356 bed 2. Need cards STAT." It was only seven minutes into my first overnight call as…

At 5:07 p.m. on July 27 of last year, my pager’s beep pierced the bustle of the hospital hallway: “CARDIAC ARREST. 6GS room 356 bed 2. Need cards STAT.”

It was only seven minutes into my first overnight call as a cardiology (“cards”) fellow, and I felt like I’d received a code-dose shot of epinephrine. In a most un-doctorly manner, I sprinted up the four flights of stairs to the ward.

Panting, …

Physician

Why physician engagement is code for physician control

Michael Breen, MD

January 10, 2017Jan 10, 2017

Are physicians unruly children? That’s the attitude I see at hospital C-suite meetings. (As in, “Our doctors are protesting our new unproven proton beam therapy center. How cute! They think they know how hospitals work: Even cuter, they think their…

Are physicians unruly children?

That’s the attitude I see at hospital C-suite meetings. (As in, “Our doctors are protesting our new unproven proton beam therapy center. How cute! They think they know how hospitals work: Even cuter, they think their opinion matters.”) Chuckles all around.

That smiling dismissiveness doesn’t surprise me. Call me cynical, but when people have power over other people, they become contemptuous. And in today’s world hospital executives have that power …

Physician

Massachusetts should reject naturopaths: A message to Governor Charlie Baker

Britt Marie Hermes, ND

January 9, 2017Jan 9, 2017

I learned recently that the Massachusetts legislature passed the latest installment of the naturopathic licensing bill S.2335 in the final minutes of the 2016 legislative session. The bill is currently sitting on Governor Charlie Baker’s desk. He has a few days to sign the bill, which would make Massachusetts the 19th state to license naturopaths. If he does nothing, S.2335 will die from a pocket veto.

Senate Bill 2335 is asking a …

Physician

Stop being surprised: I’m a physician and a mother

Miriam A. Knoll, MD

January 9, 2017Jan 9, 2017

“So, what's your story?” I knew right away what the medical oncologist was really asking. She and I were meeting for the first time while caring for a mutual patient. While getting to know each other, she asked me if…

“So, what’s your story?”

I knew right away what the medical oncologist was really asking. She and I were meeting for the first time while caring for a mutual patient. While getting to know each other, she asked me if I had children; when I answered in the affirmative, she asked me, “So, what’s your story?”

The question meant many things …

Physician

Planned Parenthood and my decision to go to medical school

Melanie Jay, MD

January 9, 2017Jan 9, 2017

As my co-workers and I peered out the window of the Planned Parenthood in Philadelphia, we saw over 200 protestors chanting the name of a man who had killed 2 people and injured several others at reproductive health centers the day before. They kept coming closer and padlocked the entrance gate so that we were trapped. We worried they might have weapons. The stand-off lasted for three terrifying hours. As …

Medications

The Cures Act comes with some big questions

Kevin R. Campbell, MD

January 9, 2017Jan 9, 2017

Recently, the U.S. House of Representatives passed the 21st Century Cures, known simply as the Cures Act. This is thought to be the largest and most powerful health care-related law since the passage of the Affordable Care Act during Obama’s first term. The Cures Act provides for a large increase in funds for boosting biomedical research and also takes aim at speeding up drug and medical device approvals through the …

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