KevinMD.com

December 21, 2016Dec 21, 2016

In my former life as a hospital-based, shift-working physician with young children at home, this time of the year inevitably brought the same question from at least a handful of individuals: “Isn’t it hard on your kids not to have you home on Christmas?” Thankfully, I was always able to answer truthfully, “no.” With consistent effort and a no-nonsense attitude, my kiddos either didn’t know the difference because they were …

Medications

The need for pharmacy electives in the medical school curriculum

Sarayna Schock

December 21, 2016Dec 21, 2016

I spent one year working full-time as a pharmacy technician at a high-volume community pharmacy prior to entering medical school. Besides learning the intricacies of billing and the dispensing process, I was granted personal access into a world nearly all patients, but few providers are aware of. At the time my job was just that: a job. There were fun perks like counting pills in multiples of five and visualizing …

Physician

Use diverse children’s books to bridge our empathy gap

Fatu Forna, MD

December 20, 2016Dec 20, 2016

When was the last time your child read a book featuring someone different from them? When did they last read a book about an African American girl celebrating her birthday, a Mexican American girl celebrating her quinceañera, or a Jewish…

When was the last time your child read a book featuring someone different from them?

When did they last read a book about an African American girl celebrating her birthday, a Mexican American girl celebrating her quinceañera, or a Jewish American boy celebrating his bar mitzvah?

What about a book featuring Chinese American, Native American, Indian American or Muslim children?

Think of the last few books you read to your children. Chances are, …

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Physician

It’s time to stop mandating board exams for family physicians

Sarah Hiam, DO

December 20, 2016Dec 20, 2016

I am a family physician who has been in practice since 2007. My practice is broad in scope; immediately out of residency I worked in a community health center where I practiced obstetrics, newborn care, and inpatient medicine and pediatrics, along with my outpatient obligations. Since 2011 I have been a locum tenens physician working in rural Colorado in emergency departments, clinics, and hospitals.

I recently received your American Board of …

Conditions and Diseases

How an oncologist used Pac-Man to teach his patient

Prateek Mendiratta, MD

December 20, 2016Dec 20, 2016

The most exciting and difficult part of my job is keeping up with all the rapid changes occurring in the field of cancer treatments. It is amazing how each day there seems to be a breakthrough treatment coming along, shifting old cancer paradigms. Although this is a good problem to have, finding time to stay current is easier said than done. Even more difficult is making sure we can explain these …

Medical Education

How medical training is like dogfighting

Stephanie Waggel, MD

December 20, 2016Dec 20, 2016

Since being fired from my program as a result of my cancer diagnosis, I am on a mission to help medical students and doctors. After starting the website, Improve Medical Culture, I have found that much of the general population has little sympathy for doctors. Some find us completely unrelatable. Because of this, I wrote the following comparison between dogfighting and medical training. I aim …

Physician

Leave judgment behind, lest our care be hindered

Chiduzie Madubata, MD

December 19, 2016Dec 19, 2016

For any health care professional, a typical day in the hospital brings about its unique challenges. Depending on the patients that we see, one second the situation can be routine, and the next second, it can become complex. In the midst of this flux, there is an expectation for us to make important decisions, with the speed of these decisions dependent on how a patient is doing at a given …

Physician

We didn’t save his life. We did better than that.

Cindy Winebrenner, MD

December 19, 2016Dec 19, 2016

"Well? Did you save him?" "No. We did better than that." He came in pulseless. The machine performing chest compressions with the rhythmic thud, thwack, thump. His ribs heaving under the force of the compressor, keeping his heart artificially beating.…

“Well? Did you save him?” “No. We did better than that.”

He came in pulseless. The machine performing chest compressions with the rhythmic thud, thwack, thump. His ribs heaving under the force of the compressor, keeping his heart artificially beating. The plastic tube secured in his airway forcing puffs of air to inflate his lungs. His skin slightly purple-gray, on that narrow brink between life and death. His eyes like speckled …

Conditions and Diseases

How the press coverage of the WHO Zika designation change hurt us

Nisha Mehta, MD

December 19, 2016Dec 19, 2016

On November 18, the World Health Organization (WHO) declared that Zika will no longer be classified as a public health emergency, while maintaining that the epidemic remains “a highly significant and long-term problem,” and emphasizing that this change in designation…

Most major news outlets rushed to report the news, with headlines focusing on the end of the emergency …

Medical Education

The financial ramifications of medical school

Cory Michael, MD

December 19, 2016Dec 19, 2016

I thought long and hard about the financial ramifications of medical school before I started. I already had a job in the medical field that I enjoyed, and I was happy with my level of compensation at the time. After running the numbers, I knew that the choice to pursue medicine would result in a delayed economic benefit that would take at least 15 years to recover, and only through …

Physician

The loss of a pregnancy is never taken lightly

Andrea Eisenberg, MD

December 18, 2016Dec 18, 2016

Voluntary termination of pregnancy. Voluntary interruption of pregnancy. These are the medical terms for what the layperson thinks of as an abortion. Missed abortion. Threatened abortion. Incomplete abortion. Spontaneous abortion. Septic abortion. Inevitable abortion. These are medical terms for the…

Voluntary termination of pregnancy. Voluntary interruption of pregnancy. These are the medical terms for what the layperson thinks of as an abortion.

Missed abortion. Threatened abortion. Incomplete abortion. Spontaneous abortion. Septic abortion. Inevitable abortion. These are medical terms for the failure of a pregnancy.

All these medical terms are just that: medical terms. Nomenclature to differentiate biological processes, so as doctors, we can clearly communicate what is happening with our patients. However, …

Physician

Essentialism for health care professionals

Timothy E. Paterick, MD, JD, MBA and Elizabeth Ngo, MD

December 18, 2016Dec 18, 2016

An excerpt from Physician—Time to Invest in Yourself: Work-Life Balance, the Needs of the Patient, and Medical-Legal Risk Management. What is an essentialist? What is an essentialist lifestyle? Essentialism focuses on identifying the important signals in life and eliminating the…

An excerpt from Physician—Time to Invest in Yourself: Work-Life Balance, the Needs of the Patient, and Medical-Legal Risk Management.

What is an essentialist? What is an essentialist lifestyle? Essentialism focuses on identifying the important signals in life and eliminating the noise. The noises are the distractions that add no value to your life and frequently monopolize time and meaning. When you assume the role of an essentialist you will discover that …

Medical Education

Is it possible for the modern day doctor to be happy?

Taylor Brana, DO

December 18, 2016Dec 18, 2016

When I wrote the article, “My future as a physician looks mediocre at best,” I did not expect the traction that it received. When it received so many shares, I realized there is an important point for us to shed…

Now I don’t mean an overly dramatic happiness involving euphoria, …

Health Policy

Will repeal and replace of the ACA move us forward or set us back?

Yul Ejnes, MD

December 18, 2016Dec 18, 2016

A guest column by the American College of Physicians, exclusive to KevinMD.com. When the Trump Administration takes office, health reform as we now know it will not go away, but it will take a different form. I don’t think the…

A guest column by the American College of Physicians, exclusive to KevinMD.com.

When the Trump Administration takes office, health reform as we now know it will not go away, but it will take a different form. I don’t think the changes will be as easy as opponents of the Affordable Care Act make them appear to be. …

Physician

Why physician burnout treatment doesn’t work

Maiysha Clairborne, MD

December 17, 2016Dec 17, 2016

Physician burnout has become a popular buzzword in the medical community causing physicians, organizations, and medical education programs to seek solutions to what seems to be a growing problem. The result: Tons of research, new pilot projects, and burnout prevention programs are being implemented to try to “treat the problem.” Yet, for all of the research that is being done, there has been no one good “solution” for doctors burning …

Patient

A blow-by-blow account of daily life with chronic pain and illness

Toni Bernhard, JD

December 17, 2016Dec 17, 2016

Obviously, chronic illness doesn’t affect everyone the same way. That said, I’ve heard from people all over the world with every imaginable chronic illness (which includes chronic pain), and our day-to-day lives are strikingly similar. And so, I thought I’d describe a typical “day in the life,” using my own experience from a few months ago as an example. My hope in writing this piece is for those of us …

Medications

We need to speed up our acceptance of the opioid guidelines

Kathryn Takayoshi, NP-C

December 17, 2016Dec 17, 2016

A couple of years ago, I inherited a patient who was on both a patch for the powerful painkiller fentanyl and a high dose of oxycodone four times daily — and she didn't have cancer. I had 15 minutes with…

A couple of years ago, I inherited a patient who was on both a patch for the powerful painkiller fentanyl and a high dose of oxycodone four times daily — and she didn’t have cancer.

I had 15 minutes with that patient to get her medical history, review her medications, assess her current complaints, and decide whether or not to continue her opioid prescriptions. I had no paper records and a …

Conditions and Diseases

MKSAP: 34-year-old man with fatigue, low libido, and infertility

mksap

December 17, 2016Dec 17, 2016

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 34-year-old man is evaluated for a 2-year history of fatigue, low libido, and infertility. His family history is notable for a brother with…

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

A 34-year-old man is evaluated for a 2-year history of fatigue, low libido, and infertility. His family history is notable for a brother with infertility. His medical history is unremarkable, and he takes no medications.

On physical examination, vital signs are normal. His height is 195.6 cm (77 in), and his weight is 86.2 …

Medical Education

Hurting medical students healing hurting patients

Anonymous

December 16, 2016Dec 16, 2016

As a medical student, I have encountered more emotional and psychological pain as a direct result of my training than I could have previously anticipated. My pain may not be physical (though sometimes it is secondary to sleep deprivation), but it is real. I look around me and am reminded of who I do not want to be, and the kind of person I would dread becoming. At first, I …

Physician

Surgery volumes should be made public. Here’s why.

Peter Pronovost, MD, PhD

December 16, 2016Dec 16, 2016

Her voice cracked with strain. I could imagine the woman at the other end of the line shaking, overcome with remorse about the hospital where her husband had had esophageal surgery. Might he still be alive, she asked me, if…

The couple had initially planned to have the procedure done at a well-known medical center, but when she went online to do her homework, she …

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