KevinMD.com

October 25, 2016Oct 25, 2016

“Being able to feel safe with other people defines mental health; safe connections are fundamental to meaningful and satisfying lives.” - Dr. Bessel van der Kolk On my last day of rotation in the psychiatric emergency room, we received a…

“Being able to feel safe with other people defines mental health; safe connections are fundamental to meaningful and satisfying lives.”
– Dr. Bessel van der Kolk

On my last day of rotation in the psychiatric emergency room, we received a new patient. The keywords and phrases rang through the air: “teenager,” “transgender,” “homeless,” “assaulted recently,” “says she feels a full-grown baby kicking.”

I immediately asked if I could see this patient, and was …

Health Technology

One device slows down health care. Get rid of it.

Suneel Dhand, MD

October 25, 2016Oct 25, 2016

The mouse is a piece of technology that we’ve all got very used to working with over the last couple of decades. They actually go back longer than we might expect — the British Royal Navy first used a version of the mouse in the 1940s. With the personal computing revolution of the 1990s, they entered almost every single American household. Go back ten years, and nobody could have imagined …

Physician

Medical speculation of Trump and Clinton leaves this doctor aghast

Linda Girgis, MD

October 25, 2016Oct 25, 2016

As with most everyone else, I am watching the presidential race with something akin to amusement and horror alike. And as with many people, I feel that the U.S., as a nation, failed to find a suitable candidate for this presidential election. While there does need to be some test for fitness for office, I remain aghast at the medical speculations and facts being leaked about the presidential candidates. Reading this …

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Physician

Poetry and music tell stories of universal experiences

Karen S. Sibert, MD

October 24, 2016Oct 24, 2016

Classic rock music lovers who think they don’t like poetry, and literary purists who think they don’t like popular music, may have been equally baffled to hear that Bob Dylan is a winner of the Nobel Prize in Literature. As…

I can’t remember a time when Dylan’s music wasn’t a part of my growing up, from the rebelliousness of the anti-Vietnam era …

Physician

Why physicians face a serious credibility problem

Hans Duvefelt, MD

October 24, 2016Oct 24, 2016

A recent issue of the New England Journal of Medicine once again questions two practices that used to be almost the backbone of primary care. One article is about the low likelihood that prostate cancer detected through PSA screening will…

A recent issue of the New England Journal of Medicine once again questions two practices that used to be almost the backbone of primary care.

One article is about the low likelihood that prostate cancer detected through PSA screening will shorten a man’s life, even if he chooses just to keep an eye on it.

The other article is about how repeated mammography screening mostly leads to the diagnosis of small and …

Physician

Quality doesn’t always equal success for doctors

James C. Salwitz, MD

October 24, 2016Oct 24, 2016

I recently spent an evening with a group of medical oncology fellows as part of a small panel discussing career alternatives. There were doctors who worked for pharma, academic medical centers, hospitals and a couple of us representing private practice. The questions and comments taught me more than I could contribute. I was surprised to learn not just about jobs and personal futures, but about something basic: the difficulty in …

Physician

A physician quits and practices medicine her way

Tracy Asamoah, MD

October 24, 2016Oct 24, 2016

I answer every phone call from every patient myself. I have no staff to respond to issues that come up during the day. There are no colleagues that take my calls after hours. This was my choice in response to what everyone knows: Health care is broken. I needed a radical change from the bureaucratic system that I experienced daily as a physician however I had no idea how to …

Conditions and Diseases

What’s the secret to weight loss? There is no secret.

Ted Paisley, MD

October 24, 2016Oct 24, 2016

How many calories are in a pound? This seemingly simple question stumped me on my family medicine board recertification exam seven years ago — twice. (I think they asked the question in two different ways. I hoped they were experimental…

How many calories are in a pound?

This seemingly simple question stumped me on my family medicine board recertification exam seven years ago — twice. (I think they asked the question in two different ways. I hoped they were experimental questions that didn’t count.) Later that day, I found the answer: 3,500 calories equals one pound.

I don’t remember which multiple-choice answer I chose, but I do remember choosing the same answer …

Medications

Patients are often the victims of medication creep

Andi Shahu and Erica Spatz, MD, MHS

October 24, 2016Oct 24, 2016

Martha arrives for an appointment with her new primary care provider. She hesitantly hands over her pill boxes at the nurse’s request; it seems to take forever to enter them all into the computer. “You are taking a lot of…

Martha arrives for an appointment with her new primary care provider. She hesitantly hands over her pill boxes at the nurse’s request; it seems to take forever to enter them all into the computer.

“You are taking a lot of blood pressure pills,” he comments. The doctor comes in and after a brief introduction, notes that she is taking five medications for her blood pressure.

“Five?” Martha exclaims in disbelief. She hadn’t …

Physician

The day when MBAs no longer have to answer to physicians

Suneel Dhand, MD

October 23, 2016Oct 23, 2016

A few months ago I wrote an article about a 28-year-old MBA who attempted to tell an experienced physician where to round first. The article was widely circulated and went a bit viral. Clearly, the scenario resonated with thousands of…

It was interesting that afterward, I received many messages from various people who had read it. The majority of these were messages of support …

Physician

It’s time we embrace the known benefits of gender-confirming surgery

Shane D. Morrison, MD

October 23, 2016Oct 23, 2016

I am constantly in awe of the patients I want to treat. I cannot fathom their strength to embrace their identity while overcoming prejudice and discrimination. I do not know what it must be like to fear being your true…

But I do know what it’s like to be told to keep my career interests quiet. When I was interviewing for residency, my goals of serving transgender …

Physician

This was my night in the ER. How was yours?

Sandra Scott Simons, MD

October 23, 2016Oct 23, 2016

"Good morning, Sandy. How was work?” How do I answer that in a normal way? Any given shift in any given ED is comprised of the gamut of emotions playing out behind the calm facade of physicians and nurses. Afterward,…

“Good morning, Sandy. How was work?”

How do I answer that in a normal way? Any given shift in any given ED is comprised of the gamut of emotions playing out behind the calm facade of physicians and nurses. Afterward, we often don’t articulate or even process the roller coaster of feelings. The story of a recent Monday overnight illustrates the wild ride of emotions most people don’t realize that emergency …

Physician

The night this physician was profiled. And he was OK with it.

Thomas D. Guastavino, MD

October 23, 2016Oct 23, 2016

One very late spring evening during my last year of residency, I was driving home and got stopped at a police DUI checkpoint. I was exhausted from being up all night from being on call the night before and having been very busy had no time to shower, shave or change into my street clothes. I also got called in at 4 a.m. the previous day and had not showered or shaved that …

Physician

A medical student realizes how he could change the system

Anonymous

October 22, 2016Oct 22, 2016

This has not been an uncommon occurrence over the past 2 1/2 years. In my bed with my laptop when I should be asleep, looking at blogs, taking quizzes, checking out stats on different specialties to find my place in this crazy world we call medicine. This wouldn’t occur all the time but enough that it was noticeable and something I clearly wanted resolved.

On these nights my thinking started out …

Physician

The precarious peril of pay-for-performance

Ish Stevens, MD

October 22, 2016Oct 22, 2016

As a primary care pediatrician, I am often on the front line of mental health care. Since child psychiatric referral services are sparse and overloaded, I often have to initiate counseling for anxiety in many of my patients. One thing that I have learned is that you can help someone with anxiety in a tremendous way by getting them to recognize a simple fact: It is counterproductive to worry about …

Physician

Defiance will inspire progress: Physicians should not surrender at any cost

Niran S. Al-Agba, MD

October 22, 2016Oct 22, 2016

Independent physicians are at the beginning of a challenging movement as we fight to stay relevant and solvent during the transition of health care from independence to “regulation without representation.” In 1773, British Parliament passed the Tea Act with the objective to help the struggling British East India Company survive. Opposition to the Act resulted in the return of delivered tea back to Britain. Boston left the ships carrying tea …

Conditions and Diseases

MKSAP: 25-year-old woman with diarrhea for 2 days

mksap

October 22, 2016Oct 22, 2016

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 25-year-old woman e-mails her internist from Mexico with a report of diarrhea for 2 days. She is traveling and reports three to four…

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

A 25-year-old woman e-mails her internist from Mexico with a report of diarrhea for 2 days. She is traveling and reports three to four loose bowel movements per day. She has been dining in the hotel restaurants but has also consumed foods and bottled soft drinks served with ice from local food vendors.

She …

Conditions and Diseases

This doctor stopped telling patients to lose weight. Here’s why.

Elisabeth Poorman, MD

October 21, 2016Oct 21, 2016

Several years ago, I was meeting a young woman in my clinic for the first time. She was healthy but had been obese most of her adult life, even though she had tried many methods of losing weight. We spoke…

A few months later, she came back to check her progress. She had lost weight, about …

Physician

11 things your psychiatrist wants you to know

Kristen Compton, MD

October 21, 2016Oct 21, 2016

There are a lot of misconceptions about psychiatrists and the way we practice, mainly because our sphere of medicine is so vastly different from that of any other medical specialty (and yes, I have an MD!) Here are a few…

1. Yes, we all have clocks in our offices. We watch the time to pace ourselves, not …

Physician

Selfie-obsessed millennials can teach doctors a thing or two

Steve Christiansen, MD

October 21, 2016Oct 21, 2016

Self-entitled, self-absorbed and selfie-obsessed. These are just a few adjectives critics use to describe the millennial generation of today’s 16-to-36-year-olds, born between 1980 and 2000. Born in the early 80s, I both understand the criticism levied against my generation and simultaneously empathize with many of my peers who were raised in the digital revolution and, thus, see the world differently. The unique and, at times, bewildering views of millennials pose …

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