KevinMD.com

October 17, 2016Oct 17, 2016

You may have read about the recent tragic deaths of two healthy children -- Marvelena Rady, age 3, and Caleb Sears, age 6 -- in California dental offices. Unfortunately, they aren’t the first children to die during dental procedures, and…

You may have read about the recent tragic deaths of two healthy children — Marvelena Rady, age 3, and Caleb Sears, age 6 — in California dental offices. Unfortunately, they aren’t the first children to die during dental procedures, and unless things change, they probably won’t be the last.

State Senator Jerry Hill has asked the Dental Board of California (DBC) to review California’s present laws and regulations …

Conditions and Diseases

Take the time to understand patients’ goals when giving treatment recommendations

Peter Ubel, MD

October 17, 2016Oct 17, 2016

A recent study of men with early-stage prostate cancer found no difference in 10-year death rates, regardless of whether their doctors actively monitored the cancers for signs of growth or eradicated the men’s cancers with surgery or radiation. What does…

What does this study mean for patients? Based on research we have conducted on prostate cancer decision-making, the implications are clear: Patients need to find physicians who will interact with …

Health Policy

Health care: The big issue Trump and Clinton choose to ignore

Manoj Jain, MD, MPH

October 17, 2016Oct 17, 2016

For me, the saddest part of the 2016 presidential election is not that we have two of the most disliked presidential candidates in history but that so little attention is being paid to health care. You may have noticed that…

For me, the saddest part of the 2016 presidential election is not that we have two of the most disliked presidential candidates in history but that so little attention is being paid to health care.

You may have noticed that health care rarely comes up in campaign speeches or in debates, and when it does it’s often scripted empty promises. Donald Trump has a plan entitled “Healthcare Reform to Make America …

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Physician

Why it’s important for physicians to have hobbies

Maria Yang, MD

October 17, 2016Oct 17, 2016

During medical school, professors advised us to “have hobbies” and to “do stuff outside of medicine”: “It’ll give you have something to talk about with patients.” “It’ll help you maintain balance as you go through your training.” “It’s important for…

During medical school, professors advised us to “have hobbies” and to “do stuff outside of medicine”:

“It’ll give you have something to talk about with patients.”
“It’ll help you maintain balance as you go through your training.”
“It’s important for self-care.”

Medical students, as a population, tend to be compulsive and there’s always more to read and learn. (Medicine, like many fields, entails lifelong learning, even when you are tired of …

Physician

Can you cut lab costs and make your patients happier? Here’s how.

Chris Moriates, MD and Victoria Valencia, MPH

October 17, 2016Oct 17, 2016

There are few worse ways to wake a person than with a needle stick in the arm to draw blood. If you have ever spent the night in a hospital, chances are the first thing that happened in the morning was a vampiric nurse or lab technician, following doctor’s orders, standing over your bed and greeting you with a needle and a set of vials.

Most of us just grit our …

Health Technology

Speech recognition errors in the ER. It’s a problem.

Skeptical Scalpel, MD

October 17, 2016Oct 17, 2016

Speech recognition errors occurred in 71 percent of emergency department notes, and 21.1 percent of notes with errors were judged as critical with potential implications for patient care says a recent study in the International Journal of Medical Informatics. Investigators…

Investigators looked at a random sample of 100 dictated notes and found 128 errors or 1.3 errors per note.

More than half of the errors were ascribed to speaker mispronunciation. Although …

Physician

Working in Kenya reminds me of earlier times in my training

Bruce Campbell, MD

October 16, 2016Oct 16, 2016

We are in the middle of an all-day ENT screening clinic at Moi Teaching and Referral Hospital in Kenya. The local ENT physicians have scheduled about 100 patients to return to see our American team to be evaluated for surgery during our visit. We have already seen several people with baseball-sized tumors in their parotids, thyroids, or necks. The surgical schedule for the next few days is getting full.

A thirteen-year-old …

Physician Finance

If you use your vacation time to work, what is the point of the vacation?

Cory Fawcett, MD

October 16, 2016Oct 16, 2016

Most physicians, including me, would fall into the category of type A personalities, always on the go with a constant need to be productive. We cram every minute of the day with productivity and leave little time in our schedule for fun and recreation. Even type A personalities need a break from working to recharge their personal batteries. How often have you been packing for a vacation and included work …

Physician

8 tips from my non-medicine friends that make me a happier doctor

Nisha Mehta, MD

October 16, 2016Oct 16, 2016

Many of my best friends are in the medical field, and there are practical reasons for that. That said, I don’t think I could survive without the perspective of my equally good friends outside of medicine. In one way or…

1. Don’t take yourself so seriously. It’s true that at work we often deal with life or death situations. But …

Physician

Racial bias in the physician community

Maiysha Clairborne, MD

October 16, 2016Oct 16, 2016

In the current climate today, the awareness of racial discrimination has risen in most communities. However, dealing with racial bias in medicine is a rare topic, and while few studies have been done to show that racial bias and microaggressions do exist and have an impact on the care of our patients, racial bias within the physician community is not widely discussed.

Though not a popular topic, racial bias does exist …

Read more…

Racial bias in the physician community

Conditions and Diseases

Physicians must prevent domestic violence at all costs

Eric S. Donahue

October 15, 2016Oct 15, 2016

Domestic violence is ubiquitous in our society. Few are untouched by the physical and emotional consequences of abuse -- whether they were directly abused or know others who were. However, little has been done to prevent it. We’ve recognized prevention…

Domestic violence is ubiquitous in our society. Few are untouched by the physical and emotional consequences of abuse — whether they were directly abused or know others who were. However, little has been done to prevent it.

We’ve recognized prevention as critical to national health. This awareness has led to everything from decreased vehicular deaths by 90 percent since 1925 to millions of lives saved from vaccines. But even with all …

Physician

Why we decided to “throw away our promising careers” and work part-time

Warren Holleman, PhD and Marsha C. Holleman, MD, MPH

October 15, 2016Oct 15, 2016

After the birth of our second child, the two of us waved a white flag and started working part-time. We surrendered the notion that we could maintain two full-time health careers and still be effective parents and loving spouses. Not…

It wasn’t supposed to be that way. Doors were opening to professional women, to two-career marriages, and to flexible work arrangements. Ours was the …

Physician

The joys of coming to work 1 hour later

Bina Dara, MD

October 15, 2016Oct 15, 2016

Coming in to work at 8 a.m. was indeed a luxury for me. As my fellow anesthesiologists would concur, our life begins at 7 a.m. on a daily basis. Some administrative duty made this possible for me one day. This…

Preparing for this morning treat, I had made sure to set my alarm for thirty …

Read more…

The joys of coming to work 1 hour later

Conditions and Diseases

MKSAP: 54-year-old man with low-risk myelodysplastic syndrome

mksap

October 15, 2016Oct 15, 2016

A 54-year-old man is evaluated during follow-up consultation regarding laboratory studies completed for a life insurance policy. He reports no symptoms. On physical examination, temperature is 37.2 °C (99.0 °F), blood pressure is 131/76 mm Hg, pulse rate is 88/min,…

A 54-year-old man is evaluated during follow-up consultation regarding laboratory studies completed for a life insurance policy. He reports no symptoms.

On physical examination, temperature is 37.2 °C (99.0 °F), blood pressure is 131/76 mm Hg, pulse rate is 88/min, and respiration rate is 15/min. No splenomegaly is noted.

Laboratory studies:

Hemoglobin 8.9 g/dL (89 g/L)
Leukocyte count 3000/µL (3.0 × 109/L) with 30% neutrophils, 10% monocytes, and 60% lymphocytes
Mean corpuscular volume 105 fL
Platelet count 75,000/µL …

Physician

Female physicians told to get out of the way during emergencies as patients nearly die

Pamela Wible, MD

October 14, 2016Oct 14, 2016

It’s true. Man nearly dies on plane because crew didn’t believe black woman was doctor. The medical fiasco on Delta Airlines has now gone viral after a Facebook post by Tamika Cross, MD, the physician who was turned away as a fellow passenger was unresponsive. Tamika joins a long list of female physicians who have experienced the same discrimination.

Meet a few of these doctors below.

When patients get help from the unexpected

Antoinette Rose, MD

October 14, 2016Oct 14, 2016

Sometimes we get help from unexpected sources. Two of my patients showed me this, during their recent hospitalizations. The first is a woman I'll call Hazel. I've taken care of her for twenty years, and she's probably had emphysema for…

Sometimes we get help from unexpected sources. Two of my patients showed me this, during their recent hospitalizations.

The first is a woman I’ll call Hazel. I’ve taken care of her for twenty years, and she’s probably had emphysema for ten of those, but had not yet ever been hospitalized for it. She has continued to smoke, and I suspect that she has not gone out of the house much for …

Medical Education

The sacrifices medical students have to make

Tapo Chimbganda, PhD

October 14, 2016Oct 14, 2016

As a therapist, I have worked with medical students struggling with depression and anxiety, sometimes addiction but mostly desperate to save what is left of their failing relationships. They are torn by guilt and conflicting concerns that make them feel out of control. Medical school demands more than they can give, and yet they give, and give, and give until finally they are depleted. Ironically, this is when they need …

Physician

Double booking patients is difficult and destructive

Hans Duvefelt, MD

October 14, 2016Oct 14, 2016

Not only have we shortened medical appointments to 15 minutes — we sometimes double book them. I get the feeling that non-providers think of this as something fairly ordinary, and even reasonable. But it is often a very difficult and…

Not only have we shortened medical appointments to 15 minutes — we sometimes double book them.

I get the feeling that non-providers think of this as something fairly ordinary, and even reasonable. But it is often a very difficult and destructive thing to do.

The term “double booking” and the way it looks in an ordinary doctor’s scheduling grid suggest that the physician might possibly be expected to be in two places …

Physician

The silent lessons of my grandmother

Cedrek L. McFadden, MD

October 14, 2016Oct 14, 2016

“I come as one. I stand as ten thousand.” - Maya Angelou I am a surgeon. I am proud of this fact partly because I am the first in my family to go to medical school. I am also proud…

“I come as one. I stand as ten thousand.”
– Maya Angelou

I am a surgeon. I am proud of this fact partly because I am the first in my family to go to medical school. I am also proud of this fact because I recognize that me becoming a surgeon has been less about me and more of a collective and cumulative effort of my parents, grandparents, great-grandparents, and countless other …

Read more…

The silent lessons of my grandmother

Patient

A new nurse gets a crash course in compassion

Marilyn Barton, RN

October 14, 2016Oct 14, 2016

"Nursing students needed to work in the University Hospital. Good pay. Orientation." As a rising nursing school senior in the 1970s, I naïvely applied for the job above without getting the full details. No one mentioned that I'd be working…

“Nursing students needed to work in the University Hospital. Good pay. Orientation.”

As a rising nursing school senior in the 1970s, I naïvely applied for the job above without getting the full details. No one mentioned that I’d be working in a psychiatric unit housing twenty-five aggressive, catatonic or schizophrenic patients, many of whom had been locked away for years.

The entrance sign, which should have read “Locked Psych/Med/Surg Unit,” said simply, …

Real physician voices, twice a week

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