KevinMD.com

October 9, 2016Oct 9, 2016

As I met with the vice dean of academic affairs to discuss my readiness for promotion from assistant to associate professor of pediatrics, I led with the usual list of accomplishments. After all, I thought I was pretty well rounded, with achievements in teaching, patient care, institutional service, quality improvement, and research. Unfortunately, this meeting was not going as I had hoped and I sensed ambivalence from the other end …

Physician

My anger isn’t the poison. Racism is.

Rhea Boyd, MD

October 9, 2016Oct 9, 2016

Although I write a blog that centers people of color in exploring the connections between the medical system and race -- an activity that has always been fundamentally personal -- I rarely discuss how it personally affects me. The occasions…

Although I write a blog that centers people of color in exploring the connections between the medical system and race — an activity that has always been fundamentally personal — I rarely discuss how it personally affects me.

The occasions in which I have, were driven by my need to make sense of Trayvon and Walter, Tamir and Read more…

My anger isn’t the poison. Racism is.

Conditions and Diseases

Doctors should not blindly extrapolate data from research studies

Robert G. Dorfman

October 9, 2016Oct 9, 2016

It is common practice in health care today for physicians to read articles published in leading journals within their fields and extract what they think is important for their patients. Though in most cases it is to the patient’s benefit that their physician stays up to date with the latest scientific advances, it is nonetheless important that doctors pay particular attention to research methodology and how generalizable these studies are …

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Health Policy

Money and virtue: An odd tension in health care

Dr. Saurabh Jha

October 8, 2016Oct 8, 2016

Publishing in the BMJ, Vinay Prasad, an oncologist and health care’s leading evidence-based iconoclast, found that over half of medical reviewers who leave the FDA work for device and pharmaceutical industries. Prasad’s findings created disquiet amongst purists of various stripes.…

Conditions and Diseases

A story for those who pontificate about patient behavior

Patricia Salber, MD

October 8, 2016Oct 8, 2016

I was offered my choice of bisphosphonates after breaking my shoulder and ended up with a diagnosis of osteoporosis. I initially opted for Reclast, a drug that only requires one dose a year albeit by IV infusion. I made an appointment to get the drug several weeks later. I wanted to have time to research my options. After reading as much as I could during that time, I made an …

Physician

Health care has lost its heart

Susan Hecker, MD

October 8, 2016Oct 8, 2016

Over the past year, I have been faced with the challenges of being a consumer of the health system that I confront daily from the physician perspective. My health needs ranged from a stubborn sinus infection to a terrifying brush with Guillain–Barré syndrome. I sampled experiences ranging from the clinic to the urgent care and then the emergency department and even dappled in the forbidden territory of self-diagnosis.

All experiences rendered …

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Health care has lost its heart

Conditions and Diseases

MKSAP: 26-year-old woman is evaluated during a routine examination

mksap

October 8, 2016Oct 8, 2016

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 26-year-old woman is evaluated during a routine examination. Her last Pap smear was performed 1 year ago and was normal. She has received…

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

A 26-year-old woman is evaluated during a routine examination. Her last Pap smear was performed 1 year ago and was normal. She has received a complete human papillomavirus (HPV) quadrivalent vaccine series. Medical history is unremarkable. Family history is noncontributory. She takes no medications.

On physical examination, temperature is normal, blood pressure is 110/72 …

Physician

When should doctors see a therapist?

Kelly Smyth-Dent, MSW

October 7, 2016Oct 7, 2016

Waiting to get help to improve your life and relationship is like waiting for the cancer to spread. You feel a lump on your body. Do you wait a few months to see if it gets bigger? Do you make…

Waiting to get help to improve your life and relationship is like waiting for the cancer to spread. You feel a lump on your body. Do you wait a few months to see if it gets bigger? Do you make an appointment right away? Do you avoid making an appointment altogether and hope it just goes away on its own?

Many times, we wait until after the divorce, after the accident, …

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When should doctors see a therapist?

Physician

What does “do no harm” really mean as a doctor?

Cory Michael, MD

October 7, 2016Oct 7, 2016

I was working at the free clinic late in the first semester of my third year of medical school when I met a patient I will call Mary, the last patient to be seen for the evening. Mary had a…

I was working at the free clinic late in the first semester of my third year of medical school when I met a patient I will call Mary, the last patient to be seen for the evening. Mary had a fairly typical story among uninsured individuals. She was 26 years old and worked three jobs near minimum wage to make ends meet, none of which offered cost-sharing for health insurance. …

Physician

A physician volunteers in Honduras. Here’s what she learned.

Apoorva Jayarangaiah, MD

October 7, 2016Oct 7, 2016

I quickly finished my day’s work in the resident’s clinic (documentations, relaying results) and raced home to hurriedly double check the list of things that I would need for my week long medical mission in Roatán, Honduras. The air was…

The air was frigid, and my pace matched the wind. In the 2-hour car ride to the airport, my mind was alive and restless; making mental note after mental note about our endeavor but …

Physician

Opioid addiction is a social failing

Jean Robey, MD

October 7, 2016Oct 7, 2016

I walked into my bathroom feeling the wet floor. I traced the source back to a toilet overflowing with a neon green T-shirt lodged in it. The T-shirt failed to evacuate into the nexus of sewage. My 7-year-old son hates the T-shirt. Having watched for years foul things disappear when flushed down the toilet, he attempted to rid himself of something he disliked. It failed and the toilet overflowed.

I called …

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Opioid addiction is a social failing

Medical Education

Dos and don’ts for your residency interview

Joseph Cooper, MD

October 6, 2016Oct 6, 2016

It’s that time again -- time to dust off your nicest suit and prepare for either residency or fellowship interviews. Being knee-deep in interview season for infectious diseases fellowships, my interview days bear some resemblance to my residency interviews, yet…

It’s that time again — time to dust off your nicest suit and prepare for either residency or fellowship interviews. Being knee-deep in interview season for infectious diseases fellowships, my interview days bear some resemblance to my residency interviews, yet also are quite different. I have a unique opportunity this year to be a part of the recruitment and decision process for our internal medicine residency program, in addition to being a fellowship applicant.

I was visiting …

Physician

The silent epidemic of sexual harassment in medical schools

Peter Ubel, MD

October 6, 2016Oct 6, 2016

It is hard for any physician to advance as a medical researcher. Competition for research funding is fierce; the rigors of publishing in prestigious medical journals are gargantuan. And women pursuing such careers face even bigger challenges, with many having to take on disproportionate burdens at home compared to their male colleagues (caring for kids, attending to chores), while receiving less effective mentorship than equally …

Physician

Making pain a vital sign caused the opioid crisis. Here’s how.

Thomas D. Guastavino, MD

October 6, 2016Oct 6, 2016

I remember the first time I experienced the paradigm shift when it came to pain management. Sometime around the late nineties while I was on call, I received a phone call from a floor nurse stating that a patient that had their ankle operated on that day by another surgeon was having increased pain that was not controlled by the pain medication that had been ordered. As I had been doing for …

Conditions and Diseases

How clickbait headlines affect prostate cancer diagnosis and management

Matthew N. Simmons, MD, PhD

October 6, 2016Oct 6, 2016

Our culture has taken a strange turn where the truth is relative, and where conspiracy theories rule the day. News sources and social networks are rife with political agendas, fake articles, and disguised advertisements. This chaos harms our social welfare, but can also impact physical health. Misleading news reports of new clinical studies make it difficult to discern medical fact from fiction.

I spend hours in clinic justifying recommendations to patients …

Physician

Evidence should not be used to enforce mandates

Don S. Dizon, MD

October 5, 2016Oct 5, 2016

Evidence-based medicine. It is what we all strive to provide. It means employing the most up-to-date knowledge to the approach of medicine, from preventive care to screening to the diagnostic work-up and treatment. Wherever the data point us, that’s what…

Physician

Physicians and patients must work together to halt the rise in opioid use

Kevin R. Campbell, MD

October 5, 2016Oct 5, 2016

Opioids are common pain medications that are used for the treatment for mild to moderate pain. These medications are highly addictive and bind to particular receptors in the brain and spinal column that produce a feeling of euphoria along with…

However, in the U.S. they are becoming a leading cause of death due to overdoses. Opioids — such as oxycodone, Percocet, and others — are now …

Physician

The day that the pediatricians quit

Kristen Compton, MD

October 5, 2016Oct 5, 2016

Once upon a time, there was a land where parents were anxious, information was pervasive, and trust was hard to come by. Misinformed celebrities with impressive influence (despite minimal education) were spouting ideas that provided concrete solutions to poorly understood…

Pediatricians everywhere were scratching their heads, wondering, what has happened? Why are our patients doubting us? …

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The day that the pediatricians quit

Physician

I am not your provider

Steven Goldsmith, MD

October 5, 2016Oct 5, 2016

Sometimes prospective new patients ask me over the phone, “Are you a medical provider?” or “Are you a provider for ?” And that gets me started. Provider. Such a generic and seemingly inoffensive noun, and yet it repels me. To…

Sometimes prospective new patients ask me over the phone, “Are you a medical provider?” or “Are you a provider for [name of their particular health insurer]?” And that gets me started.

Provider. Such a generic and seemingly inoffensive noun, and yet it repels me. To me, it is the verbal equivalent of a hair ball my cat barfs onto my pillow. And so I feel obliged to clean it up by …

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I am not your provider

Physician

Be frugal: The key to physician financial fitness

Sidney Christiansen, MD

October 4, 2016Oct 4, 2016

Becoming a physician requires a great amount of financial patience. Living on the meager remains of your student loans for four years and then transitioning into a position where the pay is not commensurate with your debt obligations can be challenging. Especially when your student loan debt is growing exponentially throughout your schooling and then growing with interest throughout your graduate training. After this kind of sacrifice, it can be …

Real physician voices, twice a week

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