KevinMD.com

September 24, 2016Sep 24, 2016

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 68-year-old woman is evaluated for a 3-month history of gradually progressive abdominal distention. Her medical history is notable for a 20-year history of…

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

A 68-year-old woman is evaluated for a 3-month history of gradually progressive abdominal distention. Her medical history is notable for a 20-year history of obesity, type 2 diabetes mellitus, hyperlipidemia, and hypertension. She also has had a 10-year history of elevation of serum aminotransferase levels, which was attributed to nonalcoholic fatty liver disease. …

Physician

Doctors must preserve their empathy at all costs

Michael Levy, MD

September 23, 2016Sep 23, 2016

It was several years ago. I was a first-year internal medicine resident. Keen, tired, overworked, and still idealistic. Mr. Smith was a 45-year-old lawyer who rolled into St. Paul’s Hospital Emergency room, while our medicine team was on intake. He was a healthy appearing lawyer who noted that for the past month he had become more short of breath performing his regular exercise. Things were especially bad for him during …

Conditions and Diseases

We have no answers to these unbearable algorithms in life

Debbie Moore-Black, RN

September 23, 2016Sep 23, 2016

Jim Morrison of the Doors once sang, "Petition the Lord with prayer ... You cannot petition the Lord with prayer." But we did that. We petitioned. On one side of the ICU, we had an 18-year-old girl, upper middle-class family,…

Jim Morrison of the Doors once sang, “Petition the Lord with prayer … You cannot petition the Lord with prayer.”

But we did that. We petitioned.

On one side of the ICU, we had an 18-year-old girl, upper middle-class family, had everything. Beauty, brains, money, supportive parents, and she was off into this new bright world, choosing her college of choice. A simple surgery led to sepsis, severe sepsis that raged through …

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Physician

This version of health care is purely a business

Jeff Kane, MD

September 23, 2016Sep 23, 2016

Many of us harbor an archaic view of what health care is, so let me offer a little history. During the past century, it's changed from Healthcare 1.0 to 2.0, and now it's Healthcare 3.0. In the early twentieth century,…

Many of us harbor an archaic view of what health care is, so let me offer a little history. During the past century, it’s changed from Healthcare 1.0 to 2.0, and now it’s Healthcare 3.0.

In the early twentieth century, Healthcare 1.0 was a service, though it amounted more to personal contact than effective medicine. At best, medications and procedures were hit-and-miss, so doctors relied heavily on their relationship with their …

Physician

How to create a modern superhero

Alberto Hazan, MD

September 23, 2016Sep 23, 2016

You start out by working in a busy emergency department. You see patients with all sorts of complaints: abdominal pain, headaches, and chest pain. Vomiting, diarrhea, and dysuria. Ankle sprains, bug bites, and allergic reactions. Domestic violence, rape, and child…

You start out by working in a busy emergency department.

You see patients with all sorts of complaints: abdominal pain, headaches, and chest pain. Vomiting, diarrhea, and dysuria. Ankle sprains, bug bites, and allergic reactions.

Domestic violence, rape, and child abuse.

You don’t ever let the stress of the job take away your humanity. You treat your patients with empathy and respect. You listen to their stories, treat their symptoms, contact the police, …

Read more…

How to create a modern superhero

Physician

Silencing end-of-life discussions fails our terminal patients

Jerry Balentine, DO

September 22, 2016Sep 22, 2016

When Kara Tippetts, a 38-year-old mother of four, died of breast cancer last year, more than 17,000 people live-streamed her funeral. Tippetts gained national prominence through her blog, where she confronted her impending death directly and offered a refreshingly frank…

Unfortunately, the openness Tippetts displayed is usually missing where it’s needed most: hospitals. Doctors, nurses and other caregivers are often reluctant …

Physician

I’m a doctor. And I love what I do.

Elizabeth Meade, MD

September 22, 2016Sep 22, 2016

OK, I’ll admit it. I’m a doctor “I work at a hospital.” Those words had left my mouth a hundred times before, and yet on this late summer day, I paused to actually think about them. Why I was saying…

OK, I’ll admit it. I’m a doctor

“I work at a hospital.”

Those words had left my mouth a hundred times before, and yet on this late summer day, I paused to actually think about them. Why I was saying them, what I really meant, and what I should have said instead.

I was making conversation with someone I had just met. The inevitable question, “So, what do you do?” was asked, and …

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I’m a doctor. And I love what I do.

Physician

Is what is good for doctors always good for patients and public health?

Vincent DeGennaro, Jr., MD, MPH

September 22, 2016Sep 22, 2016

The Haitian doctors’ strike ended recently, and it is unclear if there are any winners. The conditions in which the striking doctors -- medical residents in Haiti’s public hospitals, to be precise -- work are appalling, and the low pay…

The Haitian doctors’ strike ended recently, and it is unclear if there are any winners. The conditions in which the striking doctors — medical residents in Haiti’s public hospitals, to be precise — work are appalling, and the low pay was galling, but without the doctors, hospitals shut their doors and the poor were left to take care of their own illnesses and injuries for nearly five months.

At issue were …

Physician

Narrative medicine for social and physician wellness

Jean Robey, MD

September 22, 2016Sep 22, 2016

Physician wellness begins in realizing our identity in medicine and society. Shamans, priest, and healers have existed in ancient times and in small and large indigenous tribes since man began to gather together in social packs. The unique role of tribal and community leaders who guarded health and wellness was understood as important for the whole of society.

All doctors have degrees of empathy. We as an order select for this …

Health Technology

Doctors: Bring your practice website to the 21st-century

Robert Wong, MD

September 21, 2016Sep 21, 2016

Patients seem to be increasingly comfortable managing their health care through digital media. Last summer, our private practice of eight retinal specialists decided to find out exactly how comfortable. From July to August, 2015, we conducted a survey of 200…

From July to August, 2015, we conducted a survey of 200 of our patients during their office visit and asked them what health-care related tasks they were already doing online. Using this data, we’re starting to look at how our medical practice might …

Physician

The circus surrounding Hillary’s pneumonia

Dr. Saurabh Jha

September 21, 2016Sep 21, 2016

It is selfish of a leader of a nation to drop dead during office. Jawaharlal Nehru, India’s first prime minister, died suddenly at 74, apparently from a ruptured aneurysm. His aneurysm, allegedly, had something to do with Edwina Mountbatten, the wife of Lord Mountbatten, the last Viceroy of India. Shortly after Nehru’s death, Pakistan attacked India. Nehru’s replacement, Lal Bahadur Shastri, died mysteriously in Tashkent two years after Nehru’s death, …

Physician

Sleep is a medical necessity

Sophy Feng, MD

September 21, 2016Sep 21, 2016

We have all heard the grumblings regarding the 80-hour resident workweek. This is due to the opinion that jobs after residency typically require hours that surpass 80 hours a week. But, why? Why does medicine have to be this way?…

We have all heard the grumblings regarding the 80-hour resident workweek. This is due to the opinion that jobs after residency typically require hours that surpass 80 hours a week.

But, why? Why does medicine have to be this way?

I have worked 100 plus hour weeks for over 20 years, and I am exhausted. I am burned out and I can not catch up because of the sleep deprivation.

This …

Read more…

Sleep is a medical necessity

Physician

What truly palliates? Do we choose or do we allow the patient to choose?

Divya Yerramilli, MD

September 21, 2016Sep 21, 2016

The day I met Mr. Lightfoot, he was a medical curiosity on teaching rounds, “a great example of a Sister Mary Joseph’s Nodule,” a sign of metastatic stomach cancer. Earl was lying in a hospital bed in the cancer unit of the hospital, his stomach completely distended, nauseous and vomiting, unable to eat anything. He had undergone a cycle of chemotherapy only days before.

I organized Mr. Lightfoot into a problem …

Physician

I question the ethics of any doctor who sells supplements to patients

Linda Girgis, MD

September 20, 2016Sep 20, 2016

I was seeing a patient who brought me a bag of supplements she bought from another specialist. I looked skeptical and then she pulled out the list of lab results the other doctor ordered on her. I reviewed the results with her and asked why all these tests were ordered in the first place, some of which I had never ordered in my life. She said she told the specialist …

Health Technology

Fixing our EHR mess: What needs to be done

Kevin R. Campbell, MD

September 20, 2016Sep 20, 2016

In 2009 the Health Information Technology for Economic and Clinical Health Act (HITECH) was signed into law by President Obama and this law quickly changed the way medicine in the United Sates is practiced. The law was a first step in requiring all physicians to utilize electronic records. The president promised that creating and electronic record mandate for physicians would result in a national, universal electronic medical record system and …

Medical Education

Medical couples inadvertently sabotage their long-term happiness

Sarah Epstein

September 20, 2016Sep 20, 2016

Medical couples are experts at delaying gratification. Medical school’s rigid, unpredictable, and demanding schedule forces couples to postpone vacations, outings, dinner plans, and relationship progress. Glen Gabbard and Roy Menninger, in their book Medical Marriages, call this common trend among single- and dual-physician couples “the psychology of postponement.” They explain that medical school and demanding attending physicians become “a convenient scapegoat” for couples looking to avoid living their lives …

Physician

What medicine can learn from Wells Fargo

Andrew Spector, MD

September 20, 2016Sep 20, 2016

In 1996, Jerry Maguire was fired for advocating a reduction in his sports management firm’s client base thereby risking the firm’s profits. While writing his infamous memo (or as he would tell you, his mission statement), he recalled his mentor’s…

Tom Cruise’s voiceover continues: “Suddenly, it was all pretty clear. The answer was fewer clients. Less money. More attention. Caring for them, …

Physician

If doctors wanted to be wealthy, they would have become UPS truck drivers

Neil Baum, MD

September 19, 2016Sep 19, 2016

Do doctors make too much money? I don’t think so. I read with great interest the blog by Dr. Michael Kirsch defending physicians’ salaries: "If you think doctors make too much money, think about this." Unfortunately, the public’s perception of…

Do doctors make too much money?

I don’t think so. I read with great interest the blog by Dr. Michael Kirsch defending physicians’ salaries: “If you think doctors make too much money, think about this.” Unfortunately, the public’s perception of physicians’ incomes has been that physicians make too much money.

Whenever I hear this remark from patients or even non-physicians, I …

Conditions and Diseases

Reflecting on sepsis: Definitions, new ideas, and a continued commitment to patient care

Steven Q. Simpson, MD

September 19, 2016Sep 19, 2016

September is Sepsis Awareness Month, a month which aims to raise awareness of sepsis and strategies for prevention and treatment. Sepsis is a potentially life-threatening complication of an infection. Sepsis occurs when the body’s response to infection becomes dysregulated and…

Earlier this …

Physician

A hospital bullies a physician and threatens termination for her disability

Anonymous

September 19, 2016Sep 19, 2016

To whom it may concern: I am writing to you with great sadness, but with relentless determination to ignite change. I am a doctor with a disability. Two years ago I began residency training in pediatrics. The privilege was overwhelming…

To whom it may concern:

I am writing to you with great sadness, but with relentless determination to ignite change. I am a doctor with a disability. Two years ago I began residency training in pediatrics. The privilege was overwhelming as I stood a doctor in the very halls where I had been wheeled in as a patient with a brain tumor. I couldn’t believe that I had actually made it, …

Real physician voices, twice a week

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