KevinMD.com

September 19, 2016Sep 19, 2016

When a person gets depressed over their divorce, they are said to have a mental illness. When a person becomes psychotic from a manic episode due to their bipolar disorder, they are also said to have a mental illness. But are both of these illnesses mental illnesses? The definition of mental is that which relates to cerebral, brain, cognitive or intellectual processes.

Many disorders occur from problems in the anatomy or …

Health Technology

One action that could ease our EHR pain

Yul Ejnes, MD

September 18, 2016Sep 18, 2016

A guest column by the American College of Physicians, exclusive to KevinMD.com. This September, I reached a milestone, the tenth anniversary of my electronic health record (EHR) “go live.” Note that I did not write “I celebrated my tenth anniversary,”…

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

This September, I reached a milestone, the tenth anniversary of my electronic health record (EHR) “go live.” Note that I did not write “I celebrated my tenth anniversary,” because while the event was the most disruptive change in over 25 years of practice, the word …

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One action that could ease our EHR pain

Physician

You’ll be shocked and saddened when you find out what doctors really do

Roy Benaroch, MD

September 18, 2016Sep 18, 2016

The television doctors: Striding purposefully through the ER, giving orders, surrounded by a gaggle of eager learners and a super-team of nurses and techs. Or spending hours operating, then sipping martinis while waiting for the next disaster. Maybe saving lives…

Maybe not. A new study looked at what doctors really do all day. In the real …

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Health Policy

Fee-for-service isn’t always a bad thing

Suneel Dhand, MD

September 18, 2016Sep 18, 2016

One of the biggest shifts in American health care over the last several years (and we’ve only just seen the tip of the iceberg so far) is the shift of the system away from the traditional fee-for-service model, and towards…

By all measures, we know that the pure fee-for-service model — at least mostly funded by Medicare — …

Medications

Pain patients are being cut off from their drugs. Here’s why.

Cindy Perlin, LCSW

September 18, 2016Sep 18, 2016

In March, 2016, the CDC released guidelines for prescribing opioids. The guidelines were a response to a serious and growing problem: millions of pain patients became addicted to prescribed opioids, and hundreds of thousands died as a result. Since the…

Since the guidelines were released, reports of pain patients being abruptly cut off of their medication or having their medication abruptly reduced have become rampant. These patients report they were using opioids long …

Health Technology

Pokémon Go shows there is a better way to promote healthy behaviors

Tanishq Suryavanshi and Steven J. Hoffman, JD

September 17, 2016Sep 17, 2016

The recent release of Pokémon Go, the mobile phone augmented reality game, has taken the world by storm. The game has become a fitness icon, requiring players to walk or run around in the real world to catch Pokémon creatures…

While evidence on the long-term health benefits is not clear, it is apparent that the game does more than just allow players to live out their childhood …

Physician

How can patients get better if they live in homes tailor-made for disease?

Franklin Warsh, MD, MPH

September 17, 2016Sep 17, 2016

I'm new to the job of coroner. Though I'm sure it won't surprise anyone to hear that it's nothing like C.S.I.; you measure the wait for test results in months, not minutes. It's not like Quincy, M.E. either, where the…

I’m new to the job of coroner. Though I’m sure it won’t surprise anyone to hear that it’s nothing like C.S.I.; you measure the wait for test results in months, not minutes. It’s not like Quincy, M.E. either, where the same person responsible for the autopsy hops about cracking a case that somehow befuddles police. Most deaths are natural, with a good number of accidents and suicides, despite the media’s …

Medications

When treating chronic pain, don’t compromise your principles

Michael J. Stephen, MD

September 17, 2016Sep 17, 2016

One of the most difficult things I deal with as a physician is patients’ demands for pain medications. I treat patients with cystic fibrosis, a genetic disease present at birth with no cure, and its issues are indeed complex. There are legitimate causes for misery from the chronic coughing, abdominal pain, and joint pain recognized as common symptoms of the disease.

But the associated issues of depression, stress with family, and …

Conditions and Diseases

MKSAP: 64-year-old woman with an incidental pituitary adenoma

mksap

September 17, 2016Sep 17, 2016

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 64-year-old woman is seen for follow-up evaluation. Two weeks ago, she was in a car accident, and an incidental pituitary adenoma was found…

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

A 64-year-old woman is seen for follow-up evaluation. Two weeks ago, she was in a car accident, and an incidental pituitary adenoma was found on a cervical spine CT scan. She has no residual injuries from the car accident.

She is otherwise healthy and takes no medications. She went through menopause at age 51. …

Physician

I wish my doctor knew

Niran S. Al-Agba, MD

September 16, 2016Sep 16, 2016

Recently the New York Times published an article, "What Kids Wish Their Teachers Knew." As a pediatrician, I have spent a good part of my lifetime fighting for the health and welfare of our young people. They are the future.…

Recently the New York Times published an article, “What Kids Wish Their Teachers Knew.” As a pediatrician, I have spent a good part of my lifetime fighting for the health and welfare of our young people. They are the future. We owe our children a safe, caring, stable childhood whenever possible. Outside of a supportive family, a long-term family physician or pediatrician can be an important role model …

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I wish my doctor knew

Physician

Why hospitals shouldn’t use their miracle cases to advertise

Eric Beam, MD

September 16, 2016Sep 16, 2016

On the way to work the other day, I heard a radio commercial advertising a local hospital network’s cardiac care services. In it, a patient’s daughter related her overwhelmingly positive experience with the hospital team that treated her 90-year-old father…

It was a good commercial. It had all the elements: “I was worried at first, the doctors …

Physician

I owe it to my father to argue for death with dignity

Christine Jette

September 16, 2016Sep 16, 2016

It started, as far as I know, with a twinge. A back spasm in a healthy, but prone to back spasms, 68-year-old man, who soon was reduced to near tears in the parking lot of the Thai restaurant where we’d gone to get take out. It was early summer, and I was on a short visit to the east coast. My mother was the one to worry about. She had …

Medical Education

A medical student’s struggle with continuity of care

Tessa Lamberton

September 16, 2016Sep 16, 2016

"I can't find the fetal heart tones." The nurse states with a tone of underlying panic as she exits the patient room. It's around 7 a.m., and those of us working the night shift are getting ready for morning sign…

“I can’t find the fetal heart tones.” The nurse states with a tone of underlying panic as she exits the patient room.

It’s around 7 a.m., and those of us working the night shift are getting ready for morning sign out before we can head home and get some much-needed sleep after a crazy 14 hours shift.

“Tessa, go scan her” the resident nods towards the ultrasound machine, and I cheerfully follow …

Physician

Helping during hospice: Being present is much more important than being busy

Katherine Arnup, PhD

September 15, 2016Sep 15, 2016

“Food is love,” my partner jokes as she unloads mountains of food from her latest trip to Costco. “I can’t help it! I’m Jewish!” she protests, when I wonder aloud how the two of us will ever manage to consume…

As the lineups at superstores attest, for a great many people being able to prepare and serve meals is a vital way of showing love.

I never expected to …

Physician

The social history: Our patients are more than their diseases

David Goldberg, MD

September 15, 2016Sep 15, 2016

“Any alcohol use? Any tobacco use? Any other drugs?” These are the three main questions that most health care providers ask their patients when documenting a social history on a note. "What stressors do you have in your life? What…

“Any alcohol use? Any tobacco use? Any other drugs?”

These are the three main questions that most health care providers ask their patients when documenting a social history on a note.

“What stressors do you have in your life? What social support do you have? What is your home life like? What do you do for fun? Do you wear a helmet when you ride a bike? Do you wear a seatbelt?”

I …

Health Policy

Does the government know what it’s doing to physicians?

Don R. Read, MD

September 15, 2016Sep 15, 2016

Physicians spend almost twice as much time each day typing on computers and filling out paperwork as they do seeing patients. That astonishing conclusion comes from research published this week in the Annals of Internal Medicine. Just think about that.…

Just think about that. How would you feel if you spent two hours documenting every hour of work that you do? How would your boss feel about it? You’d be depressed and frustrated; your boss …

Physician

What this family physician learned from his dog

Justin Reno, MD

September 15, 2016Sep 15, 2016

I, much like many others, made a terrible decision on my 21st birthday. Mine, however, didn’t involve alcohol; I adopted a dog. She was a scruffy, brindle-coated, malnourished 30-pound terrier puppy. So in between organic chemistry, physics, Spanish, studying for…

I, much like many others, made a terrible decision on my 21st birthday. Mine, however, didn’t involve alcohol; I adopted a dog.

She was a scruffy, brindle-coated, malnourished 30-pound terrier puppy. So in between organic chemistry, physics, Spanish, studying for the MCAT, and multiple other classes, I had to housebreak a puppy. Those glorious visions I had of dog ownership hadn’t included several key aspects, like cleaning up accidents, cleaning up …

Physician

Physicians must lead. Here’s why.

Patty Fahy, MD

September 14, 2016Sep 14, 2016

Some docs consistently say “no thanks” to formal leadership roles. They prefer not to run for a board position, become department chief, or step into an executive role because their passion and focus is patient care. This primary interest in the core work shows up in other professions, too. My brother, a mechanical engineer (I’d say “brilliant mechanical engineer,” but he might read this), eschewed management positions his whole career. …

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Physicians must lead. Here’s why.

Physician

Doctoring requires developing relationships with people

Jean Robey, MD

September 14, 2016Sep 14, 2016

Cleveland Clinic published an article that cited the work of Cynthia Kubu, PhD, a neuropsychologist in Cleveland Clinic’s department of psychiatry and psychology. She examined the potential of focusing on relationship center care to help provide good care and long-term care giving for physicians. Cleveland Clinic uses the REDESM (relationship, establishment, development, and engagement) which focuses on the provider-patient relationship as the premise for care. The idea is a physician …

Physician

The hospital is a microcosm of America’s melting pot

Roxana Daneshjou, MD, PhD

September 14, 2016Sep 14, 2016

“Doctor, why can’t my mother breathe?” he asked, eyes full of concern as he watched his mother’s chest heave like someone who has spent too long underwater. I turned up her oxygen as we discussed the possibilities we were testing…

“Doctor, why can’t my mother breathe?” he asked, eyes full of concern as he watched his mother’s chest heave like someone who has spent too long underwater.

I turned up her oxygen as we discussed the possibilities we were testing for: infection, a reaction to chemotherapy, blood clots. Her breathing eased as we spoke, and in turn, I saw some of her son’s anxiety dissipate. As our conversation came to a …

Real physician voices, twice a week

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