KevinMD.com

August 19, 2016Aug 19, 2016

In July, I found myself needing to step away from social media and news coverage of the recent shootings in Louisiana, Minnesota, and Dallas. Being a psychiatrist has made me sensitive to the toll of pain and anguish that life may bring, even as a bystander. This occurs even more so when I can all too easily imagine myself as a victim of one of these unfortunate events.

In the aftermath …

Physician

A reminder that life is indeed too short

Neha Sharma, DO

August 19, 2016Aug 19, 2016

I recently took care of a young patient whose case left an impact on me. When I admitted him, he was fighting a lost battle with cancer. A few months prior to admission, he had been experiencing new headaches. When…

I recently took care of a young patient whose case left an impact on me. When I admitted him, he was fighting a lost battle with cancer.

A few months prior to admission, he had been experiencing new headaches. When he sought medical attention, he was diagnosed with an extremely aggressive brain tumor that had spread to his spine, and was given a very poor prognosis.

Unfortunately, his condition deteriorated quickly thereafter, …

Physician

Doctors experience the world differently

Starla Fitch, MD

August 18, 2016Aug 18, 2016

I was in the break room at the hospital scarfing down a power bar between three-hour cases. The truth is, I was multi-tasking: eating, writing on a chart, and checking my email on my phone. I had received an email…

I was in the break room at the hospital scarfing down a power bar between three-hour cases. The truth is, I was multi-tasking: eating, writing on a chart, and checking my email on my phone.

I had received an email from a businesswoman, whom I have known for a few years. She wanted to know if I wanted to join her for lunch next week.

I had to laugh out loud.

The rest …

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Physician

We can’t agree on the value of the yearly physical

Janice Boughton, MD

August 18, 2016Aug 18, 2016

"I'm going to the doctor next week for my yearly physical." So normal. Of course you are. Everyone should do that. But the concept of a yearly examination of one's whole body to see if everything checks out fine is…

“I’m going to the doctor next week for my yearly physical.” So normal. Of course you are. Everyone should do that.

But the concept of a yearly examination of one’s whole body to see if everything checks out fine is a relatively new invention and whether or not it is necessary is a very controversial question.

I just read an article by Abraham Verghese, an internist and champion of physical diagnosis, professor at …

Physician

Should guns be discussed in the exam room?

Kevin R. Campbell, MD

August 18, 2016Aug 18, 2016

Let me preface this blog by stating that I write this to stimulate discussion and debate, not to sway opinions. Today, doctors are required to spend more and more time doing administrative work -- including checking off electronic boxes in…

Let me preface this blog by stating that I write this to stimulate discussion and debate, not to sway opinions.

Today, doctors are required to spend more and more time doing administrative work — including checking off electronic boxes in the electronic medical record (EMR) — the result is less quality time with patients.

Now, those that are in Washington, DC think that requiring physicians to ask about guns in the home …

Conditions and Diseases

Please don’t take gynecological advice from Khloe Kardashian

Jennifer Gunter, MD

August 18, 2016Aug 18, 2016

The latest celebrity to use the internet like a public speculum is Khloe Kardashian. I know this because my phone blew up recently with reporters texting, e-mailing and sending direct messages on Twitter asking about vaginal vitamin E. So I…

But no. Kardashian vagina ranks up there in national significance with the first woman running for the highest office …

Physician

When should physicians lie for patients?

Michael Kirsch, MD

August 17, 2016Aug 17, 2016

Even the most honest among us do not tell the truth all of the time. We are flawed human beings. We covet, we gossip, we steal, we lie, and we stand idly by. You don’t think you steal? Have you…

Even the most honest among us do not tell the truth all of the time. We are flawed human beings. We covet, we gossip, we steal, we lie, and we stand idly by. You don’t think you steal? Have you ever “borrowed” someone else’s idea and represented it as your own?

A few weeks before I penned this, I was presented with two opportunities to lie in order to save a …

Physician

The evolution of a hospital admission

John Schumann, MD

August 17, 2016Aug 17, 2016

Once upon a time, a hospital was a place you went if you were sick. Doctors would (ideally) figure out what was wrong, offer treatment, and you would convalesce. The longer you stayed in a hospital, the more the hospital…

Once upon a time, a hospital was a place you went if you were sick. Doctors would (ideally) figure out what was wrong, offer treatment, and you would convalesce.

The longer you stayed in a hospital, the more the hospital could charge you (your insurance, really — if you had it).

This all changed in 1983, with the advent of the DRG system (it stands for diagnosis-related group). Almost overnight, the incentives for …

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The evolution of a hospital admission

Physician

Can chiropractors be saved? Only they can decide.

Roy Benaroch, MD

August 17, 2016Aug 17, 2016

Can the chiropractic profession evolve and renew itself as a legitimate part of the health care system? Prominent Australian chiropractor Bruce Walker, who is also the editor-in-chief of the Journal Chiropractic and Manual Therapies, has proposed a 10 point plan to ensure that chiropractors create a profession based on science, knowledge, and genuine healing. He makes a strong case that chiropractors need to embrace research, shun “nonsensical elements,” …

Medications

The vaccine crisis we’re facing isn’t the one that you think

Peter Ubel, MD

August 16, 2016Aug 16, 2016

We have a vaccine crisis in the this country. Not just the one caused by anti-vaxxers like Jenny McCarthy, scaring Americans away from life-saving childhood vaccines with pseudo-scientific claims about autism. Instead, I’m talking about a bigger crisis, one caused by a dangerously thin supply of vaccines. Wise parents who ignore the blatherings of people like McCarthy may soon arrive at their pediatricians’ offices prepared to vaccinate their children, only …

Physician

Getting him a new pair of pants was the least that we could do

Heena P. Santry, MD

August 16, 2016Aug 16, 2016

“Please don’t cut off my pants,” he pleaded. “I am homeless, and they are my only pants. Please.” He could say these words as we were conducting our initial assessment in the trauma bay so at least he was hemodynamically…

“Please don’t cut off my pants,” he pleaded. “I am homeless, and they are my only pants. Please.”

He could say these words as we were conducting our initial assessment in the trauma bay so at least he was hemodynamically stable with an intact airway at that moment in time. However, he had arrived seconds earlier with potentially life-threatening injuries as a level 1 trauma activation. Based on the location of …

Physician

How can we find the patient within?

Linda Girgis, MD

August 16, 2016Aug 16, 2016

My medical student found it difficult to get any information from a patient. When she presented the patient’s medical history to me, she was quite flustered and did not know what to say. I went with here to talk to…

Often, when what a patient is saying doesn’t make sense, or it is …

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How can we find the patient within?

Physician

The spectacular incompetence of third-party payers

Dr. Saurabh Jha

August 16, 2016Aug 16, 2016

To paraphrase Tolstoy, all competence is alike, but every incompetence is incompetence in its own way. Every time I think I’ve seen the horizon of incompetence, I’m dealt a surprise. The sun never sets on incompetence. In health care, incompetence…

Case 1: Downgrading caviar to boiled salmon

A patient was referred for a CT angiogram run …

Physician

I am very much a student of the Zen of call

Michael P. Jones, MD

August 15, 2016Aug 15, 2016

I can't believe I'm writing something with this title. Anyone who knows me and sees my name next to that title will probably spit their coffee all over the kitchen counter. And to all the people who have dealt with…

I can’t believe I’m writing something with this title. Anyone who knows me and sees my name next to that title will probably spit their coffee all over the kitchen counter. And to all the people who have dealt with me on call, let me begin by saying, I’m truly sorry for anything I might have said, done, thrown or broken. Mostly. Kinda mostly.

Those who know me will likely think …

Physician

Emergency physicians: You are not alone

Edwin Leap, MD

August 15, 2016Aug 15, 2016

Dear emergency medicine physicians: You aren’t alone. This is very important for you to realize. I mean, I know you aren’t ‘alone.’ You have spouses and children, parents, siblings, neighbors, dogs and cats. That’s all good. You need them. Also, every shift is chock-full of people and their maladies, which you heroically manage day in, day out. Patients are everywhere. Some are sick, and some are injured, and many are …

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Emergency physicians: You are not alone

Physician

Hospital fires doctor for having cancer

Pamela Wible, MD & Stephanie Waggel, MD

August 15, 2016Aug 15, 2016

Dear Pamela, You’ll never guess what happened to me today. Hours after the National Day of Solidarity to Prevent Physician Suicide volunteer web page went live, I received an email stating that I am officially terminated from my psychiatry residency…

Dear Pamela,

You’ll never guess what happened to me today. Hours after the National Day of Solidarity to Prevent Physician Suicide volunteer web page went live, I received an email stating that I am officially terminated from my psychiatry residency program.

On this web page, I spoke about the fact that I had become interested in this event during my …

Read more…

Hospital fires doctor for having cancer

Medical Education

6 actions new medical students should take

Robert Pearl, MD

August 15, 2016Aug 15, 2016

Dear Class of 2020, You’ve worked hard to earn the privilege of becoming a physician. I hope you took some time before starting medical school to enjoy yourself and embrace your passions, be they travel, music or art, or simply…

Dear Class of 2020,

You’ve worked hard to earn the privilege of becoming a physician. I hope you took some time before starting medical school to enjoy yourself and embrace your passions, be they travel, music or art, or simply spending time with family and friends. Becoming a doctor is a long, bumpy and often lonely road. Resiliency is essential. My first and most important piece of advice is to be …

Physician

The kind of family medicine I knew I needed to practice

Hugh Silk, MD

August 15, 2016Aug 15, 2016

"Why do you want to go into family medicine?" my internal medicine preceptor asked. It was an innocent enough question. I'd known from day one of medical school what I wanted to do, so I answered with confidence, and perhaps…

“Why do you want to go into family medicine?” my internal medicine preceptor asked.

It was an innocent enough question. I’d known from day one of medical school what I wanted to do, so I answered with confidence, and perhaps a bit of a chip on my shoulder.

“I love being with people and getting to know them,” I said. “I’ve always been this way, so it makes sense that’s what I …

Physician

The quiet leadership of the surgeon general

Maria Yang, MD

August 14, 2016Aug 14, 2016

Somehow people knew he was about to enter the room. The thirty or so people in the room were seated, though people began to stand up. “Are we supposed to stand up for the surgeon general?” I asked the person…

Somehow people knew he was about to enter the room. The thirty or so people in the room were seated, though people began to stand up.

“Are we supposed to stand up for the surgeon general?” I asked the person sitting next to me.

She shrugged. If we remained seated, everyone would have noticed. So we stood up.

“I’ve been in this position for a year and a half,” Dr. Murthy …

Medical Education

When medical students and residents are distracted by technology

Kashif Shaikh, MD

August 14, 2016Aug 14, 2016

“Please don’t spoil the movie with your own soundtrack.” Remember hearing this message before the beginning of a movie in a theater and how most people turn their devices on silent to watch the movie? The cost of the movie ticket is considerably less than the cost of medical education, but I wonder if learners consider this phenomenon when they walk into their classrooms. Is the habit of smartphones in …

Real physician voices, twice a week

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