KevinMD.com

August 14, 2016Aug 14, 2016

Being a doctor is often more about talking to people and communicating than it is about the scientific practice of medicine. This is something that is unfortunately not taught in medical school, and it’s left to newly qualified doctors to…

Throughout the busy and hectic day of any hospital-based physician — no matter what their specialty — one of the most common requests …

Patient

After a medical error: Here’s what clinicians should do

Betsy M. Cohen

August 14, 2016Aug 14, 2016

I have been a rehabilitation specialist and case manager working with patients who have neurological and neuropsychiatric impairments for thirty years. About three years ago, my life took an unanticipated detour when I was perforated during a baseline colonoscopy. All…

Although my health, body, and life were forever altered by the …

Conditions and Diseases

How the book “When Breath Becomes Air” changed my practice

Kim A. Reiss, MD

August 13, 2016Aug 13, 2016

Behind every door in my clinic, is human suffering. It hangs like a mist; I can see the living ghosts of my patients through it. As an oncologist who treats primarily pancreatic cancer, many of my patients will be dead…

Behind every door in my clinic, is human suffering. It hangs like a mist; I can see the living ghosts of my patients through it.

As an oncologist who treats primarily pancreatic cancer, many of my patients will be dead within a year of our first meeting. I knew this would be the case when I chose my specialty. Pancreas cancer is one of the last frontiers in cancer therapeutics: a …

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Physician

Dear Hippocrates: I want a divorce

Lara Salyer, DO

August 13, 2016Aug 13, 2016

Dear Hippocrates, I want a divorce. Let’s face it, you and I were young, idealistic, and naive when we met. Everyone said we were perfect for each other: valedictorian and humanitarian. We thought we could change the world, one sacrifice…

Dear Hippocrates,

I want a divorce.

Let’s face it, you and I were young, idealistic, and naive when we met. Everyone said we were perfect for each other: valedictorian and humanitarian. We thought we could change the world, one sacrifice at a time. Sleep deprivation, grueling academic hurdles, delayed gratification. We proudly wore those badges as a testament to our commitment together when we started our board certified family medicine profession in …

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Dear Hippocrates: I want a divorce

Conditions and Diseases

Exciting implications of the neuro-immune link no one is talking about

Keith Pochick, MD

August 13, 2016Aug 13, 2016

A recent research paper from the University of Virginia may pound the final nail into the coffin of the long-standing medical dogma which rigidly labels diseases as "organic" or "psychiatric." UVA researchers have discovered a complex network of lymphatic vessels…

A recent research paper from the University of Virginia may pound the final nail into the coffin of the long-standing medical dogma which rigidly labels diseases as “organic” or “psychiatric.” UVA researchers have discovered a complex network of lymphatic vessels which service the brain, prompting a serious update of the concept of a highly selective “blood-brain barrier.”

When asked about methods to study the immune response of the brain and …

Conditions and Diseases

MKSAP: 62-year-old man is evaluated for declining exercise capacity

mksap

August 13, 2016Aug 13, 2016

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 62-year-old man is evaluated for declining exercise capacity over the past year. He was diagnosed with moderate COPD 3 years ago. His symptoms…

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

A 62-year-old man is evaluated for declining exercise capacity over the past year. He was diagnosed with moderate COPD 3 years ago. His symptoms had previously been well controlled with tiotropium and as-needed albuterol. He has not had any hospitalizations. He is adherent to his medication regimen, and his inhaler technique is good. …

Conditions and Diseases

A miracle in the intensive care unit

Debbie Moore-Black, RN

August 12, 2016Aug 12, 2016

She fit into the palm of his hand. That long nine months. Waiting desperately for that baby they thought they could never have. Jeff, football player from his high school days, met the love of his life, Bridget, at the…

She fit into the palm of his hand. That long nine months. Waiting desperately for that baby they thought they could never have.

Jeff, football player from his high school days, met the love of his life, Bridget, at the school party. She was smart and beautiful; Jeff was big and burley, but as kind and gentle as a kitten. They hung out through their college days. And finally said their …

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A miracle in the intensive care unit

Physician

Let’s learn from our nurses and make medicine great again

Miriam A. Knoll, MD

August 12, 2016Aug 12, 2016

Sometimes, I wish I was a nurse. As a nurse, my work-life balance would greatly improve because my three 12-hour shifts would constitute a rewarding and flexible full-time medical career. I would care for all kinds of patients, not just…

Sometimes, I wish I was a nurse.

As a nurse, my work-life balance would greatly improve because my three 12-hour shifts would constitute a rewarding and flexible full-time medical career. I would care for all kinds of patients, not just stick to one medical specialty. Maybe I’d go for an advanced nursing degree; I would enroll in school full-time and also maintain a paid full-time job. Like many nurses, my hospital …

Physician

The art of diagnosis: How to hear more than what the patient says

Michelle M. Kittleson, MD

August 12, 2016Aug 12, 2016

A few years ago, I missed a diagnosis. I know that’s not earth-shattering, but the stakes are high for a cardiologist. Ms. A was an 82-year-old woman with chest pain. She underwent a transcatheter aortic valve replacement (TAVR) for severe aortic stenosis. The pre-procedure coronary angiogram showed no coronary artery disease and the echocardiogram post TAVR was perfect.

However, a few months after the procedure, she reported arm pain. It was …

Physician

Married to medicine: My ménage à trois

Warren Holleman, PhD

August 12, 2016Aug 12, 2016

We were the consummate lovebirds. We studied together, exercised together, and went grocery shopping together. When she started medical school, I took a summer job in the school’s maintenance department, just so we could eat lunch together. We couldn’t fathom…

It was a magical time. We worked hard, played hard, and talked late into the night — yet rose early the next morning, energized and ready to go. …

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Married to medicine: My ménage à trois

Health Policy

Demand Congress to go on Medicare at the age of 65

Gene Uzawa Dorio, MD

August 11, 2016Aug 11, 2016

Born in Canada, our mother came to the United States after World War II and blended into the Greatest Generation. Raising a family in the second half of the 20th century saw her contribute to a thriving American society then maintain retirement health on Medicare. But in her early 90s, this tranquility was threatened when her HMO hospital tried to kill her.

She went to the emergency room with symptoms of …

Health Policy

What economic theory can teach physicians about retail clinics

Kyle Morawski, MD and Joshua Liao, MD

August 11, 2016Aug 11, 2016

As clinicians continue to debate the merits and limitations of retail clinics, it is increasingly clear that they are here to stay. These nontraditional sites have proliferated around the country, appealing directly to patients’ desires for convenience in ways that many traditional primary care practices do not. A report by the Robert Wood Johnson Foundation found that retail clinics have increased by 900 percent over the last decade, an expansion …

Medical Education

A stark reminder of the opportunity we have as physicians

Shama Patel, MD

August 11, 2016Aug 11, 2016

To those of you who are still in the midst of pursuing a seemingly elusive goal of being in medical school I highly encourage you to take a few moments and jot down why you want it so badly. Make…

To those of you who are still in the midst of pursuing a seemingly elusive goal of being in medical school I highly encourage you to take a few moments and jot down why you want it so badly. Make a quick list of all the reasons why you want to be a doctor and how you will feel once you achieve that monumental goal. For those of us in …

Physician

How this pediatrician practices medicine. Her way.

Niran S. Al-Agba, MD

August 11, 2016Aug 11, 2016

My thoughts settled on the Frank Sinatra song, "My Way," when asked about necessary resources for rural health care to survive. Seven years ago, my father and I changed office buildings. We closed the office that Friday to allow three…

My thoughts settled on the Frank Sinatra song, “My Way,” when asked about necessary resources for rural health care to survive. Seven years ago, my father and I changed office buildings. We closed the office that Friday to allow three full days to get settled. However, we ended up seeing sick patients in the parking lot (seriously), while the movers were loading up the truck.

“All we need is a stethoscope, …

Physician

A physician mother as the breadwinner. Here’s how she did it.

Marianne Haughey, MD

August 10, 2016Aug 10, 2016

I was afraid. Really, I was more anxious. This wasn’t any of the typical new mother fears I had been warned about. If fact, I didn’t even see this one coming. I knew that it would be tough going back to work 3 months after my first daughter was born. I knew I would miss her terribly. I knew I had to figure out a pumping schedule with my colleagues …

Physician

Can flawed doctor ratings harm patients?

Skeptical Scalpel, MD

August 10, 2016Aug 10, 2016

Can you trust online physician ratings? Many people believe you can. But here’s what a recent article in the Harvard Business Review (HBR) about the reliability of online user ratings regarding buying a product. The authors concluded that online ratings…

Can you trust online physician ratings? Many people believe you can.

But here’s what a recent article in the Harvard Business Review (HBR) about the reliability of online user ratings regarding buying a product. The authors concluded that online ratings were generally not to be trusted for three important reasons:

The reviews are usually based on a small sample of users. The authors said, “We can be more confident …
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Can flawed doctor ratings harm patients?

Conditions and Diseases

Health care has far too many medical panels

Rocky Bilhartz, MD

August 10, 2016Aug 10, 2016

We are assembling too many panels of people in the name of health these days. Too many. They usually seem like a good idea. I’ve been supportive before. I assumed we needed them. More of them. I might have been…

We are assembling too many panels of people in the name of health these days. Too many.

They usually seem like a good idea. I’ve been supportive before. I assumed we needed them. More of them.

I might have been wrong.

There was a day when I believed my food would be toxic, my medicine harmful, and my safety gone without them. But, I’ve come to believe I was mistaken.

I was wrong because …

Physician

Caring and dedicated physicians are being driven out of medicine

Arvind Cavale, MD

August 9, 2016Aug 9, 2016

Last week, a patient with severe gastroparesis came in for an unexpected visit. She seemed very upset, on the verge of tears. Instead of asking her why she was in, I asked her why she was so sad. “My hematologist…

Last week, a patient with severe gastroparesis came in for an unexpected visit. She seemed very upset, on the verge of tears. Instead of asking her why she was in, I asked her why she was so sad.

“My hematologist just retired; I was her last patient. I don’t know who will take care of me like she did. And she wasn’t even old enough to retire,” she said. This took …

Physician

This oncologist says the USPSTF gets it wrong on skin cancer screening

Morganna Freeman, DO

August 9, 2016Aug 9, 2016

In July 2016, the U.S. Preventative Services Task Force (USPSTF) published updated skin cancer screening guidelines in JAMA, concluding “current evidence is insufficient” to screen for skin cancer in adults. The guidelines were formulated on a literature review of studies conducted in asymptomatic patients 15 years and older at general risk for skin cancer from 1995-2015; after identifying nearly 13,000 articles spanning two decades of work worldwide, the authors selected …

Physician

Multiple choice questions are a terrible way to test doctors

Jeremy Gabrysch, MD

August 9, 2016Aug 9, 2016

Most people are surprised to hear that the way doctors are recertified every ten years is through a multiple choice test. “Really?” they’ll say. “You take a multiple choice test? As a doctor?” Unfortunately, after all these years that's the…

Unfortunately, after all these years that’s the most efficient way we can think of to evaluate professionals. But the method is so flawed. And your ability to answer questions on the multiple choice test isn’t necessarily linked with …

Real physician voices, twice a week

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