KevinMD.com

June 29, 2016Jun 29, 2016

It’s an unmitigated disaster. One hundred million pain patients. Millions addicted to opioids, hundreds of thousands dead. Pain patients abruptly cut off medication they’ve depended on, sometimes for decades, and offered nothing to replace it. Doctors, fearful of prosecution for overprescribing, dropping pain patients like hot potatoes. Pain patients unable to find any doctor that will treat them. Patients turning to heroin when they can’t get their prescription painkillers. Articles …

Health Policy

People are going broke because they can’t afford care. It needs to end.

Michael P. Jones, MD

June 29, 2016Jun 29, 2016

“I need help with my colitis.” “Really? I thought we had things pretty well controlled.” I hadn’t seen her in the better part of a year. I remembered how hard it had been to get her ulcerative colitis into remission.…

“I need help with my colitis.”

“Really? I thought we had things pretty well controlled.”

I hadn’t seen her in the better part of a year. I remembered how hard it had been to get her ulcerative colitis into remission. How sick she had been, how miserable her life was. There was a bit of trial and error in the office, followed by a hospitalization for intravenous steroids, then a tapering dose …

Physician

We need to show empathy for patients who miss their appointments

Jessica M. Yeatermeyer, MD

June 29, 2016Jun 29, 2016

I have a love-hate relationship with the no-show patient. Like most doctors, I’m a reasonably good multitasker, adept enough at charting while emailing while waiting on hold with insurance companies and planning what to prepare for dinner when I get home. But there are days, more than I’d like to admit, when I feel like I need just a little bit more time, and I find myself compulsively refreshing my …

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Physician

Do hospitals need a formal appearance policy?

Richard Plotzker, MD

June 28, 2016Jun 28, 2016

One day into our medical center’s newly announced colleague appearance policy, nobody has yet approached my office with a steel wool soap pad to make any of the docs or medical assistants shine. My active white coat went into the laundry bin the day before, having inserted my left sleeve into a puddle of spilled coffee. The other two lab coats with hospital logo remain in their plastic protective coating, …

Physician

A culture of misogyny at a VA hospital

Mary Branch, MD

June 28, 2016Jun 28, 2016

This is a very controversial essay, but I am going to express how some women physicians, like myself, feel at the VA hospital. I came home one day after my clinic and was perturbed. I called my significant other and…

This is a very controversial essay, but I am going to express how some women physicians, like myself, feel at the VA hospital.

I came home one day after my clinic and was perturbed. I called my significant other and the emotion of the day unraveled. I was reporting an uncomfortable interaction I had with an older male patient. During this patient encounter, his tone and comments became sexually charged and …

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A culture of misogyny at a VA hospital

Physician Finance

Some doctors do it for the money. Here are some reasons why.

Future Proof, MD

June 28, 2016Jun 28, 2016

If you stay in medicine long enough, you will encounter physicians who seem to care more about the paycheck than the patient in front of them: think Dr. Farid Fata. You may find those colleagues revolting; I know I did. I despised these physicians and felt nauseated even to be in the same room as them. But as time went on, I realized that almost nobody starts a career …

Physician

Patient satisfaction must start with nursing satisfaction

Alberto Hazan, MD

June 28, 2016Jun 28, 2016

Ever since the U.S. government decided to link Medicare reimbursement dollars to patient satisfaction scores, hospital administrators have been obsessed with improving the quality of care for patients visiting their emergency departments. While the motivation may be partly financial, the…

Unfortunately, many of the tactics used by administrators have done little to achieve that goal. …

Medications

Why not make antibiotics over the counter?

Dana Corriel, MD

June 27, 2016Jun 27, 2016

Bacteria are rapidly becoming resistant in our antibiotic-loving society. This statement is a fact. We are facing a threat not only to our country, but to the world. I have a proposal to make: over-the-counter antibiotics. (Insert tongue-in-cheek here.) Will…

Bacteria are rapidly becoming resistant in our antibiotic-loving society. This statement is a fact. We are facing a threat not only to our country, but to the world.

I have a proposal to make: over-the-counter antibiotics.

(Insert tongue-in-cheek here.)

Will this help us deal with the falsely popular notion that antibiotics are a cure-all? I don’t know, but here’s something I do. I’ve had patients storm out because I’ve said no, and I …

Physician

How do you define success after residency?

Kelly G. Elterman, MD

June 27, 2016Jun 27, 2016

Residency is a time of immense learning. You learn from your attendings, your patients, and your colleagues. Of all the teaching moments during my residency, one that frequently stands out in my mind now is the day when one of my co-residents told me about the “post-training phenomenon.” He had previously completed a different residency and practiced in that field for a decade prior to switching to our specialty.

“Once you …

Health Technology

Innovative technologies could save millions of lives in the developing world

Bertalan Mesko, MD, PhD

June 27, 2016Jun 27, 2016

Imagine two babies being born at the exact same time: a little girl in Sweden and a baby boy in Mozambique. What are their chances for a long, healthy life? In the Scandinavian country of the easily assemblable IKEA furniture…

Imagine two babies being born at the exact same time: a little girl in Sweden and a baby boy in Mozambique. What are their chances for a long, healthy life?

In the Scandinavian country of the easily assemblable IKEA furniture and the most secure car in the world, life expectancy in 2015 reached 81.98 years, while in the South African Mozambique with 11.64 billion dollar …

Physician

Physicians have a duty to respond to emergencies if they can

Niran S. Al-Agba, MD

June 27, 2016Jun 27, 2016

“Someone else will lend a helping hand,” a physician told me once, when asked to help with an emergency in public. As a PALS instructor for more than a decade, I have always responded when possible. In the last decade, there have been three in-flight emergencies, two elderly individuals who passed out in church, and a host of other less serious maladies. A week ago, I discovered the best reason I …

Conditions and Diseases

Defending the call for a cancer moonshot

Saurabh Dahiya, MD

June 26, 2016Jun 26, 2016

In his last state of the union address, President Obama reinvigorated the nation’s interest in a long-sidelined disease/s: cancer. A call for a moonshot was announced, and the president in his address said, “I’m putting Joe in charge of mission control.” The last time such a national commitment towards this illness was announced was by the efforts of a cancer advocate, Mary Lasker. She advocated fiercely, and the National Cancer Act …

Medical Education

10 tips to handle the media as an academic researcher

Gabriela Spencer Bonilla

June 26, 2016Jun 26, 2016

As a researcher, there may come a time when you interact with the media. It may make you cringe; for traditional research publications, we have the protection of editing, and feedback from mentors and colleagues. Interviews feel much more risky: Questions are unpredictable, and there is seldom an opportunity to polish the product before it goes into the wild. Yet, interacting with the media offers an opportunity to garner attention …

Health Policy

Transparency in health care: Here’s why we need to let it be

Michel Accad, MD

June 26, 2016Jun 26, 2016

Transparency -- or its absence -- continues to fascinate health care analysts and health care economists. A study published in the Annals of Internal Medicine addresses the effects of public reporting of hospital mortality rates on outcomes. Its senior author,…

Transparency — or its absence — continues to fascinate health care analysts and health care economists. A study published in the Annals of Internal Medicine addresses the effects of public reporting of hospital mortality rates on outcomes. Its senior author, Dr. Ashish Jha, offered his perspective on the study results and on the topic.

According to the study investigators, mandatory public reporting of hospital mortality is not improving outcomes. The result of their analysis surprised them …

Medications

How Tylenol may relieve both physical and emotional pain

Manoj Jain, MD, MPH

June 26, 2016Jun 26, 2016

Last week, when I stubbed my toe on our family room coffee table, a throbbing pain ensued. Over the next two to three days, as the bruise turned pink and then purple, the pain persisted. During the same time, I…

Last week, when I stubbed my toe on our family room coffee table, a throbbing pain ensued. Over the next two to three days, as the bruise turned pink and then purple, the pain persisted.

During the same time, I had a case of the blues. I am overstressed at work with several staff on vacation, my college-age children had come home and then left to start their internships, and my …

Physician

The path to becoming a physician is not easy

Angella Woodman, MD

June 25, 2016Jun 25, 2016

As a member of the general population, we see physicians as those who were born with a calling. Though society acknowledges that becoming a doctor is difficult, it is near impossible to fathom exactly what that title entails. I was…

I was raised in a small rural community in which resources were quite limited. The nearest grocery store was a 35-minute drive away, there were no coffee shops or traffic lights, and we …

Patient

PTSD was the illness I couldn’t see

Amy Oestreicher

June 25, 2016Jun 25, 2016

I grew up thinking an “illness” was either a fever or croup. Illness was a stuffy nose -- a sick day, an excuse to miss a day of school. At 18 years old, “illness” took on an entirely different meaning.…

I grew up thinking an “illness” was either a fever or croup. Illness was a stuffy nose — a sick day, an excuse to miss a day of school. At 18 years old, “illness” took on an entirely different meaning. Illness meant waking up from a coma, learning that my stomach exploded, I had no digestive system, and I was to be stabilized with IV nutrition until surgeons could figure …

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PTSD was the illness I couldn’t see

Health Policy

Does publicly reporting hospital mortality rates improve outcomes?

Ashish Jha, MD, MPH

June 25, 2016Jun 25, 2016

Get a group of health policy experts together and you’ll find one area of near universal agreement: We need more transparency in health care. The notion behind transparency is straightforward; greater availability of data on provider performance helps consumers make better choices and motivates providers to improve. And there is some evidence to suggest it works. In New York State, after cardiac surgery reporting went into effect, …

Conditions and Diseases

MKSAP: 52-year-old woman with type 2 diabetes mellitus

mksap

June 25, 2016Jun 25, 2016

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 52-year-old woman presents for follow-up evaluation after being diagnosed with type 2 diabetes mellitus 6 weeks ago. Her initial HbA1c level was 8.0%.…

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

A 52-year-old woman presents for follow-up evaluation after being diagnosed with type 2 diabetes mellitus 6 weeks ago. Her initial HbA1c level was 8.0%. Management at this time is with lifestyle modifications. She has worked closely with a diabetes educator and a nutritionist since her diagnosis. She has lost 3.2 kg (7 lb) …

Physician

A false positive is precaution by another name

Dr. Saurabh Jha

June 24, 2016Jun 24, 2016

Diagnostic tests such as CT scans are not perfect. A test can make two errors. It can call a diseased person healthy: a false negative. This is like acquitting a person guilty of a crime. Or a test can falsely call a healthy person diseased: a false positive. This is like convicting an innocent person of a crime that she did not commit. There is a trade-off between false negatives and false positives. To …

Real physician voices, twice a week

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