KevinMD.com

June 1, 2016Jun 1, 2016

Like many physicians, I’m a people pleaser. On my medical school application, my personal statement was a literary cliché filled with my dreams of helping others, easing pain, soothing suffering — and I really meant it. What I didn’t know then was how difficult it would be to negotiate making patients happy while doing the right thing medically.

Medical school and residency didn’t adequately prepare me for the emotional strain of …

Health Policy

When things go wrong operationally, nurses feel the pain first

Colin Baird

June 1, 2016Jun 1, 2016

Twenty years of experience and research reveal two indispensable truths about hospitals and health care organizations that can no longer be ignored: Those institutions neglecting the basic fundamentals of patient care risk jeopardizing the quality and safety of care they…

Nothing can have a greater short and long-term impact on the cost of delivering health care services than nurses.

The central role of the nurse in patient care

For more than 60 years, …

Physician

A study on medical errors inflames, but doesn’t solve anything

Skeptical Scalpel, MD

May 31, 2016May 31, 2016

For the last couple of days, the Twitter medical community has been discussing the latest in a long line of papers attempting to estimate the role of medical error as a cause of death. A recent entry appeared in the…

For the last couple of days, the Twitter medical community has been discussing the latest in a long line of papers attempting to estimate the role of medical error as a cause of death.

A recent entry appeared in the BMJ and was by a surgeon at Johns Hopkins, Dr. Martin Makary, who claims that 251,454 patients die from medical error every year.

Makary’s review extrapolated that figure from three papers …

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Conditions and Diseases

How marriage affects men’s colonoscopy rates

Frederick Gandolfo, MD

May 31, 2016May 31, 2016

Did you know that married men have a lower colorectal cancer mortality when compared to unmarried men? What about the fact that married men have higher rates of colorectal cancer screening? Interesting, right? In fact, studies showing the association between…

More recently, a study published in the journal Preventive Medicine found that married men …

Physician

A black doctor’s perspective on perceptions by race

Earl Stewart, Jr., MD

May 31, 2016May 31, 2016

I received the sign-out from a colleague that he was to be transferred out of the medical intensive care unit to our service, as we were the team on call that evening. My intern and I prepared to see him in the unit before he was moved to our floor, which involved reviewing his chart and having preliminary discussions about continuing his care.

Soon after, we arrived to the unit, checked …

Physician

A sick doctor must show up to work. That’s wrong.

Neha Sharma, DO

May 30, 2016May 30, 2016

A few weeks ago, I woke up feeling under the weather. It was day one of seven consecutive shifts. I looked into the mirror. A sullen face with sunken eyes stared back. As I was getting dressed, I felt fatigue trying to triumph over my body. Next came a nagging and rude cough that kept interrupting my sentences. I started to feel feverish, and sure enough, I measured a temperature …

Conditions and Diseases

Why it’s not OK for older doctors to dismiss physician burnout

Jessica Lapinski, DO

May 30, 2016May 30, 2016

This past month I had the opportunity to present at a medical conference; my research topic was burnout and depression in osteopathic family medicine residents. A variety of attending physicians and residents stopped by my poster, excited to see this topic being brought to light. With the recent rise in physician dissatisfaction and suicide, there has been increased attention to finally start addressing this issue.

I was super excited about giving …

Patient

10 indispensables for those with chronic pain and illness

Toni Bernhard, JD

May 30, 2016May 30, 2016

This piece is based on personal experience and on the thousands of emails I’ve received from those who live day-to-day with chronic illness (which includes chronic pain). 1. Email. I know the joy of hearing the actual voice of a…

This piece is based on personal experience and on the thousands of emails I’ve received from those who live day-to-day with chronic illness (which includes chronic pain).

1. Email. I know the joy of hearing the actual voice of a loved one. That said, email is the principal way I communicate with people.

It’s hard for me to talk on the phone. It saps my energy quickly, partly because of the need for …

Physician

The alarmist approach to medical errors solves nothing

Julie Craig, MD

May 30, 2016May 30, 2016

The British Medical Journal recently published a paper boasting the astonishing conclusion that medical error is the third leading cause of death in the United States. Headlines aside, the study suffers from questionable statistics that serve up alarmist conclusions about the prevalence of serious medical errors and obscure the road to addressing the tragic phenomenon of death by medical error.

The analysis cites four observational studies on incidents that …

Conditions and Diseases

Choose your actions, not your feelings

Steven Reidbord, MD

May 29, 2016May 29, 2016

Again and again in therapy I find myself emphasizing the distinction between feeling an emotion and acting on it. Many patients, and non-patients too, take undue responsibility for their emotions, as though feelings were volitional behaviors, the result of a choice. Often there is a stated or implied should: “I should feel this, not that.” Note how commonly people blame themselves for feeling, or not feeling, a certain emotion:

“I should be more grateful after all she’s done for me.”

“It’s wrong of …

Read more…

Choose your actions, not your feelings

Health Policy

This is why health care is not a system

Margalit Gur-Arie

May 29, 2016May 29, 2016

The Merriam-Webster dictionary has many definitions for the term system, but the most straightforward, and arguably the most applicable to our health care conversation is “a regularly interacting or interdependent group of items forming a unified whole.” The common wisdom is that our health care system is broken, and hence, our government is vigorously attempting to fix it for us through legislation, reformation, and transformation. We usually work ourselves into …

Read more…

This is why health care is not a system

Physician

Fixing medical errors is more difficult than you think. Here’s why.

Marjorie Stiegler, MD

May 29, 2016May 29, 2016

Recently, a paper written by researchers at Johns Hopkins asserted that medical error was the third leading cause of the death in the United States. This received -- as you might imagine -- considerable coverage in the media. The researchers…

Recently, a paper written by researchers at Johns Hopkins asserted that medical error was the third leading cause of the death in the United States. This received — as you might imagine — considerable coverage in the media. The researchers proposed that death certificates should include a qualifier or indicator that medical error was linked to the death, if in fact it was, so that better statistics could …

Physician

Hyperbole is seldom helpful. Especially when it comes to medical errors.

Dr. Saurabh Jha

May 29, 2016May 29, 2016

Josef Stalin famously said: "One death is a tragedy; one million is a statistic." Perhaps 250,000 preventable deaths from medical errors, according to an analysis by Makary and Daniel in the BMJ, maketh a Stalin. The problem with Makary’s analysis,…

Josef Stalin famously said: “One death is a tragedy; one million is a statistic.” Perhaps 250,000 preventable deaths from medical errors, according to an analysis by Makary and Daniel in the BMJ, maketh a Stalin.

The problem with Makary’s analysis, which also concluded that medical errors are the third leading cause of death, isn’t the method. Yes, the method …

Physician

Physicians in health IT have to be better communicators

Suneel Dhand, MD

May 28, 2016May 28, 2016

The chance interaction occurred at a large medical conference I attended recently. I happened to bump into a leader in health care information technology from a major integrated medical system. As soon as I saw him and his name badge, I thought I would go over and introduce myself, seeing as I have an avid interest in health care IT myself.

He was standing alone having just finished lunch, and there …

Conditions and Diseases

The bittersweet truth about the epidemic affecting health care workers

Anonymous

May 28, 2016May 28, 2016

It was the first day of my prestigious internship at the cardiac and pulmonary rehabilitation center. I was a senior in college and eager to apply my knowledge from the field of exercise physiology to make an impact on the people beginning rehab. This was my first real opportunity to work as part of a health care team while proving that this is the right field for me to be …

Conditions and Diseases

Zika virus infection in semen: A call to action and research

Chantel Washington, MD

May 28, 2016May 28, 2016

It’s difficult to turn to any major media outlet without being confronted with the latest breaking information on Zika virus infection. The images of newborns from Brazil with excessively small heads are searing. To most of the U.S. population, the Zika virus epidemic in South and Central America is mainly a travel concern. But to the millions of people living in areas from the Caribbean to Central and South America, …

Conditions and Diseases

MKSAP: 44-year-old man with type 2 diabetes mellitus

mksap

May 28, 2016May 28, 2016

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 44-year-old man is evaluated for management of type 2 diabetes mellitus. He was diagnosed with diabetes 6 months ago after being admitted to…

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

A 44-year-old man is evaluated for management of type 2 diabetes mellitus. He was diagnosed with diabetes 6 months ago after being admitted to the hospital with diabetic ketoacidosis. He was discharged from the hospital on a basal and preprandial insulin regimen. Medications are regular insulin before meals and neutral protamine Hagedorn (NPH) …

Health Technology

Insurance companies cannot dictate which medical devices we prescribe

David Ahn, MD

May 27, 2016May 27, 2016

The diabetes community has been set ablaze after UnitedHealthcare announced an agreement for Medtronic devices to be the “preferred” in-network, durable medical equipment (DME) provider of insulin pumps. Starting July 1, 2016, UnitedHealthcare patients will be funneled toward using a…

Many diabetes advocates have eloquently voiced their outrage …

Physician

More needs to be done about sexual harassment in health care

Cory Michael, MD

May 27, 2016May 27, 2016

Having recently watched a cable television recreation of the Clarence Thomas confirmation hearings, I am left thinking about how far some of us have come and how far some of us haven't. The confirmation hearings of Supreme Court Justice nominee…

Having recently watched a cable television recreation of the Clarence Thomas confirmation hearings, I am left thinking about how far some of us have come and how far some of us haven’t.

The confirmation hearings of Supreme Court Justice nominee Clarence Thomas in 1991 changed the concept of sexual harassment in the workplace by bringing the issue to the forefront. By the time, I started residency nearly 20 years after the …

Physician

I will make a concerted effort every day to do my job with love

Angelina Somoracki, DO

May 27, 2016May 27, 2016

Since beginning my medical education, I had been on one side of the curtain; the side where the doctors confer and discuss before telling the patient his or her fate, going from room to room giving updates and prognoses. I interacted with patients for the purpose of getting their histories and physical examinations, collecting all the data so that I could present the case to my attending. I was engrossed …

Real physician voices, twice a week

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