KevinMD.com

May 26, 2016May 26, 2016

Let's get this straight. I am a doctor, but I didn't cause the opioid epidemic. That is not exactly what you hear in the media these days. After all, doctors are the ones with the prescription pads, and someone must…

Heroin-Sports-Injury

Let’s get this straight. I am a doctor, but I didn’t cause the opioid epidemic. That is not exactly what you hear in the media these days. After all, doctors are the ones with the prescription pads, and someone must be to blame.

The truth is that death from opioid abuse is on the rise. The Centers for Disease Control and Prevention (CDC) has …

Physician

A patient with a right brain injury. And an accusation.

Freida McFadden, MD

May 26, 2016May 26, 2016

You can't pick your parents, and you can't pick the side of your brain that you damage. I always thought that injuries to the left side of the brain would be the worst, because that's where the language centers generally…

You can’t pick your parents, and you can’t pick the side of your brain that you damage.

I always thought that injuries to the left side of the brain would be the worst, because that’s where the language centers generally are. And talking is basically all I do. But after seeing uncountable numbers of strokes and brain injuries, I’ve changed my mind. Right brain injuries are worse.

The right side of the …

Physician

California’s End of Life Option Act will provoke meaningful conversations

Tenessa MacKenzie, MD

May 26, 2016May 26, 2016

I hoped that my feisty patient who prevailed over brain cancer would be spared another terminal diagnosis, but after two years in remission, her mammogram showed breast cancer. She agreed to surgery, but declined further chemotherapy. When the time comes,…

The End of Life Option Act goes into effect in California on June 9, 2016, joining a handful of other …

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Physician

How I am leading doctors through change

Karen Weiner, MD, MMM

May 26, 2016May 26, 2016

Here’s a leadership challenge: Get a group of highly independent, intelligent individuals to come together to build a boat. But imagine the blueprint for that boat is vague and untested. Now imagine that this boat must be built in choppy, progressively inhospitable waters, while said individuals are frantically treading water to stay afloat. Convincing these smart people that there’s a problem isn’t the issue. Convincing them to abandon their desperate …

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How I am leading doctors through change

Physician

Here are the lessons I learned from caring for my ailing father

Michael Goldberg, MD

May 26, 2016May 26, 2016

I very distinctly remember March 16, 2015. I was the chief surgical resident on call for trauma at my busy urban training program. Like any other springtime trauma call I was steadily busy, running back and forth from penetrating and blunt trauma victims in the trauma bay to inpatients, OR cases, and attending rounds. The characteristically hectic flow of the day was interrupted when I got a call from my …

Conditions and Diseases

Why now is the time to talk to your children about terrorist attacks

Marjorie S. Rosenthal, MD, MPH

May 25, 2016May 25, 2016

It's field trip season in middle school. Which means that all over the country young adolescents are headed to memorials and museums. In New Haven, Connecticut, field trip season means the 8th graders are going to the World Trade Center…

It’s field trip season in middle school.

Which means that all over the country young adolescents are headed to memorials and museums. In New Haven, Connecticut, field trip season means the 8th graders are going to the World Trade Center in New York City. Which means that at my kitchen table, my daughters and I are discussing how safe it is to be at the World Trade Center. Two of us think it’s one of the …

Physician

Thinking of starting a cash-based practice? Here are the pros and cons.

Ashley Maltz, MD, MPH

May 25, 2016May 25, 2016

As an integrative medicine physician, I am often questioned about what I do and how I decided to diverge from the normalcy of allopathic medicine. I usually go into a short spiel about my love for thinking outside the box and creating solutions for patients that seek a kinder, gentler style of medicine; one that blends effective healing modalities from all over the globe with my traditional allopathic training.

Most people …

Health Policy

Nurses take DC to save patient lives

Rebecca Love, RN

May 25, 2016May 25, 2016

When nurses stand on the steps of our nation's capital, it is a warning that something is seriously wrong in health care. Much like a canary in the coal mine, nurses are the barometer of the health of our hospitals,…

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When nurses stand on the steps of our nation’s capital, it is a warning that something is seriously wrong in health care. Much like a canary in the coal mine, nurses are the barometer of the health of our hospitals, nursing homes and health care facilities.

On May 12th 2016, nurses from around the United States convened on our nation’s capital for the …

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Nurses take DC to save patient lives

Health Technology

Health IT: The weakest links in a system are actually the people who use it

Kerri Vincenti, MD

May 25, 2016May 25, 2016

Among the plethora of emails that I receive on a daily basis, there seems to always be at least one sent from my hospital’s information services department. Usually, I receive alerts about system downtime or notifications about resolved tickets. They all have the same general look and feel, and so I hardly ever question that they are official. And then I come across a communication with the message similar to …

Physician

Maybe it’s time to go back to index cards for medical records

Niran S. Al-Agba, MD

May 25, 2016May 25, 2016

During our dermatology section in medical school, a classmate recounted having had Henoch-Schonlein purpura as a child. Over a holiday break, he visited his primary care physician and asked if he could review his records out of curiosity. His family physician pulled out the index card that served as this man’s medical record. Yes, you read that correctly. It was not a chart or computer printout; rather a 4 x …

Conditions and Diseases

Systemic racism and racial bias in mental health care

Katie Bayne

May 24, 2016May 24, 2016

Mental health issues are something I’m passionate about and have a lot of experience with, both professionally and personally. One of the biggest lessons I’ve learned over the years is how complicated and broken our mental health system is. When one or even multiple parts aren’t functioning at their highest level, we end up with a fractured system and patients falling through the cracks.

One chasm in our mental health care …

Medical Education

What it takes to be a great doctor: Master the fundamentals

Robert Centor, MD

May 24, 2016May 24, 2016

Charles Bukowski once said, “Wherever the crowd goes, run in the other direction. They’re always wrong.” How does one become a master? What process do we use to have the highest probability of success? Here are some examples. "Picasso was…

Charles Bukowski once said, “Wherever the crowd goes, run in the other direction. They’re always wrong.”

How does one become a master? What process do we use to have the highest probability of success? Here are some examples.

“Picasso was an extraordinary craftsman, even when measured against the old masters. That he chose to struggle to overcome his visual heritage in order to find a language more responsive to the modern world …

Conditions and Diseases

The controversy that surrounds trigger warnings

Maria Yang, MD

May 24, 2016May 24, 2016

A reader I respect asked me for my thoughts on trigger warnings. Per Wikipedia, trigger warnings are “warnings that the ensuing content contains strong writing or images which could unsettle those with mental health difficulties.” Let’s put aside the last…

A reader I respect asked me for my thoughts on trigger warnings.

Per Wikipedia, trigger warnings are “warnings that the ensuing content contains strong writing or images which could unsettle those with mental health difficulties.”

Let’s put aside the last part of that definition, “those with mental health difficulties”, as some articles suggest that trigger warnings are not limited to those with mental health difficulties. Part of …

Physician

The enemy is not death. The enemy is needless suffering.

James C. Salwitz, MD

May 24, 2016May 24, 2016

Among hospice staff, it is called “getting it.” One says, “He doesn’t get it,” “I think she gets it,” or, “They definitely get it.” It is a little hard to define, but as with pornography, you know it when you see it. Nonetheless, given the importance of “getting” good end-of-life care, let us take a moment to try and explain.

The 92-year-old patient is bleeding into her head, but has blood …

Conditions and Diseases

A story that showed me how cancer is a social disease

Don S. Dizon, MD

May 23, 2016May 23, 2016

Young women get gynecologic cancers, and I have had my share of conversations about ovarian cancers with women in their 20s and 30s. It rarely happens, but when it does, it is devastating. I make it a point to talk…

Conditions and Diseases

Don’t lose weight the Biggest Loser way. Here’s why.

Jennifer Gunter, MD

May 23, 2016May 23, 2016

A new study was released on weight loss and maintenance that has been covered on many sites. Researchers from the National Institutes of Health (NIH) evaluated contestants from Season 8 of the TV show the Biggest Loser. They found that 13 of the 14 contestants studied regained some or all of their weight that was lost during the show. All the contestants studied also had slower metabolic rates than expected; …

Medical Education

Foreign medical graduates get a raw deal. Here’s why.

Eric Beam, MD

May 23, 2016May 23, 2016

On my recent tour of residency programs, I had the pleasure of meeting many foreign medical graduates (a.k.a. FMGs; not to be confused with international medical graduates, who are U.S. citizens who go abroad for medical school). Almost uniformly, they…

Almost uniformly, they struck me as confident, mature and articulate. Many were older than me, some by as much as 10 or 15 years. Most had extensive research experience, and a few had even …

Patient

To my fellow school of medicine graduates: Give it to them straight

Linda Haller

May 23, 2016May 23, 2016

I would have graduated from medical school this year. That’s right. Just like you, I’d be getting ready to move to another city and take up residence at an academic medical center to begin my clinical training. Things don’t always work out the way we planned: like Lenny and George in Steinbeck’s, Of Mice and Men. Sometimes, the best-laid plans have a way of going awry no matter how carefully we prepare them.

Cancer. I wasn’t worried. It was …

Physician

What I learned after 41 years of practicing psychiatry

Bruce Hershfield, MD

May 22, 2016May 22, 2016

Now that I’m getting ready to turn 70, I thought I’d summarize what I’ve learned since I finished my residency, when I was 28. Of course, I didn’t learn all this only by being a psychiatrist, since I would hope…

1. Psychotherapy is important, particularly if the patient is on the right medication. I won’t do “med checks,” since I …

Physician

The myth of critical care

Angela Jarman, MD

May 22, 2016May 22, 2016

When asked during a recent ICU rotation if I was considering critical care as a subspecialty, I offended more than one person with my response: “No, I really don’t enjoy torturing old people.” Granted, that unfiltered comment came at the…

As doctors, we have a number of tools to assess quality of life in research. We use fancy …

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The myth of critical care

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