KevinMD.com

May 22, 2016May 22, 2016

Naturopaths are currently engaged in an intensive lobbying effort at the Capitol in order to gain recognition as medical practitioners and inclusion in Medicare. As a retired naturopath who was licensed in two states, I want to offer a primer…

To be fair, naturopaths (NDs) are no longer obscure practitioners. NDs are currently licensed or registered in 18 U.S. …

Physician

How to change patient behaviors? Don’t lecture them.

Rob Lamberts, MD

May 22, 2016May 22, 2016

Taxes. Doing taxes feels like a financial rectal exam. I hate doing taxes. Yeah, I don't like getting rectal exams either. It's not that I resent paying the government for the fine services they render and the high quality of…

Taxes.

Doing taxes feels like a financial rectal exam. I hate doing taxes. Yeah, I don’t like getting rectal exams either.

It’s not that I resent paying the government for the fine services they render and the high quality of elected officials we have. It’s not the existence of taxes I hate; it’s just doing taxes make me feel extremely insecure. Sharing my personal and business finances with my accountant and the …

Physician

With doctors losing respect, perhaps it’s time to expose medicine’s dark side

Ahmad Yousaf, MD

May 22, 2016May 22, 2016

The following is paraphrased documentation, authored by a physician I know, regarding an intoxicated patient in the ER: 1 a.m.: Patient is telling nurse, “Before I leave, I need everyone’s name for my lawsuit. Tell the phlebotomist that if he’s…

The following is paraphrased documentation, authored by a physician I know, regarding an intoxicated patient in the ER:

1 a.m.: Patient is telling nurse, “Before I leave, I need everyone’s name for my lawsuit. Tell the phlebotomist that if he’s good, he’ll get a cut.”

1:40 a.m.: Patient is making inappropriate sexual comments and is verbally aggressive with medical staff. He is advised to stay in bed.

2:02 a.m.: Patient (who had been sleeping comfortably) wakes up and …

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Physician

Plastic surgery is more than Botox. Hopefully doctors can remember that.

Miranda Fielding, MD

May 21, 2016May 21, 2016

My friend Dawn and I recently attended an evening meeting of the Houston Society of Plastic Surgeons. Since we were invited guests, and not plastic surgeons, we didn’t stop on the way into the lovely formal dining room to pick up our name badges because the organizers had not made them for us. On the way out, however, we both noticed clear plastic perfectly formed oval objects sitting on the …

Medications

Drug addiction is a problem that requires treatment, not punishment

Chinazo O. Cunningham, MD

May 21, 2016May 21, 2016

When I meet strangers, and they ask what I do for a living, the conversation tends to go something like this: I tell them I’m a physician. They ask what type. I say that I am a general internist, but I focus mainly on addiction…addiction to prescription opioids (painkillers) and heroin. Invariably, people will say something like, “This has become such a big problem.” I agree, but then they will …

Health Technology

Here are the limitations of virtual doctor visits

Joseph Kvedar, MD

May 21, 2016May 21, 2016

Virtual visits are increasingly the rage amongst forward-thinking healthcare providers that want to jump on the telehealth band wagon. Extending the office visit across distance, using the same technology we use to keep in touch with loved ones (videoconferencing such as Skype and FaceTime), is a safe and logical way for providers to venture into a new tech-enabled world that may still be scary for some.

One way to think of …

Conditions and Diseases

MKSAP: 58-year-old man asks for advice on cardiac risk assessment

mksap

May 21, 2016May 21, 2016

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 58-year-old man is evaluated during a routine appointment and asks for advice on cardiac risk assessment. He does not have any current cardiac…

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

A 58-year-old man is evaluated during a routine appointment and asks for advice on cardiac risk assessment. He does not have any current cardiac symptoms, exercises 4 days per week, and has never smoked. He has no chronic health issues and takes no medications. He has no known drug allergies. Results of the physical examination …

Health Policy

Improving our health system requires a culture change. Can it happen?

Robert Pearl, MD

May 20, 2016May 20, 2016

Most industrialized nations have long supported the idea that access to health care is a fundamental right, and have built centrally planned systems to accomplish that goal. The result has been universal coverage that delivers excellent-quality outcomes at lower costs…

In some countries, such as England and Canada, the government controls both financing and certain aspects of health care delivery, while in others, including Australia, Sweden, and …

Physician

Do doctors reveal too much about themselves?

Hans Duvefelt, MD

May 20, 2016May 20, 2016

Physicians play many roles in patients’ health care and lives in general. In one encounter we may be the only one encouraging a hesitant or discouraged person to look inside and outside themselves for the strength to move forward with…

Physicians play many roles in patients’ health care and lives in general.

In one encounter we may be the only one encouraging a hesitant or discouraged person to look inside and outside themselves for the strength to move forward with a difficult decision.

In the very next appointment, we may be taking charge as a patient develops chest pain and shortness of breath in front of our eyes.

We sometimes find ourselves in …

Physician

Shared decision making: How this oncologist did it right

Peter Ubel, MD

May 20, 2016May 20, 2016

Sometimes in my research on physician/patient communication, I come across a doctor who is so good with her patients, I have to share their bedside manner with you. The most recent example is a (to remain unnamed) oncologist in the northeastern United States who practically gave a primer on shared decision making when caring for a patient with metastatic cancer.

The patient (I’ll call her Jennifer Decker) had stage 4 breast …

Physician

Is it possible to be a Christian and practice emergency medicine?

Edwin Leap, MD

May 20, 2016May 20, 2016

Many young physicians in training have asked me, quietly or by e-mail, "Is it possible to be a Christian and practice emergency medicine?" I think that they ask a good question, and likely for good reasons. In their rotations, they…

Many young physicians in training have asked me, quietly or by e-mail, “Is it possible to be a Christian and practice emergency medicine?” I think that they ask a good question, and likely for good reasons.

In their rotations, they have witnessed, first hand, life in the ER. They are uncertain, perhaps, because they see the frustration that boils over in the words and actions of otherwise compassionate and caring doctors …

Health Policy

Why Medicare is not the enemy

Suneel Dhand, MD

May 19, 2016May 19, 2016

With all the changes happening in health care and the increasing weight of federal mandates and requirements, it’s easy to view the Centers for Medicare & Medicaid Services (CMS) as the big, bad enemy. After all, if they just left all physicians and health care institutions on their own, everything would be OK, wouldn’t it? It’s an occasional line of thinking I’ve heard from many esteemed colleagues and also appears to be …

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Why Medicare is not the enemy

Medical Education

The stories of my medical school mentors

Greg Smith, MD

May 19, 2016May 19, 2016

Popular shows like Gray’s Anatomy, ER, and House, MD have given the television watching public a good eyeful when it comes to the inner workings of medicine, hospitals, and emergency rooms. They have also shown us how the personalities of those who take up the stethoscope and reflex hammer run the gamut from the sweet, demure, tentative types to the sons of bitches who cut first and ask questions later.

I …

Physician

The evolution of the grieving physician

Rashmee Patil, MD

May 19, 2016May 19, 2016

I remember my first death. He was my patient, a 59 year old who suffered an episode of asphyxiation. His story was tragic, a reminder of the frailty of human life. After choking on a food bolus at home, he…

Unfortunately, he suffered a prolonged cardiac arrest that resulted in irreversible brain damage. He spent two weeks in the intensive care unit in hopes of a recovery, but the …

Read more…

The evolution of the grieving physician

Health Policy

The state of health care in America: Smell the bacon

Anonymous

May 19, 2016May 19, 2016

I am forced to attend one of these mandatory continuing medical education (CME) events. My malpractice insurance provider has a deal with the state medical association. To get lower rates, I have to be a member of the association and…

I make it on time, despite the traffic.

As I walk into the lobby of this rather nice building, looking for …

Health Policy

Why Obamacare is not economically realistic

Brian C. Joondeph, MD

May 18, 2016May 18, 2016

United Healthcare announced that it plans on exiting most of the Obamacare insurance plans by 2017. Not their traditional commercial insurance plans or Medicare supplements, but specifically the insurance plans offered through the state exchanges of Obamacare. Didn’t President Obama…

Didn’t President Obama tell Americans that if they liked their insurance plan, they would be able to keep it under Obamacare? Actually he did, at least 36 times. So what happened?

In …

Medical Education

The inspiring reasons why this medical student wanted to become a doctor

Okechukwu Anochie, MD

May 18, 2016May 18, 2016

As a fourth-year medical student, I love introducing myself to patients as the "extra eyes and ears of the team, so feel free to tell me anything you forgot or would like to address, even if you think it's irrelevant…

As a fourth-year medical student, I love introducing myself to patients as the “extra eyes and ears of the team, so feel free to tell me anything you forgot or would like to address, even if you think it’s irrelevant or burdensome. I will be your advocate.”

As I establish rapport with them, the walls come down, and they often provide important information that helps my team provide the best care …

Medical Education

It’s OK for medical students to make mistakes. Here’s why.

Anonymous

May 18, 2016May 18, 2016

Aristotle said, “To avoid criticism: do nothing, say nothing and be nothing.” Sometimes I wish I was nothing; surely, that would just be so much easier. I screw up all of the time. And I hate it. My latest gaffe…

Aristotle said, “To avoid criticism: do nothing, say nothing and be nothing.”

Sometimes I wish I was nothing; surely, that would just be so much easier. I screw up all of the time. And I hate it. My latest gaffe was killing our simulated patient by causing him to aspirate. I’m sure no one in my group is still persevering on the events that unfolded during the sim. I also really …

Physician

How primary care physicians can work with patients to change behavior

Glen R. Stream, MD

May 18, 2016May 18, 2016

The behavioral aspects of poor health are even more important than we may have thought. That’s according to a new study finding adults who engage in even one unhealthy behavior double their risk for fair-to-poor health. And the risk increases…

Spotlight: Impact of Unhealthy Behaviors, a publication from United Health Foundation’s America’s Health Rankings® released in partnership with Family Medicine for …

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