Post Author: Suzanne Koven, MD

A hospital leader speaks out against the transgender military ban

Physician
August 9, 2017

On the afternoon of July 26, I opened an email from Dr. Peter Slavin, president of Massachusetts General Hospital, where I work as a primary care doctor. Dr. Slavin frequently sends messages to all MGH employees, uncontroversial broadsides announcing new hospital initiatives, grant awards, promotions and retirements that often end with: “Go Sox!” (or, depending on the season, “Patriots!” “Celtics!” “Bruins!”).

So I was not expecting that …

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Don’t hesitate to talk to your doctor about work

Physician
March 18, 2014

This month, the literature and medicine group at my hospital met to discuss Arthur Miller’s Death of a Salesman. The play, which first opened in 1949 with Lee J. Cobb in the leading role (clip here) and is now playing in Boston at the Lyric Stage Company, concerns Willy Loman, a man in his sixties who hauls a sample case up and down New England with “a shoeshine and a smile.” …

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Patients should silence their phones in the exam room

Physician
March 11, 2014

I wrote a column recently about the role computers play in the doctor patient relationship, and my concern that screens shift physicians’ focus away from their patients. This column is part of a large conversation going on nationally and beyond about what I’d call “distracted doctoring.”

A Wall Street Journal opinion piece by my colleague Dr. Victoria McEvoy addresses the issue of whether all the digital box checking now required of doctors as part …

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Why your doctor isn’t prescribing medical marijuana yet

Meds
February 12, 2014

Now that medical marijuana is legal in Massachusetts and licenses have been awarded for the first twenty dispensaries across the state, you’d guess that my practice is busily preparing to meet the demands of patients seeking marijuana prescriptions for several debilitating conditions including chemotherapy-related nausea and AIDS-related weight loss.

You’d guess wrong.

Since Massachusetts voters approved legalization of marijuana in 2012 I’ve received no special training (required for physicians to certify patients as eligible …

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When it comes to back pain, time is an underused treatment

Conditions
January 30, 2014

The doctor at the summer camp I attended as a kid believed that calamine lotion and time cured just about anything that ailed campers — and he was right. Time still heals most wounds, but patience is a tough sell to people whose visits to my office often involve taking off work or getting a babysitter, fighting traffic, and shelling out for parking and insurance co-pays.

After all that, time doesn’t …

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The legacy of Kenneth Edelin

Physician
January 9, 2014

The exam room and hospital bedside are usually non-partisan zones. Though there have been exceptions — anti-nuclear activists Dr. Benjamin Spock and Dr. Bernard Lown come to mind — physicians tend not to be particularly political people. And even when they are, their politics don’t usually intersect with their clinical work. When President Reagan was shot and joked with surgeons, “I hope you’re all Republicans,” the response from one doctor (a Democrat) …

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Is holiday weight gain a myth?

Physician
December 11, 2013

How much weight do you think the average person gains over the holidays? I guessed about 5-10 pounds. I was wrong.

According to a 2000 study in the New England Journal of Medicine, people overestimate how fattening the holidays are. We think we’re likely to gain at least five pounds, while the actual gain is closer to one pound.

Perhaps holiday weight gain has increased since 2000 — it hasn’t been formally studied …

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What if exercise counseling came in prescription form?

Physician
October 8, 2013

Mark Twain once quipped: “Everyone talks about the weather, but nobody does anything about it.”

Is the same true of exercise? Despite a growing, multibillion dollar fitness industry, despite an increase in sales of treadmills, weights, and other home exercise equipment, despite public education campaigns like Let’s Move, eighty percent of Americans — four out of five of us–do not get the recommended amount of cardiovascular and strength training. 41 million Americans belong to …

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Social support matters in cancer survival

Conditions
October 2, 2013

A study by researchers at Brigham and Women’s Hospital and Dana Farber Cancer Institute published in the Journal of Clinical Oncology confirms what primary care doctors already know: marriage is often, but not always, good for your health. The study found that among more than a million people with common cancers such as colon, lung, breast and prostate, those who were married were more likely to be diagnosed early and stick …

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Is there any single secret for aging well?

Physician
September 11, 2013

The word “doctor” derives from the Latin verb docere: to teach and, as a doctor, I do often offer instruction. But when a woman in her eighties comes in for her annual physical and tells me she’s still dancing, mowing her own lawn, and helping out herolder neighbors, I have no illusions about which of the two of us should be doing the teaching.

Particularly since reading this lovely feature story about Ethel Weiss, …

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Who accommodates a doctor with a disability?

Physician
August 29, 2013

In my practice, as in most medical practices, we accommodate patients’ particular needs in all kinds of ways: wheelchair accessible rooms and hallways, interpreters of virtually all languages including American Sign Language, gowns and instruments in a wide range of sizes, information sheets and videos suitable for patients with a variety of educational backgrounds.

No one questions the appropriateness of these accommodations.

But what about when the doctor or nurse requires an …

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We face an epidemic of excessive busyness

Conditions
August 11, 2013

In the past few years, I’ve observed an epidemic of sorts: patient after patient suffering from the same condition. The symptoms of this condition include fatigue, irritability, insomnia, anxiety, headaches, heartburn, bowel disturbances, back pain, and weight gain. There are no blood tests or x-rays diagnostic of this condition, and yet it’s easy to recognize. The condition is excessive busyness. It’s one with which, as a fellow sufferer, I empathize …

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Is your doctor really present during your visit?

Physician
August 5, 2013

During a recent visit to Dublin I was saw a neon sign in a pharmacy which read: “Doctor present.”

I was, first, amused by the wording. Dublin, home of George Bernard Shaw and Yeats and Joyce (and storytellers and bards in every pub) is a city with a deep and natural love of language–where even pharmacy signs are poetry.

But, next, I got to thinking. Am I “present” in my practice, even …

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Is obesity really a disease?

Conditions
July 25, 2013

A few years ago, while I was teaching in the hospital, a medical student presented the case of a man with coronary artery disease, diabetes, hypertension, and hyperlipidemia. When we entered the man’s room I was surprised that the student had omitted a certain fact from his presentation: the man weighed well over 400 pounds.

No one argues that diabetes and blocked coronary arteries are diseases. And nobody argues that obesity, …

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One source of information that never feels overwhelming

Physician
July 14, 2013

A fascinating op-ed piece by Brigham and Women’s physician and Harvard Medical School professor Jerry Avorn appeared on June 11th in the New York Times. It’s called “Healing the Overwhelmed Physician.” What the ‘overwhelmed physician” about whom Dr. Avorn writes is overwhelmed by may surprise you.

It surprised me.

Looking at the title of the piece, I thought it might be about the emotional toll of practicing medicine, which may contribute …

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Education that occurs among patients in a group

Physician
July 2, 2013

Several years ago I cut my hand badly on a broken glass and required surgery to reattach a tendon. For a few weeks after the operation, I attended regular sessions in a physical therapy department devoted to people with hand injuries. There were no closed curtains in the large therapy room — we bared only our hands, after all. As I had my fingers warmed, splinted, or stretched, I observed …

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For some, a loss of independence is a worse fate than falling

Physician
June 28, 2013

A moving van pulled up to my house the other day. It contained the last of my mother’s belongings, a few pieces of furniture that neither my brothers nor I nor our children had wanted. It’s been over four years since Mom died and we finally gave up trying to sell the things down in Florida, where they’d been sitting in storage.

Among the items was a china cabinet fashioned from …

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HPV and oral sex: Is Michael Douglas correct?

Conditions
June 9, 2013

michael_douglas

I’ve invented a new medical term.

The Michael Douglas Factor: When a celebrity, even one with good intentions, uses his or her own condition to disseminate incomplete, misleading, or incorrect medical information.

I could have called this phenomenon “The Gilda Radner Factor,” in recollection of efforts by Radner’s husband Gene Wilder to encourage women to ask their doctors for the CA 125 blood test …

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