Women’s health

869 articles · Since 2011

Articles, page 36

A normal pregnancy framed as a one with special needs

June 29, 2014Jun 29, 20147

What if healthy pregnancies were treated like special needs pregnancies? Mr. and Mrs. Johnson, good afternoon. I’m Doctor Dumas, a visiting obstetrician in Doctor Kwak’s practice. It’s nice to meet you. Look, there’s no easy way to say this, so…

What if healthy pregnancies were treated like special needs pregnancies?

Mr. and Mrs. Johnson, good afternoon. I’m Doctor Dumas, a visiting obstetrician in Doctor Kwak’s practice. It’s nice to meet you.

Look, there’s no easy way to say this, so at the risk of sounding blunt, I have some bad news.

The technician and I reviewed your scans and we found that you’re about ten weeks along with a human fetus. I’m not seeing …

Conditions and diseases

MKSAP: 35-year-old woman with new-onset thrombocytopenia

mksap

June 28, 2014Jun 28, 2014

A 35-year-old woman is evaluated for new-onset thrombocytopenia. She is gravida 1 at 36 weeks' gestation. Her pregnancy has been otherwise uncomplicated. She takes only a prenatal vitamin. On physical examination, temperature is normal, blood pressure is 110/65 mm Hg,…

A 35-year-old woman is evaluated for new-onset thrombocytopenia. She is gravida 1 at 36 weeks’ gestation. Her pregnancy has been otherwise uncomplicated. She takes only a prenatal vitamin.

On physical examination, temperature is normal, blood pressure is 110/65 mm Hg, pulse rate is 110/min, and respiration rate is 22/min. There are no ecchymoses or petechiae. Abdominal examination discloses no right upper quadrant pain. She has a gravid uterus. Neurologic examination is …

Patient voices

After giving birth, the small sting that hurt the most

Laurie Filipelli

June 25, 2014Jun 25, 201414

My second miscarriage started in a Starbucks bathroom, and I couldn’t have felt more alone. Where to go from there? I drove home, took as much ibuprofen as I could stomach, and resolved to quit my stressful teaching job. I…

I found a new position at a nonprofit, training writers to teach in public schools. My husband, who’d always been an entrepreneur, continued to lead a startup that encouraged girls to dream …

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Health technology

Why this doctor loves her EHR

Jennifer Gunter, MD

June 18, 2014Jun 18, 201439

There is a recent and interesting piece in the Wall Street Journal by an orthopedic surgeon, Dr. Craviotto, about the maddening aspect of forced mandates and bureaucratic requirements in medicine that seem to have very little to do with actual…

There is a recent and interesting piece in the Wall Street Journal by an orthopedic surgeon, Dr. Craviotto, about the maddening aspect of forced mandates and bureaucratic requirements in medicine that seem to have very little to do with actual medical care and more about hoops through which we must jump that seemingly lead to nowhere.

While I do find the bureaucracy of medicine in the United States insane versus the Canadian system, I …

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Why this doctor loves her EHR

Medical education

Reducing the stress of teaching surgical residents

Eve Karkowsky, MD

May 30, 2014May 30, 2014

When I graduated from my residency, far from my current professional home, I wanted to write a book called How Not to Get Yelled At in the Operating Room. Or How to Clear the Fear from Your OR. I had…

When I graduated from my residency, far from my current professional home, I wanted to write a book called How Not to Get Yelled At in the Operating Room. Or How to Clear the Fear from Your OR.

I had these titles in mind because I struggled so much during my intern year. It was a tough year, full of intense patient care and sleep deprivation, but the challenge that I most wanted help …

Conditions and diseases

Power morcellation: Answers to your safety questions

Jennifer Gunter, MD

May 28, 2014May 28, 20146

The Food and Drug Administration (FDA) recently released a statement about power morcellation during hysterectomy and myomectomy (surgery to remove uterine fibroids), raising concerns about these devices spreading unanticipated cancers. There have been several reports in the literature and the press alike of this happening and when it does it significantly worsens the prognosis. The American Congress of Obstetrician and Gynecologists (ACOG) is now re-exploring this issue. Pending a full review the FDA …

Conditions and diseases

Having an epidural doesn’t mean you’re any less of a mom

Jennifer Gunter, MD

May 19, 2014May 19, 201423

Reports that Mila Kunis, the actress, plans on a “natural” delivery is all over the Internet. As a celebrity she is clearly a medical expert and somehow it is relevant to hear how an actress with no financial concerns, doesn’t need to work on her feet until she goes into labor, has a BMI of 19 (OK, that’s a guess) who has never delivered before is planning to have her …

Physician voices

A physician not knowing her business: A cautionary tale

Linda Burke, MD

May 10, 2014May 10, 20149

The future of our health care system, lies with you, dear medical students and residents. While medical school and residency training does a pretty good job giving you didactic and clinical training, they might do a better job teaching you how to avoid the potential mess you will encounter once you complete your training. Perhaps the most shocking thing I encountered after completing residency training was how non-clinical administrators placed …

Physician finance

Pay me like a French doctor. You know you want to.

Kevin Pho, MD

May 8, 2014May 8, 201498

Whenever new physician salary data is released, reporters and policy experts often compare doctor salaries in the United States to those of other countries: most notably, France. And on cue, Vox's Sarah Kliff -- normally an excellent health care writer,…

Whenever new physician salary data is released, reporters and policy experts often compare doctor salaries in the United States to those of other countries: most notably, France.

And on cue, Vox’s Sarah Kliff — normally an excellent health care writer, by the way — is uncharacteristically lazy in framing physician salaries through a biased lens.

After presenting the …

Patient voices

Empowering patients to become proactive with their medical bills

Michelle Del Monico

May 5, 2014May 5, 20146

As health care providers are tasked with more administrative duties such as documentation, coding, and billing, the goal to minimize health care costs will continue to be extremely challenging. In my role, I work with physicians on these challenges daily…

As health care providers are tasked with more administrative duties such as documentation, coding, and billing, the goal to minimize health care costs will continue to be extremely challenging.

In my role, I work with physicians on these challenges daily to ensure not only do the physicians get paid accurately but patients understand their benefits when they see our physicians. Currently, I am the revenue cycle manager for the department of …

Physician voices

Dr. Mom: No instructions included

Gina M. Blocker, DO

April 26, 2014Apr 26, 20142

The day I graduated from medical school and walked across that stage with my diploma in hand, I was sure that I had achieved the highest honor in the land. I could not help envisioning myself in a long, crisp white coat, walking down the long hallways of the hospital, with my name badge perfectly displayed that read: “doctor.”

I was certain in my mind that I had finally made it. …

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Dr. Mom: No instructions included

Physician voices

Arizona lawmakers have stepped into the doctor’s office

Jennifer Gunter, MD

April 18, 2014Apr 18, 201427

Imagine you want health care. You go to your doctor who recommends a medication. Your doctor tells you that the medication used to be prescribed one way 14 years ago, but very rigorous, more recent studies indicate a lower dose…

You are pleased because a) your doctor is up on the latest medical therapies, and b) the least …

Conditions and diseases

Increasing the use of long-acting reversible contraception

Jeff Livingston, MD

April 13, 2014Apr 13, 20142

Of the 6.7 million pregnancies in the US each year 48% are unplanned. Disturbingly, about half occur in women who were using contraception at the time of conception. That statistic haunts me. As health care providers we must take that to heart and change the way we think about birth control counseling. Is there more that we can do to help prevent unplanned pregnancy in those who are actively using …

Conditions and diseases

Water births should be treated as a medical intervention

Jennifer Gunter, MD

April 9, 2014Apr 9, 20142

The joint statement on laboring in water and delivering in water (the latter also known as immersion births) from the American Academy Pediatrics (AAP) and the American Congress of Obstetricians and Gynecologists (ACOG) is making the rounds. I’ve linked to the full statement above, but in essence it says that some women find laboring in water helpful for pain relief (in the first stage of labor it reduces the need for …

Physician voices

Sharing secrets with my grandmother

Maria Gervits, MD

April 4, 2014Apr 4, 20148

"I feel bad ..." Amy whispered, then paused. I'm a family medicine resident, and I was doing my gynecology rotation, which involved spending a few days at a Planned Parenthood facility. This was my first day. I'd been assigned a…

“I feel bad …” Amy whispered, then paused.

I’m a family medicine resident, and I was doing my gynecology rotation, which involved spending a few days at a Planned Parenthood facility. This was my first day. I’d been assigned a patient to shadow: a young woman named Amy, who was here to have a first-trimester abortion.

I’m a fan of Planned Parenthood’s work providing high quality, affordable contraceptive and gynecological care. In …

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Sharing secrets with my grandmother

Patient voices

When childbirth becomes a financial stress

Ashley Lane

April 2, 2014Apr 2, 201411

On December 31, 2011 right before midnight, I took the test of excitement and new beginnings and found out that I was pregnant. While this news was joyous in nature, it was soon marred by uncertainty and harsh reality. After…

After my test, I followed up with a doctor’s visit a month later, as was expected, and soon learned that the cost for this bundle of joy would be around $12,000 to …

Conditions and diseases

One example where the EMR can really make a difference in outcomes

Margaret Polaneczky, MD

March 31, 2014Mar 31, 20144

Given all the complaining I and my colleagues do about the problems with the EMR, I figured I’d take the opportunity to tell you about something good that came from having my practice online. A patient came to see me…

Given all the complaining I and my colleagues do about the problems with the EMR, I figured I’d take the opportunity to tell you about something good that came from having my practice online.

A patient came to see me last week for a check up and requested a prescription for birth control pills. She’d used them in the past without problems. I wrote the script and sent her on her …

Conditions and diseases

It’s OK to laugh after a procedure

Susan D. Klugman, MD

March 31, 2014Mar 31, 20142

She asked me, “Is it OK to laugh?” My patient Linda, who was only 12 weeks pregnant, had just had a chorionic villus sampling, or CVS. During this procedure, a small piece of placenta (chorionic villi) is removed via a…

She asked me, “Is it OK to laugh?”

My patient Linda, who was only 12 weeks pregnant, had just had a chorionic villus sampling, or CVS. During this procedure, a small piece of placenta (chorionic villi) is removed via a long, thin needle inserted into the woman’s uterus, and then the sample is sent to a laboratory for genetic analysis. My patient fell into the category of advanced maternal age, and …

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It’s OK to laugh after a procedure

Conditions and diseases

Statistical significance doesn’t always warrant a miracle headline

Jennifer Gunter, MD

March 28, 2014Mar 28, 2014

Interpreting studies is a dicey thing. Often I find what might be statistically significant translated into headlines that might not really get at the nuance of the study or the results. Take these three for example: "Pine bark extract improves…

Interpreting studies is a dicey thing. Often I find what might be statistically significant translated into headlines that might not really get at the nuance of the study or the results.

Take these three for example:

“Pine bark extract improves severe perimenopausal symptoms”
“Two weeks of antibiotic therapy relieves IBS (irritable bowel syndrome)”
“Study: ‘Female viagra flibanserin’ works”

The first line of the last article: “Need a boost to your sex life. The magic could be in …

Drugs and prescribing

Is acetaminophen taken during pregnancy associated with ADHD?

Roy Benaroch, MD

March 28, 2014Mar 28, 2014

Readers have contacted me about a recent study that links acetaminophen use in pregnancy to the later development of ADHD in children. Is Tylenol yet another thing pregnant women need to avoid? The study, titled “Acetaminophen use during pregnancy, behavioral…

Readers have contacted me about a recent study that links acetaminophen use in pregnancy to the later development of ADHD in children. Is Tylenol yet another thing pregnant women need to avoid?

The study, titled “Acetaminophen use during pregnancy, behavioral problems, and hyperkinetic disorders” was published this month in JAMA Pediatrics. Dutch researchers looked at about 60,000 children born from 1996-2002. Their parents have been filling out questionnaires and …

Women’s health

Articles, page 36

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