As I greeted my next patient of the morning, I knew from the early folder number that I had seen him six or seven years before. I no longer expect to remember everyone I have ever met professionally. The man before me was tall, fit and well built. There is usually some inkling of recognition, but nothing about him was familiar to me at all.
We made small talk for some …
The rewards of medicine can be overwhelming
Of all possible times, it happened during Ramadan. The test of faith would be extreme.
Azka was the first of four children born to Persian parents in a small town thirty miles outside of Tehran, Iran. Being devout Muslims, her father chose the name Azka in part because it meant “pious”. His wife later revealed to Azka that he also liked how the name rolled off the tongue when spoken in …
A test of faith during Ramadan
I see this as a glass half-full, glass half-empty issue. Recently, a study was published in Pediatrics detailing research conducted in May of 2010 about parents’ preferences to use alternative vaccination schedules versus following the recommended CDC vaccination schedule. The majority of the media coverage focused on the finding that over 10% of parents followed a schedule other than the one recommended by the CDC. Not perfect and not ideal …
Do most parents use the alternative vaccine schedule?
Suffice to say, as a physician, I’m not germ phobic. If I were, I wouldn’t work as a health care provider in the “culture media” of an ambulatory care clinic. I certainly respect the pathogens I come in contact with daily, along with the host who harbors them. For the most part, the virus and the patient know I don’t have much effective artillery to fight back with and my …
Handshakes during viral outbreaks
While body language can be interpreted in many ways and it’s not an exact science, it is often possible to read body language and have a basic understanding of a persons mood or dispositions and the rapport that people have with each other through observing non-verbal communication. This issue focuses on reading everything that hands can tell you and ways to use your hands to influence interactions with others.
What’s …
Use body language to improve your patient encounter
The Dr. Oz show recently featured a scary show about deadly arsenic in apple juice. On his own web site, he trumpets “Dr. Oz’s Extensive National Investigation,” and claims “After testing dozens of samples from three different cities in America, Dr. Oz discovered that some of the nation’s best known brands of apple juice contain arsenic.”
His show further claimed that based on his independent testing, many brands of apple juice …
Why Dr. Oz is wrong about arsenic and apple juice
I recently had some physical therapy for a minor injury. Since the office forgot to charge my co-pay the first time I went in I received a so-called Explanation of Benefits (EOB) from my insurance carrier, BlueCross BlueShield of Massachusetts. EOBs are a holdover from the mainframe era: arcane, inflexible reports that are hard to interpret. They may have done their job in the day when their only purpose was …
What does the Explanation of Benefits really mean?
Last month, vegan couple Jade Sanders and Lamont Thomas’ appeal of their life in prison sentence was overturned. The couple reportedly starved their 6 week old to death by feeding him only soymilk and apple juice. When reading this, so many questions arise. How could they not know their child was starving? Where was their support? Were they truly negligent? And what happened to all the systems in place to protect children?
In an …
The United States lacks postpartum support for mothers
A couple of years ago, a frail 88 year old Filipino woman came into the emergency department of my hospital complaining of confusion and weakness of her left arm. Her blood sugar level was extraordinarily low, so low that she would have died had she not received immediate treatment.
The emergency room doctors treated her by injecting her with sugar, and then called the team of internists on call to admit …
Hospital discharge summaries are a health literacy issue
Irrational exuberance was a term once used to describe the stock market before the last crash. It also seems an apt description for much of the talk these days about empowered health consumers.
To be sure, patients today have unprecedented access to health information. Patient decision-support tool can be found on just about every provider, payer and self-insured employer website. Consumers can go to any number of websites to find …
Top 5 myths about empowered patients
With the obesity crisis in America, one of the major reasons for increasing health costs, the issue of the causes inevitably arises.
There seem to be two sets of causes postulated by a growing crowd of experts. Unfortunately, each set is aligned in our current polarized political climate with the right or the left. Each set of causes has some basis in reality, but neither fully explains the problem.
On one …
Whose responsibility is childhood obesity?
A guest column by the American College of Physicians, exclusive to KevinMD.com.
Up until 2001 I practiced medicine in the hospital where I was born. I still work in the hospital that was built to replace it. In our mobile society that is clearly the exception rather than the rule.
I love what I am able to offer my patients as …
ACP: Relationships enhance patient care
The relationship between doctors and their patients has changed dramatically over the past few years. Medical beneficence became paternalism and is now near obsolete. Shared decision making is the new lofty ideal we should all be striving for. It is guiding new health policy both in the UK, with the new mantra “nothing about me without me,” and in the US.
We are at the start of the Century of the …
Shared decision making is impossible in a government run health system
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Why is a trip to the doctor’s office more like going to the DMV than to Disney World? Both the DMV and Disney World involve waiting in long lines, but Disney has made the entire experience fun and exciting, while the DMV has made it cold and frustrating.
“But medicine is different,” you may say. After all, seeing the doctor was never meant to be a fun or exciting experience. When …
Time to put a little bit of Disney into medicine
A doctor’s primary responsibility is to heal, and all of our efforts and resources should be devoted to that goal. At times, it is impossible to restore a patient to perfect health and he or she must unfortunately deal with some degree of chronic disability. Still other times, though, the line between “perfect health” and “disability” is blurred, and nowhere is this more problematic than in psychiatry.
To illustrate, consider …
Psychiatry should not be a tool for social justice
Prostate cancer screening has always been controversial.
Now, with the USPSTF is recommending against screening for prostate cancer, gas is about to be poured on the proverbial fire.
Recently, the New York Times Magazine published a lengthy piece on the issue, perhaps not coincidentally, perfectly timed with the Task Force’s announcement.
In 2009, advocates for breast cancer screening were up …
USPSTF prostate cancer screening guidelines need emotion to resonate
Breast cancer may be the most common cancer among women. But, that doesn’t mean you can’t do something to help prevent it.
Researchers have found certain risk factors that increase a woman’s chances of getting breast cancer. We can’t change some of these factors, like age or race. But we can try to control others, like weight gain and alcohol use.
And, taking responsibility for the things you can control may …
5 ways to cut breast cancer risk
I caught the tail end of a recent #hcsm (health-care social media) tweetchat and it looked to be a good one. I saw a few comments about teaching bedside manner and whether it’s a thing of the past (oh, how I hope not). It occurred to me that sharing a real-life story could be instructive.
I put on a brave face when I got a mastectomy for stage 0 DCIS …
Is teaching bedside manner a thing of the past?
By now you’ve probably seen the internet jokes that compare the mammogram experience to having your breast squashed in a refrigerator door. A few years back, I joined the club of women who have our annual mammograms, and I can’t say that I disagree with the imagery of the jokes. However, the benefits of early detection far outweigh the discomfort, so I’m willing to put up with it.
I’d like to …
Practical tips for a more comfortable mammogram
Sadly, recent news reports described two food allergy-related deaths in a single week. Although the details are scant, the victims were a 15 year old and a 20 year old, who apparently ingested unsafe foods and were not treated promptly. These preventable tragedies behoove us to learn how to better manage our food-allergic patients and advocate for them as well.
The Centers for Disease Control and Prevention (CDC) estimated that approximately …
Preventing deaths from food allergy
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