I was in practice about five years and was about to do a radical nephrectomy on a patient.
I met with the patient and his son in my office and the son informed me that he and his father were Jehovah’s Witnesses and that he didn’t want his father to receive any blood or blood products before, during, or after surgery. I asked the father if that was his wish and he …
Transfusing a Jehovah’s Witness during surgery
A guest column by the American Medical Association, exclusive to KevinMD.com.
A wise physician once said, “Health is not valued til sickness comes.” The same can certainly be said about health insurance.
This concept is at the heart of our current debate about individual responsibility for health insurance coverage. While we hope never to need surgery or chemotherapy or to have an unexpected accident or illness, it’s certain that many of …
AMA: Individual responsibility for health insurance helps America’s patients, pocketbooks
The Douglas County Health Department in Omaha, Neb., responded to a 26-person outbreak of pertussis from Sept. 26 to Nov. 21, 2008. Afterward, the department and the CDC assessed the total cost in time and personnel of the response.
“The elevated incidence of pertussis and the burden of response placed on health departments warrants exploring the impact of alternative response and …
The best way to control a pertussis outbreak is to vaccinate
What does low-carb mean? Well, the first thing it means is that something else has more carb. So what are you comparing it to? Breakfast cereal? Angel food cake? The standard American diet (sAd)? Anything would be low-carb compared to those.
A whole bunch of folks at the Nutrition & Metabolism Society have been working hard to help people understand that carbohydrate, and not dietary fat, is the main dietary component causing …
The problem with naming a diet low carb
“This job is killing me” is not a statement of jest. It is a desperate plea of outright sincerity.
Stress, anxiety, depression – all have been associated with an increased risk of cardiovascular disease and mortality. But can interventions to help people cope with stress positively affect longevity and decrease risk of dying? The results of a study in the Archives of Internal Medicine would imply the answer …
Treating stress with cognitive behavioral therapy can impact cardiovascular disease
Why is it that some people have a psychiatric disorder and they bounce back and it’s not a big deal, while others struggle terribly? For the unlucky ones, mental illness defines them.
Here are some factors that affect how much impact psychiatric illness has in a person’s life.
Predicting how much impact mental illness has in a person’s life
by Robert Rodvien, MD
When a person is told that they have a serious illness, they are similar to Alice falling down the rabbit hole.
They enter a bewildering new world of discussions, tests and treatment programs that must be navigated while maintaining a job, life obligations, and relationships with friends and family. Just when …
How podcasts can help patients with health literacy
The Wall Street Journal reported that a study of prescription patterns in 2009, conducted by IMS Health, showed that 25% of children in the US were on regular medication.
IMS Health is a firm that provides “marketing intelligence” to pharmaceutical companies. The firm’s job is to keep the $800 billion per year global pharmaceutical industry on a continued pattern of growth. Hopefully these consultants accomplished something quite different this week. Hopefully they …
One in four children in the United States are on chronic medications
If you need laser eye surgery in the state of Kentucky, or a little cosmetic work around the eyelids, it now behooves you to ask your prospective surgeon the following question before signing the operative consent form:
“Say doc, did you go to medical school?”
Kentucky joined the company of Oklahoma earlier this year as the second state to conflate optometrists and ophthalmologists. Only ophthalmologists are the sort of doctors who graduated …
Why the ophthalmologist and optometrist conflict should concern patients
Your current thought patterns are likely what keep you trapped in the prison of social anxiety.
To unlock yourself from this prison, you will likely need to have to rewire your brain with new thoughts that take time to cement in the brain, but if you try this as a start, it will lead you up the correct path.
1. The change cannot happen …
How to escape the prison of social anxiety
I had never heard of ductal carcinoma in situ before I was diagnosed with it. Nor did I have a clue that breast cancer could be classified as stage 0; I only thought it came in stages 1 through 4. And I’m far from alone; most people I talked to had never heard of it either, including a …
Treatment for stage 0 breast cancer is definitely real
As an academic gastroenterologist at a tertiary care university medical center, I often see patients who have failed traditional therapies that many of my colleagues in the community have tried.
Over the past several years my practice has evolved, from dealing with predominantly the medical aspects of my patients’ diseases to embracing the biopsychosocial model of illness. One of my colleagues has been the world leader in patient care and research in the …
Health related anxiety in patients with complex problems
by Synphen H. Wu, PhD
Mr. C is a 46-year-old Chinese immigrant restaurant worker who came to Bellevue Hospital after two weeks of fatigue, malaise, right upper quadrant (RUQ) abdominal pain, and progressive jaundice.
He was referred from a Chinatown clinic, where his blood tests showed hepatitis B surface antigen, a hepatitis B viral load of 133 million copies, and elevated liver transaminases and bilirubin levels, …
Our personal commitment and social engagement as physicians
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It’s certainly been fascinating monitoring the response to Theresa Brown’s New York Times’ op-ed on physician bullying.
Predictably, most physicians were outraged, while the rest of the population generally supported Brown. As alluded to in a comment, whenever you have an aggrieved party accusing another one in a national forum, controversy is what you’re going to get. The piece was the …
Doctor bashing and confronting physicians in the media
“Psychiatry consult, returning a page,” she said, cradling the phone between her left ear and left shoulder. Digging around in her pockets, she eventually pulled out a half-sheet of paper that wasn’t already covered in barely legible writing and boxes marked with Xs. Her right hand clicked the pen and prepared to write.
“Hi, this is Cardiology,” the male voice on the phone said. Doctors tend to lose their names when they …
Why medical students should go through a psychiatry rotation
Our society thrives on tension and competition.
Ideas, like sports teams, compete to win. We are the referees of these contests. Many of these competitions in the public square are ongoing. Some of these duels are locked in a dead heat. Others are in overtime. Some are ‘challenge matches’ when a vanquished idea wants another shot to change the original outcome. …
Honored to care for many priests and nuns in my practice
I am really enjoying my geriatrics rotation.
Although my attending preceptor is primarily a geriatrician, and practices deep in the heart of retiree central in southeast Florida, he also sees some patients who are younger. I took a history on a patient who was younger than me today, in her early thirties.
She started off complaining about insomnia and headaches, and then said …
Bereavement related depression and consoling a new widow
Bullying is a problem within health care.
Stung by a physician’s rebuke, Theresa Brown, an oncology nurse, takes to the op-ed pages of the New York Times to address the issue.
In it, she cites several vignettes that paint doctors poorly:
But while most doctors clearly respect their colleagues on the nursing staff, every nurse knows at least one, if not …
Theresa Brown unfairly blames doctors for hospital bullying
Eric Cropp was a pharmacist who was sent to prison for a mistake that resulted in the death of a child.
This was a high profile case, but it was just one of many examples of a disturbing trend I’ve seen in the U.S. in recent years: a person commits a mistake–with no malicious intent and without being under the …
Where do we draw the line on criminalizing mistakes?
When I was a little girl, attending the circus was the highlight event of the year. I remember looking forward to it each year – perhaps because it was something fun, and each year something new. Never the same show twice. Very busy behind the scenes, yet at the same time, quite organized and appearing smooth on the surface.
In the same way, the clinic can be a truly hectic scene. …
Be like a circus ring master when seeing a patient in the clinic
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