Primary Care

Test results without physician guidance will cause patient anxiety

KevinMD
August 23, 2012

The following column was published on August 5th, 2012 in USA Today.

A patient once blamed me for causing him considerable anxiety because he had to wait several weeks before receiving the results of a lab test, which I had ordered. Many patients commonly have to wait days, if not weeks, before getting lab results from their doctor. The delay can affect patients’ health negatively.

For instance, one study looked at women who underwent …

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How to think like a doctor: Start with differential diagnosis

Conditions
August 17, 2012

“What would you do if you were your doctor?” Mary asked me. Mary is my physical therapist and she was trying to figure out why the rehab after my shoulder surgery was progressing so slowly. A month after my operation I was still in pain and still not moving the joint well.

Without hesitation I replied: “I’d come up with a differential diagnosis.”

Differential diagnosis is a two word summary of how …

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Work-life balance in medicine: Is it possible?

Physician
August 13, 2012

Unless you’ve lately returned from a retreat at a remote Cistercian abbey, if you’re interested at all in women’s issues you’ve probably read Anne-Marie Slaughter’s recent article in the Atlantic, “Why Women Still Can’t Have It All.”  The author eloquently tells how she left her dream job in the State Department as the first woman director of policy planning in order to return to her husband, her two …

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Why are so many doctors complete jerks?

Physician
August 12, 2012

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As odd as this might sound, my mother was upset when I declared my intention to go to medical school.

It wasn’t the mountain of debt I was sure to incur since I’d already figured out how to get Uncle Sam to pick up the bill (a small deal that put me in a military uniform for a decade).  It wasn’t the …

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Should I get a spray tan? A doctor discusses whether it’s safe

Conditions
August 12, 2012

We all know that the use of baby oils and baking in the sun for hours on end is probably not a good idea.  We know that increased sun exposure correlates with increasing skin cancer rates.  We know that it can cause accelerated skin damage in the form of pigmentation changes, wrinkles, and increased skin laxity.  Don’t believe me?  Check out this picture!  Truck drivers tend to get increased sun …

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Computers in the exam room: Good and bad setups

Tech
August 10, 2012

Does your doctor use a computer in the exam room? Some people think that computers are a great way to keep track of patient information.   Others see some advantage, but problems in the implementation.  There are also a few Luddites who oppose this change simply on principle.   I’ve had good experiences, and bad experiences, and believe we have a long way to go before computers are as helpful as they could be.

There …

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How to avoid Zumba injuries: 10 physician tips

Conditions
July 29, 2012

Zumba, the Latin dance-inspired fitness craze, is a great way to burn calories, up to 500 per hour. It also gives you a good cardiovascular workout without making you feel like you’re exercising. This increasingly popular workout attracts a diverse crowd at dance studios and health clubs, including a sizable number of those 50 and up.

But for people who are out of shape, taking the first classes can be like …

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Do people need to suffer the consequences of their bad behavior?

Physician
July 19, 2012

You know the headlines. You read them and hear them and see them every day.

Someone gets angry at the system and shoots someone or several someones in cold blood, often having planned the act, gathered the necessary firepower and ammunition ahead of time, stalked the victims, checked the schedules and shown up at the right time to do maximum damage.

A family including mother and young children in a van are …

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How will ObamaCare affect prostate cancer screening?

Policy
July 11, 2012

When President Obama turned 50 last year, he made an “informed patient request” for a PSA (prostate specific antigen) test. This is the blood test routinely used to screen men over 50 for possible prostate cancer. The President received his PSA test. But under ObamaCare, you may not be able to.

Now that ObamaCare has been upheld by the Supreme Court, all of its major provisions will be in force, …

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Take the time to educate yourself before forming an opinion

Physician
July 5, 2012

Student loan debt is at an all-time high at a little over 1 trillion dollars, a figure that now, for the first time ever, exceeds our nation’s credit card debt. Higher education has never cost more, the rate of rise of college tuition having exceeded in recent years the rate of rise of many other services. Perhaps as a result of this, as well as of the difficulty in obtaining …

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10 topics to discuss with your teen this summer

Conditions
June 27, 2012

In a pediatrician’s office, summertime is teen check-up time.

And, I love it.

Annual checkups are a time for me to catch up on the school year, brag about amazing extra-curricular accomplishments, and swoon over summer vacation plans. It is also a time for anticipatory guidance, private conversations, and facing the often sobering reality of teen life.

Throughout this past year, I have had the privilege of being involved in the lives of many …

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Lesser known symptoms of seasonal allergies

Conditions
June 26, 2012

My boys and I suffer from tree pollen allergies. More than birds chirping or flowers blooming, I have come to associate boogery sleeves and sneezing with the onset of spring. But these are the typical symptoms, which are easily recognizable as allergy-induced.

What I’d like to address in this post are some lesser known symptoms of seasonal allergies, which may also be rearing their ugly heads this spring. Red eyes and …

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Why I chose to become a rural primary care doctor

Physician
June 25, 2012

My mom always told me she gave me the “doctor name” (apparently my name looks good with an MD after it), so in some ways I knew from an early age that this was going to be my profession. Though I toyed with the idea of being a bank teller in kindergarten, I realized after a while that this was really not the job I thought it was (no offense …

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Should medical students consider a combined psychiatry residency?

Education
June 19, 2012

“What about combined psychiatry-family medicine-neurology-internal medicine programs?  Should I try to do a triple board program in psychiatry-child psychiatry and pediatrics?”

Every April, I field such questions from a slew of rising fourth year students who have become, to their surprise (and sometimes dismay), passionately interested in psychiatry. Psychiatry is a shortage specialty and psychiatric issues rank high among the challenges facing medical care systems here and around the world. For …

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Marcus Welby, MD is still relevant today

Physician
June 17, 2012

The year is 2012. A 58-year-old veteran Family Physician who has just finished a day with more human heartaches than clinical triumphs settles down among the pillows with his wife in front of his MacBook to watch a movie, delivered wirelessly over the Internet:

“The year is 1969. A 62-year-old veteran general practitioner who has just seen his health threaten to fail him, speaks passionately to a group of doctors about …

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Does it matter if your doctor is board certified or board eligible?

Physician
June 16, 2012

Does your doctor have something on the wall that starts with “American Board of … “?

The terms “board certified” and “board eligible” are confusing to people not in the medical profession. It doesn’t help that more than a few doctors blur the distinctions to their own benefit. This post gives you a brief rundown of the distinctions at stake.

The first thing to understand is that anybody who has graduated from …

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Clinician researchers meet the physician scientists

Physician
June 15, 2012

Recently our department of medicine grand rounds was on the subject of asthma.  It began with a clinical vignette about a child with asthma, lasting three minutes, and, was followed by 47 more of intracellular cascades.  The talk was like many others this year, and the speaker, who was introduced as a physician scientist, lived up to the part.

As someone who works in an academic hospital, I know many physician-scientists.  …

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What does an ACO mean in small town America?

Policy
June 9, 2012

At the end of long days I often stand gazing out my window at the beautiful, timeless Rocky Mountains in Colorado Springs and am taken by their sense of permanence. I recently returned from Nampa, Idaho, where I presented hospital Grand Rounds on Accountable Care Organizations.

The parallels between the timeless mountains and the physicians I met in Nampa struck me. Strange, you say? Maybe, but I am accustomed to the …

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