Social anxiety refers to the fear of being around people due to the threat of embarrassment.
People who are socially anxious frequently freeze and are unable to seek the very company their hearts desire. They may make adaptations: they may decide that they “hate” being around people; they may isolate and play video games; they may absorb themselves in their work, but no matter what they do, this anxiety always exists …
by Walter van den Broek, MD, PhD
Often I ask my residents that if you can’t take care of yourself, how do you expect to take care of your patients?
Or in another way: the only difference between God and a doctor is that God knows he’s not a doctor. These sound like cliches but there is some truth in them. In short, doctors are just ordinary people …
I am a medical doctor. I am also called an allopath, someone who practices “Western medicine.”
We allopaths like data, proof, science, randomized, double-blind, placebo-controlled trials. We want to know the “mechanism of action.” We want someone to prove that yoga or medication or some procedure actually helps your depression or blood pressure or back pain and that these treatments are safe before we prescribe them. We feel more confident about …
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 62-year-old man is evaluated for an asymptomatic nodule on his shoulder that has been present for more than 1 year. Skin findings are shown.
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Eating right, exercising, avoiding the sun or using sunscreen, moderating alcohol consumption, abstaining from tobacco use, getting mammograms, Pap smears, colonoscopies—almost every measure we’re asked to take to safeguard our future health is difficult. It’s a strange paradox that we have to work in some way, to expend energy, and experience discomfort of some kind in order to gain benefit in life.
Wouldn’t it be nice if the most pleasurable things …
Medicine is a very old profession. Ancient and honorable. Sadly, for the vast majority of recorded history, honor was pretty much all it had. The Hippocratean ideals of “first do no harm” and putting the patient first and all held special importance when medicine truly had nothing to offer. Make no mistake: up until the last two centuries, the vast majority of what passed as …
Recently, I had a discussion with a prominent academic family physician. I had last seen him 37 years ago when he was getting ready to graduate from medical school and I was a new medical student.
We had a wonderful discussion and agreed to disagree about merging primary care. Long time readers know that I dislike the term for the tasks that outpatient internists do. Most of the push for merger …
At the recent AAMC meeting on how to integrate quality into teaching hospitals, the question that kept popping up from speaker after speaker was how to address the fact that doctors in teaching hospitals don’t get along.
Unfortunately, all the specialty bashing that takes place prevents the adoption of a team based culture necessary to advance quality and safety. As one speaker highlighted, how can we really start to address this …
A couple of months before my son was born 2 1/2 years ago, we were notified that my husband, an active duty member of the Navy, was getting deployed to Iraq.
His date of departure was exactly one week after my due date. To any wife or family member of a service member, this would be difficult news — a loved one going into a war zone. But, to me, 8-months …
I was in a room full of Family Doctors – who call themselves everything but Family Docs: Family Physicians (FPs) Primary Care Physicians (PCPs) General Practitioners (GPs). It was the Society of Teachers of Family Medicine (STFM) Spring Conference, at a session entitled: “Language Matters: Women-centered talk during pelvic exams.”
Two men amongst 20 women, all interested in learning more about being Politically Correct (PC) whilst conducting a pelvic exam. Session leaders Drs …
I’ve been interested in the role of testosterone in physical performance, depression and aging for many years. While at the University of Iowa, I was involved in research to detect testosterone doping, the psychological effects of testosterone and the potential for testosterone to alleviate depression in older men.
One of the difficult questions facing clinicians is when is testosterone too low in older men.
One problem with answering this question is the …
“I’m worried about my daughter’s posture. What can I do about it other than constantly nagging her to stand up straight?”
You’re probably talking about “kyphosis,” which is the rounded-shoulders, hunched forward kind of posture common in children and many adults. It’s often called “postural kyphosis” because it can be corrected if the child tries to stand straight up. Rarely, there’s a genuine spinal deformity, called Scheuermann’s Kyphosis or Scheuermann’s Disease, …
Among medical specialties, some are more prestigious than others. You can generally tell which ones are more prestigious by how well they pay. Surgery and cardiology, for example, rank at the top of the prestige scale. Psychiatry and dermatology are near the bottom.
One can also ask if some diseases are considered more prestigious than others, in the opinion of doctors.
A Norwegian doctor, Dag Album, has been investigating the prestige …
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“Hey doc, all I need is this referral.”
I’ve been encountering more of this lately. A patient who has not been seen in the office for months to years (well beyond when they were supposed to come back for a follow up visit) walks in and requests a “referral” for a specialist visit but they can’t be bothered with actually being seen and evaluated in the office or to be compliant …
Difficulty with sleep is one of the most common patient complaints presenting to the primary care office.
Chances are, you will suffer from difficulty with insomnia at some point in your lifetime. It can be distressing, and cause difficulty with functioning during your wake hours. The first thing you may want to do is to run to the doctor for a prescription for a medication to help you sleep.
However, you don’t …
A primary care resident wrote in one of the journals recently about making the limited time she has with each patient matter the most.
How refreshing, I thought when she concluded that time ultimately is an absolute and finite resource. We often feel as if we are battling time as much as we are battling disease, and we sometimes have trouble admitting when we are losing either one of those battles. …
by Diana E. Lee
One member of my health care team is a migraine specialist in another state. Since we don’t have many opportunities to work together in person, we generally try to pack a lot into my periodic two-day visits.
Last time I was there I had an experience that has left me feeling guilty all these months later.
My doctor, who I respect and admire greatly, asked if I was interested …
Regular exercise has been shown to be helpful in the prevention and management of a variety of clinical neuroscience conditions including: Alzheimer’s disease, Parkinson’s disease, major depression and anxiety disorders. However, motivating people to get involved in a regular exercise program is a significant challenge. Wii Sports and Wii Fit Plus may provide the motivation edge for some patients to start and maintain an exercise program.
The Wii video game system …
What is “MRI Abuse”? This is when the health care provider orders MRIs (Magnetic Resonance Imaging) in excess or for the wrong reasons. There are many causes of MRI abusive behavior but most evolve out of a significant misunderstanding of how to properly utilize this diagnostic tool. MRI imaging has a high sensitivity to detect anatomic abnormalities, does not expose the patient to high doses of radiation like a CAT …
Though I’ve never lost a friend or family member to suicide, I have lost a patient.
I have known a number of people left behind by the suicide of people close to them, however. Given how much losing my patient affected me, I’ve only been able to guess at the devastation these people have experienced. Pain mixed with guilt, anger, and regret …
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