Ebola is everywhere. Turn on the television, and you will see the headlines. “Ebola in America.” Or, “Hospital worker who handled Ebola is on cruise.” And then there is the “Ebola fears prompt parents to keep children home from school.” The headlines go on. Go onto Facebook or Twitter, and you will see Ebola as the most viewed article, or the most tweeted topic. Ebola is everywhere. Ebola is incredibly infectious. Ebola is ...

Read more...

Not too long ago I suggested hospice to a patient who had progressive cancer, although she likely had months to live.  “I don’t think it is time,” she replied, “hospice is for morphine.” “That is not how I see hospice,” I replied, “I think hospice is about getting the best care and support, even if there is no real treatment for the disease.  It is about living well, maybe better. Even ...

Read more...

While driving to work, I listened to Mike and Mike (a radio sports talk show). Mike Greenberg made a wonderful point about his job. He described what they do as “professional over-reactors.” They take every game and extrapolate, sometimes irrationally, about the implications of that game. Does this remind you of health reporting? A study appears in a serious medical journal, and the press “blows it up” as the next great advance. ...

Read more...

What I found most disturbing about the man’s arm was not the deep, stellate laceration on the underside of his biceps. It was the swastika tattoo next to it. “Sir,” I said, “we’ll have you fixed up in no time. I’m going to numb up the wound, irrigate it, then repair the laceration with sutures and send you home on antibiotics and pain medication. The nurse will update your tetanus shot. But ...

Read more...

A recent case that I saw in consultation at the patient’s request highlights the pervasive problem of overdiagnosis and overtreatment of endometrial hyperplasia. This 46-year-old woman was diagnosed with simple hyperplasia without atypia within an excised endometrial polyp, for which both her gynecologist and pathologist recommended hysterectomy. The basis for this recommendation was a perceived increased risk of endometrial cancer, either currently lurking within her uterus or to be developed ...

Read more...

Go into any hospital today and notice that between every great nurse and patient sits a computer terminal. The quantified health movement has created the great digital divide, between the patient and everyone else. The nurse of old used to actually touch the patient. No more. Now, they wheel in a computer console, sit down and record the digital output of the wired up patient, every vital sign, every drug order or ...

Read more...

Top stories in health and medicine, October 21, 2014From MedPage Today:

  1. Study Links Enterovirus in Kids to T1D. Enterovirus infection may be tied to the development of type 1 diabetes.
  2. LVAD Patient Education Misses the Mark. Patient information on left ventricular assist devices (LVAD) is biased in favor of the device, and is suboptimal for helping people determine their pros ...

    Read more...

I wear a lot of hats in my job.  Though I’m a physician who specializes in the practice of anesthesiology, I don’t spend all day every day at the head of an operating room table. Many days I spend in an administrative leadership role or conducting research studies.  These functions support the best interests of my patients as well as the science and practice of anesthesiology.  On my clinical days that ...

Read more...

Every so often you have a patient in your practice that you sort of know, but really don’t. You’ve seen the name somewhere, but your mind draws a blank when asked about him. You may even have a vague idea of what he looks like, but if he were to bump into you on the street, you won’t even recognize him, despite the fact that you’ve been inside his heart ...

Read more...

Ebola: Whos looking out for the nurses? Being a nurse is a risky job.  Needle-stick injuries, violence, back injuries, and infectious disease are all potential threats.  But until recently, nursing was not usually viewed, like police work, or commercial fishing, as a life-endangering career choice. Those who risk their lives for their work go into it knowing the risks, and receive intensive training and protective gear. Not so the ...

Read more...

Nancy Snyderman shows indifference for her role as a medical communicator I wish Dr. Nancy Snyderman the best of health. I'm happy that she remains free from the deadly Ebola virus, and hopefully it will stay that way. It must have been extremely difficult for her to be under quarantine, especially since she was feeling healthy. It's simple: When you feel good, you want to be active. In Dr. Snyderman's case, she ...

Read more...

In June 2014, the first patient with Ebola arrived at Liberia’s county hospital, Redemption. As tensions grew around the city of Monrovia, administrators at JFK Hospital began to devise plans for handling patients with suspected Ebola. Officials from the CDC then came and gave us lectures. They discussed prevention of spreading and what our plans would be in the event of a potential outbreak. Before that moment, there were no ...

Read more...

Many physicians are discouraged by the state of medical practice in 2014. Maintaining job satisfaction and well-being for the duration of a decades-long medical career can be as daunting as completing an uphill marathon. In addition to keeping up with the explosion of medical knowledge and maintaining certification in your specialty, what concrete practices can you adopt to insure that you will make it to the finish line in good ...

Read more...

I recently attended my 10-year medical school reunion class party, and I have to admit, I had a great time. From the beginning, my class was special. We had 104 amazing people who were truly inspired to make a difference. However, regardless of how talented and hard working you are, medical school is one of the most challenging things you will ever do in your life. During our class party, we ...

Read more...

We all start out as idealistic medical students, downright puppy-like in our devotion to our patients, eagerly bounding to their rescue and spending hours listening to their concerns. Somewhere along the way, we start shutting down, seeing patients as demanding and feeling as if we're always fighting them off. I used to do it too; hide behind my layers of staff, complain to the office manager if a patient somehow made it ...

Read more...

Top stories in health and medicine, October 20, 2014From MedPage Today:

  1. Ebola: Politicos Mull Travel Restrictions; Docs Say No. As Ebola continues to dominate the headlines, one hotly debated question is whether the U.S. should ban travelers from the West Africa nations where the disease is raging, as a preventive measure.
  2. Ebola: Do the Dogs Have It? Bentley, the dog ...

    Read more...

Pain is one of the few things in life universally common to all races, all ages, virtually all people for the history of time.   Though it is always with us, it is also the most difficult of human feelings to describe or even talk about. Doctors in an attempt to understand the degree to which we hurt invented a 1 to 10 pain scale. I was very fortunate my first 47 ...

Read more...

Few will argue that the overall health of Americans has deteriorated in the past quarter century.  Diabetes or prediabetes afflicts nearly 120 million people. Roughly two of three Americans are either overweight or obese. Pharmaceutical companies focus on drug discovery as a solution.  Thousands of apps for smart phones are being developed to change our destructive behavior.  But, lacking in both of these is a true solution, one that draws ...

Read more...

On July 1, 2014, I retired after 35 years in practice. Or at least so it seemed. Before and after retirement, my cardiology group asked if I might be interested in part-time work. At first I said no. Due to my retirement, a physician's poor health, and one partner's departure due to chronic complaints of being overworked and under-appreciated, the group found itself without three doctors. As my retirement approached ...

Read more...

With all the news about enterovirus 68 sending hundreds of children to hospitals, it's easy to panic when you hear about a case in your neighborhood -- or, even worse, if your child starts coughing. But please, don't panic. This virus has certainly caused trouble and tragedy. But enteroviruses are incredibly common, causing 10-15 million illnesses a year -- and usually, those illnesses are minor. This one, for reasons we ...

Read more...

1166 Pages

Most Popular