May 2011

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Why you shouldn’t ignore a swollen knee

by | in Conditions | one response

If you develop a swollen knee, please don’t consider it a normal occurrence.If there was a clear cause, such as a fall to the knee, or some twisting injury to the knee, it’s likely that the cause is due to some mechanical damage. An easily recognized example would be a football or rugby player sustaining such an injury on the playing field. In that case, its typically serious and when ...

How managed care caused the mental health care crisis

in Physician | 15 responses

by George H. Northrup, PhDNo one becomes a mental health professional—in my case, a clinical psychologist—for the financial rewards.With comparable (or less) education, far more lucrative careers exist in law, business, or other health care specialties.  Psychotherapy tends to draw practitioners who are fascinated by the mysteries of the mind and who find satisfaction helping others in distress.   Money has typically been a ...

How medical students are key to innovating in medicine

by | in Education | 8 responses

Why does health care seem to lag behind other industries in innovation?There's a temptation to manufacture reasons that don't necessarily explain why health care has not seen the kinds of revolutionary changes evident in industries from computing and telecommunications to music and retail? People routinely marvel at how easy it is to manage their bank account these days, but they don't appreciate continuing to wait hours in their doctors' offices, ...

Getting into residency: What medical students need to know

in Education | 2 responses

by James LambergWhen medical students are applying for residency positions, what do program directors care about most? This may become the ultimate question for many students on clinical rotations.Thankfully, publications exist to help answer this very problem.Unfortunately, many students are not aware of this published information. In a 2005 article from Medical Education Online titled “Residency Selection ...

The tension between physicians and health policy experts

by | in Pho | 54 responses

The tension between physicians and health policy expertsThere's an underlying tension between physicians and health policy experts.Health policy experts take subtle jibes against physicians in their analyses, with many feeling American doctors are overpaid, which exacerbates health costs.  They tend to be politically progressive, and generally dismiss the issues that most doctors care deeply about.  Medical malpractice, tort reform and the cost of medical education, for ...

Pros and cons of private or hospital owned practice

by | in Physician | 4 responses

Private practices are organized in a corporate model where the physicians are shareholders, or where one or more physicians own the practice and employ other physicians or providers.   Private practices are almost exclusively for-profit.  Physician practices are organized into corporations for the tax benefits as well as protecting the owners from liability judgments.Hospitals can be for-profit, not-for-profit ...

Improve health journalism to improve consumer knowledge and decisions

by | in Patient | 4 responses

Gary Schwitzer is Publisher of HealthNewsReview.org, where he and his team grade daily health news coverage. He works to improve health journalism with the goal of improving consumer knowledge and decision-making. He was the founding editor-in-chief of the MayoClinic.com site. While his guest lecture at Web Strategies for Health Communication was on health news reporting, I realized that his review criteria seemed equally applicable to any ...

Breast implants and the risk of cancer

by | in Conditions | 3 responses

The FDA has issued a statement alerting physicians and patients to a possible link between breast implants and a rare type of cancer.   Although anaplastic large cell lymphoma (ALCL) is extremely rare, the FDA believes that women with breast implants may have a very small but increased risk of developing the condition.ALCL in the presence of breast implants has been noted in sporadic case reports over the past 25 years.  ...

Transitions of a first year medical student

in Education | 15 responses

by Kristine CasalThe moment you get accepted to medical school, you never really think about how everything is going to be different. You figure everything’s going to stay the way they are, with the exception of the inevitable long and laborious hours of studying day and night. You don’t think about how much time you won’t have ...

Vascular diseases that present as obstructive atherosclerotic arterial disease

in Conditions | no responses

by Joe F. Lau, MD and Jeffrey W. Olin, MDPhysicians who perform percutaneous endovascular procedures encounter a multitude of vascular diseases that may masquerade as obstructive atherosclerotic arterial disease. While atherosclerosis is clearly the most common condition seen, complex inflammatory, genetic or structural processes may either not be amenable to an endovascular approach or actually be harmful and thus lead to outcomes that are not ...

How physicians can take more responsibility in the care of patients

by | in Physician | 36 responses

Medical care in  America isn't doing so well when compared to other developed nations. Historically physicians did not want to take ownership of their  patients' problems. Patients have  free will. They can "choose" to be non-adherent. They can choose to not take the medication the doctor prescribes -- even if the one prescribed is $70 dollars a month when there is a $4 dollar

Does psychiatry treat symptoms or diseases?

by | in Physician | 52 responses

Do we treat diseases or symptoms in psychiatry?  While this question might sound philosophical in nature, it’s actually a very practical one in terms of treatment strategies we espouse, medications and other interventions we employ, and, of course, how we pay for mental health care.It’s also a question that lies at the heart of what psychiatry is all about.Anyone who has been ...

KevinMD posts of the week, May 22, 2011

in Potpourri | no responses

Here are the top posts from this past week, based on the number of times they were viewed.1. Two words that hurt communication between physicians and patients. Communication between physicians and patients is critical to quality care and improved outcomes, however, such discussions often seem labored and fraught with anxiety and stress.2. 5 rules for living well with a chronic illness. Here’s the thing about depression and chronic ...

What is normal for a teen with diabetes?

in Patient | one response

by Doctor D, MDA teacher asks Doctor D about a diabetic teenager in his class: "His sugar readings are often over 400. His mom says this is normal. Can this be normal?"What is normal?a) A state of harmony within the body and mind that leads to health and well-being. b) The typical or status quo for a person; the way things usually are. c) WTF? There is no such ...

MKSAP: 32-year-old man with crampy abdominal pain

by | in Conditions | one response

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.MKSAP: 32 year old man with crampy abdominal painA 32-year-old man is evaluated in the emergency department for a 5-day history of worsening crampy abdominal pain and eight to ten loose bowel movements a day. The patient has a 5-year history of ulcerative colitis treated with azathioprine and topical mesalamine; before this episode, ...

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