Today’s restless society has taken its toll on modern medicine. Among all the strategies for protocol optimization and health insurance improvements, doctors get to spend less and less time actually talking to their patients. Each check-up needs to be performed in a certain amount of time, and every procedure needs to be completed as quickly as possible so that hospitals are efficient and profitable. While this makes perfect financial sense, it ...

Read more...

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 77-year-old woman is evaluated 4 months following a left middle cerebral artery ischemic stroke. The severity of her stroke required prolonged initial hospitalization and a 3-month stay in a rehabilitation center before returning home. Residual deficits include dense right-sided hemiparesis and dysphagia requiring oral feeding with thickened liquids. Medical history is ...

Read more...

We are born with arms wide open, and we die in much the same way.  It is that which we carry, in the time between, that defines us. The newborn, caught in the primordial stew of beginnings, is unable to recognize the difference between self and other.  She grasps and roots at inanimate objects with the same voracity she reaches for her mother.  It is a time of differentiation, a time ...

Read more...

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 30-year-old woman is evaluated for a 2-day history of increasing pain in the right antecubital fossa and biceps. She reports daily injection drug use. Medical history is otherwise unremarkable, and she takes no prescription medications. On physical examination, temperature is 39.7 °C (103.5 °F), blood pressure is 90/56 mm Hg, pulse rate ...

Read more...

Back in my first year of blogging, I wrote a post, titled "A Day Without a Diagnosis," about the way we now spend most of our time “managing” chronic diseases, some of which weren’t even considered diseases when I went to medical school. That’s not how all my days go nowadays: A week ago I had a day of some very real doctoring. My first patient of the day was ...

Read more...

"I hereby authorize xxx, my patient, to donate plasma up to two times per week." I moved to Cleveland over the summer to start work as a full-time primary care internist. Within a few weeks, I started receiving a form in my mailbox that I had never seen during my training in San Francisco: an authorization request for my patients to donate their plasma. By the time the fourth form came, I realized ...

Read more...

An excerpt from Seductive Delusions: How Everyday People Catch STIs. Dear Ashley, Your blood count and mono test did not show any signs of mononucleosis infection. Unfortunately, however, your throat swab was positive for gonorrhea. Please schedule an appointment today in urgent care so you can be treated with the appropriate shot ...

Read more...

The Abnormal Prostate In this Medcomic, we’ll visualize three common abnormalities of the prostate.  Let’s meet our new friends. On the left is Burney and he could certainly benefit from a trial of antibiotics and an analgesic. The large fellow in the middle straining to urinate goes by the name of Turp. On the far right is Grampa Addy, currently dealing with the ...

Read more...

Decisions about how many children to have (if any) or what type of contraception to use are complex. For patients who are not health care providers, the doctor-patient relationship remains a critical relationship by which these sometimes difficult decisions are navigated. As a practicing gynecologist for 13 years, I continue to be mystified at how many women report to me a nearly complete lack of counseling prior to being prescribed ...

Read more...

As far as follow-up appointments go, this one was routine. My 65-year-old patient had undergone hip replacement surgery two weeks prior, and we discussed her pain level, progress with physical therapy, and eagerness to return to everyday activities. But as she stood up to leave the exam room, I could tell there was something left unsaid. She stepped out the door then stopped, turned around, and leaned in close to ...

Read more...

Most Popular