I was seeing a patient who brought me a bag of supplements she bought from another specialist. I looked skeptical and then she pulled out the list of lab results the other doctor ordered on her. I reviewed the results with her and asked why all these tests were ordered in the first place, some of which I had never ordered in my life. She said she told the specialist ...

Read more...

In 2009 the Health Information Technology for Economic and Clinical Health Act (HITECH) was signed into law by President Obama and this law quickly changed the way medicine in the United Sates is practiced. The law was a first step in requiring all physicians to utilize electronic records. The president promised that creating and electronic record mandate for physicians would result in a national, universal electronic medical record system and ...

Read more...

Medical couples are experts at delaying gratification. Medical school’s rigid, unpredictable, and demanding schedule forces couples to postpone vacations, outings, dinner plans, and relationship progress. Glen Gabbard and Roy Menninger, in their book Medical Marriages, call this common trend among single- and dual-physician couples “the psychology of postponement.” They explain that medical school and demanding attending physicians become “a convenient scapegoat” for couples looking to avoid living their lives or ...

Read more...

In 1996, Jerry Maguire was fired for advocating a reduction in his sports management firm’s client base thereby risking the firm’s profits.  While writing his infamous memo (or as he would tell you, his mission statement), he recalled his mentor’s advice: “The key to this business is personal relationships.” Tom Cruise’s voiceover continues: “Suddenly, it was all pretty clear. The answer was fewer clients. Less money. More attention. Caring for them, ...

Read more...

figure-1-for-kevin-pho Do doctors make too much money? I don’t think so. I read with great interest the blog by Dr. Michael Kirsch defending physicians’ salaries: "If you think doctors make too much money, think about this." Unfortunately, the public’s perception of physicians’ incomes has been that physicians make too much money. Whenever I hear this remark from patients or even non-physicians, I show ...

Read more...

sepsis-blog-9-2016 CHEST_sig_horiz_PMS-TMSeptember is Sepsis Awareness Month, a month which aims to raise awareness of sepsis and strategies for prevention and treatment. Sepsis is a potentially life-threatening complication of an infection. Sepsis occurs when the body’s response to infection becomes dysregulated and white blood cells and chemicals cause injury to organs throughout the body. Earlier this ...

Read more...

Dear Dr. Wible, I am writing to you with great sadness, but with relentless determination to ignite change. I am a doctor with a disability. Two years ago I began residency training in pediatrics. The privilege was overwhelming as I stood a doctor in the very halls where I had been wheeled in as a patient with a brain tumor. I couldn’t believe that I had actually made it, that I ...

Read more...

Treat Yourself: An ode to everyone suffering during this opioid epidemic. From the one and only ZDoggMD.

As physicians, we often don’t have time to down a cup of coffee, much less spend extra time on patient education, but we might want to rethink this. I’ve been involved in a study that illustrates a strong connection between educating patients about medical technologies and their decision to go forward with necessary treatments. This study assessed sinus surgery candidates’ opinions on endoscopic sinus surgery before and after the ...

Read more...

When a person gets depressed over their divorce, they are said to have a mental illness. When a person becomes psychotic from a manic episode due to their bipolar disorder, they are also said to have a mental illness. But are both of these illnesses mental illnesses? The definition of mental is that which relates to cerebral, brain, cognitive or intellectual processes. Many disorders occur from problems in the anatomy or ...

Read more...

acp new logoA guest column by the American College of Physicians, exclusive to KevinMD.com. This September, I reached a milestone, the tenth anniversary of my electronic health record (EHR) “go live.” Note that I did not write “I celebrated my tenth anniversary,” because while the event was the most disruptive change in over 25 years of practice, the word ...

Read more...

The television doctors: Striding purposefully through the ER, giving orders, surrounded by a gaggle of eager learners and a super-team of nurses and techs. Or spending hours operating, then sipping martinis while waiting for the next disaster. Maybe saving lives in between daydreams and liaisons with hot colleagues and nurses. All in a day’s work! Maybe not. A new study looked at what doctors really do all day. In the real ...

Read more...

One of the biggest shifts in American health care over the last several years (and we’ve only just seen the tip of the iceberg so far) is the shift of the system away from the traditional fee-for-service model, and towards a system based more on quality, outcomes, and yes, a degree of rationing. By all measures, we know that the pure fee-for-service model -- at least mostly funded by Medicare -- ...

Read more...

In March, 2016, the CDC released guidelines for prescribing opioids.  The guidelines were a response to a serious and growing problem: millions of pain patients became addicted to prescribed opioids, and hundreds of thousands died as a result. Since the guidelines were released, reports of pain patients being abruptly cut off of their medication or having their medication abruptly reduced have become rampant. These patients report they were using opioids long ...

Read more...

The recent release of Pokémon Go, the mobile phone augmented reality game, has taken the world by storm. The game has become a fitness icon, requiring players to walk or run around in the real world to catch Pokémon creatures in their virtual world. While evidence on the long-term health benefits is not clear, it is apparent that the game does more than just allow players to live ...

Read more...

Medical students are told two things: The first is that we are the future generation of health care. We are the ones who have the potential to make a difference, and we will lead the revolution. The second is that our current spot in the medical hierarchy is definitively at the bottom of the totem pole, where we are too powerless and inexperienced to have any tangible impact. How can both be ...

Read more...

I'm new to the job of coroner. Though I'm sure it won't surprise anyone to hear that it's nothing like C.S.I.; you measure the wait for test results in months, not minutes. It's not like Quincy, M.E. either, where the same person responsible for the autopsy hops about cracking a case that somehow befuddles police. Most deaths are natural, with a good number of accidents and suicides, despite the media's ...

Read more...

One of the most difficult things I deal with as a physician is patients’ demands for pain medications. I treat patients with cystic fibrosis, a genetic disease present at birth with no cure, and its issues are indeed complex. There are legitimate causes for misery from the chronic coughing, abdominal pain, and joint pain recognized as common symptoms of the disease. But the associated issues of depression, stress with family, and ...

Read more...

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 64-year-old woman is seen for follow-up evaluation. Two weeks ago, she was in a car accident, and an incidental pituitary adenoma was found on a cervical spine CT scan. She has no residual injuries from the car accident. She is otherwise healthy and takes no medications. She went through menopause at ...

Read more...

Recently the New York Times published an article, "What Kids Wish Their Teachers Knew." As a pediatrician, I have spent a good part of my lifetime fighting for the health and welfare of our young people.  They are the future.  We owe our children a safe, caring, stable childhood whenever possible. Outside of a supportive family, a long-term family physician or pediatrician can be an important role model ...

Read more...

Most Popular