Let me start by saying that I am by no means an expert in medical oncology and I have great respect for what my colleagues in this field are able to do for their patients and their families.
From my earliest days of internal medicine training at the University of Virginia, I can remember the oncologists as being some of the most caring and compassionate physicians around. However, recently I came ...
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You probably know patients who present with entitled attitudes and you may think there’s not much you can do about them. Entitled patients often demand excessive attention and may question your competence when they are not satisfied with how important you make them feel.
By using one or more of the following approaches, you can manage entitled patients respectfully while reducing your risk of stress and burnout.
1. Be on the same ...
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Physicians are bothered by their patient’s fear. One of the worst parts of actually caring is that when other people suffer and especially when they are frightened, you suffer with them. It is bad when the trepidation is about something real, such as a new disease, but it is particularly disturbing when the source of the fear is confusion or bad information.
There are several common sources of inaccurate terrifying data. ...
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Brought to you by MedPage Today.
1. Low Vitamin D Linked to Hepatitis B. Vitamin D deficiency might be a key player in hepatitis B (HBV) replication.
2. Wrinkles Emerge in SGR Repeal Debate. As Congress inches toward a change in the way physicians are paid under Medicare, an early-stage Republican proposal drew criticism this week for not going far enough.
3.
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As physicians, we are all privileged to share with our patients the experience of illness, helping to inform and guide. When we as physicians become ill ourselves, we face unique challenges and gain unique insights. This column will explore those dimensions of experience, when doctors become patients.
We recently spoke with Robert S. Brown, MD, FACP, associate professor of medicine at Harvard Medical School and attending nephrologist at Beth Israel Deaconess ...
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Below find excerpts of an email sent by a faithful reader. I have included the whole text, but broken it down to respond to each point accordingly.
I have really enjoyed your blog postings and the sensitivity you showed toward patients. But, your new venture is a real turn off, and makes it hard for me to want to read your posts anymore.I have been waiting for this. Expecting it. I knew ...
When we think of strokes, we imagine older adults. Yet, one out of every 2,800 newborns (under 1-month) suffers a stroke. In children up to 18, it occurs in 11 out of 100,000. I know how serious this can be – my daughter experienced a stroke before birth. The day before she was born, we discovered she had hydrocephalus (water on the brain). When she was a day old, an ...
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“Maybe we shouldn’t urge people to engage in their health care: it sets them up for failure and punishment from their clinicians.”
A senior patient advocate and researcher recently made this comment to a gathering of experts in patient engagement.
For a few minutes, I was inclined to agree with her. I thought back over the previous three months: the passive aggressive (and aggressive-aggressive) responses of some of my clinicians to my ...
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I've invented a new medical term.
The Michael Douglas Factor: When a celebrity, even one with good intentions, uses his or her own condition to disseminate incomplete, misleading, or incorrect medical information.
I could have called this phenomenon "The Gilda Radner Factor," in recollection of efforts by Radner's husband Gene Wilder to encourage women to ask their doctors for the CA 125 blood ...
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A few weeks ago my wife, my son, and I went out for dinner. My son, though usually well-behaved and pleasant, was boisterous and disruptive, alternately leaping off his seat to crawl under the table and banging his silverware on his water glass to see what different volume of sound he could make it produce. Our tolerance for disciplining him patiently having been exhausted in us both by our respective challenging ...
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Autism is a communication disorder where children have difficulty relating to other people. Pediatricians watch for speech delay as a sign of autism. Even before your child is expected to start talking, around a year old, you can watch for communication milestones. Problems attaining these milestones may indicate autism or other disorders such as hearing loss, vision loss, isolated language delay, or other developmental delays.
By six weeks of age, your ...
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Since I’ve always had an interest in food and nutrition, as a young nurse and student, I just assumed that all health care providers assessed nutrition. After all, we know how important it is. However, as a staff nurse in the ER and a nurse practitioner doctoral student, I learned that wasn’t true. Many providers in both arenas reported it was not the priority that medication and disease management were.
Throughout ...
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An important article was recently published in the New England Journal of Medicine, titled The Oregon Experiment — Effects of Medicaid on Clinical Outcomes. This study provides a rare look at the effects of expanding Medicaid coverage (specifically, Oregon Health Plan, Oregon’s version of Medicaid) to a population of previously uninsured patients. Having practiced medicine in Portland, ...
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From my interview with Andrew Thompson the other day, the issue of a medical malpractice crisis was raised. Mr. Thompson averred that such a concept is pure myth, a spook story older docs tell young interns around the campfire at night. And he may be right.
In a paper from the Journal of Healthcare Quality, researchers at Johns Hopkins demonstrated, using data from the National Practitioner Data ...
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As the saying goes, "With great power comes great responsibility." That applies to physicians when prescribing medications, but it also should apply to pharmacies when they're dispensing medications.
In December, after seven years of exams, lectures and rounds, I received my medical license. Finally, I had the power to prescribe medications without the co-signature of my supervisor. "Be careful," she advised, "remember the ...
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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 52-year-old man is evaluated in the emergency department for a 5-day history of right leg pain and swelling. He has never had a previous episode of venous thromboembolism. Following a physical exam and ultrasonography, what is the most appropriate management of this patient's transition to warfarin therapy?
On physical examination, temperature is 36.5 °C ...
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As a medical student nearly two decades ago, I remember how excited I was to begin my rotations on the wards. After two intense years in the classroom, I felt that I had a good fund of knowledge that I could finally apply in a clinical setting. Still, very soon after beginning my ward rotations, I noticed that while I was able to adequately manage my patients’ symptoms, I could ...
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Coming to an office near you: a new test that can "confidently" predict whether or not you need to have aggressive therapy for your newly diagnosed prostate cancer.
Really?
That's what the press reports would lead you to believe. And it's really going to catch your attention if you're one of the tens of thousands of men who will have ...
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Over the last couple months, I have often been asked what I plan to do as a recent college graduate. My response has been that I will be attending medical school in Chicago.
“Oh! Medical school!” many exclaim as their eyes light up, “So you’re going to be a rich doctor.”
This response as well as most others I have received seemed to imply that medicine is an ideal profession if one ...
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How much to treat this pneumonia? The Centers for Medicare and Medicaid took a step towards answering such questions by publicly releasing how much each of 3000+ U.S. hospitals charged Medicare for 100 common medical issues in 2011 and how much Medicare actually paid them.
The charges were remarkably variable, even among hospitals that share a zip code. Massachusetts hospitals tended to charge below the national average (eg. ...
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"A comprehensive and extremely useful roadmap for doctors."
-Eric Topol, MD, author of The Creative Destruction of Medicine
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Past 6 Months
What I’ve learned from saving physicians from suicide
Pamela Wible, MD | PhysicianDear lawmakers: This is what it’s like to be a doctor today
Matthew Moeller, MD | PhysicianIf I’m wrong about guns, can you please explain why?
Claire McCarthy, MD | PhysicianIs Chris Christie too obese to run for president?
Jeffrey Parks, MD | PhysicianPrimary care doctors may no longer be needed
Doug Olson, MD | PhysicianWalgreens moves into primary care, and it’s our own damn fault
Kevin Pho, MD | Kevin's Take