Recently, the new surgeon general of the United States, Vivek Murthy, was officially sworn in by Vice President Joe Biden. Congratulations to him, it’s quite an achievement at the relatively young age of 37. Nobody can doubt the hard work, intelligence and passion that must have gone into reaching such a height. His nomination was first put forward at the end of 2013, and he faced something of an uphill political ...

Read more...

Although the time of year when everyone has their list of tax questions has just passed, tax questions are appropriate all year. It’s best to be prepared at tax preparation time, so much less stress is created. Tax time can be especially stressful for younger taxpayers who are going through life changes, or earning substantially higher income for the first time. Young physician families are an excellent example of this type ...

Read more...

shutterstock_174096008 Each year children ingest an array of foreign bodies including coins, magnets, and a new subset of batteries known as button batteries. Awareness of this small yet very dangerous foreign body is important for parents to understand so they can act quickly if their child is suspected of ingestion. What is a button battery? A button battery is a cylindrically shaped object measuring ...

Read more...

My 85-year-old patient was brought in from home. She was cachectic, contracted, minimally responsive to questions, covered in multiple decubitus ulcers on both hips, both knees, both shoulders, and her sacrum. She had polymicrobial sepsis-bacteremic with two different organisms. She was, in fact, dying. Despite her profoundly debilitated condition, her son, who cared for her at home wanted “everything” done. So she was placed on IV fluids, antibiotics, received an ...

Read more...

What's the first year of medical school like?  Students at Washington University School of Medicine show you in "First Year Funk."  Enjoy.

A while ago, I wrote about “The secret lives of doctors.” The post must have struck a nerve because it went viral, maybe because it helped patients to realize that doctors are human. We doctors can’t really know how human we are until we become a patient. That happened to me recently. And it wasn’t pretty. You need to know the truth. I truly understood what patients are really thinking. At ...

Read more...

medpagetodayFrom MedPage Today:

  1. Testosterone Shots: Riskier Than Gels or Patches? Short-acting testosterone injections are associated with greater risk of cardiovascular events, hospitalizations, and death compared with gels or patches, according to a large retrospective cohort study.
  2. Liberia Declared Free of Ebola. In what the World Health Organization called a "monumental achievement," Liberia ...

    Read more...

You gotta hand it to our health department. They are laser focused on this one. They want 85 percent of payments made to doctors by the Centers for Medicare & Medicaid Services (CMS) to be linked to clinical quality measures within the next two years. Moreover, I suspect the health department is still giddy from Congress passing a new health care bill earlier this month. The legislation implements a number ...

Read more...

Somewhere along the way I learned to believe that if a declaration is written down on physical paper and signed, it carries with it an almost magical certainty of follow-through: it can be framed, cited, stored in a safe, and, if need be, brandished in a court of law. This is an interesting idea in the realm of advance directives. Well-intentioned advance directives The goal of an advance directive is to protect ...

Read more...

Fire-Doctor-640x399 Not all relationships work out. My prescription: If a relationship isn’t working, end it. Now. Recently an insurance plan told me they were sending a nurse to my office for a chart review that would take 3 hours. After 24 years of education, state licensure, board certification, and over 50 hours of continuing medical education each year, I’m not trusted to provide Pap ...

Read more...

shutterstock_146442830 For many women, pregnancy is a wonderful experience. There are, however, many changes and challenges the mom-to-be can expect, and back pain is one of them. The good news for pregnant women is that the development of severe or debilitating low back pain is very rare. The incidence of symptomatic low back pain that is severe is about 1 to 2 percent. ...

Read more...

It is with regret that meaningful use legislation has barreled down the path of insanity. As a primary care physician, I don’t see how 700+ pages of rules and proposals mean any bit of relevance to my clinical practice anymore. As the attrition continues regarding eligible providers, it is leading primary care physicians towards the junction point of going off the grid entirely or being enslaved by horrible EHRs forever. I ...

Read more...

shutterstock_263483609 Emergency medicine physicians: Could these be your cases?

  • A 35-year-old presents with shortness of breath and numbness to the legs. CXR and EKG are normal. She is discharged to see her doctor in two days, but is found dead at home. Autopsy reveals a dissecting aortic aneurysm.
  • A 15-month-old is triaged to fast track and seen by a physician assistant for fever, lethargy, ...

    Read more...

medpagetodayFrom MedPage Today:

  1. Newer Antiplatelet is Faster in Ad Hoc PCI. Ticagrelor (Brilinta) dropped platelet reactivity lower sooner when given on the table for patients going directly to revascularization after diagnostic angiography.
  2. Abandoned Painkiller Makes a Comeback. In 2006, in the midst of a growing opioid epidemic, the FDA approved the new ...

    Read more...

As a primary care physician with a special interest in tackling obesity, I spend a large portion of my day pointing out the obstacles between my patients and a healthier lifestyle. In the United States, these stumbling blocks are everywhere and often cloaked in legitimacy by people or groups that hold sway over consumer confidence. Say, for instance, the placement of a seal of approval by the Academy of Nutrition ...

Read more...

"She's safe," my friend and fellow resident told me over the phone just hours after reaching his Mom in Kathmandu. A text from my undergraduate Hindi Professor read, "My own family is safe. But it’s hard to comprehend the amount of loss. My own house in which I was born is gone." Calls, texts, and emails over the last week have been reassuring in the midst of media depictions of ...

Read more...

shutterstock_173706362 With the flurry of Twitter posts about Maureen Dowd’s article “Stroke of Fate” in the New York Times, it almost seems as if the subject is already stale. Maureen Dowd is the Pulitzer Prize-winning op-ed columnist for the New York Times who tells a compelling story about a young patient who suffered from a stroke. The patient was healthy triathlete, ...

Read more...

When we got an NIH grant last year to ascertain how teens could get their peers interested in research careers, we did not anticipate turning to Jimmy Kimmel for inspiration. Kimmel’s “Lie Witness News” segment is notorious for asking unsuspecting pedestrians to share their opinions about ridiculous topics from a new "scented" iPhone to the "appointment" of Judge Judy to the U.S. Supreme Court. While the interviews are purely for amusement, ...

Read more...

Radiologists-day-4 It takes one to know one.  Here's a day in the life of a radiologist, illustrated. James Chang is a radiologist and author of Oh Doctor, The Places You Will Go... He blogs at Poor MD and can be reached on Facebook.

Two modest kiosks far in the back of a cavernous HIMSS 2015 exhibit hall symbolized two separate streams of the patient engagement effort as filtered through health information technology (IT). One featured a Bluetooth-enabled toothbrush paired with a personalized video game to teach kids to properly care for their teeth. Call that approach, “enabling compliance.” Nearby, another kiosk showcased a computerized questionnaire to help patients understand their treatment goals and true ...

Read more...

Most Popular