Every primary care doctor has been faced with this situation. A patient reports vague symptoms and is very worried that they are a sign of a catastrophic illness. The symptoms aren't even slightly suggestive of the disease the patient is worried about, but the patient's neighbor's brother-in-law was just diagnosed with the same disease, and so the patient is pretty sure that ...
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In the past, neither hospitals nor practicing physicians were accustomed to being measured and judged. Aside from periodic inspections by the Joint Commission (for which they had years of notice and on which failures were rare), hospitals did not publicly report their quality data, and payment was based on volume, not performance.
Physicians endured an orgy of judgment during their formative years – in high school, college, medical school, and in ...
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Recently, I was having a discussion with a colleague about being a doctor. She confided in me that if someone asked her about becoming a doctor, she would tell him or her to become a nurse practitioner. After reading the emotional open letter to our policymakers in Washington DC, it may sound like a reasonable suggestion. After all, why go into this much debt and spend so much ...
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I have found that many physicians have a strong desire to serve, yet often don’t know where to begin or if it is the right move for them both personally and professionally. I believe that by answering a few simple questions, a physician can decide if a mission is right for them.
1. Decide where you want to help. Hailing from Africa, I wanted to return to the poorest regions such as ...
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I saw a thoracic surgeon in the doctor’s lounge today. I have read his cases and frozens for a year or so, but never introduced myself. I still get intimidated in that man’s world of the doctor’s lounge. It's not just me, my female partner was urged by her male recruiter to eat with him every morning in the lounge when she started seven years ago, and chit chat with ...
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I am affiliated with the institution where Dzhokhar Tsarnaev is currently hospitalized. I am friends with people who have treated him. I’m trying to stay away from those people; I would be unable to help asking them about him. They might be unable to help talking about him.
There has been a flurry of emails and red-letter warnings cautioning people here not to talk about Mr. Tsarnaev or look him up ...
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Emergency physicians experience burnout at a rate of more than three times that of the average doctor and more than anyone else inside or outside of the medical field, according to a study published in the Archives of Internal Medicine. The study surveyed over 7000 physicians in more than two dozen specialties and compared them with almost 3500 working adults ...
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Wemberly worried about everything. Big things. Little things. And things in between.
–Wemberly Worried, Kevin Kenkes
The bottom line: you can add arsenic in rice to your long list of health risks you don’t need to worry about. And you can add Consumer Reports to your long list of media outlets that you can’t depend on for reliable health advice. Inaccuracy and breathless scaremongering ...
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One of the things about which I'm asked most commonly is calcium. Some of the confusion comes from the fact that our knowledge about calcium and health is evolving. A recent study showing that men who take calcium supplements have an increased risk of heart attacks is just the latest in an avalanche of sometimes conflicting information.
Here are a few of the questions I am most often asked ...
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Text message: “John, This cough and congestion is killing me. It’s turning thick and green. Can you write me a Z-pak? It always works for me.” If you write a blog on medical decision-making and heart rhythm matters, it seems an incredible omission not to opine on the FDA warning concerning the commonly used antibiotic azithromycin (the drug in a Z-pak). Quoting directly from the FDA warning:
[Azithromycin] can cause ...
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Watching my grandfather pass away changed my life. It wasn’t sudden and it shouldn’t have been unexpected. Yet it seemed unnatural, mysterious, and incredibly uncomfortable. I can still remember receiving the phone call from the hospital, my mother letting out a distraught cry that my grandfather was no more. My initial reaction was shock and confusion: I just couldn’t understand what had happened. Looking back, he had been under intensive ...
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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 for a 5-year history of gradually progressive left knee pain. He has 20 minutes of morning stiffness, which returns after prolonged inactivity. He has minimal to no pain at rest. He reports no clicking or locking of the knee. Over the past several months, the pain has limited his ...
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It’s been three years since the Patient Protection and Accountable Care Act (PPACA) became law. There have been widely divergent opinions published by journalists on the impact of the law for Americans: from a rose-colored account from the New York Times, to a not-so-peachy account published at Reason.com. Few doctors have ventured into this discussion.
The need for health care cost reform
I should start by saying that I am biased. I grew ...
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Am I safe surgeon, or merely a board certified one?
I usually spend Tuesdays fixing elective hernias. But the other day I was asked to clear a c-spine, handle an unexpected gynecologic finding, manage a pediatric trauma, resuscitate a septic ICU patient, and opine on a neck dissection. No, I wasn’t in Africa or 1985; I was sitting in front of a computer ...
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When should drivers retire from driving? This question is always difficult to answer. In our suburban car culture driving allows seniors to maintain their independence and prevents social isolation. However, at what point does it become unsafe for the elderly to drive and what are the risks?
One month ago my fit and about 80-year-old in-laws were involved in a serious car accident. A young ...
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When I came to medical school, I was certain I wanted to do primary care. Despite the forces that steer many of us off the path – how many times have we heard, “but you’re too smart to do primary care!”? – after three years of medical school, I was still committed to primary care.
But I struggled with which type of program would be best for me. I applied to both ...
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Perhaps you already know the behind-closed-doors guiding principles of the news media, but if so, I suppose I'm a bit naïve in comparison. I thought they would be all about reliably reporting the news. Instead, I learned this guiding principle during my days working as an on-air contributor for ABC News' Good Morning America: "Comfort the afflicted, and afflict the comfortable." This is by no means an ABC mantra; it's industry-wide. ...
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On April 15, 2013, my kids and I were in Stamford, CT, visiting with my sister, Precy, and her family. I had been reading when an email came up, stating a bomb had gone off at the Boston Marathon. I immediately turned to Twitter where #BostonMarathon had already started trending.
There before me, gruesome details emerged, coupled with ...
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American Medical News has an important article - Will a “silent exodus” from medicine worsen doctor shortage?
Frustrated by mounting regulation, declining pay, loss of autonomy and uncertainty about the effect of health system reform, doctors are cutting back the number of hours they work and how many patients they see. Between 2008 and 2012, the average number of hours physicians worked fell by 5.9%, from 57 hours a week to 53, ...
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A common belief, even among doctors, is that almost no one succeeds in losing weight in the long term. And for almost two decades, I’ve counted myself among the skeptics, being able to tally on the fingers of one hand the number of my patients who’ve managed to do it—literally less than five out of multiple hundreds, if not a few thousand.
When I stumbled across the ideas put forth in ...
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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
Dear lawmakers: This is what it’s like to be a doctor today
Matthew Moeller, MD | PhysicianA gun owner responds to Sandy Hook
Edwin Leap, MD | PhysicianIs Chris Christie too obese to run for president?
Jeffrey Parks, MD | PhysicianIf I’m wrong about guns, can you please explain why?
Claire McCarthy, 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