What if healthy pregnancies were treated like special needs pregnancies? Mr. and Mrs. Johnson, good afternoon. I’m Doctor Dumas, a visiting obstetrician in Doctor Kwak’s practice. It’s nice to meet you. Look, there’s no easy way to say this, so at the risk of sounding blunt, I have some bad news. The technician and I reviewed your scans and we found that you’re about ten weeks along with a human fetus. I’m not seeing ...

Read more...

A 35-year-old woman is evaluated for new-onset thrombocytopenia. She is gravida 1 at 36 weeks' gestation. Her pregnancy has been otherwise uncomplicated. She takes only a prenatal vitamin. On physical examination, temperature is normal, blood pressure is 110/65 mm Hg, pulse rate is 110/min, and respiration rate is 22/min. There are no ecchymoses or petechiae. Abdominal examination discloses no right upper quadrant pain. She has a gravid uterus. Neurologic examination is ...

Read more...

My second miscarriage started in a Starbucks bathroom, and I couldn’t have felt more alone. Where to go from there? I drove home, took as much ibuprofen as I could stomach, and resolved to quit my stressful teaching job. I found a new position at a nonprofit, training writers to teach in public schools. My husband, who’d always been an entrepreneur, continued to lead a startup that encouraged girls to dream ...

Read more...

There is a recent and interesting piece in the Wall Street Journal by an orthopedic surgeon, Dr. Craviotto, about the maddening aspect of forced mandates and bureaucratic requirements in medicine that seem to have very little to do with actual medical care and more about hoops through which we must jump that seemingly lead to nowhere. While I do find the bureaucracy of medicine in the United States insane versus the Canadian ...

Read more...

Jordan Grumet is an internal medicine physician who blogs at In My Humble Opinion.  He's a gifted storyteller, with many of his articles regularly featured here.  In this dotMED 2013 presentation, Jordan shares powerful stories from medical training that define him as the physician he is today.

When I graduated from my residency, far from my current professional home, I wanted to write a book called How Not to Get Yelled At in the Operating Room. Or How to Clear the Fear from Your OR. I had these titles in mind because I struggled so much during my intern year. It was a tough year, full of intense patient care and sleep deprivation, but the challenge that I most wanted help ...

Read more...

The Food and Drug Administration (FDA) recently released a statement about power morcellation during hysterectomy and myomectomy (surgery to remove uterine fibroids), raising concerns about these devices spreading unanticipated cancers. There have been several reports in the literature and the press alike of this happening and when it does it significantly worsens the prognosis.  The American Congress of Obstetrician and Gynecologists (ACOG) is now re-exploring this issue. Pending a full review ...

Read more...

From MedPage Today:

  1. SNRI Equal to Hormones for Hot Flush Tx. A low dose of the antidepressant venlafaxine (Effexor) appeared roughly as good as hormonal therapy to ease hot flushes in menopause.
  2. USPSTF Urges HBV Screening for High-Risk People. People at high risk for hepatitis B (HBV) should be screened for the virus, according to a new recommendation from the U.S. Preventive Services Task ...

    Read more...

Reports that Mila Kunis, the actress, plans on a “natural” delivery is all over the Internet. As a celebrity  she is clearly a medical expert and somehow it is relevant to hear how an actress with no financial concerns, doesn’t need to work on her feet until she goes into labor, has a BMI of 19 (OK, that’s a guess) who has never delivered before is planning to have her ...

Read more...

The future of our health care system, lies with you, dear medical students and residents. While medical school and residency training does a pretty good job giving you didactic and clinical training, they might do a better job teaching you how to avoid the potential mess you will encounter once you complete your training. Perhaps the most shocking thing I encountered after completing residency training was how non-clinical administrators placed ...

Read more...

Most Popular