Medical journals aren't what they used to be. Just ten short years ago, medical journals were places to report scientific study, interesting cases or clinical updates and reviews. They were, for the most part, about science and discovery. Now, there is a dramatic shift of scientific content in our journals to politics and policy. No where is this more evident than the much-heralded and widely read New England Journal of ...

Read more...

Some physicians will make over 7 times what the average college dropout will earn over a lifetime. Even within medicine there are significant differences in lifetime earnings between primary care, surgery, and specialty care. With the recent Powerball lottery jackpot at a record high, there was a lot of daydreaming going on recently for many Americans, maybe even some doctors: What would you do if you actually won it all? ...

Read more...

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. All of us know the unpleasant feeling of pain. Often we know what caused it: a burn, a sprain or a surgical procedure. Most pain stops when the cause is removed and healing takes place. That is acute pain. When pain arises and persists for three months or more without ...

Read more...

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 65-year-old man is evaluated for a 1-month history of headaches and blurred vision, early satiety, and itching that occurs after showering. He has a 90-pack-year smoking history. He has no history of cardiopulmonary or sleep disorders, no other medical problems, and he takes no medications. On physical examination, temperature is normal, blood pressure is ...

Read more...

Outrage #1: Wasting time of skilled caregivers. Everyday skilled nurses and physicians’ assistants waste hours of time on the telephone either getting approval for medications that we prescribe for our patients or trying to fight a rejection for a medication we requested. Outrage #2: Choosing a medication for cost, not effectiveness. A child cannot breathe because the acid and other nasty stomach ...

Read more...

Waking before dawn, I scurry into the study.  Sitting in front of the computer, I wiggle the mouse, bringing the screen to life.  Hesitantly, I call up the site for the major local newspaper.  Since being notified by my attorneys one week prior that a reporter was hunting me down for comment, I am on heightened alert.  Every day spent awaiting a story that could potentially decimate my life. The home ...

Read more...

One of the greatest risks I faced from surgery to repair a macular hole in my eye was from a hospital acquired infection. But when I tried to find data on the performance of various hospitals in New York City, there were no ratings for Manhattan Eye, Ear & Throat where I would have my surgery. My doctor had moved from a prestigious New York City hospital to Manhattan Eye, ...

Read more...

As predictable as the leaves falling this time of year, another paper on the subject of unnecessary preoperative laboratory testing has appeared. A group from the University of Texas Medical Branch looked at more than 73,000 elective hernia repairs in the National Surgical Quality Improvement Project (NSQIP) database. Almost 2/3 of the patients had preoperative laboratory tests. Of that group, 58.6% had a CBC, 53.5% had electrolytes, 23.7% had ...

Read more...

She had only been in the hospital twice in her life: once when she was nine and now, 60 years later.  She had gotten tonsils out then.  She was getting tumors out now. Her abdomen hurt when she was awake.  Her abdomen would also hurt during exploratory surgery, although she wouldn’t be able to feel it under general anesthesia.  Her body would feel it, though, and could respond by dangerously spiking ...

Read more...

Recently, a medical student confided in me a thought that few in our profession would dare say aloud: “We may have come to medical school to help people, but we choose our specialty careers based on potential salaries.” This in part explains why the most-prized residencies are in fields such as dermatology and radiology, whose procedures generate high fees. According to a physician survey by the Medical Group Management ...

Read more...

Most Popular