Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 25-year-old woman with type 1 diabetes mellitus is evaluated for recent-onset glycemic fluctuations without symptomatic hypoglycemia. She was diagnosed with diabetes 7 years ago. Her HbA1c levels since diagnosis have ranged from 6.4% to 7.3%, with the most recent value at 7.3%. She reports eating a carbohydrate-consistent diet ...

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Everyone always jokes with doctors, “What happens if you get sick?” Some of us laugh off the question. The busy schedule of health care often means our own health comes last. However, what happens when it’s a chronic disease that requires treatment? Then the answer to this question is a little different. I am a family medicine physician dealing with congenital heart disease (CHD). Saying that someone has congenital heart disease ...

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The Hippocratic Oath, as presumably most of us know, is the oath taken by physicians promising to uphold ethical standards in treating their patients. The four pillars of medical ethics primarily stem for this oath: autonomy, beneficence, non-maleficence, and justice. The world we see now is socially different compared to what it was when Hippocrates was alive. Physicians and policymakers in health care now face new ethical challenges that they ...

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If you search for “how to pass a urine drug test” on the internet, you will get several million results. As physicians, we see and manage the national opioid crisis every day. We see the impacts of this in our practices and our lives. The crisis frankly shows no signs of abating or becoming a less critical issue. Unfortunately, one major reason for our inability to control this issue might ...

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There exists a large, mostly-underground, growing community consisting of those iatrogenically harmed by benzodiazepines. Guilty only of following doctors orders, these patients are marginalized and misunderstood. This has been enabled, at least in part, by poor terminology. Recently on Twitter, Michael P. Hengartner and Marnie Wedlake both posted critical questions in response to a benzodiazepine news story:
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asco-logo It usually starts with a phone call: “Doc, can I come and talk to you about something?” The “something” might be erectile difficulties or other side effect(s) from prostate cancer treatment. It might be confusion or indecision about what treatment to agree to. I always inform the caller that any of these issues are better resolved if their spouse/partner is present and ...

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“Polio. I’ve seen polio.” Last night, I was speaking with one of the most experienced pediatricians I’ve ever met, Dr. Jack Burstiner. I’ve known him for 50 years. I would have known him even longer if I had been born earlier. He lived in my neighborhood, two doors down. He was my pediatrician. Jack is almost 90 years old. But he still looks like a pediatrician. He’s got a smile a child ...

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A few weeks ago, I saw a patient with shortness of breath during my Saturday clinic. He had been short of breath for a few weeks, and on a couple of occasions, he had also experienced mild chest pain. He has known aortic stenosis, moderate according to his last echocardiogram two years ago. My brain kicked into autopilot, and I asked: “Have you fainted or passed out recently?” It was a ...

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1. Cancer is not rare.  Technically, childhood cancer is rare compared to adult cancer, but it’s not as rare as you think.   Outside of my work, I can think of 3 people who I know personally that had a childhood cancer.  A teammate on my high school basketball team, my sister-in-law, and a high school debate teammate.   My guess is that you also know someone from church, a coworker’s ...

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As a mom to two little girls, I understand the lure of online forums. With so many accessible tools — including Google, Instagram, and online support groups like Facebook groups — before a parent brings their child to the doctor, they will inevitably first post their inquiry online. They post a picture: “What’s this rash?” Or they’ll write: “My baby has had a fever of 135-degrees! Do I need to take her ...

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