I was misinformed about medical school. Growing up, I wanted to help people become healthy. After four years at the Ohio State University Medical School and three years of a family medicine residency, I still did not know enough to accomplish my goal. My training allowed me to become a disease-care expert, not a health care specialist. I was taught little to nothing about nutrition and true disease prevention. Despite ...

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In 2013, the American Medical Association (AMA) announced its decision to classify obesity as a disease, moving against the recommendation at the time of a group studying obesity. Yet there are still those who believe that obesity is not a disease but rather a “condition,” and this has downstream ramifications for health policy, health care provider reimbursement, and, ultimately, societal health and well-being. But this is ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. An 82-year-old woman is evaluated for a 1-week history of urinary incontinence with lower abdominal discomfort. She reports no dysuria, fever, or back pain. Medical history is significant for hypertension and allergic reaction to sulfa drugs, which cause a generalized rash. Her only medication is amlodipine. On physical examination, temperature ...

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A physical therapist, commenting on my blog, recently shared an excellent point of view with me:

As a therapist myself, I don’t know that I’d want to be betting on that differential diagnosis of tear, rupture, etc. when giving online advice. What is good treatment for one, can be disastrous for the other. Seeing someone in person can make all the difference, especially with the amount of self-diagnosis that the internet ...

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For $199 and a tube of saliva, I found out that I have straight hair and green eyes. Mirrors have been telling me this my whole life for free. But as a genetics counselor, I wanted to learn more about the recreational home genetics tests that have been captivating people. What I was left with (aside from the aforementioned physical description and unsurprising heritage data), was the sense that the dangers ...

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When I finished my training, I was taught that the vast majority of dementia was Alzheimer's disease, with occasional cases of multi-infarct dementia as well as odd syndromes such as Kreutzfeld-Jacob disease and genetic, traumatic, toxic and tumor-related syndromes. Parkinson's disease, we were taught, caused a tremor and freezing up of a person's movements and only very rarely was associated with any kind of memory loss. These teachings helped us modern ...

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Imagine this scenario. Your two-year-old son has had a runny nose for a day or two and an occasional cough, but seemed no worse to you that everyone else in his preschool class. Two hours after you put him to bed you hear him coughing, only this cough is like none you have ever heard from him before. It sounds like a barking seal at the circus -- a brassy, ...

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There is a wealth of information about your health circulating in your blood. For people with diabetes, accessing that information can be a matter of life or death. For nearly 30 years, the prevailing technology for checking the blood sugars of someone with diabetes has been the fingerstick. People with diabetes are often asked to stick their fingers and check their blood multiple times a day to assess whether their blood ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 42-year-old man arrives for follow-up consultation. Three months ago he developed a proximal right leg deep venous thrombosis following a skiing-related fracture of the right tibia. Although not recommended by guidelines, a thrombophilia evaluation was performed, which revealed an elevated plasma homocysteine level, and subsequent genetic testing revealed ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 64-year-old man is evaluated in follow-up after recent abnormal findings on intraoperative liver biopsy. Two days ago he underwent right colon resection for a large villous adenoma with high-grade dysplasia. At the time of surgery, an abnormal-appearing liver was noted and biopsy was performed. His medical history is ...

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