How often do we face a physical or mental feat that we’ve always wanted to do, but never seemed to be able to complete successfully? I had a physical feat that I wanted to do my entire life, and this year, at age 56, I finally succeeded. I can still picture my junior high gym class. Lots of other people could do it. Why couldn’t I? They didn’t seem to ...

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A wonderful senior resident helped me understand the goal of rounding.  Rounds should focus primarily on understanding the key problems and the diagnostic and therapeutic approaches to those problems.  She suggested that some rounds spend too much time on “minutia” that the resident could handle, and not enough on understanding the big issues.  According to her, rounds work best when we spend our time addressing the problems that the patient ...

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This article is sponsored by Careers by KevinMD.com. What makes any particular job a "bad" one? Maybe the pay is too low. Perhaps the hours don’t work with your other commitments. It could be the commute is too long, or the opportunity for advancement is too little. A job might be bad because it has a poor ...

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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 seen for follow-up evaluation of Alzheimer disease. Since her last visit 12 weeks ago, she has been taking rivastigmine, with a progressively titrated dosage. The patient's only new symptoms are increasing insomnia, loss of appetite, and occasional diarrhea; she has had no feelings of hopelessness, ...

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In 2006 Dr. Tom Bodenheimer wrote an article that was published in the New England Journal of Medicine entitled, “Primary Care – Will It Survive?” Dr. Bodenheimer spoke with great concern about patients’ growing unhappiness with their primary care physicians and physicians’ increasing frustration with their practice environments. The patient-centered medical home (PCMH) model entered the scene in 2007 -2008 with the lofty goal of fixing the ills of primary ...

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Ask any physician what quality is, and you’ll get many different answers. You will hear answers such as “finding a cause for their pain,” “ruling out a life-threatening condition,” “partnering with patients to improve their health” or “offering the most evidence-based and up-to-date medical treatments.” Here’s what quality isn’t: Running a bunch of useless tests, prescribing non-evidence-based medicines, or spending hours on documentation in an EHR. Therein lies my frustration with the government’s ...

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My puppy looked sick. Not just any sick but “get an attending, two large bore IVs, start fluids, get her on a monitor, move her to the resuscitation bay” sick. And I was scared. “You have to take her to the vet!” I pleaded with my husband as I sprinted down the street to get home to get the keys to the car. As I sat at home waiting for updates ...

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November 2017. I was on my pediatrics rotation at a local community clinic. My attending asked me if I could see Johnathan (identifying information and event details altered to protect confidentiality), an eight-year-old boy who has been increasingly fatigued since the start of the school year. I walked down the hallway laden with paintings of Amazon animals and knocked on room #13. "Good afternoon, Ms. Sanders. My name's T.J., and I'm ...

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America in 2018: 307 mass shootings in 311 days. Recently, a veteran with presumed PTSD shot up Borderline Bar & Grill. His Facebook declaration:

I hope people call me insane… (laughing emojis).. wouldn’t that just be a big ball of irony? Yeah.. I’m insane, but the only thing you people do after these shootings is ‘hopes and prayers’.. or ‘keep you in my ...

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“If only there was just one more creative way to increase my child’s sugar intake,” said no parent ever. As a pediatric cardiologist, I spend much of my day counseling parents of children with obesity, hypertension, and hyperlipidemia. I tell them to increase their physical activity. Remove all junk food from the house. Join a sports team. Cut back on refined sugars. And of course, I am always thrilled when a ...

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As an internist, I strived to give patients hope by prescribing therapies that increased their chance — their hope — of the best outcome and by encouraging them with hopeful words. My own hope was to care for patients until I was old. Just weeks after celebrating my 36th birthday, I was diagnosed with non-Hodgkin lymphoma. Throughout the ups-and-downs of my chemotherapy, I felt the kind of hope I’d wanted my ...

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Our country is at risk of losing an iconic institution that has played a pivotal role in the history of medical education. A school, which has produced some of the boldest pioneers in medicine, could lose accreditation upon the opening of a new hospital that will shunt away 40 percent of their current patients. Scores of our brightest potential medical students will be ripped away from the communities that desperately ...

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I use social media.  Specifically, I use Facebook, Twitter, and LinkedIn.  In the beginning, I did so for utilitarian purposes.  As a columnist and aspiring writer of books, these were (and indeed are) useful marketing tools. I have, in the past, carried around a note-pad to jot down ideas.  I was never without my note-pad.  I always wanted a small legal-pad with a blue or black gel-ink pen.  It was my ...

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The general consensus among physicians who have a solid grasp on their finances is that they are realistic about their earnings and expenses. Ins and outs. Just like in nephrology, except a net positive in your finances is considered a win.  One would expect that doctors ought to be generally conservative in their expenditures, since medicine is a generally conservative profession. But life is unpredictable, and that’s why there are ...

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For many of us, “the most wonderful time of the year” is anything but. If we let the holiday season get the better of us, we can find ourselves overeating, overspending, and over-extending from now through New Year’s Eve. Holiday stress has real health implications: The American Heart Association warns that the increased stress we feel this time of year can lead to significant coronary events. The American Psychiatric Association urges ...

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As a family physician, I treat patients of all ages – children to those nearing 100 years old. One issue that plagues young and old alike is lack of sleep. In fact, according to the Centers for Disease Control and Prevention’s (CDC) 2016 Morbidity and Mortality Weekly Report, more than one-third of American adults do not get enough sleep on a regular basis. This is a common ...

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Prevailing wisdom states that more is better — and it is no different when it comes to our expectation of medical treatments. With the help of the internet, patients and their families have come to expect intensive tests, treatments and therapies at every life stage. But sometimes, too much treatment can do more harm than good. This is true in all ages but is especially relevant for older adults living with ...

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It was my first day of orientation at medical school. In a hallway stood a coat rack overflowing with white garments. I set down my accumulated papers, reached for a hanger and — for the first time ever — shrugged first one arm and then the other into a white coat. It was too large, but I had no other options. The unisex coats ran from XXS to XXL, but the ...

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Physician Speaking by KevinMD is a boutique speakers bureau founded by Kevin Pho, MD. Today's spotlight physician speaker is Dr. Jordan Grumet. Dr. Grumet is next speaking in February 2019 at a corporate retreat for Esse Health. Jordan Grumet, MD is an internal medicine physician and a hospice medical director.  He has worked in academic as well as private ...

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As a medical student, you are thrilled to start your residency and to put your four years of studying and clinical rotations to the test. Now the time has come to begin earning a paycheck. This is the beginning of the financial stages of physicians. As an attending who has transitioned into practice, you may be stressed and wondering if you are on track to meet your financial goals. You are ...

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