On October 1, 2019, Nevada began allowing individuals to avoid living in late-stage dementia. The new statute recognizes the legitimacy of an advance directive that instructs health care providers to stop hand feeding food and fluid by mouth. Individuals have already been completing such directives in New York and Washington. The Nevada law is the first that explicitly authorizes such instructions.
Growing …
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 54-year-old woman is evaluated for flushing of the face of 1 year’s duration. These episodes occur two or three times per week and last about 30 minutes. She went through menopause at age 50 and is on estrogen and progesterone hormone therapy. She also experiences episodes of anxiety, …
Reality star and meta-celebrity Kim Kardashian West made the rounds on the network news and talk shows last week to promote her new line of shapewear. But she also talked about the recent health scare that was revealed on the latest episode of “Keeping Up with the Kardashians.”
Talking to Savannah Guthrie and Hoda Kotb on Today, …
I am an experienced OB/GYN, well-versed in obstetrics, infertility, gynecology, surgery and — yes — menopause, or so I thought. So why was I so blindsided by my own menopause transition?
I thought I was going through burnout, with anxiety, anger, mood swings, irritability, and depression. I was at a point in my career as an OB/GYN of 20-plus years that patients flocked to me because of my reputation and expected …
Four years ago, there was legitimate concern over Hillary Clinton’s health. Between her coughing spells, facial tics, stumbles and falls, not to mention her prism glasses and inability to hold more than a few campaign events per week, it wasn’t at all clear that she was up to the rigors of being president.
Now it’s Joe Biden and his red eye-raising red flags over his health. His so-called gaffes are well …
An interesting article in the journal Pediatrics is both intriguing and sobering. It is intriguing because it lays bare something we don’t talk much about or teach our students about; it is sobering because it describes the potential harm that can come from it, harm I have personally witnessed. The issue is overdiagnosis, and it’s related to our relentless quest to explain everything.
Overdiagnosis is the term the authors use to describe …
Actor Peter Fonda, son of Henry Fonda and younger brother of Jane Fonda, passed away August 16 at his Los Angeles home. Fonda, who was 79, is probably best known for his role as Wyatt in Easy Rider, a movie he co-wrote, produced, and starred in. Fonda was nominated for the Academy Award for Best Original Screenplay for that film as …
Over the last three decades, surgery has slowly but steadily evolved towards a minimally invasive technique. The standard of care for appendicitis now involves creating three half-inch incisions and using a laparoscopic technique to remove the appendix. This technique uses a camera to see inside the body via a large screen. Instruments that are over a foot long are used. Sufficient research has shown that this minimally invasive technique leads …
The science of complexity lays a conceptual foundation for understanding “complex adaptive systems.” What all complex adaptive systems have in common is that they are all bound by the same set of physical laws. Their “behavior,” i.e., growth, maintenance, and death, can all be described using the same set of mathematical relationships. These systems (animals, plants, ecosystems, etc.) are the most productive and functionally effective systems known to man.
Unfortunately, our …
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 25-year-old woman is evaluated in the emergency department for chest pain after a belted motor vehicle accident. She is pregnant at approximately 23 weeks’ gestation. She reports no additional symptoms and is otherwise well. Her only medication is a prenatal vitamin.
On physical examination, the patient is afebrile, blood …
The decision seemed straightforward. Bob McHenry’s heart was failing, and doctors recommended two high-risk surgeries to restore blood flow. Without the procedures, McHenry, 82, would die.
The surgeon at a Boston teaching hospital ticked off the possible complications. Karen McHenry, the patient’s daughter, remembers feeling there was no choice but to say “go ahead.”
It’s a scene she’s replayed in her mind hundreds of times since, with regret.
On the operating table, Bob …
Claire Elise Boucher, 31, known professionally as Grimes, is a Canadian singer, songwriter, record producer, and visual artist. Her music incorporates elements of varied styles, including dream pop, R&B, electronic music, and hip hop. Since 2018, Boucher has been in a relationship with technology entrepreneur Elon Musk.
Grimes recently became the star of a new Adidas advertising campaign. In announcing this new …
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.
For years, research and common belief have supported the concept that patient education alters patient behavior and improves patient outcomes. For instance, lifestyle changes, implemented after improved physician-patient engagement and education, have demonstrated clinical benefits in a wide range of chronic illnesses, …
“Planned death.”
When you put it like that, this can only mean one of two things: suicide or murder. For most of us in medicine, the very idea of “planned death” seems safely outside our purview. After all, the bulk of medicine is concerned with staving off death. And the very nature of death’s uncertain timing enables practitioners of everyday medicine to take refuge in its mystery.
When necessary, we prognosticate. But …
Some hospitals are trying a curious new tactic to attract patients: free hernia screenings.
One Illinois hospital raffled off tickets for a smart speaker to entice people to get their abdomens checked by a surgeon, while an Indiana hospital offered a chance to win dinner at a chophouse.
Announcements for screening events in Colorado and Maryland warned about “life-threatening” complications that could arise if hernias are left untreated. And hospitals in Read more…
One evening in the clinic’s bullpen provider office, a colleague of mine wondered aloud how to respond to a difficult question a patient asked via patient portal message. A physician within earshot responded, “Just because someone asks you a question doesn’t mean you have to answer that question.”
I tried to empathize with where the physician was coming from. Surely after decades of practicing medicine, one might become weary of spending …
Literature surrounding the effects of social isolation and loneliness for older adults is no longer lacking. Studies and articles outlining the dreadful consequences of these epidemics have even pierced large media outlets like Time magazine, where they emphasize how one in three older adults are lonely.
While any attention brought to the fact that the age group containing people age of 85 and up is …
On several occasions, most recently during a press conference in March 2019, Speaker of the House Nancy Pelosi has advocated changing the voting age to 16. Pelosi told reporters that lowering the voting age would increase engagement in politics among younger Americans and would help drive a higher level of voter awareness and turnout.
Speaker Pelosi is not the only prominent lawmaker to advocate for a lowered voting age. Also in …
Here is a standard emergency department situation, played out all across America today.
Patient X has schizophrenia. He takes medication, but only until he feels better. He is calm when he takes it, but sometimes aggressive and assaultive when out of treatment and off medications.
Patient X decides to leave town and drive somewhere else because he is angry at 1) family 2) significant other 3) health care system 4) situation.
He is …
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 23-year-old woman is evaluated for 2 weeks of painful lumps on her legs. The lumps persist for several days and make it difficult for her to go to work as a waitress. She is a college student in Ohio where she has lived her whole life. She has …
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