Who will be delivering babies in the United States in coming years?
The American Congress of Obstetrics and Gynecology (ACOG) estimates that the U.S. will have between 6,000 and 8,800 fewer OB/GYNs than needed by the year 2020. Additionally, there is a possible shortage of 22,000 by the year 2050.
What is being done about this problem? Well, there are currently efforts to attempt to increase the number of residency positions. There is also talk of having nurse midwives take a greater role. While those are valid interventions, let’s take the issue much deeper, as that is certainly not doing enough to mitigate the problem. Perhaps of equal or greater importance in the consid...
Source: Kevin, M.D. - Medical Weblog - April 10, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/valerie-a-jones" rel="tag" > Valerie A. Jones, MD < /a > Tags: Physician OB/GYN Source Type: blogs
Our responsibility to refugee children
I am a pediatric resident working, like many residents, in a clinic that sees many of the most vulnerable children in our area. We see many refugees and immigrants coming through our clinic, including many from the countries named in President Trump’s immigration ban.
These refugee children often suffer from afflictions we rarely see amongst our usual patient population: severe vitamin and nutritional deficiencies, intestinal parasites, malaria. They are often thin and short from spending their formative years without sufficient nourishment, their blood full of lead from old pipes or pottery. They have nightmares like so...
Source: Kevin, M.D. - Medical Weblog - April 9, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/lacey-castellano" rel="tag" > Lacey Castellano, MD < /a > Tags: Physician Pediatrics Source Type: blogs
How much health can you buy for $14,000?
Unparalleled reductions in cholesterol levels are now possible with a new class of cholesterol medicine, a PCSK9 antibody, reported in one of the large national cardiology meetings recently. But this latest example of high-tech cholesterol treatment comes with a staggering price-tag, $14,000 a year for the new genetically engineered injectable. As a preventive cardiologist, I began to wonder if this is the best way to spend our money.
A few caveats first. This novel treatment for cholesterol promises to be a breakthrough for a small but significant group of people with a severe inherited form of high cholesterol for whic...
Source: Kevin, M.D. - Medical Weblog - April 9, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/stephen-devries" rel="tag" > Stephen Devries, MD < /a > Tags: Conditions Heart Source Type: blogs
Fighting burnout: No is the wrong answer. It is not acceptable.
Down in Baltimore for a meeting, long days full of plenary sessions and workshops, awards ceremonies and poster sessions. Recycled hotel air, bad coffee, great camaraderie.
Lots of new ideas, lots of new ways of looking at things, lots of reinventing the wheel, lots of hope for change. Lots of sessions about how to improve the environment for learners, how to engage medical students, how to build a curriculum, how to evaluate residents.
And lots of sessions on wellness.
At least we are paying attention to wellness, recognizing that the stress of working in the environment we’ve allowed to become created around us, in...
Source: Kevin, M.D. - Medical Weblog - April 9, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/fred-n-pelzman" rel="tag" > Fred N. Pelzman, MD < /a > Tags: Physician Primary care Source Type: blogs
How micropractices can help the opioid crisis
A confluence of events has occurred in the United States that could help to save the lives of many patients as well as the lives and careers of many physicians. The solution is to apply the use of micropractices to address the current opioid addiction crisis. A micropractice is a small medical practice that is run efficiently to keep overhead low and put the patient first. The patient is given more time and attention than is traditionally given in a big box, assembly line clinic. Barriers between doctor and patient are removed. A micropractice may simply be one doctor working in a single room. The size of the patient panel...
Source: Kevin, M.D. - Medical Weblog - April 9, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/mark-leeds" rel="tag" > Mark Leeds, DO < /a > Tags: Meds Pain management Source Type: blogs
This physician fights burnout by having a binder of successes
The hold music on the telephone cut off abruptly as the doctor I was trying to reach picked up the line. “Yes?” she said curtly.
“Hi, this is Erin Barnes,” I said. “I’m calling from Temple University Hospital in regard to one of your patients. She was admitted last week with anemia. We were initially concerned about a gastrointestinal bleed given her history …”
“I’m sorry,” the doctor interrupted, “who is this I’m speaking with?”
I felt my face start to flush.
“Is this a resident?” she asked. I could hear the anger in her voice.
“I … no, I’m a sub-intern.”
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Source: Kevin, M.D. - Medical Weblog - April 9, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/erin-barnes" rel="tag" > Erin Barnes, MD < /a > Tags: Physician Residency Source Type: blogs
Recognize the importance of the physical exam in the history of medicine
A patient comes into the ER complaining about throbbing migraines after falling off her bicycle; thus, the physician quickly orders an X-ray, complete blood count, and asks the nurse to schedule the patient for an MRI of the head and neck in case both those tests come back inconclusive. As an ER scribe, I saw many conditions where the physician would quickly do a physical exam, and then use a myriad of technology to appropriately diagnose the patient. Although it is commonplace for modern physicians to use technology, we often take for granted that many of these technological advancements have only been in use for less tha...
Source: Kevin, M.D. - Medical Weblog - April 9, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/rafid-rahman" rel="tag" > Rafid Rahman < /a > Tags: Tech Primary care Source Type: blogs
Surviving opioids in the fentanyl era
There’s a clear culprit in the rising drug overdose death count in Massachusetts — the synthetic opioid fentanyl. More powerful and more deadly than heroin, fentanyl has sparked a new set of survival rules among people who abuse opioids.
About 75 percent of the state’s men and women who died after an unintentional overdose last year had fentanyl in their system, up from 57 percent in 2015. It’s a pattern cities and towns are seeing across the state and country, particularly in New England and some Rust Belt states.
Fentanyl may be especially lethal because it’s strong, it’s mixed with other drugs in varying amo...
Source: Kevin, M.D. - Medical Weblog - April 9, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/martha-bebinger" rel="tag" > Martha Bebinger < /a > Tags: Meds Pain management Source Type: blogs
Bioterrorism: 10 facts about sarin gas
As the civil war in Syria shows no signs of de-escalating, worrisome evidence points towards the deployment of chemical warfare with banned agents recently, resulting in almost a hundred deaths with more than a quarter of them children. Chlorine and Sarin gas are primarily being implicated. Here are ten facts to know about Sarin gas and how it works.
1. Historically, Sarin was used for bioterrorism by members of Aum Shinrikyo, a radical religious cult group in Japan, in 1994 and 1995 that collectively poisoned 6500 people on the subway. In 1998, Saddam Hussein used it against Iranians and Kurdish people. The Syrian governm...
Source: Kevin, M.D. - Medical Weblog - April 9, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/tanu-s-pandey" rel="tag" > Tanu S. Pandey, MD < /a > Tags: Conditions Emergency Source Type: blogs
Congressman Chaffetz: iPhones are the future of medicine
Recently, Utah Republican Jason Chaffetz made comments concerning health care reform that illustrates just how out of touch Congress is with modern medicine. In a press conference addressing the ongoing debate over Obamacare repeal, he stated that Americans should make a choice between purchasing health insurance and an iPhone — in the Congressman’s own words “rather than getting that new iPhone that they just love … Americans should invest … in their own health care.” As expected, Chaffetz was met with sharp criticism for comparing the cost of a phone to the cost of health care.
However, I think that most ev...
Source: Kevin, M.D. - Medical Weblog - April 8, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/kevin-r-campbell" rel="tag" > Kevin R. Campbell, MD < /a > Tags: Tech Mobile health Source Type: blogs
What are the best uses of rehabilitation medicine in patients with cancer?
Rehabilitation medicine is one of the best-kept secrets in health care. Although the specialty is as old as America’s Civil War, few people are familiar with its history and purpose. Born out of compassion for wounded soldiers in desperate need of societal re-entry and meaningful employment, “physical reconstruction” programs were developed to provide everything from adaptive equipment to family training, labor alternatives and psychological support for veterans.
Physical medicine and rehabilitation (PM&R) then expanded to meet the needs of those injured in World Wars I & II, followed closely by children disa...
Source: Kevin, M.D. - Medical Weblog - April 5, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/val-jones" rel="tag" > Val Jones, MD < /a > Tags: Conditions Hospital Source Type: blogs
5 ways physicians suffer by complaining
There’s a saying: “Pain is inevitable, but suffering is optional.” However, some people thrive by complaining. These people, when presented with potential solutions to the problem, argue and invalidate all possibilities presented. Sounds familiar? Being a physician advocate in the battle to lower physician burnout and prevent suicide in doctors, I am disheartened to see this phenomenon in our community. While there are frontline physicians — even physician leaders — who gladly get on board, looking at and for new solutions to what seems to be an unsolvable problem, many of our community are content to...
Source: Kevin, M.D. - Medical Weblog - April 5, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/maiysha-clairborne" rel="tag" > Maiysha Clairborne, MD < /a > Tags: Physician Primary care Source Type: blogs
A video for the medical students taking USMLE Step 1
Good luck to the medical students taking USMLE Step 1. After studying, enjoy this video from the Howard University College of Medicine Class of 2019.
Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - April 5, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/admin" rel="tag" > Admin < /a > Tags: Video Medical school Source Type: blogs
Will we solve health care by blaming doctors?
I started my career in the late 1980s and retired just recently. I am very grateful that I caught at least a few years of the “golden age” of medicine because those years made all the difference.
Over my career, I witnessed many different efforts at health care reform proposed, attempted and failed. DRGs, Hillarycare, private insurance capitation, “To Err is Human,” Medicare fraud crackdowns, Global and Bundled payments, general reimbursement cuts, anonymous online patient satisfaction scores, “value-based” reimbursement, Obamacare, EMRs and more.
Anyone who practiced during the same time frame ...
Source: Kevin, M.D. - Medical Weblog - April 5, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/thomas-d-guastavino" rel="tag" > Thomas D. Guastavino, MD < /a > Tags: Physician Primary care Source Type: blogs
The metric, the dialectic, and the chart electric
“There is no document of civilization which is not at the same time a document of barbarism.”
– Walter Benjamin, Theses on the Philosophy of History
It is 1940, and the Nazi horror is bearing down on Europe. France has fallen, and refugees are streaming out, fleeing to safety through neutral states and America. Walter Benjamin, a Jew, and a German philosopher, joins a small group being guided through southern Spain with the hope of making it to Portugal and safety. He has just completed his manuscript that would reverberate through modernity with its insight into how rationality brought us civilizat...
Source: Kevin, M.D. - Medical Weblog - April 4, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/kjell-benson" rel="tag" > Kjell Benson, MD < /a > Tags: Physician Health IT Source Type: blogs
