Weird and Wild: Back Piercing and Langers’ Lines
A patient presented to the emergency department with a request to remove her back ring. Yes, that's right, her back ring. We were a bit confused at first by the piercing. The stud was placed in her back with no obvious way of removal. Our original thought was to send the patient to dermatology or even plastic surgery. The piercing certainly didn't qualify for emergency surgery or removal.A 23-year-old woman with a back piercing in the left lower back. The underlying skin condition is not infectious. This is a classic example of tinea versicolor, and is not related to the piercing. It is a common fungal infectio...
Source: The Procedural Pause - January 31, 2018 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Difficult Patient vs Difficult Doctor
Discussion Blog)
Source: Bioethics Discussion Blog - January 21, 2018 Category: Medical Ethics Source Type: blogs
Difficult Patient vs Difficult Doctor
One cannot ignore the potential for conflictive behavior as a potential in medical patient-physician relationships (and indeed associated with other individuals in the medical system interacting with patients and patients interacting with them.) This behavior can be disruptive to attain important professional relationships and effective diagnosis and treatment. The following is a brief analysis of the dynamics associated with such behavior and hopefully toward resolution as researched and written by a first year medical student. The obvious goal, hopefully, is resolution of potential conflicts to promote a ther...
Source: blog.bioethics.net - January 21, 2018 Category: Medical Ethics Authors: Maurice Bernstein, M.D. Tags: Health Care syndicated Source Type: blogs
Please change the culture of surgery
It is December 2017. I have been on the road for the last five months, completing my five months of elective rotations. I am a fourth-year medical student aspiring to specialize in family medicine. I also want to learn procedures, so I did two months of surgery, three months of family practice electives. At the beginning of this process, I had wanted to be a general surgeon, but I ended up choosing family medicine.
Back in third year, I had very auspicious rotations in rural Appalachia where I was one on one with a few general surgeons. I loved it; the hours were not too bad and the weekend calls were thrilling. Three atte...
Source: Kevin, M.D. - Medical Weblog - January 8, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/anonymous" rel="tag" > Anonymous < /a > Tags: Education Surgery Source Type: blogs
Dr. David Brownstein fought Shingrix, and Shingrix won
Dr. David Brownstein is a "holistic" family practice physician in my area. Consistent with being "holistic," he is antivaccine to the core. That's why he's unhappy with the recent CDC recommendation that adults over 50 receive the new shingles vaccine. He thinks he's found a clever argument to show it doesn't work. Unfortunately, his argument only reveals his bias and misunderstanding.
The post Dr. David Brownstein fought Shingrix, and Shingrix won appeared first on RESPECTFUL INSOLENCE. (Source: Respectful Insolence)
Source: Respectful Insolence - November 17, 2017 Category: Surgery Authors: Orac Tags: Antivaccine nonsense Homeopathy Medicine Pseudoscience Quackery Skepticism/critical thinking chickenpox clinical trial David Brownstein GlaxoSmithKline number needed to treat ozone Peter Lipson shingles Shingrix vaccines va Source Type: blogs
Believe Them the First Time
By NIRAN AL-AGBA, MD
I remember the first time someone threatened to kill me. It was my day off, so I was not in the clinic that day; a Children’s Hospital specialty group was working there instead, and after a staff member called the police, she notified me. A father had walked in saying he wanted to kill me for “taking his children away from him.” Wracking my brain as to this man’s identity, I drew a blank.
The police found him in a local park a short time later and judged him to be “harmless.” Somehow, I did not share their reassuring sentiment. I figured out who the man was, tracked down his mot...
Source: The Health Care Blog - July 5, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
The slow death of private practices
Doctors have been bemoaning changes in the practice of medicine for years and with good reason. It’s harder and harder to make a go of it in private practice. In recent years our area has lost several small practices — Hal Grotke’s Redwood Family Practice closed, Dr. Garcia retired, Teresa Marshall’s solo office shut its doors, Eureka Internal Medicine transitioned to Humboldt Medical Specialists (which then became St. Joseph Hospital Medical Group) and Beverly Copeland relocated to Ashland.
As I was writing this, Dr. Windham announced that he is ceasing the provision of primary care at his small office. Unfortunat...
Source: Kevin, M.D. - Medical Weblog - June 13, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/emily-dalton" rel="tag" > Emily Dalton, MD < /a > Tags: Physician Primary care Source Type: blogs
It ’s time for graduating medical students to celebrate their dream
A transcript of the Loyola Stritch School of Medicine 2017 commencement speech, Saturday, May 20, 2017.
Angela Jiang: Good morning! As the class vice president, it is my pleasure to welcome Dr. Pamela Wible to our graduation. Dr. Wible is a family physician and a pioneer in the ideal medical care movement. After completing a family medicine residency and working in different family practices for over ten years, Dr. Wible found that neither doctors nor patients were happy with a system that felt much like an assembly line. She decided to follow her vision of practicing medicine in a way that could please both herself and h...
Source: Kevin, M.D. - Medical Weblog - June 3, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/pamela-wible" rel="tag" > Pamela Wible, MD < /a > Tags: Education Medical school Source Type: blogs
This family physician is deeply disappointed in maintenance of certification
An open letter to the American Board of Family Medicine (ABFM):
I recently chose to sit for my sixth (and I hope final) family practice maintenance of certification (MOC) examination, having now practiced as a board certified family physician for the past 34 years and intending to work a few more years. I want to share my experience taking this examination your organization prepares, promotes and uses at a high cost to determine which physicians meet the standards of family medicine, as stated on your website:
Family medicine is the medical specialty that provides continuing, comprehensive health care for the individual an...
Source: Kevin, M.D. - Medical Weblog - May 11, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/emily-gibson" rel="tag" > Emily Gibson, MD < /a > Tags: Physician Primary care Source Type: blogs
What life is like for this retired physician
I have now been out of the active medicine for two years. I still have dreams about being a doctor and practice. I don’t think you can do the same thing day in and day out for 40 years and not have it be a part of who you are. I am still asked my opinion by friends and family about their health issues, and frankly, I find my fund of knowledge is slipping away. I did renew my license in the state of Florida that required 40 hours of continuing medical education. (I did mine mostly online.) I don’t know if I will renew it again in 2019.
Being on Medicare, I visit doctors — probably too often. I have become ...
Source: Kevin, M.D. - Medical Weblog - April 16, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/david-mokotoff" rel="tag" > David Mokotoff, MD < /a > Tags: Physician Primary care Source Type: blogs
What this physician learned from a medical mission
In August of 1991, I became a family practitioner in the United States Air Force and was sent to Clark Air Force Base in the Philippines. During my time there, I was asked to go on a medical mission. This experience struck me with the missionary bug to provide my talents and to care for others in another country. With medications that were near expiration date in USAF stock and due to the U.S. departure from the Philippines following the eruptive destruction of Mount Pinatubo at Clark AFB, we went out to a local barangay, village, and cared for the ill. It was an uplifting compassionate experience that started decades of t...
Source: Kevin, M.D. - Medical Weblog - March 10, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/dirck-a-curry" rel="tag" > Dirck A. Curry, DO < /a > Tags: Physician Primary care Source Type: blogs
His power over her was cultural. How could I do the right thing?
She burst into tears when I asked if she wanted to get pregnant.
Eman, a beautiful young woman from Jordan, sat in my family-practice office with her husband, Ali, and two adorable children about one and two years old. With her scarf and dark clothing covering all but her pale face and enormous sable-brown eyes, Eman looked closer to fourteen than twenty-four, and scarcely old enough to have any children.
“How can I help you?” I started.
“We wish to remove her IUD so that we can have another baby,” Ali answered.
I don’t think he expected me to address Eman directly.
“Do you want to get p...
Source: Kevin, M.D. - Medical Weblog - March 3, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/andrea-gordon" rel="tag" > Andrea Gordon, MD < /a > Tags: Physician Primary care Source Type: blogs
Don ’t Get Too Distracted By the Smoke Coming Out of Washington
By CECI CONNOLLY & MARGARET MURRAY
Health care has risen to the top of the national agenda and Washington policymakers are once again debating how to affordably provide coverage and care for Americans. It is a discussion we welcome. But in the meantime, let’s not lose sight of the fundamentals that will ultimately produce greater value for our health care dollars.
At the heart of a high-performing health system is quality outcomes. For consumers to make informed decisions, they’ll need more data—reliable, actionable data. Health plans operating in managed care are accustomed to demonstrating their value and in fa...
Source: The Health Care Blog - February 16, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
TRIAD VIII: Nationwide Multicenter Evaluation to Determine Whether Patient Video Testimonials Can Safely Help Ensure Appropriate Critical Versus End-of-Life Care
Conclusions: For most scenarios, consensus was not attained for
code status and resuscitation decisions with stand-alone LW and POLST
documents. Adding VMs produced significant impacts toward
achieving interpretive consensus. (Source: blog.bioethics.net)
Source: blog.bioethics.net - February 15, 2017 Category: Medical Ethics Authors: Thaddeus Mason Pope, JD, PhD Tags: Health Care medical futility blog syndicated Source Type: blogs
Can Community Health Centers Fill The Health Care Void Left By Defunding Planned Parenthood?
House Speaker Paul Ryan has stated that the House bill to repeal the Affordable Care Act (ACA), like its 2016 Congressional predecessor vetoed by President Obama, will include a provision that excludes certain providers that furnish abortions (other than those permitted under the Hyde Amendment) from the Medicaid program. Not only would such providers be excluded for family planning services; their exclusion would extend to the full range of Medicaid-covered services furnished in primary and preventive settings, such as breast and cervical cancer screening, mammograms, diagnosis and treatment of sexually transmitted diseas...
Source: Health Affairs Blog - January 27, 2017 Category: Health Management Authors: Sara Rosenbaum Tags: Costs and Spending Featured Organization and Delivery Population Health Quality Community Health Centers Congress Paul Ryan Planned Parenthood Primary Care Republicans Women's Health Source Type: blogs
