So You Think You Have COVID-19?
There is plenty of anxiety. And many patients have made appointments with a request to be tested. But the answers they have been getting are confusing and often frustrating as well. What should you do if you think you have COVID-19 (the disease caused by the novel coronavirus aka SARS-CoV-2)? The first step is figuring out if you need to go to the emergency department. If you are feeling short of breath and/or having trouble breathing, this is definitely an indication (or a reason) to go to your nearest emergency department for evaluation. Having low oxygen saturation (or hypoxia) may necessitate supplemental oxygen usu...
Source: JeffreyMD.com - April 9, 2020 Category: Internal Medicine Authors: Dr. Jeff Tags: After Residency My Life coronavirus covid covid19 pandemic quarantine testing Source Type: blogs
I ’m Baaack
This week I returned to work after needed to stay off and isolated for the last week. While I didn’t come to work, I wouldn’t consider it a vacation. My days were filled with taking care of the toddler (3 year old) while my wife worked from home. In one word, it was exhausting. As far as recovering goes, I noticed improvement almost each day in terms of the severity of my cough. I was coughing less frequently each day. I never developed a fever. I also never developed any shortness of breath or difficulty breathing. And so, here I am, back at work. Stay safe and healthy, everyone. (Source: JeffreyMD.com)
Source: JeffreyMD.com - April 7, 2020 Category: Internal Medicine Authors: Dr. Jeff Tags: After Residency My Life covid19 doctor physician sick leave Source Type: blogs
A physician ’s first night at the MICU in New York City
Tonight will be my first night shift in the medical ICU (MICU) since COVID began ravaging New York City. I was on the hospital floors as an internal medicine resident during the early period of the COVID-19 pandemic. Since then, my clinic block was canceled, and I was placed on sick call, though I didn’t […]Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - April 6, 2020 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/nasir-malim" rel="tag" > Nasir Malim, MD, MPH < /a > < /span > Tags: Conditions COVID-19 coronavirus Critical Care Infectious Disease Source Type: blogs
Governors Send Out S.O.S. for More Doctors —Immigrant Doctors Can Heed the Call
Jeffrey A. SingerAs hospital emergency rooms and intensive care units swell with patients infected with the COVID-19 virus, political leaders coordinating responses in “hot spots” are asking doctors and other medical professionals in parts of the country less impacted by the pandemic to come to the rescue. New York Governor Andrew Cuomo issued such a plea the other day. Governors are issuing executive orders that relaxoccupational licensing restrictions on the free movement of health care practitioners. Some are also expanding thescope of practice of various licensed health care professionals, permitting t...
Source: Cato-at-liberty - April 1, 2020 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
I have seen that a few companies are offering paid leave if their workers test positive for COVID19. In theory this is great. In reality, this is bogus. Policies are worded very specifically. Most of the statements I have seen that list paid leave are for patients that TEST positive for COVID19. The problem is we do not have enough tests! At my practice (a large, tertiary, University-based clinic in Southern California), we are operating under the assumption that most people who contract COVID19 will have a mild form of the disease that will not require a hospital admission. However, they will need...
Source: JeffreyMD.com - April 1, 2020 Category: Internal Medicine Authors: Dr. Jeff Tags: After Residency My Life covid19 doctor internal medicine paid leave physician Source Type: blogs
Banned From Work
This week has started off oddly. I am at home. I am not on vacation. I wish I were. Instead, I am at home in a sort of self-quarantine. Last week, as I was getting ready to go to work I noticed that I was coughing. Initially I thought that I was had a tickle in my throat and that I just needed to clear it. But the cough persisted. At our institution our outpatient faculty clinics had already instituted a strict screening policy. All visitors to the building were funneled to the main entrance. There, two people screen any person entering regardless of whether they are visitor or employee. The questions each day ...
Source: JeffreyMD.com - March 31, 2020 Category: Internal Medicine Authors: Dr. Jeff Tags: After Residency My Life covid19 doctor nationaldoctorday pandemic physician work Source Type: blogs
Thoughts from the COVID-19 front lines
I am an internal medicine physician directly taking care of patients admitted to the hospital who are COVID-19 positive or those who are being tested for COVID-19. Last week, my hospital created a special team dedicated to taking care of these patients. During that time, the hospital was eerily quiet: the ED no longer had […]Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - March 27, 2020 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/sunny-kung" rel="tag" > Sunny Kung, MD < /a > < /span > Tags: Conditions COVID-19 coronavirus Hospital-Based Medicine Infectious Disease Source Type: blogs
COVID-19: journal, books and databases with some freely available content
Last updated 8th April 2020, 2240 UK time. Items added at that time are marked NEW.Some publishers are making COVID-19 related content available in PubMed Central - they are asterisked on a list from the WellcomeGIDIF-RBM (an Italian association for health librarians) have a list of freely available resourcesAmerican Academy of Pediatrics - Critical updates and resources for pediatriciansAmerican College of Physicians - A collection of Annals of Internal Medicine articles related to coronavirus is freely available.American Medical Association - JAMA Network COVID-19 inform...
Source: Browsing - March 26, 2020 Category: Databases & Libraries Tags: coronavirus COVID-19 NCOV Source Type: blogs
Rationing tests? In the U.S.A.? It may sound strange to hear that in the land of plenty we are rationing tests. But here we are, ill prepared for a global pandemic. One of the most difficult things to say to patients who are having symptoms of cough and/or fever during this pandemic is that they need to stay home and act as if they had COVID-19. Testing, for the most part, is being reserved for the patients sick enough to require a hospital admission. I don’t think it helps that many people keep seeing things in the news touting how people can get tested without fully explaining the limitations we have. Or maybe ...
Source: JeffreyMD.com - March 25, 2020 Category: Internal Medicine Authors: Dr. Jeff Tags: After Residency My Life covid covid19 infection pandemic panic Source Type: blogs
It is painful to watch the amount of distrust or disbelief amongst the public – even among those who are in healthcare. Last week I saw an article about young people still going on about their usual life, not willing to put things on hold. One of the people interviewed was a nurse. I saw another article from this week that beaches remain open in Florida for spring break. Parties were just told that they must keep their groups to 10 or less. However, the article also showed a picture taken on a Florida beach in Clearwater that showed pretty crowded situations (the picture was taken on 3/27/2020). Sometimes I just want...
Source: JeffreyMD.com - March 25, 2020 Category: Internal Medicine Authors: Dr. Jeff Tags: After Residency My Life News Opinion covid19 isolation panedmic social distancing Source Type: blogs
How can we redefine locum tenens?
Physician burnout and shortage have a profound impact on the ability to deliver quality, accessible health care in the United States — especially in rural areas where specialists are scarce. Burnout is costing the U.S. health care system roughly $4.6 billion a year, according to a study published in the Annals of Internal Medicine. Another […]Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - March 24, 2020 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/sridhar-rajamani" rel="tag" > Sridhar Rajamani, MD, MPH < /a > < /span > Tags: Physician Practice Management Source Type: blogs
A curious CT scan in Cardiology
Presentation A 38-year-old women,with episodic chest discomfort, mild dyspnea, and occasional non-productive cough. She was investigated in a non-emergent fashion. After an abnormal X-ray chest, A CT scan was requested. (*X-ray chest is Intentionally not posted here to add some curiosity factor) This is probably one of the most curious Images in cardiology I have stumbled upon. At the first look, it seemed a baseball has replaced a heart. Is it not? Posted with Creative Commons Attribution License CC-BY 3.0. Afzal et al. Dept of Internal Medicine, Florida Hospital, Orlando, USA.Cureus 10(11): e3566. Whe...
Source: Dr.S.Venkatesan MD - March 23, 2020 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized aneurysm of coronary artery coronary artery aneurysm Images in cardiology Source Type: blogs
The Dizzying Experience of Healthcare in the Time of a Pandemic
By Lyle Fettig@fettiglyleCheck out the Pallimed COVID-19 Resource page here. - Ed.I love theletter co-published by Pallimed and Geripal about COVID,and you should read that too. As an erstwhile (for now) Pallimed contributor, I thought I'd toss in my two cents with some additional thoughts/reflections based on week 1 of preparing for the COVID pandemic as a palliative care physician.Over the last week, I've operated mentally in most of these lanes:1. Primary prevention and public health:Through extensive advocacy for social distancing and widespread testing. I have talked about it with my patients and my own family and fri...
Source: Pallimed: A Hospice and Palliative Medicine Blog - March 17, 2020 Category: Palliative Care Tags: covid emergency preparedness fettig Source Type: blogs
The "Risk and Distraction" of MOC
From the American Board of Internal Medicine: We did not come to this decision lightly, but we believe removing the potential risk and distraction of sitting for a spring exam is the right thing to do for our diplomates and for the country at this time. Learn more: https://www.abim.org/media-center/Coronavirus-Updates.aspxPhysicians can help make sure this risky, unproven, and "distracting" ABMS (Source: Dr. Wes)
Source: Dr. Wes - March 17, 2020 Category: Cardiology Authors: Westby G. Fisher, MD Source Type: blogs
Prevent the spread of COVID-19 with telemedicine
I am a board-certified internal medicine physician practicing in a small outpatient clinic with a highly reputable academic organization in the greater Boston area. Regarding COVID-19, I am not panicked, but I am concerned– concerned for our patients, concerned for our workforce and health care providers, concerned for our parents and loved ones. The situation […]Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - March 13, 2020 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/solmaz-amirnazmi" rel="tag" > Solmaz Amirnazmi, MD < /a > < /span > Tags: Conditions COVID-19 coronavirus Infectious Disease Source Type: blogs
Lessons from Range by David Epstein
I received an email from Ryan Holiday – author of The Obstacle is the Way, a wonderful book that introduced me to Stoic philosophy as a guiding principle. In that email, he recommended Range: Why Generalists Triumph in a Specialized World by David Epstein. As a generalist, the title intrigued me. So as I am prone to do, I bought the Audible version, and over a 10 day period, listened to the book. Like many books in this genre, one can criticize the trees of his argument, but I think he gets the forest right. This website has a collection of reviews, many of which are somewhat critical. Nonetheless, I found that hi...
Source: DB's Medical Rants - March 13, 2020 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
Internal Medicine is a Wicked Problem – implications
Currently listening to RANGE: Why Generalists Triumph in a Specialized World by David Epstein. In the first chapter he discusses the differences between wicked problems and kind problems. For example, chess is a kind problem. It has specified rules and clear outcomes. Because it is a kind problem, AI can successfully play the game. Wicked problems do not have rules or even a single known solution. One cannot always determine outcomes because we have many variables and many dimensions to the outcomes. Internists face wicked problems regularly. Many of us chose internal medicine because we love the challenge of these wick...
Source: DB's Medical Rants - March 5, 2020 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
Can Startups Save Primary Care?
By ANDY MYCHKOVSKY Today, primary care is considered the bee’s knees of value-based care delivery. Instead of being viewed as the punter of the football team, the primary care physician (PCP) has become the quarterback of the patient’s care team, calling plays for both clinical and social services. The entire concept of the accountable care organization (ACO) or patient-centered medical home (PCMH) crumbles without financially- and clinically-aligned PCPs. This sea change has resulted in rapid employment or alignment to health systems, as well as a surge in venture capital being invested into the primary car...
Source: The Health Care Blog - March 3, 2020 Category: Consumer Health News Authors: Christina Liu Tags: Health Tech Primary Care Start-Ups ACOs Adelade Andy Mychkovsky ChenMed Iora Health Oak Street Health One medical Population Health Privia Health Startups VillageMD Source Type: blogs
Health Care in Prison: Legal vs. Ethical Obligations
In 1976, the U.S. Supreme Court ruled that jails and prisons must provide medical care to incarcerated people on the grounds that “deliberate indifference to serious medical needs” violates Eighth Amendment protections against cruel or unusual punishments (Estelle v. Gamble, 429 U. S. 97). Prior to this, the only medical care offered in 65% of U.S. jails was first aid (Steinwald et al. 1973, in Rold 2008). The case, Estelle v. Gamble, made incarcerated people the only group of Americans other than Native Americans with a constitutionally protected right to health care. However, because federal la...
Source: blog.bioethics.net - March 2, 2020 Category: Medical Ethics Authors: Bioethics Today Tags: Health Care Author: Crane Inmate prison syndicated Source Type: blogs
How eConsults Can Help PCPs Benefit From the Primary Cares Initiative
Conclusion Primary care has increasingly been recognized as the key to addressing many lingering issues within the United States patient population, and the Primary Cares Initiative offers new models to support leveraging primary care physicians to improve performance in terms of health care costs, efficiency of care, patient outcomes, and overall satisfaction. By implementing innovative asynchronous telehealth technologies such as eConsults–aimed to overcome access, quality, cost and satisfaction challenges stemming from the specialist referral system–PCPs gain a means to play an even more integral and acti...
Source: The Health Care Blog - February 28, 2020 Category: Consumer Health News Authors: Christina Liu Tags: Health Policy Primary Care Value-Based Care AristaMD Chris Jaeger eConsults primary cares initiative Source Type: blogs
Here ’s why you should get a chaplain for your patient
It was my first week of internal medicine rotation. A newly-minted third-year, I was rotating on the wards back in the spring, when I met a 90-something-year-old gentleman. He had come in for confusion after a fall. There were no relatives or friends in the waiting room. I was assigned to follow him. During his […]Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - February 26, 2020 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/anna-delamerced" rel="tag" > Anna Delamerced < /a > < /span > Tags: Education Hospital-Based Medicine Medical school Source Type: blogs
Here ’s How We Did It: Eliminating Barriers of Early Medical Education Scholarship
Although a randomized, controlled education study may be the ultimate goal in medical education research, a new attending physician may not possess the confidence, experience, or skills to do so in year one. In our Academic Medicine Last Page “Hit the Ground Running: Engaging Early-Career Medical Educators in Scholarly Activity,” we encourage our physician colleagues to broaden the scope of what counts as medical education scholarly work by presenting four tips for learning the landscape, four types of presentation-based work, and four types of publication-based work in order of complexity. To supplement this g...
Source: Academic Medicine Blog - February 18, 2020 Category: Universities & Medical Training Authors: Guest Author Tags: Featured Guest Perspective faculty development medical education scholarship mentorship scholarly publishing Source Type: blogs
The Step 1 Score Reporting Change – A Step in the Right Direction for IMGs?
By TALAL HILAL, MD The United States Medical Licensing Examination (USMLE) Step 1, a test co-sponsored by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME), has been the exam that people love to hate. For many years, blogs, Twitter feeds, and opinion pieces have been accumulating urging the presidents of the FSMB/NBME to stop reporting a 3-digit score and instead report a pass/fail score. This animosity towards the Step 1 exam originates from the reality that medical schools have increasingly focused their curriculum on teaching what the Step 1 wants you to learn – me...
Source: The Health Care Blog - February 14, 2020 Category: Consumer Health News Authors: Christina Liu Tags: Medical Education Medical Practice Physicians FSMB IMGs international medical graduates Match NBME Residency Step 1 Step 1 Madness Talal Hilal USMLE USMLE Step 1 Source Type: blogs
The Primary Cares Initiative: How Value-Based Payment Models Aim to Strengthen Primary Care
Conclusion The Primary Cares Initiative represents not just a single push to improve the health care system as a whole through primary care, but an overarching drive to do so via many initiatives and programs. Bringing more practices on board with initiatives such as the PCMH, CPC+, innovation within Medicare Advantage, and the Primary Cares Initiative will undoubtedly solidify the success of these and future programs, as stakeholders and policymakers come to a greater understanding of how to incentivize and create a path toward improved health care outcomes. Chris Jaeger is the Advisor for ACO and Health System Stra...
Source: The Health Care Blog - February 11, 2020 Category: Consumer Health News Authors: Christina Liu Tags: Health Policy Primary Care AristaMD Chris Jaeger CMS primary cares initiative Source Type: blogs
With a little planning, vegan diets can be a healthful choice
Recently there has been much discussion and many questions about vegan diets. Are vegan diets — which exclude meat, poultry, seafood, eggs, and dairy — healthful? Do they provide complete nutrition? Should I try one? Will it help me lose weight? Many people around the world eat plant-based diets for a variety of reasons, some because meat is not readily available or affordable, others because of religious convictions or concerns about animal welfare. Health has become another reason people are moving to plant-based diets. And research supports the idea that plant-based diets, including vegan diets, provide heal...
Source: Harvard Health Blog - February 6, 2020 Category: Consumer Health News Authors: Katherine D. McManus, MS, RD, LDN Tags: Healthy Eating Source Type: blogs
PA Medical Society and MOC
Are medical societies advocating to end the unproven American Board of Medical Specialties' Maintenance of Certification (MOC) mandate or are they burying the controversy? In 2016, the Pennsylvania Medical Society (PAMed) issued a strongly-worded "Vote of No Confidence" against the American Board of Internal Medicine (ABIM). Good luck finding that earlier statement on PAMed's webpage concerning (Source: Dr. Wes)
Source: Dr. Wes - February 4, 2020 Category: Cardiology Authors: Westby G. Fisher, MD Source Type: blogs
Growing Consensus on the Need to Revise the Uniform Determination of Death Act
With law and neurology colleagues, I published two articles, in the past few weeks, that propose a Revised Uniform Determination of Death Act, the RUDDA. The shorter article is in the Annals of Internal Medicine. The longer article is in the&nbs... (Source: blog.bioethics.net)
Source: blog.bioethics.net - January 30, 2020 Category: Medical Ethics Authors: Thaddeus Mason Pope, JD, PhD Tags: Health Care syndicated Source Type: blogs
How to Empower Medical Residents to Speak Up and Share Their Suggestions for Change
Medical residents are experts on work “how it’s done,” as they work at the frontline of health care delivery day in day out. This means that they are valuable sources of information to improve the quality of health care. However, my colleagues’ and my research, presented in a recent Academic Medicine article, suggests that residents tend to remain silent when they have ideas for change. In short, they feel that it is not safe to speak up or that it would not make a difference. In this blog post, I offer suggestions for how to empower medical residents in your training program or organization to shar...
Source: Academic Medicine Blog - January 28, 2020 Category: Universities & Medical Training Authors: Guest Author Tags: Featured Guest Perspective quality improvement quality of care residents speaking up Source Type: blogs
Beyond heart health: Could your statin help prevent liver cancer?
Liver cancer is hard to treat. It’s a top-five cause of cancer-related death worldwide and a growing cause of cancer-related deaths in the United States. Since liver cancer is often found at a late stage, when treatment has limited benefit, there has been increasing interest in prevention. That’s where statin medications might come in. Liver cancer is usually caused by chronic liver disease, so an important way to prevent liver cancer is to treat the underlying trigger. For example, curing hepatitis C infection — an important cause of chronic liver disease — reduces the risk of liver cancer. However...
Source: Harvard Health Blog - January 27, 2020 Category: Consumer Health News Authors: Irun Bhan, MD Tags: Cancer Drugs and Supplements Health Source Type: blogs
Menopause and insomnia: Could a low-GI diet help?
Sleep disturbances such as insomnia are extremely common, especially in women after menopause. According to data from the National Institutes of Health, sleep disturbance varies from 16% to 42% before menopause, from 39% to 47% during perimenopause, and from 35% to 60% after menopause. Insomnia is a serious medical problem defined by frequent difficulty falling or staying asleep that impacts a person’s life in a negative way. Hormone changes around menopause can lead to sleep problems for many reasons, including changing sleep requirements, increased irritability, and hot flashes. What menopausal women eat could have...
Source: Harvard Health Blog - January 17, 2020 Category: Consumer Health News Authors: Monique Tello, MD, MPH Tags: Fatigue Food as medicine Healthy Eating Menopause Nutrition Sleep Source Type: blogs
Who Is the ABIM Chief Medical Officer?
Drs. Richard G. Battaglia and Richard Baron(Image from the ABIM Blog) Who is Richard G. Battaglia, MD? In 2015, the American Board of Internal Medicine (ABIM) announced Richard G. Battalgia, MD as their new Chief Medical Officer (CMO). This was the same year the American Board of Medical Specialties (ABMS) paid $922,479 to PriceWaterhouseCooper LLP (PwC) for "Manag ement Consulting:" What (Source: Dr. Wes)
Source: Dr. Wes - January 16, 2020 Category: Cardiology Authors: Westby G. Fisher, MD Source Type: blogs
Who Is the ABIM Chief Medical Officer?
Who is Richard G. Battaglia, MD? In 2015, the American Board of Internal Medicine (ABIM) announced Richard G. Battalgia, MD as their new Chief Medical Officer (CMO). This was the same year the American Board of Medical Specialties (ABMS) paid $922,479 to PriceWaterhouseCooper LLP (PwC) for "Management Consulting:" What the ABIM website fails to mention with their announcement, is that Mr. (Source: Dr. Wes)
Source: Dr. Wes - January 15, 2020 Category: American Health Authors: DrWes Source Type: blogs
The Study We Weren't Supposed to See
Most US physicians are well-acquainted with the American Board if Internal Medicine's (ABIM) breathless claims of ABIM board certification and Maintenance of Certification's benefits. These have included: The Public Expects It Physicians Value It Amount of clinical experience does not necessarily lead to better outcomes or improvement of skills Certification is Associated with Better Care But (Source: Dr. Wes)
Source: Dr. Wes - January 13, 2020 Category: Cardiology Authors: Westby G. Fisher, MD Source Type: blogs
From Lifespan to Healthspan: Brain Scientists Tap Into The Secrets Of Living Well Longer
Yolanda Esparza (right) and Mary Lyons (left) continue their 2‑mile group trail ride originating from the Conley-Guerrero Senior Activity Center in Austin, Texas, on Dec. 3, 2019. (Julia Robinson for KHN) _____ AUSTIN, Texas — Retired state employees Vickey Benford, 63, and Joan Caldwell, 61, are Golden Rollers, a group of the over-50 set that gets out on assorted bikes — including trikes for adults they call “three wheels of awesome” — for an hour of trail riding and camaraderie. “I love to exercise, and I like to stay fit,” said Caldwell, who tried out a recumbent bike, a low-i...
Source: SharpBrains - January 8, 2020 Category: Neuroscience Authors: Sharon Jayson at KHN Tags: Cognitive Neuroscience Education & Lifelong Learning Health & Wellness behavioral neuroscientists brain brain-body connection brain-training-exercises cognitive decline Golden Rollers healthspan keep-brain-sharp lifespan nutritioni Source Type: blogs
A primary care physician at his peak is forced into early retirement
Time is of the essence. The very utterance of this phrase connotates a sense of urgency for an impending crisis or adversity if some essential action is not taken. I find myself most unexpectedly at this crucial junction. I am a seasoned, experienced general internal medicine physician, trained traditionally in hospital medicine, and subsequently evolved […]Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - January 6, 2020 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/ross-l-fisher" rel="tag" > Ross L. Fisher, MD < /a > < /span > Tags: Physician Primary Care Source Type: blogs
40 years of ward attending
January 1, 1980 I walked onto the 7th floor of the old North Hospital at the Medical College of Virginia to make rounds as the attending physician. I had spent much time there as an intern and resident, but now I had a new role. As I reflect on 40 years and probably between 12 and 15 years of total time making rounds, I first feel fortunate that I quickly discovered that my vocation was also my avocation. Now while I have retired from administrative responsibilities, I still devote 3.5 months each year to rounding with students, interns and residents. And each rotation still brings out the same excitement of going to t...
Source: DB's Medical Rants - January 2, 2020 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
Pyrethroid insecticides may increase cardiovascular mortality
A study published in JAMA (Journal of American Medical Association) Internal Medicine evaluated the environmental exposure to pyrethroid insecticides by checking the levels of general pyrethroid metabolite 3-phenoxybenzoic acid in urine samples . Pyrethroids are used in mosquito repellents, lice shampoos and pet sprays are generally considered to be safe insecticides. But this study found that higher levels of pyrethroid metabolites in urine over a 14 year observation period was associated with a higher risk of death from all causes or from cardiovascular diseases. The study involved 2116 adults aged 20 years or more w...
Source: Cardiophile MD - January 1, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
An omnivore ’s dilemma: How much red meat is too much?
In October 2019, the Annals of Internal Medicine published controversial guidelines advising Americans to carry on consuming red and processed meat at current amounts. The guideline authors characterized meat-eaters as somewhat incapable of dietary change, and portrayed the benefits for reducing red and processed meat intake as insignificant. These guidelines contradict previous studies that link processed meat and red meat with early death and an increased risk of disease, including cardiovascular disease (CVD) and cancer. If omnivores are confused, it’s hard to blame them. Americans are eating less meat, but not le...
Source: Harvard Health Blog - December 30, 2019 Category: Consumer Health News Authors: Emily Gelsomin, MLA, RD, LDN Tags: Health Healthy Eating Source Type: blogs
It ’ s Time to Revise the Uniform Determination of Death Act
I have recently participated in a series of articles that call for amendments to the Uniform Determination of Death Act, the law that establishes who is alive and who is dead in every U.S. jurisdiction. The first of these articles is now available from the Annals of Internal Medicine: "It's Time to Revise the Uniform Determination of Death Act." Ariane Lewis, Richard Bonnie, and I argue that it is time to revise the UDDA to legally standardize death declaration around the country by: 1. Specifying the “accepted medical standards” 2. Indicating whether hormonal functions are included in &ldq...
Source: blog.bioethics.net - December 24, 2019 Category: Medical Ethics Authors: Thaddeus Mason Pope, JD, PhD Tags: Health Care syndicated Source Type: blogs
Cardiology MCQ – Type of respiratory failure in shock – Answer
Cardiology MCQ – Type of respiratory failure in shock Type of respiratory failure in shock: Correct answer: 4. Type 4 Type 1: Hypoxic respiratory failure Type 2: Hypercapnic respiratory failure Type 3: Perioperative respiratory failure due to atelectasis Type 4: Hypoperfusion of respiratory muscle in shock Back to question Reference Harrison’s Principles of Internal Medicine, 20th Edition (Source: Cardiophile MD)
Source: Cardiophile MD - December 21, 2019 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs