What is mental illness? Words matter.

Posted on 25. Apr, 2015 by in conditions, Psychiatry

I’ve been invited to speak to a group of attorneys who work at the interface of psychiatry and the law. The topic of my talk? “Psychiatry 101.” A psychiatrist who gave this talk to a similar group a few years ago advised me: “You should assume that lawyers are laymen. It’s surprising how little they […]

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There are limitless opportunities to practice high-value, cost-conscious care

Posted on 25. Apr, 2015 by in Policy, Primary care

I am not an economist. This is how I start my high-value care session during the internal medicine clerkship orientation day at the Medical College of Wisconsin (MCW), and it is absolutely true.  It doesn’t take an economist, though, to realize that health care is too expensive.  Health care spending as a percentage of GDP […]

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IMGs matching into surgery: What are the chances?

Posted on 25. Apr, 2015 by in Education, Residency, Surgery

Anyone considering attending a Caribbean or any foreign medical school should do due diligence. An Internet search is step one. If the school does not list residency match statistics, that could be a red flag. It would not be easy to accomplish, but try to speak with some current students or recent graduates of any […]

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Why I love being an angel investor

Posted on 25. Apr, 2015 by in Uncategorized

I just attended a Board Meeting of Bibox, where Madhu and Sandeep presented the cutting edge work they are doing in sparking innovation in school children using the Bibox kit.They help children to sharpen their “Innovation Quotient” by improving their …

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Open Letter to Minnesota’s Heath Commissioner Dr. Edward Ehlinger on ill-informed health IT puff piece

Posted on 25. Apr, 2015 by in Chair Adam Duininck, Commissioner Kevin Lindsey, Commissioner Lucinda Jesson, Edward Ehlinger, healthcare IT myths, healthcare IT risk, Minnesota Heath Commissioner, minnpost.com

Minnesota’s Heath Commissioner Dr. Edward Ehlinger penned a puff piece on EHRs entitled “Electronic health records advance quality care for all Minnesotans” (Minn Post, 4/23/15, http://www.minnpost.com/community-voices/2015/04/electronic-health-records…

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MKSAP: 48-year-old woman with gradual weight gain

Posted on 25. Apr, 2015 by in conditions, obesity

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 48-year-old woman is evaluated during a routine examination. She is concerned about her gradual weight gain over the years and requests counseling on how she can most effectively lose weight. Over 8 years, she has gained approximately 18 kg (40 […]

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Why Not Grow Embryos to Day 10 in the IVF Lab ?

Posted on 24. Apr, 2015 by in Blastocyst, hatched blastocyst, hatching blastocyst, IVF blastocyst, IVF blastocyst success rates

We know that pregnancy rates are better with day 5 embryos rather than day 3 embryos because the chances of a day 5 embryo implanting are better than those of a day 3 embryo implanting.  This is because if we grow the embryos to day 5, we allow th…

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An inadvertent physical exam

Posted on 24. Apr, 2015 by in Palliative care, patient, Primary care

“Nobody does this …” Dr. D said as a greeting as he walked in holding the 700-word letter I had sent him some weeks before my periodic physical examination. Half the letter addressed six issues that had arisen during the year and a half since my last physical. I thought, nearing age 62, that it’d […]

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So you want to be a female surgeon.  Here are 10 tips to make it.

Posted on 24. Apr, 2015 by in Physician, Surgery

I am lucky enough, from time to time, to be invited to speak to young women who want to be surgeons when they “grow up.” I always have a hard time striking a balance between what I should share that is positive and inspirational and what I should share that is a little harsh and […]

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A vision for a more efficient, more elegant health care visit

Posted on 24. Apr, 2015 by in Physician, Primary care

As a patient, I would like a primary care visit that is pleasant, comprehensive, convenient, and efficient. As a future practitioner, I hope for a visit that is unhurried, educational, efficient, and holistic. We may have through all these years grown accustomed to the status quo — on both ends — that is, we have […]

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Can pharmacists refuse to fill prescriptions?

Posted on 24. Apr, 2015 by in Medications, Meds

I argue that pharmacist should fill prescriptions even if their own morals do not agree. Pharmacists should not be limiting someone from getting something they may need because they do not agree with it. Pharmacists have no right putting their business (ideology) where it doesn’t belong. Continue reading … Your patients are rating you online: […]

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The Elizabeth Sedway case: In defense of Alaska Airlines

Posted on 24. Apr, 2015 by in Cancer, Physician

Elizabeth Sedway, a 51-year-old undergoing treatment for multiple myeloma, was outraged to be removed from a Hawaii-San Jose flight due to concerns about her health.  Wearing a mask to prevent infection as her immune system was compromised from chemotherapy, she requested handicapped seating and told an airline employee she felt “weak.”  The employee consulted with […]

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Medallion Quilt

Posted on 24. Apr, 2015 by in friends, quilt

I made this medallion quilt for someone I know who has metastatic lung cancer.  The quilt is machine pieced and quilted.  It measures 47 in X 64 in.   The inner square was a pre-marked piece.  The fabric adjacent to it is a …

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The arc of injustice: How racism kills

Posted on 24. Apr, 2015 by in Physician, Primary care

The tragic deaths of Oscar Grant, Michael Brown, Eric Garner, Tamir Rice, Walter Scott, and untold others, deeply grieve our national conscience. But more black men die in America from heart disease than from police brutality, and we never mention those parallel realities in the same breath, let alone collectively mourn those dead. Why is […]

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Overconfident IVF experts

Posted on 23. Apr, 2015 by in Dr.Malpani, IVF clinic, ivf hype, IVF treatment, ivf trend

IVF specialists come in all shapes and sizes.Some are conservative. They respect their patients , and are open and transparent with them. They share both their knowledge and ignorance , and are happy to discuss the limitations of IVF technology and the…

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Repeat IVF Cycles

Posted on 23. Apr, 2015 by in failed IVF cycle, IVF failure, repeat IVF cycle, second IVF cycle

Women who are doing their second IVF cycle will often find their experience very different from their first IVF cycle.  In some senses , the second IVF cycle is a lot easier because patients have already been through a cycle, so they understand ex…

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A brief history of the EHR

Posted on 23. Apr, 2015 by in Health IT, Primary care, Tech

A guest column by the American College of Physicians, exclusive to KevinMD.com. So far, 2015 has been a busy year for reflecting on the use of electronic health records (EHRs). CMS just released its proposed rules for meaningful use stage 3. One might say that “MU 3” supports the belief that the sequel is never as good […]

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Creating the safe place for patients and caregivers

Posted on 23. Apr, 2015 by in Uncategorized

Here’s a beautiful video presented by David Mayer, Vice President of Quality and Safety for MedStar Health, as an attachment to a column he recently posted on Educate the Young,  He says:High Reliability science is one area we are looking to for a…

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How Murphy’s law applies to medical students

Posted on 23. Apr, 2015 by in Education, Medical school, Surgery

If the analogy between medical training and a fraternity is true, then medical students are the pledges. For many, the most grueling part of this pledge process is the third year surgery rotation where the modified Murphy’s Law is applicable almost daily: Anything a medical student can do wrong, a medical student will do wrong. […]

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Do we neeed to worry about the right ventricle in endurance exercise?

Posted on 23. Apr, 2015 by in Uncategorized

Is the right ventricle the Achilles heel of endurance exercise? I wrote briefly about this subject in 2007 .In that regard there is more data now about which to fret.  A 2011 article by researchers in Australia and Belgium  gives reason to be…

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Sorry, but I’m not part of the ancillary staff. I’m a physician.

Posted on 23. Apr, 2015 by in Hospital, Physician

A few months ago, I was on call as a cardiology fellow, and I had to go up to one of the inpatient floors to do a stat echocardiogram on a patient. Given how hemodynamically unstable he was, I was rushing to the room as fast as I could with this hefty machine that could […]

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The trade-offs of statins: How much benefit is needed for you to take a pill?

Posted on 23. Apr, 2015 by in Medications, Meds, Primary care

Do you like to take pills? I don’t. I bet most family physicians would say they have some patients who should be better at taking pills and some who love taking pills too much. For people who don’t like taking pills, what would a trade-off look like? If you were given the option of living […]

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My first experience with a dead body

Posted on 23. Apr, 2015 by in Physician, Primary care

I assumed she asked because besides being a hospice volunteer,  I was a medical student and wouldn’t get spooked by a dead body.  She probably didn’t realize that it was my first week of classes, and I hadn’t experienced much yet. She walked into the room with her head slightly bowed forward.  She was physically […]

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Unity Farm Journal – Fourth Week of April 2015

Posted on 23. Apr, 2015 by in Uncategorized

This week a coyote visited the barnyard during the day.   Daytime activity is not unusual for females which have an active den of hungry pups.   We have fox, coyote, and fisher cat dens at Unity Farm, so there is a high predator load.   …

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MiM Mail: Part-time residency?

Posted on 23. Apr, 2015 by in MiM mailbag

Dear Colleagues and mothers, I’m a final year IMG who, just like my husband, soon am about to apply for residency. The thing is that I am also a mother, and that’s why I’m now writing here. I consider myself ambitious and strive to become a well-educat…

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The April 2015 HIT Standards Committee Meeting

Posted on 22. Apr, 2015 by in Uncategorized

The April 2015 HITSC meeting focused on the Certification Rule NPRM and a comprehensive review of the Federal Interoperability Roadmap.I suggested that a guiding principle for the committee’s work is to emphasize the enablers in the proposals while r…

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I Cannot Give my Wife a Child !

Posted on 22. Apr, 2015 by in Azoospermia, infertile man, male infertilty, zero sperm count

The young man sitting in front of me was crying.  ‘I have failed my wife, Doctor, I have failed to give her a child.  My sperm count is zero which means I’m shooting blanks which means she will never be able to become a mother.  Really, …

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The next bend up in the cost curve: Rising prices for old proven drugs?

Posted on 22. Apr, 2015 by in Uncategorized

A anesthesiologist friend sent me the note below. If accurate, as this doctor says, “The expense of the surgical robot will pale in comparison to the coming tsunami of overpriced drugs!”  I’m hoping some full-time health care reporters take a look…

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Is the doc-fix bill worse than SGR?

Posted on 22. Apr, 2015 by in Uncategorized

Here is what Dr. Scott Gottlieb has to say in his Forbes column on 3/19/15:”The current Medicare reforms being put before Congress ( he was writing before the bill was passed) are better than the existing scheme, the so-called sustainable growth rate …

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Medical jokes portray an unflattering picture of doctors in general

Posted on 22. Apr, 2015 by in Humor

From this French study:Sociological studies have shown the link between humor and unconscious ideas that we have of the society in which we evolve. Researchers conducted a survey to answer the question: “What were the stereotypes of our medical profess…

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