Category: Conditions

Celebrity suicides make the irony of our era clear

These recent weeks have been hard for me, and I suspect for a lot of other people as well. Not because I spent it in a board review course listening to lectures for 12 hours a day, and not because I drank enough coffee to practically burn a hole in my stomach, but because the […]

MKSAP: 70-year-old man with a transient ischemic attack

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 70-year-old man is admitted to the hospital with a 1-hour episode of left arm and left leg weakness. He is diagnosed with a transient ischemic attack. The patient has a history of hypertension and type 2 diabetes mellitus and a […]

The art of medicine is needed to prevent migraine headaches

He spoke with an aura of superiority, in a slightly nasal voice, and his topic was migraines. It was in the late 70s, a time when there were few options to treat migraines. “Most people who claim to have migraines just have simple tension headaches,” he scoffed. And in a move that seemed unorthodox at […]

Restricting opioid prescribing: Some error has to be tolerated

I have written previously about the raging opioid epidemic in Ohio.  Attacking and reversing this tidal wave will require many weapons, resources and time.  Opioid addiction is a crafty and elusive adversary that will be difficult to vanquish.  Our battle plan will have to be nimble and adjusted over time, much as military leaders must do in actual armed […]

The risks of publically reported surgical outcomes

“Some data is better than no data at all.” Do you believe that? I heard it frequently when the infamous ProPublica’s Surgeon Scorecard first appeared three years ago. Back then I blogged about it saying “To me, bad data is worse than no data at all.” A recent study in BJU International confirmed my thoughts about this type of publicly posted […]

The risks of publically reported surgical outcomes

“Some data is better than no data at all.” Do you believe that? I heard it frequently when the infamous ProPublica’s Surgeon Scorecard first appeared three years ago. Back then I blogged about it saying “To me, bad data is worse than no data at all.” A recent study in BJU International confirmed my thoughts about this type of publicly posted […]

When does a condition become a medical issue?

It has become a sign of legitimacy to call a personal problem “medical.”  This aims to distinguish the problem from those of morality or character.  It implies both that the problem is serious, and that it is unbidden and largely out of the sufferer’s control.  Unfortunately, it isn’t clear what exactly qualifies as “medical,” so […]

Accept the decisions patients make

In an era where health information is freely flowing thanks to the internet and Dr. Google, I’ve come to expect that patients who see me for the first time will have done their homework — about their cancer, treatment options, and yes, even about me. To be frank, it’s not uncommon for patients to mention they’ve […]

The physician reluctance to seek mental health treatment

The recent suicides of an NYU resident and a medical student highlight the growing mental health problem among physicians and physicians-in-training in this country.  This crisis is certainly not exclusive to physicians, as evidenced by the suicides of designer Kate Spade and television personality Anthony Bourdain.  However, suicide among physicians is of particular concern.  A […]

MKSAP: 30-year-old woman with systemic lupus erythematosus

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 30-year-old woman is evaluated during a follow-up visit for systemic lupus erythematosus. She was diagnosed 3 months ago after presenting with pericarditis and arthritis. She was initially treated with prednisone, 40 mg/d, with improvement of her presenting symptoms. The prednisone […]