Category: OB/GYN

MKSAP: 24-year-old woman with severe cramps associated with her menstrual periods

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 24-year-old woman is evaluated for severe cramps associated with her menstrual periods. The cramps have worsened over the past year, and the discomfort is severe enough that she has periodically missed work. She reports no abnormal vaginal discharge. Menses are […]

A health insurer’s true motives

A patient came to see me with lower abdominal pain.  Was she interested in my medical opinion?  Not really.  She was advised to see me by her gynecologist who had advised that the patient undergo a hysterectomy.  Was this physician seeking my medical advice?  Not really.   Was this patient coming to see me as her […]

Doctors are conditioned to deny

13 years ago a colleague of mine did a labiaplasty on my 18-year-old daughter for medical reasons. What was supposed to be routine has become a nightmare for her.  Not only did he remove all of her labia minora, but he also denervated her clitoris. When he saw her post-op, he told her she was fine, […]

Doctors are conditioned to deny

13 years ago a colleague of mine did a labiaplasty on my 18-year-old daughter for medical reasons. What was supposed to be routine has become a nightmare for her.  Not only did he remove all of her labia minora, but he also denervated her clitoris. When he saw her post-op, he told her she was fine, […]

Crying when a patient suffers a devastating loss

I was a second-year resident, doing a 24-hour shift on maternity care. I’d spent some arduous nights on call with my attending physician, Dr. Campbell. Now, we sat at the nursing station, joking about what this one might bring. “You must be a black cloud,” she teased, accusing me of being one of those unfortunate […]

Come see for yourself why medicine rarely runs on time

“Sorry, I’m running late … sorry, to keep you waiting.” How many times a day do I say that? Sometimes it is every time I walk into a patient’s room as if it is a normal greeting. Sometimes patients respond with: “Oh, you aren’t late” or “I haven’t been waiting long.” I can be so […]

Don’t tell patients they look great, except in these cases

One of my colleagues sat on a wheeled clinic stool at the end of the examination table and told the patient, which was in this case an actor, “Everything looks great.” After, he swiveled around to face the instructor and the small group of onlooking medical students behind him. Our instructor also turned to us […]