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Dating An American Medical Student? Some Financial Advice

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The average medical school debt today, according to the Association of American Medical Colleges, is $156,456.

The United States is the only country in the world were future doctors have to bear such a financial burden of their education. That places significant strain on any relationship involving an American medical student.

Recently, there was an interesting piece in the New York Times discussing this very issue. The article profiled a female medical student who had amassed $250,000 of school debt:

Still, if she and [her boyfriend] Mr. Kogler are going to move in together and get engaged, she wants their financial arrangements to be clear and fair. But how do you define fair when you’re bringing a quarter of a million dollars in debt to a relationship?

Indeed. It’s an issue that’s rarely discussed, yet frequently encountered by medical students. With that degree of debt, there is little room for flexibility should one’s future plans change. You have to continue working to pay off the loan. Read more »

*This blog post was originally published at KevinMD.com*

Tech-nitis: New “Overuse Injuries” From Too Much Personal Technology

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It’s not surprising to people that I’m a “techy” type of guy. Reading tech stories about the latest gadgets is a nice occasional escape from work. One of the ways that medicine and tech intersect is in some “overuse injuries” that I’ve seen and talked with people about. When the Nintendo Wii first came out, there were many stories of “Wii-itis” and tendonitis-related injuries.

Last week American Medical News interviewed me for a story posted on their site [on September 27th] called “New Personal Technology Creating New Ailments.” The article opens like this:

When Mike Sevilla, MD, sees young patients at his Salem, Ohio, family practice, he often finds them text messaging or listening to music on portable media players. These tech-savvy patients may not realize it, but they could be on the way to developing health problems related to overuse of personal technology. That’s why Dr. Sevilla uses such exam room encounters as a springboard to talk about the potential health impact of today’s tech devices.

“I talk about listening to loud music and being distracted while driving. … I bring up those examples of people who were hurt or killed because they could not disconnect themselves from their cell phone,” he said. Dr. Sevilla and other physicians across the nation are adding questions about cell phone use and computer habits to the office visit at a time when dependence on electronic devices has reached unprecedented levels.

The article goes on to say that the most common physical problems that are seen include problems with vision, elbow, thumb, and wrist. These are due to prolonged use of computers and mobile devices like cell phones and electronic handheld devices. Read more »

*This blog post was originally published at Doctor Anonymous*

The Government’s Involvement In New Primary Care Models

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Government healthcare reform efforts are picking up the pace to roll out new reimbursement and practice models for primary care.

Medicare is giving out $10 billion for pilot projects encouraging new models of primary care, including the patient-centered medical home. New Jersey just passed legislation to explore the patient-centered medical home. Now, Massachusetts, the early adopter of mandatory health insurance, is now ambitiously planning how to take on the fee-for-service reimbursement system and moving toward accountable care organizations. Under discussion are the scope of power for state regulators, what rules will apply to accountable care organizations, and how to get rid of the existing fee-for-service system.

Blogger and pediatrician Jay Parkinson, MD, MPH, comments about the “bureaucrats in Washington” that, “they’ve decided for doctors that we’ll get paid for strictly office visits and procedures when, in fact, being a good doctor is much, much more about good communication and solid relationships than the maximum volume of patients you can see in a given day.”

Now, it’s those same bureaucrats who are changing the system, trying to find a model that will accomplish just those goals. (CMS Web site, NJ Today, Boston Globe, KevinMD)

*This blog post was originally published at ACP Internist*

Why Pain Can’t Be A Vital Sign

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There’s been a movement afoot for several years now to quantify pain as the so-called “Fifth Vital Sign.” It all started as a well-intentioned effort to raise the level of awareness of inadequate pain control in many patients, but has gotten way out of hand. The problem is that the word “sign” has a specific meaning in medicine that, by definition, cannot be applied to pain.

When you hear us medicos talk about “signs and symptoms” of a disease, it turns out that they are not the same thing. “Symptoms” are things the patient experiences subjectively. “Signs” are things that can be observed objectively by another person.

Headache is a symptom; cough is a sign. Itching is a symptom; scratch marks over a blistery linear rash are a sign. Vertigo, the hallucination of movement, is a symptom; nystagmus, the eye twitching that goes with inner ear abnormalities that can cause vertigo, is a sign. If someone other than the patient can’t see, hear, palpate, percuss, or measure it, it’s a symptom. Anything that can be perceived by someone else is a sign. Read more »

*This blog post was originally published at Musings of a Dinosaur*

An Obesity-Causing Virus?

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Finally, the answer to the obesity epidemic. [According to the LA Times], it’s a virus:

New evidence indicates that children who are exposed to a virus called adenovirus-36 are more likely to be obese than those who are not exposed to it, and to be heavier than other obese kids who were not exposed to it, researchers said this week. The virus…is one of 10 bacteria and viruses that have been associated with a propensity for putting on plural poundage.

Maybe this explains why I and two of my sisters all became fat in the same year. Well, that — combined with the fact that we had just moved to a new neighborhood where there were no kids we knew to play outside with, and we started taking a bus to school instead of walking, and “Dark Shadows” had just started, leading us to spend every afternoon after school snacking in front of the TV. But I like to think it was a virus.

*This blog post was originally published at tbtam*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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