For the hundreds of thousands of Americans whose kidneys have stopped functioning, there are two options: lifelong dialysis or kidney transplantation.  Dialysis is time consuming, carries serious risks, and only partially replaces the functions of a healthy kidney.  Patients live longer and have a much better quality of life after receiving a kidney transplant.  The difficulty with transplantation...

My bachelor’s degree is in engineering.  (I hear all of you thinking “Ah!  No wonder he’s such a geek.”  But I was a geek long before that.)  In engineering, safety is an entire field of study with formal ways to account for and measure errors, plan for system failures, and quantify the likelihood of adverse outcomes. Until the last several years, medicine had a very different culture.  Tradition...

On January 1 the pharmaceutical industry started imposing on itself a ban against the branded gifts to doctors that have been a constant companion of pharmaceutical sales representatives.  The Post-It notes, pens and coffee mugs bearing the brand names of various medications are gone.  The paperweights and staplers and occasional plush toys with names of prescription antacids and antidepressants a...

Many people use the occasion of the New Year to reflect on the last year and make specific goals for the next.  Resolutions can be very helpful motivators if they are specific, realistic and written down.  Just as people make goals for their careers and their relationships, resolutions for your health are a smart way to work for achievable targets in the health-related struggles you face. So I en...

Every year the British Medical Journal has a Christmas issue devoted to more offbeat and lighthearted scientific studies.  This year’s issue had an article reviewing holiday themed medical myths. The article debunks the following myths:

• that sugar increases children’s hyperactivity
• that suicides increase around the holidays
• that poinsettias are poisonous for...

Or: Just Give it to Me Straight, Doc Any primary care physician from time to time has to give a patient bad news, sometimes terrible news.  These conversations can be extremely difficult for the patient and his loved ones, but also for the doctor.  When the patient is too sick to understand or participate in conversations about his prognosis and his treatment options, the terrible burden falls on...

This week an FDA advisory panel reviewed the evidence on asthma medication and released recommendations about a class of inhaled medications that may be unsafe.  Their conclusions drew much media attention. The panel’s concern is the increasingly worrisome evidence about long-acting beta agonists (LABAs).  LABAs are a family of inhaled medications including Serevent and Foradil which are frequent...

Almost everyone at some time becomes anxious about his health.  Even people who can stay calm through a stock market crash can get worried about new or nagging symptoms.  And while some anxiety about our health is perfectly normal, in some it can reach a level that interferes with day-to-day functioning and becomes incapacitating.  Even when it’s not that bad, anxiety about health is frequently mi...

Before we gather with loved ones to give thanks for our abundant blessings and eat until we lose consciousness, I wanted to take this opportunity to express my gratitude to you. To all my readers, thanks for all the medical news articles, the feedback and the encouragement.  The weekly writing would get very dull if I thought I was talking to myself. To all my patients, thanks for granting me th...

Early in life we all have to choose which of the seven dwarfs we want to be.  Most of us physicians, for mostly altruistic reasons, chose to be Doc.  But it turns out that many of us instead ended up being Grumpy. A survey of twelve thousand U.S. physicians released this week by the Physician’s Foundation paints a grim picture of our morale, and it received a lot of press.  78% of physicians beli...