Word: internists
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...pregnant woman enough of the antibiotic to be effective. Kidney function is so revved up during pregnancy that even in high doses, amoxicillin is excreted before it can work its magic. Think of it as trying to fill a bathtub with the drain open, suggests Jason Umans, an internist and maternal-fetal pharmacologist at Georgetown University. "In emergencies, you always hear, 'Treat the pregnant women first!'" he says. "The joke should be 'Yeah, how?'" (See how the FDA classifies drugs and their effects on pregnancy...
...small operation) or put a cast on with the foot flexed down. The cast treatment isn't as good - it won't restore normal power - but there are none of the risks of surgery (like scarring and infection). So he demanded an MRI, which he got, then called his internist to ask for another specialist. "You're not playing any more basketball, at least not the kind that requires jumping, if you don't have that tendon repaired" is what I told him after taking him out of the cast and examining the ankle. "Can't we get another...
There has been much hand-wringing over the dangers of medical residents' grueling schedules. Doctors-in-training often forgo sleep entirely, racking up as many as 30 work hours in a single stretch. The term resident is in fact no accident, says Dr. Teryl Nuckols, an internist and assistant professor at the David Geffen School of Medicine at UCLA, who says that when she was in training 10 years ago, 36-hour shifts without rest were common. "[Residents] used to live in the hospital," Nuckols says. "They were there 24/7...
...Right now egg donors are treated like vendors, not as patients. Patients need to be followed up," says internist Jennifer Schneider, who has been advocating for the government to track egg donors since 2007, a few years after her daughter, a three-time egg donor, died of colon cancer at age 31. "After the first few days of being discharged from the IVF clinic and seeing that there were no immediate consequences, they are never contacted again...
...years as an internist, I have found that many of my patients' concerns are, in fact, spiritual. As their treating physician, I am often the first to identify these issues and provide appropriate care, and I continue to refer patients who have spiritual needs I am not trained to manage. My experience shows that physicians can and should get training to skillfully recognize and ethically provide initial spiritual care for patients, and to refer those needing more intensive follow-up. Harvey A. Elder, LOMA LINDA, CALIF...