Latest news with #physician
Wall Street Journal
15 hours ago
- General
- Wall Street Journal
I'm 88 and Prospering Thanks to Routine PSAs
Regarding Allysia Finley's column 'Biden's Prostate Cancer and the Tyranny of the Experts' (Life Science, May 27): When I was 83, I was worked up thoroughly for a sudden rise in my routine PSA. Regular digital exam and special biopsy led to diagnosis of invasive but confined prostate cancer. Even though I had no symptoms of cancer, and knowing the arguments, I elected to have anti-gonadal and radiotherapy treatments. Whatever complications ensued were managed, and I have enjoyed more than five normal years with no PSA elevation. Without this intervention—and my defying the Preventive Services Task Force guidance—I might have been in the former president's present medical situation. I am still working as a physician, feeling useful and enjoying all there is to enjoy with the functional imperfections of being 88. One swallow doesn't make a summer but one contrary example can defy a rule.
Fox News
3 days ago
- General
- Fox News
I'm a physician and I'm worried that our health agencies are facing increasing chaos
The American health system is bleeding out, and it desperately needs a real doctor. Leading Health and Human Services (HHS) today is like navigating a chaotic hospital — patients in every hallway, monitors screaming, seconds ticking away. Yet, instead of a seasoned physician who triages and trusts proven protocols, that hospital is overseen by an activist named Robert F. Kennedy Jr. A patient's oxygen level plummets; nurses turn to HHS Secretary Kennedy. Instead of orders, they get a lecture on conspiracies. Chaos follows. That chaos is now national. Our health agencies are trying to perform open-heart surgery while debating the effectiveness of a scalpel. Scientists who should be developing next-generation cancer vaccines are, instead, defending 60-year-old elementary science. Conspiracy ideology is beginning to take over, and we're all going to pay the price. I'm a board-certified physician and one of the most-followed online, and since Kennedy took office, I've been forced to swap from fact-checking Instagram influencers to fact-checking the nation's top public-health official. Our nation's health system is in shambles, and the leadership of HHS plays a pivotal role in fixing this disaster. That's why it's deeply alarming that Kennedy, who continues to spread misinformation and denies the fundamentals of medicine, remains at the helm of the agency. Although he claims he's "not anti-vaccine," his words and actions tell a different story. He recklessly attacks vaccine efficacy, spreads disproven theories linking vaccines to autism, and denies fundamental virology — from diseases like HIV, measles, and more. I'm all for healthy skepticism, but scientific skepticism means investigating data, not cherry-picking it … or making it up. These aren't privately held beliefs either — a post on his active X account states that the HPV vaccine "increases cervical-cancer risk" all despite mountains of real-world data showing up to 88% drops in cancer among vaccinated teens. Sweden, England, and even the CDC surveillance report plunging pre-cancer rates. Recently, he claimed, "50% of the population is diabetic" and that "one out of every three kids" already has the disease. In reality, true estimates put China's diabetes prevalence around 12%, and the U.S. pediatric figure closer to one in 300. If one of my interns inflated numbers by a factor of 10, they'd be sent back to remedial math. Kennedy does it regularly on primetime television. Worse, he's now canceled $12 billion in disease outbreak prevention programs, proposed a 26% cut to the NIH budget, and pink-slipped roughly 20,000 public-health scientists and staff. Those decisions have consequences: dozens of federally funded vaccine clinics in Arizona, Minnesota, Nevada, Texas and Washington were canceled just as measles cases blew past 1,000 — the worst surge in a generation. He's dismantling the firehouse while buildings are burning. Public health cannot survive an HHS head who guts the programs that keep us safe and then fans the very myths that make outbreaks explode. Kennedy's long record of undermining proven public health measures and spreading scientific falsehoods makes him a threat to millions of Americans. Certainly, he should never have been confirmed to lead the office in the first place, but choosing to leave him in charge is like handing the keys to a driver who continues to insist that stop signs and red lights are optional. Today, I say that Kennedy is the wrong person to lead HHS. The integrity of our nation's health agencies demands leadership grounded in facts, research, and transparency — not misinformation. Doctors like me take an oath to 'do no harm.' We must call out leaders like Secretary Kennedy when they cause great harm to public health. We must stop the bleeding.
Medscape
23-05-2025
- Health
- Medscape
Going From Resident to Attending Can Be ‘Scary, Lonely'
Alex Jahangir, MD, was thrilled 16 years ago to land a job as an orthopedic trauma surgeon at Vanderbilt University Medical Center in Nashville, Tennessee. But between the time he was hired and the time he started his job, turmoil erupted within the department leaving him without much support. Alex Jahangir, MD One of the partners in the practice became ill, and 'a lot of extra hands' were needed, Jahangir said. Yet several other surgeons had left. When he arrived for his first day of work, he didn't have an office space or a parking badge, and he was the only doctor taking calls for the team. 'What have you gotten yourself into?' he recalls his wife asking him. Once a physician completes residency or fellowship training and becomes an attending physician, 'the buck stops with you,' Jahangir told Medscape Medical News . Even for physicians entering jobs without the turmoil Jahangir experienced in his department, the transition to attending is not easy. 'Truly…it's scary, it's hard, it can be very lonely…,' he said. 'As an attending, all of a sudden you realize people will listen to you and…maybe you're not fully sure that's the right thing to do or say, but you recognize 'Hey…this is what I have to do,'' Jahangir said. Residency training is generally done in a stepwise fashion with increasing levels of responsibility over the years, said John Allen, MD, assistant dean of student affairs at the University of Maryland School of Medicine in Baltimore. Most young attendings are 'very well prepared and able to jump right in,' he said. Still, becoming an attending is a transition. 'The biggest difference to me was things that felt routine when I was a resident — when I had that safety net — suddenly felt like much higher stakes when I was an attending,' Allen said. What are the best ways to navigate the transition from resident to attending with the accompanying shifts in responsibility and accountability? Medscape Medical News reached out to experts in the field to get their take. 'So Hard' 'The first year is so hard because we all have complications. We all feel the stress of everything, thinking you should have all the answers,' said Jahangir, who now serves as vice chair in the Department of Orthopaedic Surgery and senior vice president for Provider Network Development at Vanderbilt University Medical Center. John Allen, MD Young doctors need to recognize what they don't know, Allen said, adding that this self-awareness is important at all levels of training but becomes even more key when doctors become attendings. It's important to realize that mistakes can happen, Jahangir think you're the only one who has ever had this happen, he said. Staying up to date on medical guidelines and research becomes more self-driven as an attending, Allen said. Continuing medical education is more 'curated' during training years and that changes as an attending. 'Make sure that you're reading. Staying current becomes more of something you have to deliberately do as an attending,' Allen said. At the same time, a little grace is good. Recognize that it is normal to feels self-aware that you don't have much experience as a new attending. Imposter syndrome is real, Allen said. 'A lot of people do experience that when they're a new attending,' he said. 'As you settle in and realize that you're making good decisions, you are helping, that imposter syndrome does tend to lift over time.' Only after 16 years of practice can Jahangir finally say that when a student or resident approaches him to discuss a patient case, based on his breadth of knowledge in orthopedic trauma surgery, 'I probably have seen it or have heard about it or could have an intelligent conversation about it,' he said. Not only the practice of medicine but also people skills matter, Jahangir said. For example, if early career surgeons don't learn certain skills — like how to manage an operating room — well in the first year or two of practice, 'I think it leads to a cascade of bad stuff that can happen in one's career that may eventually lead you to quit medicine, or to have a bad patient outcome, or to have a bad professional or liability outcome,' Jahangir said. Be Thoughtful in Job Searching There are also steps a resident or fellow can take before becoming an attending to help ease the transition, such as being proactive when job searching, experts said. 'It's good to get a sense of the partners you're joining,' Jahangir advised and to see what the general 'gestalt' is at the practice. 'Because if you have a bunch of partners that obviously aren't, don't care and only see you as a source so they have to take less calls, that may not result to a long-term successful practice,' he said. Before signing on, early-career doctors should also ask about how the practice supports a new physician, Jahangir advised. Try to find out how many doctors have left the practice within the first 2 years of joining, he suggests. 'Practices that have physicians that stay there 20, 30 years are probably a good, functional group of people.' Maria Phillis, MD It's also crucial to read your employment contract carefully before accepting your first job out of residency or moving to a new one, said Maria Phillis, MD, an Ohio physician who is also chair of the Young Physician Section at the Ohio State Medical Association, Columbus, Ohio, a lobbying group. Phillis also has a law degree. 'Like really read it,' she said of the contract. 'Really understand what [malpractice] coverage you are being offered. If it doesn't explain in your contract what that looks like, then ask for supplemental documents or policies that exist,' she said. 'Have a really clear understanding of what it is that the hospital is willing to cover for you, whenever you leave that position,' Phillis said. Many early-career doctors change jobs within a couple of years, so it's important to make sure that you have a tail coverage that's either covered by your employer or that you're covering, Phillis said. Tail coverage applies to malpractice claims made after the physician's policy ends regarding services rendered during the policy coverage. Seek Support Once in the job, make sure to cultivate a solid support network, experts said. Just like a newly hired chief executive officer might hire a professional coach, new attending doctors should seek out support too, Jahangir said. 'It's a big job. Anytime there's a big transition into a big job, it's good to have that.' Early-career doctors might be hesitant to ask colleagues to talk through a patient case or ask for help if needed, but they should do it anyway, experts suggested. Asking for help is a sign of strength, Allen said. 'If you genuinely are not confident, phone a friend. Like ask for help. That help is still there,' Allen said. 'You may think it's not, but there are lots of ways that you can curbside a friend or run a case with a mentor.' 'It's ok to feel overwhelmed and get help,' Jahangir said. He was able to survive the chaotic start to his job in large measure because a mutual friend introduced him to someone who became a mentor — the healthcare group's deputy chief executive officer Wright Pinson, MD. Pinson saw that Jahangir was drowning, 'and he took me under his wing, and he gave me the support and he would check in on me,' Jahangir said. Get Your Financial House in Order The job is not the only thing that will change after becoming an attending. There are also personal transitions that go along with it. 'Recognize that you're transitioning not only to a new career, but your life changes such as your tax bracket changes and people approach you differently,' Jahangir said, adding that some who approach don't always do so with the greatest intent, he said. 'Like, all of a sudden every financial advisor wants to come hang out.' Make sure you have a good financial plan in place to stay secure, he advises. For example, Jahangir never thought about life insurance or disability insurance as a resident. Early-career physicians are often paying back loans and potentially have lots of credit card debt from trying to survive on a resident's salary, Phillis said. 'Now you're out of training, and you're trying to figure out what to do with your salary so that you are financially stable,' she said. More Than the Practice of Medicine Before he was invited to lead his division 8 years ago, Jahangir observed that every year there would be turnover in his department. 'And I realized that the reason people were coming and going was because nobody was thinking about the other part of it,' he said, referring to work-life balance. 'So now when we hire someone, I'm like, what is it that you, what excites you outside of medicine?' To protect personal time, Jahangir changed journal club from evening to early morning hours. He also supported team members in pursuing their outside interests. One colleague ran for political office, while another who had an interest in agriculture took a more active role on his farm. It shows 'that if you build a supportive system that people — the work's hard, but people know they come here and we'll support them professionally and personally,' Jahangir said.
Wall Street Journal
22-05-2025
- Health
- Wall Street Journal
House Republicans Revive Investigation of Biden's Decline
WASHINGTON—The Republican-led House Oversight Committee on Thursday requested interviews with former President Joe Biden's physician and several top aides as it reopened a probe into what was known about Biden's health and age-related decline while in office. The investigation appears largely to be picking up where it ended last year. Many of the same people whom the committee subpoenaed in the last Congress were again asked to be interviewed. The letters issued Thursday came short of compelling them to come forward, though the panel has the ability to do that.
Telegraph
22-05-2025
- Health
- Telegraph
Don't forget to read about the side effects of the drugs you've been prescribed
For the many nowadays who must take several different pills daily it is only sensible, if a bit tedious, to check out the detailed information leaflet that accompanies them – for reasons well illustrated by the salutary experience of a Preston reader. Not far off 80, she has acquired over the years several seemingly unrelated ailments: insomnia, thinning hair, dry eyes and generalised itchiness of the skin – warranting a medley of appropriate remedies. She was thus more than interested to discover on picking up her prescription for the blood pressure lowering beta blocker propranolol that the several side effects mentioned in the leaflet included sleep disorders, thinning of the hair, dry eyes and itchy skin! Sometimes, of course, the consequences of those 'hidden' adverse effects can potentially be most serious, as befell (or very nearly) a previously fit and active woman in her nineties – a keen reader and movie goer, brandy connoisseur and formidable member of her local bridge club. 'We realised something must be seriously amiss' her granddaughter writes 'when she started missing out on her weekly bridge game and no longer asked for her brandy'. Numerous medical consultations and investigations followed, whose results suggesting her uncharacteristic malaise might be due to an under active thyroid or low salt levels proved to be red herrings. She was eventually persuaded to seek a second opinion from a wise old physician who rather than arranging for her to have yet more tests advised she stop the medicines she was taking to control her irregular heartbeat and bladder troubles. Within a fortnight she was back at the bridge table. 'I was left pondering how things might have ended up so much worse,' her granddaughter comments 'In her miserable exhausted state my granny was on track to have a fall and fracture her hip – then she would have lost her much prized independence'. The moral of this tale is obvious enough. When symptoms remain unexplained it is imperative to consider the culprit might be one or more of the medicines being taken. There is little harm in temporarily discontinuing them in anticipation this might result, as here in a prompt and miraculous recovery. The changing reality of acne That bane of adolescence, acne vulgaris, has in recent times changed its spots (as it were) persisting for increasing numbers into their twenties and beyond. This has considerable implications for the continuing efficacy of that mainstream of treatment, antibiotics. These, whether applied topically or taken orally, inhibit the proliferation of the species of bacteria whose flourishing in the skin's oily sebaceous glands gives rise to those characteristically disfiguring pustular nodules. They certainly work very well but the need to take them long term necessarily predisposes to the emergence of antibiotic resistant strains. Hence the need for alternative treatment 'strategies', a couple of which have recently been shown to be gratifyingly effective. The first is a face mask incorporating a Light Emitting Diode (LED) device that generates blue and/or red light at wavelengths known to be toxic to the bacteria in the sebaceous glands. A review published last month confirms that exposure at home for fifteen minutes once or twice daily markedly reduces the number and severity of acne lesions with 'minimal adverse effects'. Next, the surge of the androgen sex hormones at the onset of puberty is a major factor in initiating and perpetuating acne. Logically then blocking its action with the drug spironolactone – usually prescribed as a diuretic but which also has 'antiandrogen' properties should lead to a distinct improvement. As indeed it does often resulting in 'complete clearance' observes skin specialist Dr Deirdre Buckley writing in the British Medical Journal – though as it also counters the effects of the male sex hormone testosterone its use is confined to women.
