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It’s the middle of a busy shift when you walk into the room and find your patient cradling their shoulder, equal parts uncomfortable and frustrated. There’s no trauma, no clear inciting event, just a story that starts with mild pain a few weeks ago and has quietly progressed to the point where they can’t reach overhead, can’t get dressed without help, and can’t quite understand what went wrong. You run through the usual differential —...
Multi-cancer early detection (MCED) tests are emerging blood-based screenings designed to detect multiple cancers by analyzing cell-free DNA and methylation patterns. While these tests are already available (despite lacking FDA approval), current evidence shows high specificity (~99%) but relatively low sensitivity (~40%), meaning false reassurance from negative results is a real concern. Additional challenges include lengthy diagnostic...
We’ve all been there. A patient shifts uncomfortably on the exam table, hesitating before admitting what brought them in: “I think I have…hemorrhoids.”
It happens at the worst possible time. You’re wrapping up a visit, already running behind and just as your hand reaches for the doorknob, your patient says:
Regardless of your specialty or setting, there is a mountain of knowledge to take in during your first year of practice that goes far beyond medicine. Whether you work in-patient or clinic, ICU or dermatology, there is a unique culture that you are stepping into. Hopefully, it is a culture of teamwork, grace, and growth. But wherever you find yourself, there are a few universal lessons that all NP’s need to learn during this crucial...
Insomnia and I are very well acquainted with one another. Like 10% of the population, I experienced chronic insomnia for years. And like nearly one-third of adults, I still experience insomnia from time to time. Through my own history, as well as years of research into the literature and undergoing cognitive behavioral therapy for insomnia (CBT-I), the gold standard for treatment of chronic insomnia, I have developed a helpful, informal...
It’s 9 a.m. in urgent care, and your next patient is here for a sore throat. They want a rapid strep test and antibiotics. But we all know that most sore throats are viral, and antibiotics won’t help. That’s exactly why clinical decision tools, such as the Centor and McIsaac criteria, matter. They guide testing decisions, help us avoid unnecessary antibiotics, and keep care efficient on a busy shift.
Many pediatricians have had this moment in clinic: a patient returns for a follow-up weight check after months of conversations about nutrition, physical activity, and screen time — and the number on the scale hasn’t budged. Maybe it has even gone up.
It’s 2 a.m. in the ED. The waiting room is full, and the next patient sounds straightforward: fever. Then they add, “I just got back from an international trip.”
It’s a scene most of us know well: a worried parent, a frustrated athlete, and the inevitable question: “When can they go back?”
I was working in one of our satellite EDs talking with an elderly patient and her daughter about some recent headaches and increased confusion. She was in her early 70s, with a history of Alzheimer’s Dementia (AD). After my initial evaluation and exam, I went back to my computer to place some orders. Looking over her chart, I noticed something odd; the patient had been getting MRIs of her brain every month.
