Sandeep Juahar, who wrote an excellent warts-and-all account of his medical education in Intern: A Doctor’s Initiation, is now old enough to be having a midlife crisis. In a recent New York Times essay, he may or may not have been projecting his own current feelings of disillusion onto the entire medical profession. He writes about the sorry state of medical practice today.

In the next 5 minutes, Wilmer L. Sibbitt Jr, MD-one of the world's leading authorities on the subject-offers succinct answers to questions.

A Roster of HIV/AIDS-Related Resources

Biomarker:   Putative molecular indicator of a specific biological state.1  Some biomarkers, called surrogate endpoints, are used as substitutes for actual clinical endpoints such as incidence of disease or death.2

For 2 months, a 29-year-old man had pain and circular, soft swelling (7 x 7 cm in diameter) over the anterior left knee, superficial to the patellar ligament. Pain was minimal and associated with extension and flexion.

When counseling patients about why they should receive the influenza vaccine, I remind them that each year the disease kills 250,000 to 500,000 persons worldwide and more than 37,000 persons in the United States. This means that influenza kills more people per year than auto accidents.

Sometimes patients, particularly children and adolescents, are very anxious during the abdominal examination.

To make wound closure easier, position the patient so that the wound “points” to your solar plexus or xyphoid process.

Those of us who have responded to overhead announcements for a doctor on the plane or tended to an ailing friend on the hiking trail know that medical care is rarely limited to the 4 walls of the office.

During the past 24 hours, a 56-year-old man has experienced melena and 2 episodes of hematemesis. He has biopsy-proven cirrhosis that resulted from heavy, prolonged alcohol consumption; however, he no longer drinks. Previous endoscopy revealed esophageal varices.

Chronic kidney disease (CKD) has become a burgeoning epidemic. Patients with various stages of CKD initially seek care from their primary care physician; some of these patients sustain acute, reversible renal injuries as well.

The essential feature of private insurance induced stress disorder (PIISD) is the development of characteristic symptoms following exposure to an insurance-induced traumatic stressor involving direct personal experience of an event or witnessing an event that threatens another person. Traumatic events include, but are not limited to, recission of health insurance after developing a costly illness, denial of health insurance due to a pre-existing condition such as being female and fertile or delay of needed treatment or medication due to requirements for pre-authorization. In the case of physicians, traumatic events include witnessing the deterioration of patients due to financial ruin resulting from uncovered costs of care. Similar to some forms of PTSD, this disorder is prone to be severe because the stressor is of human/corporate design. Note: this diagnosis is not currently reimbursed by health insurance carriers.

Dyslipidemia plays a dominant role in atherosclerotic plaque formation and as a modifiable risk factor for cardiovascular events.

Coronary heart disease (CHD), the leading cause of death in men and women in the United States, was responsible for about 1 of every 6 deaths in 2006.

Approximately 37% of adult Americans have cardiovascular disease (CVD), and the prevalence of CVD risk factors such as obesity and dyslipidemia is growing.

Too many physicians forget to billfor supplies and imaging services.

Here, a simple option to help relieve a painful symptom.

Ask a colleague to visit your practiceand point out ways to improve efficiency.

If a child seems frightened or cries during the physical examination in a way that limits your ability to do a proper assessment, try this trick.