‘Silent’ heart attacks more common than thought, study says

From CNN:

Undiagnosed, or “silent,” heart attacks affect nearly 200,000 people in the United States annually. As many as 40 to 60 percent of all heart attacks are unrecognized, studies show.

By definition, a heart attack usually happens when a clot gets in the way of blood flow from a coronary artery to the heart. This may cause symptoms such as severe chest pain, shortness of breath, fainting and nausea. Anyone who believes that he or she is having a heart attack should seek emergency medical attention.

But sometimes a heart attack is not painful, or the person experiencing it does not recognize the symptoms as heart-related, so he or she does not go to a hospital for treatment.

A new study from Duke University Medical Center shows that these silent heart attacks may occur more frequently than physicians thought.

As Nest Eggs Shrink, Some Doctors Try to Return From Retirement

From the Wall Street Journal Health Blog:

Some doctors in retirement who thought they had hung up their stethoscopes for the last time are taking a look at their shrunken investment portfolios and having second thoughts. But they’re finding that getting back in front of patients isn’t so easy.

American Medical News, published by the American Medical Association, reports that retired docs who want to make a comeback sometimes have to go through re-entry programs or catch up on continuing medical education, while at the same time having to contend with concerns that they won’t stick around for long. One gastroenterologist quoted in the piece said he couldn’t get liability coverage because he hadn’t done an endoscopy in three years.

Emergency-doc shortage could linger: study

From Modern Healthcare:

A shortage in the number of trained emergency physicians, especially in rural areas and the central part of the U.S., is expected to continue for several decades, according to a study in the Annals of Emergency Medicine. Also, the nearly 40,000 clinically active emergency physicians in the U.S. are not enough to treat the increasing number of people who visit emergency departments.

Researchers from the University of Colorado at Denver and the Emergency Medicine Network at Massachusetts General Hospital, Boston, analyzed the 2008 American Medical Association Physician Masterfile, which contains data on all 940,000 U.S. physicians. Their research found that nearly all (98%) of emergency physicians who graduated within the past five years were emergency-medicine-trained or board-certified in emergency medicine, compared with only 44% of emergency physicians who graduated 20 years ago or more.

“Although an increasing number of emergency physicians are now emergency-medicine-trained or board-certified in emergency medicine, 31% of practicing emergency physicians were neither,” Adit Ginde, of the department of emergency medicine at the University of Colorado at Denver School of Medicine, said in a news release announcing the study. “It is difficult to satisfy completely the current demand for emergency physicians with emergency medicine board-certified physicians, especially in rural areas. We need to improve access to high quality emergency care for all Americans.”

10 Reasons Doctors Get Burned Out

From the Wall Street Journal Health Blog:

As a piece in the current Archives of Surgery describes it, there’s an unwritten “code” among surgeons that involves “coming in early and staying late, working nights and weekends, performing a high volume of procedures, meeting multiple simultaneous deadlines, never complaining, and keeping emotions or personal problems from interfering with work.”

The authors list some causes of burnout among surgeons and other physicians:

• Length of training and delayed “gratification”
• Long working hours and enormous workloads
• Imbalance between career and family
• Feeling isolated / not enough time to connect with colleagues
• Financial issues (salary, budgets, insurance issues)
• Grief and guilt about patient death or unsatisfactory outcome
• Insufficient protected research time and funding
• Sex- and age-related issues
• Inefficient and/or hostile work environment
• Setting unrealistic goals or having them imposed on oneself