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Since continuing technological advancements are going to add to rising costs (dialysis, for example, with more “baby boomers” coming of Medicare age), one has to wonder what the something is that “has to give” in the future.

MRI scans of the kidneys of an 83-year-old woman with history of myelodysplastic syndrome are shown. Normal MRI scans are shown for comparison. The patient had intermittent episodes of dark-colored urine for years. Findings from repeated cystoscopies were normal.

A 48-year-old woman sought medical attention after an episode of gross hematuria associated with mild right-sided loin discomfort. She did not have urinary frequency, urgency, or dysuria. Her history included 3 urinary tract infections; a Proteus species was cultured on each occasion. The family history was unremarkable. Other than mild loin tenderness, physical findings were normal.

Patients' descriptions of their medications can cause confusion-with potentially dangerous results.

I use ICE at each visit to help ensure that patients are satisfied with the care they receive.

Measure your volume by season and day.

Many patients with a viral upper respiratory tract infection still expect an antibiotic prescription when they come to the office.

Remember that patients will Google you and nowadays rate you on one of the many rating sites.

A 69-year-old man presents with a cough of 3 months' duration. He has taken a variety of over-the-counter suppressants and received a course of antibiotics, without resolution. The cough is not position-related; it produces a small amount of sputum and recently flecks of blood as well.