From Dr. K

The Lost Art of Diagnosis

By Dr. Kunwar, East County Internal Medicine

A wise attending once told me, “If you listen carefully enough, the patient will tell you the diagnosis.”
That used to be the heart of medicine. Today, it’s becoming rare.

Across the country—and right here in Lakewood Ranch, Bradenton, Sarasota, and Parrish—millions of people are misdiagnosed every year. Studies from Johns Hopkins and the BMJ show that diagnostic errors touch at least one in ten outpatient visits, and when the condition is stroke, heart attack, or cancer, the results can be life-altering.

Why is this happening more often?

  • Rushed visits that leave no room for real conversation
  • Over-reliance on tests instead of thoughtful history-taking
  • Fragmented care where no one connects the dots
  • Burned-out doctors buried in computers instead of listening

The result? Patients told “it’s just anxiety,” “it’s just aging,” or “lose weight and you’ll feel better” when something real is being missed.

I’ve seen it too many times: a Lakewood Ranch golfer told his chronic fatigue was depression, a Bradenton teacher told her joint pain was “normal wear and tear,” a Parrish mom told her racing heart was stress. In each case, a little time and careful listening uncovered thyroid disease, vitamin deficiencies, or early cardiac changes that were completely treatable once correctly identified.

At East County Internal Medicine, accurate diagnosis remains the foundation of everything we do. We believe medicine should still be practiced as an art: unhurried, attentive, and deeply respectful of each person’s story.

If you’ve ever left a doctor’s office feeling unheard or dismissed—whether you’re in Lakewood Ranch, Sarasota, Bradenton, or Parrish—you’re not alone. And you don’t have to stay there.

Sometimes the greatest healing begins with simply being listened to.

Dr. Kunwar
East County Internal Medicine
Lakewood Ranch, Florida

Florida Hits Rock Bottom in Nursing Exam Pass Rates – And Your Local Hospital Could Pay the Price

December 2, 2025
East County Independent Monitor

For the first time ever, Florida now ranks dead last in the United States for first-time NCLEX pass rates – the all-important licensing exam every nurse must pass to practice.

The numbers are brutal:

  • Florida: 83.12% pass rate (2024–2025 data)
  • National average: 89.4%
  • States like New Hampshire and Vermont: above 96%

That 6-point gap translates into thousands of would-be nurses who studied here, took on massive debt, but are currently barred from working at Brandon Regional, South Florida Baptist, AdventHealth Wesley Chapel, or any other hospital in the Tampa Bay area.Why This Should Worry Every Resident of Hillsborough, Pasco, and Polk CountiesFlorida already faces a critical nursing shortage. The Florida Hospital Association projects we’ll be short more than 59,000 nurses by 2035. When our own nursing schools are graduating fewer licensed nurses than almost anywhere else in America, the math gets ugly fast:

  • Longer ER wait times
  • Closed hospital beds
  • Burned-out nurses handling even heavier patient loads
  • Higher medical error risk

What Went Wrong?

State investigators and the Board of Nursing point to a perfect storm:

  • Rapid growth of for-profit nursing programs with questionable quality
  • Inadequate clinical placement sites
  • Some schools accepting students with little realistic chance of passing the NCLEX
  • Outdated or inconsistent curriculum that doesn’t align with the new Next Generation NCLEX format

The Coming Crackdown

Tallahassee is no longer looking the other way. Bills already filed for the 2026 legislative session include:

  • Automatic probation or closure for programs with three consecutive years below 80% pass rates
  • Mandatory public “report cards” for every nursing program in Florida
  • New scholarship and loan-forgiveness incentives tied directly to NCLEX success
  • Increased funding for high-performing public college programs (think Hillsborough Community College and Polk State)

The East County Angle

We have several nursing programs right here in our coverage area. Some are excelling; others are on the state’s watch list. Over the next few weeks, East County Independent Monitor will publish a local scorecard showing exactly how each school in Hillsborough, Pasco, and Polk performed on the 2025 NCLEX – because families deserve to know before they (or their kids) sign those tuition checks.

Bottom Line

This isn’t just a “nursing school problem.” It’s a patient-safety and access-to-care crisis that will hit every clinic, hospital, and nursing home from Plant City to Lakeland to Wesley Chapel.We’ll keep following this story closely and bring you updates as lawmakers, colleges, and hospitals respond.Bookmark this page and follow East County Independent Monitor for the most detailed local coverage of the Florida NCLEX crisis and how it affects you.Because when it comes to healthcare in East Hillsborough and the surrounding counties, we’re the source that actually lives here and digs deeper.

– The East County IM Team

https://eastcountyim.com/florida-nclex-crisis

Share this article if you want your friends and neighbors to know what’s really happening with nursing in Florida.

Walking Pneumonia Cases Are Rising in Lakewood Ranch and Manatee County: What Residents Need to Know

Posted on November 13, 2025

If you’ve noticed more lingering coughs among family members, coworkers, or classmates in the Lakewood Ranch and Bradenton area this fall, you’re not alone. At East County Internal Medicine, we’ve seen an uptick in patients presenting with symptoms of “walking pneumonia” — a milder form of pneumonia caused by the bacterium Mycoplasma pneumoniae. This trend aligns with statewide and national reports of increased cases throughout 2025, particularly after a period of unusually low activity during the height of the COVID-19 pandemic.

Why the Increase in Walking Pneumonia Now?

Mycoplasma pneumoniae infections historically cycle every 3–7 years, but they dropped dramatically during pandemic restrictions like masking and social distancing. As those measures eased, the bacteria has made a strong comeback:

  • The CDC reports that M. pneumoniae infections began rising in late spring 2024 and have remained elevated through 2025, with test positivity rates climbing nationwide.
  • Notably, cases are affecting younger children (ages 2–4) more than in previous cycles — a shift from the typical school-age group (5–17 years).
  • In Florida, hospitals and clinics, including those in South Florida and Central Florida regions, have reported surges, with some pediatric centers seeing 5–10 times more cases than in recent years.

While exact Manatee County numbers aren’t publicly tracked for this bacterium (there’s no national or state mandate for reporting mild cases), local urgent cares and primary care offices like ours in Lakewood Ranch are diagnosing more patients with persistent respiratory symptoms consistent with walking pneumonia.

Symptoms to Watch For

Walking pneumonia gets its name because most people feel well enough to go about daily activities, even with an infection. Symptoms develop gradually over 1–4 weeks after exposure and can last for weeks:

Common in adults and older children:

  • Persistent dry or productive cough (often worse at night)
  • Low-grade fever
  • Sore throat
  • Headache and body aches
  • Fatigue that lingers

In younger children (under 5):

  • Sneezing, stuffy/runny nose
  • Wheezing or vomiting
  • Diarrhea in some cases

Because symptoms overlap with flu, COVID-19, RSV, and even allergies, accurate testing is key — we offer rapid respiratory panels in-office to distinguish Mycoplasma from viruses.How It Spreads in Our CommunityThe bacteria spreads through respiratory droplets from coughing or sneezing, especially in close settings like:

  • Schools in Lakewood Ranch and Manatee County districts
  • Holiday gatherings and indoor events
  • Offices and gyms

With cooler weather driving people indoors and Thanksgiving/Christmas travel on the horizon, now is the time to be proactive.

Prevention Tips for Lakewood Ranch Families

There’s no vaccine for Mycoplasma pneumoniae, but these steps go a long way:

  1. Frequent handwashing and covering coughs/sneezes
  2. Staying home when sick (even if you “feel okay” to walk around)
  3. Good ventilation in homes and classrooms
  4. Keeping up with flu and COVID vaccines — they won’t prevent walking pneumonia but reduce the risk of co-infections that make illness worse

Treatment: The Good News

Most cases resolve on their own in 2–4 weeks with rest and fluids. When antibiotics are needed (especially if symptoms are severe or prolonged), we prescribe macrolide antibiotics like azithromycin — which work well against Mycoplasma (unlike common penicillins such as amoxicillin). Early treatment shortens duration and reduces spread.

When to Seek Care at East County Internal Medicine

Don’t wait if:

  • Cough lasts more than a week or worsens
  • Fever exceeds 101°F or persists
  • You have shortness of breath, chest pain, or wheezing
  • Symptoms affect a young child, senior, or anyone with asthma/COPD/diabetes

We offer same-day appointments and targeted treatment plans.

Stay healthy this season, East County! For the most accurate and up-to-date contact information or to schedule, please visit our website at eastcountyim.com or check the Contact Us section directly.

Shaan Kunwar, DO
East County Internal Medicine
Bradenton / Lakewood Ranch, FL

Tags: walking pneumonia Lakewood Ranch, Mycoplasma pneumoniae Manatee County, lingering cough Bradenton, respiratory illness Florida 2025, East County Internal Medicine

(This post is for educational purposes. Always consult your physician for personal medical advice.)