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A doctor cracked open an airplane emergency kit and found a sticker saying there was no epinephrine inside. Lianne Mandelbaum, president of No Nut Traveler and airline correspondent for Allergic Living, has …
Food allergies are treated differently, airline by airline [PODCAST]
A patient recently told me she hadn’t seen a doctor in six years. Not because she felt perfectly healthy, but because nothing had ever felt “bad enough” to justify an appointment. By the time she came in, her blood pressure was stage 2 hypertension, her fasting glucose was in the prediabetic range, and she was carrying a level of chronic stress she’d simply learned to live with.
None of this is …
Why the importance of primary care is easy to miss
There was a time when becoming a physician meant entering a profession in which your experience was not merely appreciated; it was actively sought after. My father belongs to a generation that remembers this world. He once told me about the difficult decision he faced: whether to continue as chief of staff at a primary health care center or leave and establish his own practice. The difficulty was not finding …
Experienced physicians and patient safety defy spreadsheets
As a young person living with chronic pain, I entered a health care system that was built to find explanations to clinical problems. That is, of course, what medicine is supposed to do. Physicians are trained to identify patterns, order tests, interpret results, establish diagnoses, and develop treatment plans. When those pieces fit together, the process can feel almost reassuring. There is a problem; there is an explanation; and there …
Believing patients with chronic pain is clinical rigor
The first time I treated a newborn with the same congenital heart defect my unborn son was expected to have, I hesitated at the doorway. I couldn’t stop picturing my own baby intubated and sedated, a fresh incision running the length of his sternum.
I thought a terrifying fetal diagnosis would be the primary stressor of my pregnancy. I was wrong. The greatest obstacle wouldn’t come as a parent navigating her …
Return or resign: the Pregnant Workers Fairness Act at work
A physician says she is exhausted after months of working short-staffed. Burnout. A resident feels increasingly detached from patients after repeated 80-hour weeks. Burnout. A doctor cannot stop thinking about a patient who died unexpectedly. Burnout. A clinician feels powerless working in a system where patients wait months for care they need now. Burnout. Someone returns to work while grieving and discovers that the emotional reserve they once relied on …
Stop calling every form of physician distress burnout
In the early 1990s, while the American Academy of Pediatrics (AAP) was formalizing its vision of the “medical home,” we were already living it, without a name. At Minot Air Force Base in North Dakota, our pediatric team operationalized what would later be codified: interdisciplinary care, family partnership, coordinated services, and continuity across settings. We didn’t call it a medical home. It was excellent pediatric care, and we simply made …
The history of the medical home includes an Air Force base
I’m not a physician. I want to say upfront that this is just a theory; however, working with physicians and being married to one for twenty-one years has sparked a theory I think is worth bringing up.
I came to these thoughts by helping physicians launch and grow their own independent practices and from co-hosting a podcast with my husband where we spoke to health care workers. On-Call with Dr. Dave …
Physician burnout and autonomy are not just math
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An eye surgeon who used to see forty patients a day now sees one to three in a morning, and he has no staff. Oren Fass, a board-certified ophthalmologist and cataract surgeon, …
Staying salaried may now be the riskier bet for doctors [PODCAST]
Every patient who has spent time in an emergency department knows it’s overcrowded. They’ve sat in the waiting room for hours. They’ve watched physicians move fast and nurses move faster. They’ve heard the department through the curtain: the monitor alarms, the overhead pages, the sound of a place where everyone is doing too many things at once.
What they haven’t seen is the board.
The board is how an emergency physician experiences …
Why I wrote an emergency medicine novel about 1 night
Artificial intelligence is making health information easier to summarize, explain, organize, and discuss. A patient can copy a laboratory report into a chatbot, ask for help understanding a medical term, upload a long history, or use an app to organize questions before an appointment. The convenience is obvious. The data question is less obvious. Before someone pastes a medical history, medication list, diagnosis, insurance document, or other sensitive information into …
Health data privacy with AI starts before you press send
Oluyemisi Famuyiwa, MD is a double board-certified reproductive endocrinologist, infertility specialist, and obstetrician-gynecologist, and the founder and medical director of Montgomery Fertility Center in Rockville, Maryland. She has published 21 essays on KevinMD since June 2024 and has been a guest …
Oluyemisi Famuyiwa, MD, on fertility and PCOS: a KevinMD subscriber spotlight
I currently split my time between two worlds. I see patients in clinic and also work on AI and innovation in the health system. Most days, the dichotomy is an asset. Some days, it feels like it is two different jobs that share one calendar.
AI has closed much of the knowledge gap in medicine and did it faster than expected. The chart review, the differential diagnoses, the literature search, it …
AI and clinical judgment: why patients still trust doctors
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For those of us who have spent decades practicing medicine across multiple systems, the daily reality feels less like the noble healing art we trained for and more like a corporate assembly line. We watch as science-based, patient-centered care is nickel-and-dimed by administrators into mere metrics. In our exhaustion, we can easily identify with Odysseus. Like the legendary king wandering the dark seas, we feel a profound sense of alienation, …
Moral injury in medicine is an odyssey without Ithaca
There are plenty of things we tend to accept as part of getting older: turning the television up, struggling to follow conversations in restaurants, or asking people to repeat themselves because everyone seems to mumble these days.
Other signs are easier to overlook. You stop noticing the microwave beep or refrigerator alert. You miss phone notifications. While none of these seem significant on their own, they capture one of the biggest …
Why hearing loss and brain health belong together
It has already been said, “We will die in the system we create.” The statement raises a larger question: What do we mean by death? Death can be spiritual through excommunication, economic through expulsion from work, social through eviction from a community, psychological through exclusion and loss of sanity, or physical through extinction. Birth and death often result from forces beyond an individual’s control. Yet death can also become intentional. …
AI and assisted dying raise questions of accountability
There is a small, unreasonable part of us that expects our doctors to stay in one place forever.
We know better, of course. We know they grow older, become tired, change jobs, and make plans. Yet the person we bring our uncertainty to is not supposed to become another uncertainty. We may notice the gray hair without quite imagining the day when someone else opens the door.
Few relationships ask so much …
Losing your doctor: the grief no health system notices
I very recently started work at a new hospital as part of a yearly rotation while in training. This hospital has a fire board with the names of staff, followed by two small circles containing the words IN and OUT, and a tiny black magnet that closely resembles a knight from a portable chessboard. The idea, at least at first glance, seems deceptively simple.
Two days into my new job, a …
Human factors in health care start with better design
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A surgeon’s kids FaceTime him from their iPads while he is in the operating room, and he cannot pick up. Alyssa Kressel, a strategic communications professional, has spent more than fifteen years …
Doctors’ kids miss them, and the family builds its own fixes [PODCAST]
Becoming a physician is one of the longest professional journeys in America. The path typically requires four years of college, four years of medical school, and three to seven or more years of residency and fellowship training. For surgeons, training routinely extends well beyond a decade after college.
The investment is financial, professional, and deeply personal. Medical graduates routinely carry substantial educational debt, spend thousands of hours studying, take licensing examinations, …
A national hotline could track bias in physician discipline
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