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Our health system is a sick system

Health Policy

September 23, 2018

Unhealthy behaviors such as smoking, overeating, or lack of exercise lead to chronic health conditions, and many patients wanting to make positive changes to their health may seek the advice of their doctor to do so. But our insurance payment system works against supporting people when they want to act in a healthy way, and some of these payment decisions seem rooted in prejudices against those suffering from certain conditions.

Smoking …

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Our health system is a sick system

Quality over quantity in life and care

Jeffrey Cannon

Physician

September 23, 2018

The surgical team filed out of the patient’s room. I looked over my shoulder to see a shaken daughter holding the wrinkled hand of her quiet, elderly mother who lay in the bed. I shuddered as I thought of the surgery her body would endure the next day. I knew I needed to return to her room later in the day to find out more about her history. After rounds …

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Quality over quantity in life and care

10 financial tips for physician maternity leave

The Frugal Physician

Physician Finance

September 22, 2018

Let’s be real here. Women make babies. Women also kick butt working. Sometimes women need to make babies while kicking butt working. So, you know, the human race can survive … no big deal. But, all too often, families are unfairly burdened by our dismal maternity support system. Bleary-eyed and bloody, new mamas emerge from childbirth facing a mountain of medical bills and no income.

For my first pregnancy, my family …

Why this physician sees a therapist

Sanjana Vig, MD, MBA

Physician

September 22, 2018

I’ve had a lot of ups and downs throughout my schooling and career — not just related to my profession but personally as well. In the past, it has crossed my mind that I should probably seek professional help, but then some way or another, I would get past my issues and life would normalize. Then I would move on and forget about it.

However, after last summer, things were different. …

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Why this physician sees a therapist

Sometimes the most I can offer is to be present with people

Holland M. Kaplan, MD

Physician

September 22, 2018

I’m sitting in the ICU team room, staring at the computer, trying to look like I’m writing a note. But my head is pounding.

As an internal-medicine resident doing my first month of residency, I’ve found the ICU of the bustling county hospital a jarring place to start my training. Although I’d anticipated the clinical challenge of caring for very ill ICU patients, I was unprepared for the emotional burden of …

MKSAP: 25-year-old woman with type 1 diabetes mellitus

mksap

Conditions and Diseases

September 22, 2018

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 25-year-old woman with type 1 diabetes mellitus is evaluated for recent-onset glycemic fluctuations without symptomatic hypoglycemia. She was diagnosed with diabetes 7 years ago. Her HbA1c levels since diagnosis have ranged from 6.4% to 7.3%, with the most recent value at 7.3%. She reports eating a carbohydrate-consistent diet at each meal, with …

Why doctors can’t take sick days

Lisa Sieczkowski, MD

Physician

September 21, 2018

I learn all manner of interesting things from the information sheets posted on the walls of the employee bathrooms at my hospital. I learn, for example, about upcoming CME offerings for advance practice providers, how many seconds one has to scrub the hub of a central line, and what the new process is when nurses need to call in sick. They call a specific phone number and state that they …

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Why doctors can’t take sick days

100 percent satisfaction doesn’t work in our health system

Cory Michael, MD

Physician

September 21, 2018

“I want answers!” My mother was upset over the care for her ill husband. Previously able to converse normally, he was now incoherent and disoriented. The recent recipient of a bone marrow transplant to treat his advanced leukemia, he probably experienced a brain infection because of the immune suppression therapy needed to accept the marrow. The marrow transplant didn’t work. He was sent home from the hospital on hospice care …

What physicians need to make a telehealth program stand out

Sylvia Romm, MD, MPH

Physician

September 21, 2018

When I became a physician years ago, the idea of telehealth had barely taken hold among doctors or patients. Today, as we bask in the passage of the CHRONIC Care Act of 2017, we’re seeing dozens of use cases in stroke, emergent care, psychiatry and more that underscore telehealth’s potential.

Consumers are becoming increasingly digitally savvy too — and not just the millennials. Today, about one in five adults Read more…

What physicians need to make a telehealth program stand out

Challenging gender bias in the house of medicine

Barbara McAneny, MD

Health Policy

September 21, 2018

A guest column by the American Medical Association, exclusive to KevinMD.com.

Since the 1970s, women have been carving out an increasingly large role in medicine, and the profession is becoming more representative of our society. September is Women in Medicine Month, a great time to acknowledge the changing face of medicine, but also to note that female physicians are not immune from the …

A patient waits. And waits.

Michele Luckenbaugh

Patient

September 21, 2018

I sit before you and others like you, in silence, anxious about what I might be told. You deliver a litany of questions to my countenance as I sit in a chair beside you. Your attention is diverted to the cold and detached computer screen where my responses are entered without you ever noticing the fear in my eyes. There is no acknowledgment to indicate a level of understanding of …

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A patient waits. And waits.

A physician with congenital heart disease

Sweta Shah, DO

Conditions and Diseases

September 21, 2018

Everyone always jokes with doctors, “What happens if you get sick?” Some of us laugh off the question. The busy schedule of health care often means our own health comes last. However, what happens when it’s a chronic disease that requires treatment? Then the answer to this question is a little different.

I am a family medicine physician dealing with congenital heart disease (CHD). Saying that someone has congenital heart disease …

Doctor, when is your next vacation?

Jasmine Toor, MD

Physician

September 20, 2018

Life is short. We always hear that phrase but really don’t know what it truly means. What I mean is that life doesn’t feel short; we complain of our days being too long, or weeks too busy and dragged out. The only thing that feels too short in my life are weekends. There comes a point in life where I think you figure out what it means, you look back …

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Doctor, when is your next vacation?

Looking for the silver lining at supervised injection facilities

Mahdi AlBasri, MD

Conditions and Diseases

September 20, 2018

The Hippocratic Oath, as presumably most of us know, is the oath taken by physicians promising to uphold ethical standards in treating their patients. The four pillars of medical ethics primarily stem for this oath: autonomy, beneficence, non-maleficence, and justice. The world we see now is socially different compared to what it was when Hippocrates was alive. Physicians and policymakers in health care now face new ethical challenges that they …

Opioid cheating is a billion-dollar industry

Giri Venkatraman, MD, MBA

Conditions and Diseases

September 20, 2018

If you search for “how to pass a urine drug test” on the internet, you will get several million results. As physicians, we see and manage the national opioid crisis every day. We see the impacts of this in our practices and our lives. The crisis frankly shows no signs of abating or becoming a less critical issue. Unfortunately, one major reason for our inability to control this issue might …

Happy National Grateful Patient Day!

R. Lynn Barnett

Patient

September 20, 2018

One day I found out that it was National Limerick Day. I didn’t even know there was a National Limerick Day. I investigated other “days” and found out that September 7th was National Grateful Patient Day. So, this grateful patient will start her post with a limerick:

There was a patient in a flimsy gown,
Who was also wearing a frown.
She was getting a bad cold,
And feeling cold and old,
She wanted another …

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Happy National Grateful Patient Day!

Words can hurt those on benzodiazepines

Nicole Lamberson, PA

Conditions and Diseases

September 20, 2018

There exists a large, mostly-underground, growing community consisting of those iatrogenically harmed by benzodiazepines. Guilty only of following doctors orders, these patients are marginalized and misunderstood. This has been enabled, at least in part, by poor terminology.

Recently on Twitter, Michael P. Hengartner and Marnie Wedlake both posted critical questions in response to a benzodiazepine news story:

In response to …

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Words can hurt those on benzodiazepines

Shortening time in medical school is a bad idea. Or is it?

Charles Dinerstein, MD, MBA

Medical Education

September 20, 2018

Recently, there has been a number of articles on reducing the length of medical training to help ease the physician shortage. And our medical curriculum is due for a major overhaul. Its foundational document, the Flexner report, was released over 100 years ago, and our medical needs and knowledge have changed. Shortening medical education may provide a “bonus” in easing the anticipated shortage of physicians …

The hazard of the health care common is communication

Eric J. Keller, MD

Physician

September 19, 2018

Both in and outside of health care certain buzz words and phrases become so ubiquitously used that a shared understanding is assumed despite conflicting perceptions of what these sentiments actually mean. Examples in health care include: shared decision making, quality of life, professionalism, patient-centered care, and evidence-based. Each sounds positive and intuitive — what health care provider perceives her/himself as not professional and patient-centered or not providing shared, evidence-based, quality …

Think of investing as one long road trip

Wall Street Physician, MD

Physician Finance

September 19, 2018

I was driving up to Northern Michigan recently for a nice vacation with family, and like any long road trip, before I left, I turned on my GPS on my iPhone to see how many hours it would take to get there.

There’s an initial excitement to get on the road, looking forward to how enjoyable your upcoming vacation will be.

However, once you hit the highway, road trips can become long, …