Month: October 2022
A personal mission to get obese patients on GLP-1 agonists
Admittedly, this comes to you from a place of concussion-inducing-head-banging-against-brick-walls-level frustration.
For the past year, I have made it a personal mission to get people suffering from obesity on GLP-1 agonists. These drugs are all in the same class, have identical mechanisms, and three are the same generics. (Ozempic, Wegovy, and Rybelsus are all semaglutide.)
They are advertised as Wegovy, Ozempic, Rybelsus, Saxenda, Trulicity, and Mounjaro.
To say these are life savers is …
How major depression strengthened my practice and my faith in God
I had a fairytale courtship, engagement, and wedding to my Prince Charming. We came home, starry-eyed, ready to start our forever together. Within weeks, I began to struggle. Always an extrovert, suddenly going to my family medicine rotation took extraordinary effort. I began to worry about my every word and action. Some days, I said nothing — unsure whether I could form a coherent sentence. I decided to take time …
26 hours in a day: the impossible math and timing of providing quality care
You recently told me that I have the physician’s group’s highest patient satisfaction scores. This doesn’t surprise me. I know what makes me great: I take time. I let patients tell their stories. I listen, educate and collaborate. When I don’t know something, I find the answer. I am the poster woman for “AIDET.”
Recognizing that time is finite, I strive for efficiency. I delegate. I refer. I use order sets. …
Using simulations to improve medical decision making [PODCAST]
Gun violence during residency: Run. Hide. Fight.
I no longer react to the chiming from my phone when a push notification alerts me of another mass shooting. I have become numb to such alarms. Perhaps it is the increasing frequency of these alerts or a feeling of inevitability, made even starker by my personal and multiple encounters with gun violence in the last year. The gun violence epidemic is ubiquitous.
Ten months ago, there was an active shooter …
The middleman mentality is killing American medicine
Between producers and consumers, you’ll find a cadre of professionals who broker deals, facilitate transactions, and move goods and services along.
They’re called “middlemen,” and they thrive in virtually every industry — from real estate and retail to finance and travel services. If not for middlemen, houses and blouses wouldn’t sell. Banks and online booking sites wouldn’t exist. Middlemen are the reason a tomato grown in South America makes it aboard …
The perioperative surgical home: a model to tackle today’s pressing health care issues
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.
The health care landscape has never been more complex. A deadly and enduring pandemic; health care delivery challenges that leave some communities at higher risk for adverse outcomes; an opioid crisis that takes nearly 200 American lives per day; and an ever-evolving regulatory …
We are lost and forgotten in the immensity, waiting in the shadows
We traverse parallel paths, you and I. Paths that intersect during times of stress, loss, and illness. Each of us searching for truth, understanding, and resolution.
Our stories need to be heard, but in these trying times, we are but mere specks in the immensity of the corporate orb of health care which rolls and overpowers all in its path. Its hunger seems not to be satiated, its grasp ever stretching.
The …
Physician burnout: a lack of resilience or a lack of control?
When I quit my clinic job after four waves of the COVID-19 pandemic as an intensivist, I decided not to work in direct patient care for a while. I expected harsh criticism from my colleagues. Surprisingly, that never happened. The feedback was unexpected, at least for me. Most of my colleagues admired my decision. They called me brave for taking the leap, and many admitted thinking about the same for …
Singing doctors in the operating room
An excerpt from Fifty Years a Doctor: The Journey of Sickness and Health, Four Plagues and the Pandemic.
It took me years to fully realize what a unique residency program I had enjoyed in my one-year general surgical training in Honolulu.
Early in this residency, we had state-mandated education in leprosy. All …
Telemedicine is not medicine
The COVID-19 pandemic ushered in many insidious handmaidens among its foul equipage. From Zoom meetings and school closures to masks and lockdowns, our world was torn asunder and, eventually, rendered anew into a place where almost everything has been changed, by large degrees and small, perceptibly and imperceptibly. It will come as no surprise that medicine is foremost among the more obviously perceptible areas of life that have been irrevocably …
A story that changed this pediatrician forever
I’m a pediatrician and have been practicing for 29 years. I currently own a solo practice.
Here is a story I wrote years after a patient encounter during my residency in 1993. I didn’t know it at the time, but it was an experience that would shape my career in general pediatrics.
Marcus is the worst case of child abuse I’ve seen to date. He’s two years old. His mom’s boyfriend dips …
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Practicing great medicine got a lot simpler. It’s health care that’s getting in the way.
We pay more than any other nation for health care, yet we have suffered the single biggest decline in life expectancy since WWII. Something went wrong. At a time of record inflation and rising taxes, isn’t it time we stopped to ask where the money is going, what exactly we are paying for, and why?
Astonishingly, nearly half the federal budget goes to health care in one way or another. Either …
Invest in your child. Invest in their future: ESG funds and 529 plans
For parents looking to fund their child’s education, a 529 plan is an optimal way to grow savings through investments and gain significant tax breaks in the process. But as we have previously explored, investments that grow your own portfolio may be causing harm to others by supporting companies that don’t take their social or environmental impact into as much consideration as their bottom line.
In recent years, “environmental, social, …
Tips to be a more productive, less stressed physician
Why should you be more productive? Because time is money? Not only that. I prefer time is family or time is go-home-sooner.
Being more productive in medicine isn’t working more hours or faster; it means working better.
Take breaks. Doctors rarely take breaks during their workday. Yet most employees do take two 15 minutes breaks each day. Do you feel like 15 minutes is too long? Take at least five minutes per …
Batman catching babies
Whenever asked, I hesitate to tell people what I do because when a young man says: “I’m a gynecologist,” he never seems to be taken quite so seriously. “No, really, I am” – “Oh.” Instead, I opt for the more charming “I deliver babies” line. Works every time.
And why is that? What about birth and babies triggers a sense of astonishment in people? Whatever it is, it seems to magically …
Activity is good. Exercise is better.
An excerpt from Man Overboard!: A Medical Lifeline for the Aging Male.
OK, you don’t consider yourself an exerciser. It’s just not you. You hate running. You don’t have the social temperament or the body image to show up in a gym. You’re not interested in doing a Turkey Trot, Reindeer …
The White House should help students swap out dairy milk in school lunches
I have an urgent request for the White House as it is garnering support for its national nutrition strategy that was unveiled at the September 28 White House Conference on Hunger, Nutrition, and Health: Tell the U.S. Department of Agriculture to stop putting students’ health at risk, and cut the red tape for them to get nondairy replacements for dairy milk in school lunches.
In the United States, …
Next of kin in the medical decision making process
Four years ago, as chairman of the hospital ethics committee, I was asked to convene an emergency meeting brought by a distraught family as medical decisions had to be made for their ill loved one. The hospital, HMO lawyers, the family, three adult children, and their mother were at the meeting.
The father had arrived at the hospital unconscious and was admitted to the intensive care unit, where medical care was …
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Forced voicemail and diagnosis codes are endangering patient access to medications
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Why specialist pain clinics and addiction treatment services require strong primary care
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Who gets to be well in America: Immigrant health is on the line
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When a medical office sublease turns into a legal nightmare
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America’s ER crisis: Why the system is collapsing from within
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FDA delays could end vital treatment for rare disease patients
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Past 6 Months
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Forced voicemail and diagnosis codes are endangering patient access to medications
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How President Biden’s cognitive health shapes political and legal trust
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Why are medical students turning away from primary care? [PODCAST]
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The One Big Beautiful Bill and the fragile heart of rural health care
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Why “do no harm” might be harming modern medicine
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Here’s what providers really need in a modern EHR
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Recent Posts
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Why peer support can save lives in high-pressure medical careers
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Bundled payments in Medicare: Will fixed pricing reshape surgery costs?
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How Project ECHO is fighting physician isolation and transforming medical education [PODCAST]
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Why clinical research is a powerful path for unmatched IMGs
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Addressing menstrual health inequities in adolescents
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How to advance workforce development through research mentorship and evidence-based management
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Past Week
-
Forced voicemail and diagnosis codes are endangering patient access to medications
-
Why specialist pain clinics and addiction treatment services require strong primary care
-
Who gets to be well in America: Immigrant health is on the line
-
When a medical office sublease turns into a legal nightmare
-
America’s ER crisis: Why the system is collapsing from within
-
FDA delays could end vital treatment for rare disease patients
-
Past 6 Months
-
Forced voicemail and diagnosis codes are endangering patient access to medications
-
How President Biden’s cognitive health shapes political and legal trust
-
Why are medical students turning away from primary care? [PODCAST]
-
The One Big Beautiful Bill and the fragile heart of rural health care
-
Why “do no harm” might be harming modern medicine
-
Here’s what providers really need in a modern EHR
-
Recent Posts
-
Why peer support can save lives in high-pressure medical careers
-
Bundled payments in Medicare: Will fixed pricing reshape surgery costs?
-
How Project ECHO is fighting physician isolation and transforming medical education [PODCAST]
-
Why clinical research is a powerful path for unmatched IMGs
-
Addressing menstrual health inequities in adolescents
-
How to advance workforce development through research mentorship and evidence-based management
-
