Could a greater miracle take place than for us to look through each other’s eyes for an instant?
-Henry David Thoreau
It is almost 7:00am I carry my briefcase and lunch bag from the car to my office. I nod to some of the night shift employees heading home. Another day has begun.
I type my password and check the computer, reminding myself of the twenty patients I am scheduled to see today …
Stories surround every physician
In many of our local supermarkets, there is a section of organic produce in addition to produce that is traditionally farmed. For those of us selecting and preparing food for our families, we often wonder what items, if any, we should purchase with the organic label.
When I shop, I typically choose traditionally farmed foods for my family’s meals. There are certain items …
There is little nutritional advantage to organic food
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.
Recently, discussion about health care has reached a fever pitch, between changes in policy, adjustments to scope of practice and a multitude of other medical issues. As health care providers, it is our duty to provide the highest level of medical care to all patients to …
ASA: Doctors and nurses are simply not one and the same
In addition to the possible legal pitfalls of advertising on Groupon-type websites, there are also ethical and practice management concerns to be weighed by healthcare practitioners before agreeing to such arrangements. Even with the recent announcement that companies such as Groupon and LivingSocial may be offering contracts to healthcare providers that take into consideration the prohibition against fee splitting, practitioners should nonetheless proceed with caution.
The concerns about social coupons in the healthcare context extend …
Why Groupon and other social coupons are unethical in healthcare
One of the more contentious topics on my site is the scope of practice for non-physician providers, such as nurse practitioners. This echos the debate on the national stage where leaders of physician organizations, who want to protect their scope of practice, conflict with those of nurse practitioners’, who want to perform the tasks that physicians traditionally have.
Simply Google “nurse practitioner” on this site, for instance, and you’ll see …
How I would end the war between nurse practitioners and doctors
When I recently read the phrase, “I’m embarrassed to be sick,” it made my stomach clench and my breath catch. That’s exactly what I’ve been feeling: this vague sense of social unease even with close friends, a reluctance to be seen or even talk to people–especially those that knew me before I became chronically ill.
At the age of 55, after a lifetime of seemingly …
In today’s society, chronic illness is viewed as a personal failing
Recently, an article by Kate Baicker and colleagues came out in the New England Journal of Medicine. Almost immediately, the article received widespread attention in the media where headlines claimed that giving people Medicaid coverage doesn’t improve their health. This is not exactly what the article said, but most journalists aren’t scientists, so we should cut them a bit of …
The Oregon Medicaid study: What does it tell us?
The FDA announced recently that it is approving Plan B for all girls age 15 and up without a prescription.
This is good news for girls in the US of A. The easier the access to contraception, the less likely girls will have an unintended pregnancy.
As many as 80% of pregnancies in teen girls in the United States are unintended. Most pregnancies are …
We want teens to know about emergency contraception
I almost fell off my chair. It was bad enough that he showed up to the ER. But what happened next really blew my mind. He fell and bruised a rib. The pain in his left chest had obvious enough origins. But triage had put in for an electrocardiogram and the interpretation apparently scared the resident. The attending took a look, and shook his head.
“Left bundle branch block. Better call …
When the business of medicine trumps appropriate care
For people of color, skin cancer may not be top of mind as a significant health threat. But as I tell my patients in the multi-cultural borough of the Bronx, NY, skin cancer does not discriminate and it impacts all populations regardless of color.
While somewhat rarer in skin of color, skin cancers, including potentially deadly melanoma, do occur and can be quite …
Skin cancer does not discriminate
An excerpt from How a Blog Held Off the Most Powerful Union in America.
The long-term decline in private sector unions in America has been well documented. From almost 25 percent of the workforce in 1973, the rate of unionization has fallen to under 8 percent in 2005. Some unions, though, have been able to buck this trend, most notably the 2.1 million-member national Service Employees International …
How a blog was a potent weapon against a union’s corporate campaign
Ah, the addictive power of modern food. Never underestimate it.
On a recent trip to New York I happened to be flipping through the channels on my in-flight TV when I ran across Mike Huckabee doing an interview on Fox News. I was surprised to see that he had gained his weight back. The former governor of Arkansas and presidential candidate had staked quite a bit on the success of his …
Did Mike Huckabee foreshadow his journey back to obesity?
I’ll start with this: it’s great to be back.
I’ve been on hiatus from blogging for the past few months because of the exam I took last week: the medical boards, or Step 1, an eight hour test that covers all of the first two years of medical school to prepare us for the hospital wards. To give you an idea of what it entails, most second-year medical students use a …
The process of studying changed the way I think about medicine
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I used to be a stickler for time. One of my first blog posts was about how it felt to go to work without my wristwatch.
I also used to be very particular about knowing the purpose of each visit, partly to help me manage my time, and partly to help me feel prepared and in control of the visit.
I often questioned why my colleagues’ patients would sometimes end up in …
What is the role of the physician in today’s health care system?
This is a topic that comes up from time to time for often spirited discussion. The most recent example comes in a couple of articles in the New England Journal of Medicine. One was a research paper; the other was a pro and con discussion.
The research paper studied cardiac arrests that happened outside the hospital. The authors tested the premise that allowing families to watch the efforts of …
Should families be allowed to witness CPR?
Experts, most recently former CMS administrator Don Berwick, tell us that no less than 20% – 30% of medical care is waste. At the very least, waste is harmful to all those who pay for Medicare. But often it’s directly harmful to the patient as well.
I recently saw a friend at a party. Since we’d last seen each other my friend’s spouse had died. (I’m deliberately avoiding gendered pronouns and …
How waste is directly harmful to patients
Here’s a joke I love: A man goes to an old-school psychiatrist who, at the first session, administers some Rorschach tests.
“Just tell me the first thing that comes to mind,” the doctor instructs the patient as he shows him the ink blots.
“Sex,” answers the patient.
“I see,” says the doctor. “And this one?”
“Sex.”
“And this one?”
“Sex again.”
“Well,” says the doctor, “I see we will have to work on your obsession with sex.”
“Me??” …
The controversy over DSM-5 and the cataclysm in mental health
I remember going to see the movie “Oliver” in the theater when I was a kid. Since this was my first movie in a theater, my mom made me a treat: a bag full of raisins and chocolate chips (Raisinets for Dutch people) and sent me there with my sister. It was a fine film, with Oliver getting kicked out of the …
American health care: The problem of always wanting more
It was bound to happen.
By “it,” I mean that the small group of specialty hospitals (usually orthopedic or cardiology-focused) across that country that are owned by doctors were going to have their “See! We Told ‘ya so!” moment.
Doctor-owned hospitals. How many are there? Two hundred and thirty-eight of them in the whole country (out of more than five thousand)–somewhere between four and five percent of the total in the U.S. (numbers courtesy …
Doctor owned hospitals: Are the rich getting richer?
Of all the different criteria people use when deciding for whom to vote in presidential elections, I’ve never heard anyone talk about the importance of a background in clinical psychology—but it’s always struck me as important for a president to have as for a clinical psychologist. Certainly, foreign policy experience, a firm grasp of the principles of economics, a bold and confident leadership style, and the ability to get people …
Why politicians should have backgrounds in clinical psychology
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