Making the decision each day to stay in clinical medicine

Physician
July 1, 2022

I have wanted to be a doctor for as long as I can remember. I played hospital with my dolls as a child. I never thought of alternative career paths. I climbed the long, sometimes unbearably steep mountain to reach the top.

I loved clinic medicine for many years. Most days, I still do. Until recently, I had never considered leaving, choosing a different path.

Then, I walked into the clinic and …

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Making the decision each day to stay in clinical medicine

Direct care with a podiatry twist

Conditions
July 1, 2022

A patient, let’s call him Jay, came to me refusing a leg amputation. He had open sores that were necrotic, foul-smelling as if he had been neglected for a long time. At his consultation, he fought with every cell of his being, refusing to lose his leg as his uncle did. He wanted a second opinion on whether or not his foot could be saved.

Traditional insurance-based medicine has …

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Direct care with a podiatry twist

Dear sirs: I am a woman orthopedic surgeon

Physician
July 1, 2022

From an early age, I shared the soccer field with my younger brother, and later, we shared an orthopedic surgeon when I tore my ACL. I worked hard and excelled at my public STEM high school in New York City. I was also an athletic trainer in high school and college. I fit the classic stereotype of the injured sporty kid going into orthopedic surgery, right?

Not exactly.

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Dear sirs: I am a woman orthopedic surgeon

The promise of change

Physician
June 30, 2022

Change is a mysterious creature. It can be both welcome and unwelcome at the same time. It can make us grow in ways we’ve never imagined and yet bring us to our knees. Ironically, it is one of the few things we are promised.

Learning how to navigate change with some grace has been one of the silver linings of living during a pandemic. We were quickly reminded of how little …

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The promise of change

Are you guilty of anchoring bias?

Physician
June 30, 2022

As doctors, we have all been guilty of anchoring bias, which means we put too much weight on the first complaint. When a patient presents to the clinic with a complaint that sounds vaguely like a headache due to a sinus infection, we whip out the script pad and write a script for Augmentin. We tell them to return if they are not better in two days. That latter statement …

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Are you guilty of anchoring bias?

What a lifetime of gaslighting by other doctors feels like

Conditions
June 30, 2022

“If your shoulder were really injured, that maneuver would make you scream in pain,” he told me confidently.

My husband and I recently established care with a new family doctor. I was frightened and scarred from a long history of medical gaslighting that still tightens my throat whenever I meet a new physician.

Will this doctor believe me? Will he understand?

Years of dismissal made me wary of a new start, but we …

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What a lifetime of gaslighting by other doctors feels like

Why the baby formula shortage happened

Policy
June 29, 2022

By the end of April 2022, nearly 40 percent of the country’s baby formula ran out of stock, leading to a major baby formula shortage in the United States. The plummeting availability of baby formula has left parents and caregivers anxious as they struggle to feed their infants, since roughly 75 percent of babies in the U.S. receive at least some formula …

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Why the baby formula shortage happened

Is being a victim a part of being a doctor?

Physician
June 29, 2022

On June 1, two doctors, a medical receptionist, and a patient were gunned down in the doctors’ outpatient office in Tulsa, Oklahoma. An investigation revealed that one of the doctors was the intended target — a patient, angry because his pain was not relieved after spinal surgery, decided that the doctor who performed the surgery deserved to die. The other victims were collateral damage.

This event is shocking. It’s frightening that …

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Is being a victim a part of being a doctor?

Why doctors are getting their asses kicked by technology

Physician
June 29, 2022

Physicians have terrible technology, but they refuse to recognize high-tech as a medical specialty. They must integrate technology as they do laboratory science.

Physicians are certainly suffering from poorly-designed electronic medical records (EHR), but they are also guilty of wilful blindness in abdicating responsibility for technology in medicine. This must change.

Physicians have a higher suicide rate than post-combat troops in the military. A lot of this is due …

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Why doctors are getting their asses kicked by technology

Medical school loan repayment tips [PODCAST]

Podcast
June 28, 2022
YouTube video

Subscribe to The Podcast by KevinMD.

“My wife is a urogynecologist lucky enough to get through her seven years of residency plus fellowship with “only” $124,000 of student debt. When we discussed how we were going to get rid of this debt, she had always assumed that it was …

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Medical school loan repayment tips [PODCAST]

Gun control vs. violent criminal control

Policy
June 28, 2022

KevinMD contributors, virtually without exception, have asserted the solution to events like the horrific tragedy in Uvalde, Texas, is “gun control.” Allow me to present an alternative viewpoint in the interest of diversity of opinion.

First of all, I favor reasonable gun restriction laws. But sadly, I don’t think that will solve the problem. Look at the city of Chicago. It has one of the strictest laws on gun control in …

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Gun control vs. violent criminal control

The “wonder years” of health care

Physician
June 28, 2022

In the wake of medical home certification, meaningful use, the Cures Act, and the pandemic, it’s clear that virtually all health care is now built on a digital foundation. EHRs are pervasive in the delivery system and are increasingly connected to practice management software, virtual visit, mobile capabilities, health information exchanges, and population health platforms. As we consider the criticality of interoperability throughout this evolving digital ecosystem, I’m moved to …

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The “wonder years” of health care

Malpractice may be negative, but its data can generate positive results

Policy
June 27, 2022

When most health care professionals hear the word “malpractice,” they want to run the other way. This is understandable—but also a missed opportunity. We can leverage malpractice data to target and drive investment in patient safety efforts. Malpractice data shows us that good communication and teamwork are vital to preventing adverse events and malpractice claims—while dramatically improving working conditions and enhancing patient safety.

Malpractice data shows that communication-related factors contribute to …

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Malpractice may be negative, but its data can generate positive results

Get ready for a COVID culture shock

Physician
June 27, 2022

A friend called me for medical advice two weeks ago. He’s single, in his 30s and generally healthy, but he’d developed a dry cough with mild congestion. After a self-administered COVID-19 test turned up negative results, he remained suspicious he could be infected.

He was set to fly west in a couple of days for a conference and dreaded the thought of infecting other passengers. I recommended a PCR test if …

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Get ready for a COVID culture shock

How to fix the psychiatrist shortage in the U.S.

Physician
June 27, 2022

Mental health disorders are by far the largest cause of disability in the world. More money is spent on mental health than either diabetes or cardiovascular disease. About 45 million people in the U.S. have a mental illness. Almost every American will, at some point or another, face a mental health challenge. It may be related to depression, anxiety, suicidal thoughts, substance abuse or maybe something more circumstantial like grief …

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How to fix the psychiatrist shortage in the U.S.

Boards should protect the public, not destroy doctors

Physician
June 26, 2022

Every primary care doctor knows what we are up against. The obstacles are many: payers, licensing boards, MOC, CME requirements, coding for billing, access issues, and the changing clinical field.

Sometimes these cause real harm.

Fifty miles north of where I-95 ends in Maine, winters there are long. My friend Dr. J did locums and spent a winter there. He tries new things wherever he goes, like spearfishing on Maui. So he …

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Boards should protect the public, not destroy doctors

A dead baby in my arms

Conditions
June 26, 2022

Five days before this story begins, where everything is upside down, and the end is the beginning.

Me, standing in my PICU, slowly approaching that cradle, then removing the medication, one by one, turning off the syringe pumps. Saying out loud the number of milliliters passed, where that line is trapped, that little division between the professional and me, the person.

Where I stopped being a doctor and became a woman holding …

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A dead baby in my arms

Why is there a shortage of mental health professionals?

Conditions
June 26, 2022

There are many topics on which I cannot claim to be an expert. I cannot solve the issue of gun violence, I don’t know what will “fix” the current societal crises, and I have no idea what will happen in the future regarding climate change.

There is one topic that seems to be coming up with more frequency and regularity, and I am qualified to speak on that. The shortage of …

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Why is there a shortage of mental health professionals?

America trains enough doctors: Redefining medical supply and demand

Policy
June 25, 2022

If the U.S. medical system is a chessboard, and providers are the game pieces, America is playing those pieces with one column, row, and role instead of using the whole space. Several journals, economists, and medical professionals forecast physician supply to be dangerously low in 10 to 20-plus years. They’re 100% correct that supply won’t meet demand (as things stand now), but the reasons are flawed. Alarmists have been complaining …

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America trains enough doctors: Redefining medical supply and demand

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