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Warning: The medical system is fragile. And that’s OK.

Mary Braun, MD

Physician

January 9, 2020

Because everything around us usually works, it can be easy to forget how fragile some of the workings are. My patients see this with their bodies, as they fail, but not so apparent to them are the fragilities of the health care system that we doctors get to see.

Despite what the if-it-bleeds-it-leads press might have you thinking, our health care system is pretty good. Good, however, is never good enough, …

Don’t ask me about your husband’s flatulence if he’s not my patient. Bring him in instead.

Michael Kirsch, MD

Conditions and Diseases

January 8, 2020

Doctors dispense medical advice. That’s what we do. Folks come to our office with various medical issues. We talk to them. We poke around some of their body parts. Then, we exercise our medical judgment. We might order a CT scan. We might prescribe stuff. We might simply reassure them and send them on their way.

This is a typical day in the life of a health care provider, formerly known …

Corporate games have ruined the health care system

Osmund Agbo, MD

Health Policy

January 8, 2020

There are certain paradoxes of life that are beyond the realm of rational explanation. To me, one of such is that a country that figured out how to defy gravity and conquered the cosmos has time and time again proven to be incapable of taking care of the most basic human need, namely: a commonsense health care delivery system.

U.S. spending on health care in 2016 was estimated at about 17.2 …

My name is not “Med Student”

Anonymous

Medical Education

January 8, 2020

“I should explain to you, Socrates, that our friend Cratylus has been arguing about names; he says they are natural and not conventional; […] that there is a truth or correctness in them.”
– Plato

I once heard that the sound of one’s name is the most beautiful thing in the universe, which is probably an overstatement. But one’s name is one of the first words one hears from birth, as parents …

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My name is not “Med Student”

A pediatrician’s 5 ways to curb kid’s digital media consumption

Johanna Vidal Phelan, MD, MBA

Conditions and Diseases

January 8, 2020

During the winter months, it’s common for many families to spend more time indoors due to colder weather and fewer daylight hours.

Unfortunately, children may also end up spending an increased amount of time using electronics to entertain or divert themselves from the dreaded childhood condition commonly known as “boredom.” As parents and caregivers, we must be aware of the time our children are committing to digital media and regularly monitor …

Both physicians and patients need to stop viewing technological tools as threats

Robert Pearl, MD

Health Technology

January 7, 2020

A recent study published in Science, one of the world’s leading academic journals, found that a predictive health care algorithm discriminated against black patients.

The tool, created by Optum, was designed to identify high-risk patients with untreated chronic diseases, thereby helping administrators re-distribute medical resources to those who’d benefit the most. But there was a glitch in the algorithm, according to researchers. Rather than ranking the needs …

Why intangible skills are so important for surgeons

Mara L. Schenker, MD

Physician

January 7, 2020

As a fourth-year orthopaedic surgery resident, we had some surgical autonomy. Always at arm’s length from the attending oversight, this was just enough to push us past our comfort zones.

My problem was I loved my comfort zone.

The single most influential day in my career happened late one evening as a PGY-4. I was about to start a complex ankle fracture by myself. The ankle fracture involved the fibula and the …

To err is human, to empathize is to heal

Ameer Khowaja, MD

Physician

January 7, 2020

Empathizing with others’ suffering is one of the most human expressions in life. For empathy to nurture, like any other emotion, it needs time and space, and in none other professions, this maxim is codified as profoundly as in medicine. Even in the times of pre-modern medicine, humans had the temptations to heal fellow humans’ suffering from ailments about which they knew little and had no therapeutics to offer. Nevertheless, …

Why gratitude is a superpower

Michael Maddaus, MD

Physician

January 7, 2020

I found this note waiting for me this morning in the kitchen.

It was from my daughter, who is home for the holiday week from New York. I made her a cup of coffee yesterday morning, and it was waiting for her on the table when she woke up and meandered sleepily into the kitchen.

Seeing the warm and happy …

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Why gratitude is a superpower

Medicine is for the birds, or it should be

Michael Kirsch, MD

Physician

January 6, 2020

Medicine is for the birds, or it should be. Hear me out.

A day before I wrote this, I was on the trail in northwest Ohio, binoculars in hand, trying to tell one warbler from another. This was the final weekend of the biggest week of birding in Magee Marsh on the shore of Lake Erie. Birders converged here from neighboring states and even from foreign countries …

A primary care physician at his peak is forced into early retirement

Ross L. Fisher, MD

Physician

January 6, 2020

Time is of the essence. The very utterance of this phrase connotates a sense of urgency for an impending crisis or adversity if some essential action is not taken. I find myself most unexpectedly at this crucial junction. I am a seasoned, experienced general internal medicine physician, trained traditionally in hospital medicine, and subsequently evolved into outpatient care of comorbid complex chronic disease management. From everything I read and hear …

A physician’s story of addiction, depression, hope, and recovery

Adam B. Hill, MD

Physician

January 6, 2020

An excerpt from Long Walk Out of the Woods: A Physician’s Story of Addiction, Depression, Hope, and Recovery.

As a young child’s heart rhythm faded to a stop, I walked off the hospital floor and got in my car with a plan to end my own life. …

The sad demise of an idealistic family physician

Cory Michael, MD

Physician

January 6, 2020

Graduation from my residency program was a bittersweet experience. At the time, my specialty was suffering from a crippling job shortage, so our futures were uncertain, and a dark mood had come to permeate my radiology residency. We were disgruntled with the specialty, with the system, and with medicine in general. I attended my graduation without any guests and only stayed long enough to receive my certificate.

I was, however, honored …

What’s the hardest part of a physician’s job?

Rada Jones, MD

Physician

January 5, 2020

I work in the ER. It’s not an easy job. Not glamorous either. At least not as glamorous as my mother-in-law used to think.

Years ago, when I declared I was going into emergency, she looked at me askance. She didn’t ask why. She looked at me with her wise old eyes. “Let me tell you about ER,” she said. “I know all about it. I watch every show.”

She was politely dismissive …

My dream as a physician

Kamala Tamirisa, MD

Physician

January 5, 2020

Everything in life starts as a dream. Big or small. My dream was to become a physician since I was quite young — the first one in my family to walk the path. I wanted to understand the science of the human body and help the sick. Heal with my skills, knowledge, and empathy. Hold my patients’ hands with care and confidence. My work was to be like none other. …

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My dream as a physician

Who are the doctors who end their own lives?

Fariha Shafi, MD

Physician

January 5, 2020

Recently, a fellow physician mom ended her life. While outwardly, a very vibrant, lively, and happy woman, she fought her own internal demons for some time. From what we know, she struggled with depression but was still committed to being a good mom, physician, and wife. Sadly, a few days before her birthday, she could no longer bear her sadness and decided to end her agony. I know many physicians’ …

What doctors can (and should) learn from patients

Philip A. Masters, MD

Physician

January 5, 2020

A guest column by the American College of Physicians, exclusive to KevinMD.com.

In many ways, the patient-physician relationship is seen as being mostly one-sided, with doctors possessing medical knowledge and wisdom, and patients with less medical information being in a position where they need a physician’s help and guidance in managing their health issues. Consequently, …

Most medical offices are hopelessly old fashioned

Hans Duvefelt, MD

Physician

January 4, 2020

Imagine if your bank handled all your online transactions for free but charged you only when you visited your local branch — and then kept pestering you to come in, pay money and chat with them every three months or at least once a year if you wanted to keep your accounts active.

Of course, that’s not how banks operate. There are small ongoing charges (or margins off the interest they …

How your mind can turn against you

Kyle Bradford Jones, MD

Conditions and Diseases

January 4, 2020

An excerpt from Fallible: A Memoir of a Young Physician’s Struggle with Mental Illness.

Jason had an entire group of voices in his head that he called “the committee.” They talked nearly constantly, sometimes in a flat roar but often escalating to shouting. He described it as …

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How your mind can turn against you

Would a Hippocratic Oath for health care executives make a difference?

Paul B. Hofmann, DrPH, MPH

Health Policy

January 4, 2020

Would a Hippocratic Oath for health care executives make a difference? Probably not. Nonetheless, there is ample evidence that the organizational cultures of too many hospitals are not conducive to physician well-being.

In a provocative blog posted on May 2, 2019, emergency medicine physician Mark Borden indicated a Hippocratic Oath was urgently needed for administrators.

Dr. Borden wrote: “Physician employment was, and is, obviously an intrinsically flawed structure …