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We must find a way to reward doctors who are caring and compassionate

Physician

October 24, 2019

It was about ten years ago.

I was already running about an hour behind, and the next patient on my schedule was a familiar one. But not for good reasons. This was a very complicated patient with huge emotional needs, whose visits would routinely go 30 to 45 minutes, well beyond the 15 minutes allotted. My heart sank. I would either have to hurry a visit with a genuinely needy person, …

The Resident and Fellow Bill of Rights

Eden Almasude, MD

Medical Education

October 24, 2019

Last June, I became a freshly-minted young doctor, bright-eyed, and enthusiastic about heading off to my dream residency program. By August, I found myself crossing the street on my way home, wondering if I had made a horrible mistake that could have harmed a patient. The most painful thing was, I hardly had the energy to care.

This is not why I chose to dedicate myself to medicine.

Like many medical trainees, …

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The Resident and Fellow Bill of Rights

We must hold the government accountable for the health of the most vulnerable

Bonnie H. Arzuaga, MD

Physician

October 23, 2019

898.

This is the number of cases of mumps that occurred in migrant detention camps in a 12-month period between September 2018 and August 2019. According to the Center for Disease Control (CDC), 84% of the migrants who contracted the illness did so while they were in the custody of Immigration and Customs Enforcement (ICE) or another U.S. agency. Only 5% had been infected before they were apprehended. …

Applying for residency? Read this first.

Sudhakar Nuti, MD

Medical Education

October 23, 2019

Residency application season has begun!

When I was applying last year, I spent a lot of time thinking not just about what programs I wanted to go to, where I wanted to live and how best to answer “Where do you see yourself in five years?” — but also trying to develop a method for making this decision. This is the mental model I came up with that helped me through …

An American reporter looks at Germany’s health system

Shefali Luthra

Health Policy

October 23, 2019

Researchers around the world hail Germany for its robust health care system: universal coverage, plentiful primary care, low drug prices, and minimal out-of-pocket costs for residents.

Unlike in the U.S., the prospect of a large medical bill doesn’t stand in the way of anyone’s treatment. “Money is a problem in [their lives], but not with us,” said Merangis Qadiri, a health counselor at a clinic in one of Hamburg’s poorest neighborhoods.

But …

Moral injury from a primary care perspective

Talal Khan, MD

Physician

October 23, 2019

The backbone of a great health care system is its primary care task force. From Singapore to France, elite health care systems rely on these cerebral doctors to provide preventive, urgent, and acute care along with chronic disease management. Primary care doctors have a broad-ranging impact from health care access, cost control, and impact on mortality and morbidity rates.

I was a graduate of a class of 50, of which only …

Physicians: Constantly focus on raising your game

Suneel Dhand, MD

Physician

October 23, 2019

A couple of months ago I was having a conversation with a good friend of mine, who is a doctor in England. We were talking sports, specifically tennis at Wimbledon and the superb performance of Roger Federer. He made a remark that I thought was great observation: “That psychological ability to raise your game rather than lose heart when behind is common to all elite sportspeople, but quite unusual in …

Our doctors are dying in medical school

Imshan Dhrolia, MPH

Medical Education

October 23, 2019

It’s fascinating — the strange clarity that a little panic brings.

I remember thinking this in the days after, startled at the level of detail in my memories of the first time I watched a patient die.

“Just got a call, transport’s bringing in a code. You good to standby for compressions?”

I nodded as I felt my stomach free fall ten-thousand feet, managing a, “Yeah, totally,” that sounded more confident than I …

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Our doctors are dying in medical school

The unintended consequences of keeping hospital patients in bed

Melissa Bailey

Conditions and Diseases

October 22, 2019

Dorothy Twigg was living on her own, cooking and walking without help until a dizzy spell landed her in the emergency room. She spent three days confined to a hospital bed, allowed to get up only to use a bedside commode. Twigg, who was in her 80s, was livid about being stuck in a bed with side rails and a motion sensor alarm, according to her cousin and caretaker, Melissa …

Crossing the threshold when residency begins

Ashley McMullen, MD

Physician

October 22, 2019

Today, I’m thinking about the end of residency. But first, let me tell you about the beginning of residency. My first day of clinic, my very first week of residency, I had a grand total of one patient scheduled. A seasoned, outgoing resident had given me sign-out on this person, along with some big, knowledgeable shoes to fill. I did my most thorough pre-rounding the evening before. I prepped my note and …

Why electronic medical records should be standardized

Fred N. Pelzman, MD

Physician

October 22, 2019

How can we possibly get to standardization in medicine? And is that a good thing?

Standardized checklists save lives; rigid procedures for sterilization of equipment saves lives; universal compliance with recommended beneficial treatments saves lives. And while it’s sometimes a wonderful thing to let a surgeon solve a problem creatively or to allow a patient visit to go overtime in order …

Why this physician never tells anyone she’s a doctor

Rada Jones, MD

Physician

October 22, 2019

I’m an ER doc, and proud of it. But I never mention it when I meet new people. Unless someone’s fixing to die, I avoid it like the plague. “I work in a hospital,” I say. “Where in the hospital?” “The ER. How about you?” That’s a topic changer, since most people would rather talk about themselves.

Why not own it, you ask? There’s no shame in being a doctor. It’s not like …

Expensive Medicare patients aren’t who you think

Peter Ubel, MD

Health Policy

October 22, 2019

Over half of Medicare spending is concentrated in 10 percent of patients. With Medicare expenditures rising at an unsustainable clip, reigning in the costs of those patients is key to controlling health care spending.

So who are those patients and what expenses are they racking up?

It’s not who or what I expected. When I think of high-cost patients, I envision people with drawn-out hospital stays, or imagine people …

We need physician leaders who understand our problems

Sasha K. Shillcutt, MD

Physician

October 22, 2019

You cannot work in medicine today without being inundated with burnout statistics and commentary on your feed, coming to your inbox, or spoken from stages about the state of medicine we are in. The data is dire: we are disengaged, we are making mistakes, we are not heard, and we are not empowered to make decisions.

There’s passionate debate on whether it’s individual versus institutional changes that will save medicine from …

4 significant misconceptions about universal health care systems

Niran S. Al-Agba, MD

Health Policy

October 21, 2019

Recent polls show a majority of Americans support Medicare for all, but few seem to realize that no other system in the world operates like the current single-payer proposals in Congress. I addressed the concept of single-payer health care, with Cuba’s system as an example. Today I’m writing more about the ideas being discussed now in our country and how those compare to other nations that provide …

How internal medicine got its name

Philip A. Masters, MD

Physician

October 21, 2019

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

Of all medical specialties, perhaps the most difficult to understand is internal medicine.

While the name suggests that those who practice internal medicine focus primarily on non-dermatologic diseases of “Internal” organ systems (which in many ways is true), unlike other medical fields whose names …

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How internal medicine got its name

When you’re a physician, you’re a detective

Lauren Joseph

Medical Education

October 21, 2019

A professor recently romanticized my idea of clinical reasoning as he began our session by saying, “When you’re a physician, you’re a detective.” He elaborated: “Every fact you have, every piece of evidence you have, must be consistent with your leading diagnosis.” As he said this, my eyes narrowed, and I sat up a little taller.

My fellow first-year medical students and I have begun our official training in clinical reasoning, …

Why we need more transplant physicians

David Weill, MD

Physician

October 21, 2019

During the 25 years I’ve been a transplant doctor, I’ve cared for hundreds of patients who received lung transplants. I’m now worried about the growing number of people who will need this lifesaving procedure in the future but who won’t have enough transplant physicians to do it.

At any given time in the U.S., about Read more…

Why we need more transplant physicians

A father-physician tests if a little peanut a day keeps allergy away

Edwin Kim, MD

Conditions and Diseases

October 20, 2019

No one I knew had food allergy, let alone peanut allergy, when I was a child. I grew up at a time when peanuts were given freely on airplanes, and there was no such thing as a peanut-free table at school. Fast forward to today and the world has changed, with food allergies taking on almost epidemic-like proportions.

I am an allergist and became interested in food allergies …

Gold is pretty, but it is not an investment

Cory Fawcett, MD

Physician Finance

October 20, 2019

I often hear people talking about their “investment” in gold. Then there are those who have a “diversified portfolio,” and gold is one of their forms of diversification. I’ve encountered people who have $60,000 worth of gold bars in their home safe, in case of a major financial crisis. We all see the celebrities pitching gold on national television ads with “now is a great time to buy gold.”

If you …

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