| KevinMD.com

It’s time for physicians to stop thinking like dogs

Physician Finance

July 3, 2019

When I sat on the management committee of our surgery center, I was wondering why owners didn’t bring all their cases to the facility. They would clearly benefit financially if they increased their caseload. So why didn’t they? I realized, it was because we all think like dogs.

Dogs will do tricks if you give them a treat immediately after their successful performance. Dogs will not do tricks if you promise …

In the age of EHRs, why are we still asking patients to fill out paper forms?

Fred N. Pelzman, MD

Physician

July 3, 2019

From the sublime to the ridiculous.

That’s sort of how my day went yesterday.

It started out with an early morning meeting with a colleague who has been implementing a telehealth program at one of our institution’s practices, learning about how they have been using this technology, some of the bumps in the road they’d hit, and how they’d been able to …

The man who defecated outside the ER

StorytellERdoc, MD

Physician

July 2, 2019

“Sometimes sh*t just happens.”

Just a few days ago, I finished yet another string of four hectic shifts in the ER of our incredibly busy trauma center. After saying my goodbyes to my coworkers and transferring the care of my remaining patients to my partner, I left the building through our ambulance doors, avoiding the main pedestrian entranceway where the hectic waiting room sat.

It was a safe choice to leave this …

Read more…

The man who defecated outside the ER

Technology is corrupting the culture of medicine

Robert Pearl, MD

Health Technology

July 2, 2019

To help then-candidate Bill Clinton remain focused on the No. 1 voter issue ahead of the 1992 presidential elections, political strategist James Carville coined an unforgettable mantra, which he posted inside Clinton campaign headquarters.

It read, “The economy, stupid.”

The quote became famous both for its edginess and wisdom, reminding us to separate the big picture from everything else.

In health care, it can be hard to define the “big picture” issue when …

You’re lucky to have a medical student in the family

Nathaniel Fleming

Medical Education

July 2, 2019

One of the most common experiences faced by a medical student is being asked for health care advice from a friend or family member. My initial reaction to these questions is usually something along the lines of, “Are you sure you want to be asking me that? I’m not even a doctor yet!” This is especially true when the question is about something that I’m not particularly experienced in (which, …

A key strategy to use for difficult conversations: Ask questions

Suneel Dhand, MD

Physician

July 2, 2019

No matter what profession you are in, having uncomfortable and difficult conversations is something you have to get used to. Tim Ferris said in his bestselling book, The 4-Hour Workweek (which I’d highly recommend), “A person’s success in life can usually be measured by the number of uncomfortable conversations he or she is willing to have.”

It could be with another colleague, a client or customer. Even in your personal …

The tension between guidelines and individualized treatment

Steven Reznick, MD

Physician

July 1, 2019

I recently read an article in a peer-reviewed journal citing the benefits of a few eggs per week as part of a low carbohydrate dietary intervention for Type 2 diabetes. The information was so meaningful about a controversial food source of protein that I decided to write about it in my blog and pass it along to my patients. Three days later the American Heart Association and American College of …

Physicians are problem solvers and artists

Hans Duvefelt, MD

Physician

July 1, 2019

I keep thinking about the dichotomy between covering a lot of ground and getting to the point.

The other day I saw my bosses at one of my clinics stop in their tracks when I suggested that a lot of the things we are measured on as physicians could be turned into standing orders and simply get shifted off my plate. I have just created a letter that anybody can send …

Your home life is what you make it. Don’t let your specialty control you.

Cory Fawcett, MD

Physician

July 1, 2019

The Match is complete, and now the fourth-year medical students are preparing to make their move to residency and chief residents are preparing to start their new career as an attending. The next phase of their lives is about to begin.

The Match got me thinking about a comment I read recently from a doctor who decided to not become a general surgeon, which she had always wanted to be, and …

Electronic health records cannot replace a doctor who knows you

Richard Gunderman, MD, PhD and James Lynch, MD

Health Technology

July 1, 2019

The introduction of electronic health records (EHRs) was accompanied by a great deal of fanfare. Such systems, which replace old paper-based charts in doctor’s offices and hospitals, were designed to make patient data more accurate, safer and more accessible. It was also claimed that they would make it easier for doctors and other health professionals to monitor medical care and ensure that guidelines were followed. The federal government was so …

Why doctors shy away from business

Smart Money, MD

Physician Finance

June 30, 2019

The Hippocratic Oath says nothing about taking out a bank loan to outfit your own office to start your practice, nor does it include investing in real estate to diversify your income. Of course, most doctors didn’t opt to enter medicine with the intention of building an empire of medical care (although some end up doing so anyway). Large hospitals, insurance-run medical groups, and entities that operate with high revenue …

Read more…

Why doctors shy away from business

The end of a life never just impacts the individual who died

Maria Yang, MD

Conditions and Diseases

June 30, 2019

To my knowledge, three people who were under my care killed themselves.

The first was a young man — late 20s, maybe? — who I met while I was a psychiatry intern. He was hospitalized in the psychiatric unit where I had just started my rotation. I did not have the opportunity to get to know him well. Our paths crossed, at most, for two days. He had a diagnosis of …

What does it mean for physicians to be financially free?

Passive Income, MD

Physician Finance

June 30, 2019

What does it mean to actually be financially free? If we make it a goal, what are we really working toward?

Rather than looking at financial freedom as an abstract concept, it can be very useful to visualize exactly how it could impact your life.

Ultimately, financial freedom means different things to different people. To me, true financial freedom comes when you can quit your day job and still be able to …

The sigh of relief on Match Day quickly changed into a sobering reality

Steven Zhang, MD

Medical Education

June 30, 2019

The residency interview trail quickly becomes a lonesome journey, so when I was on it this winter, I’d usually have the hotel room television turned on for some background noise and often find myself watching ESPN’s SportsCenter. On my last interview in Philadelphia, the show was featuring the high flying phenom Zion Williamson, who’s set to be drafted this year to the NBA. When I finally returned to home in …

What to do with physicians who don’t explain

Christopher Johnson, MD

Physician

June 29, 2019

How doctors treat patients’ need for information has changed significantly over the past decades. Sixty years ago medical practice was much more paternalistic than it is now, although some would say it continues to be so in important ways. Still, not too long ago it was common for doctors to tell patients or their families next to nothing about what was going on. The presumption always was: the doctor knows …

Physicians and the employee conundrum

DocG, MD

Physician

June 29, 2019

I used to loathe being an employee. I felt like I was always a slave to the whims of my employer. Exposed. So it was with great excitement that I started a business of my own. Yet, it took only a short period of time to realize that being your own boss carried it’s own perils. The buck stops with you. And so does the …

Read more…

Physicians and the employee conundrum

The consequences of being treated by a master herbalist

Skeptical Scalpel, MD

Physician

June 29, 2019

In August 2014, a 13-year-old boy with Type 1 diabetes died after being treated by self-described “master herbalist” Tim Morrow who was tried for child abuse resulting in death and practicing medicine without a license.

He had told the boy’s mother to stop administering insulin and instead prescribed herbs which he sold. According to one report, Morrow told the parents that insulin was poison, and if they took …

MKSAP: 52-year-old man with progressive weakness

mksap

Conditions and Diseases

June 29, 2019

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 52-year-old man is evaluated for a 1-year history of progressive weakness that began as right foot drop and bilateral tingling in the feet. Within the past 2 months, the patient has developed progressive weakness, which makes walking difficult; he also notes weakness in the hands and burning below …

Why this physician will no longer see nursing home patients

Michael Kirsch, MD

Physician

June 28, 2019

Our practice will no longer see nursing home patients in our office. If a nursing home patient is already established with us, then we will see him; but, we have decided not to accept new patients.

Of course, we believe that these individuals — like the rest of us — deserve medical care. This demographic not only deserves care, but has the greatest need for medical services. Our practice will see …

A diagnosis of pneumonia in a rehab facility: We can do better

Hans Duvefelt, MD

Physician

June 28, 2019

I’ve known Pat McCann (identifying information changed) for many years. He carries a diagnosis of COPD and has a preventative and a rescue inhaler, but he has never really had any serious flare-ups.

He fell and broke his hip. Then he went to skilled rehab, one of a half dozen near Cityside Hospital. His stay turned longer than expected because he fell, luckily didn’t break anything, but had to go back …

Most Popular

Past Week

Past 6 Months

Recent Posts

Subscribe to KevinMD and never miss a story!

Most Popular

Past Week

Past 6 Months

Recent Posts