Jimmy McMillan might have been right. Mr. McMillan ran for mayor of New York City as the founder and candidate of the “Rent Is Too Damn High” Party. And while he was talking about real estate rent, he might have made a similar complaint about health care’s rent — payments made for costs over what is needed to produce a good or product.
Rent is not …
The rent is too high in health care
World Kidney Day reminds us of the 850 million people globally affected by kidney diseases. It draws attention to the 1 in 7 American adults managing Chronic Kidney Disease (CKD) and the 660,000 Americans with end-stage renal disease (ESRD). It also reminds us that kidney disease is the 9th leading cause of death in the United States.
But perhaps one of the most important statistics on World …
Kidney disease patients deserve better, and so do their doctors
As medical professionals, one of the most challenging things to do is to motivate a patient to make changes in their lives. We passionately want the best for our patients, and it is sometimes so difficult for us to be able to connect with and inspire them to take the next step on a path to disease prevention and longevity. The solution? Enter Lebron James and Tom Brady.
It is no …
How Tom Brady and Lebron James can change your patients’ health
Are you or a loved one aging, perhaps with a chronic heart or lung condition that limits daily activities? Do you have an older parent in a nursing home or who needs assistance with daily living activities? If so, read on and make the pledge.
As physicians, we see death every day. We see death made worse and more painful by poor advance care planning. Yet, despite the certainty of death …
Pledge to end your fear of death and end-of-life care
For the past several years, I have been befuddled by patients calling me by my first name (Sara) instead of my professional title (Dr. Jones). At first, I ignored this, but as it became more common, I started telling some of these patients that I preferred being called Dr. Jones rather than by first name. This took some patients aback — probably thinking I was a snob — while others …
Why do patients call me by my first name?
I’m an ER doc. I care for patients. All patients: Those who need to be in the ER; those who don’t; those who wouldn’t be there if they knew better. For them, for you and for fun, I’ve got some tips to keep you happy, safe and away from my ER. Enjoy.
1. Never, ever say “hold my beer and watch this!” Besides “I do!” they are the most dangerous words …
I didn’t become a primary care doctor to treat opioid addiction.
I wasn’t trained for it. To be honest, it scared me.
But when you work, like I do, at a clinic that serves a lot of people who have little money or who struggle with mental health and substance use issues, there comes a point when you have to step up.
When I started seeing patients in 2009, I knew that opioid …
Physicians can choose not to be powerless against opioid addiction
If you’re in the emergency department, it’s probably the worst day of your life. You’re scared, confused, anxious, sad, maybe emotionally numb.
You were at home with your husband and witnessed him have a cardiac arrest. He was unresponsive, and he wasn’t breathing. You felt hopeless because you didn’t know how to help him, but you called 911. They rushed him to the hospital, and you followed the ambulance. By the …
A scribe’s haunting view of emergency medicine
Most patients have an idea of how surgery and chemotherapy work. It’s not difficult to picture a surgeon cutting out a cancer or a medical oncologist prescribing chemotherapy. But how does radiation therapy work? For the vast majority of patients, and a good number of physicians, radiation therapy is a completely foreign concept.
In my practice, I find that a good portion of every new patient consultation is spent explaining what …
How does radiation therapy work? A radiation oncologist explains.
As a pediatrician, I am asked by worried parents about what they should give their child with a fever, Motrin (ibuprofen), or Tylenol (acetaminophen) to bring down the temperature daily.
This question always requires more than a one-word response to the choice between anti-fever medications. An explanation of medication even being necessary for the fever and to clarify many long-standing fever phobia misconceptions.
Mainly, it is not necessary to treat the number …
Motrin vs. Tylenol for children: A pediatrician explains
Studies show that when people know what palliative care is, they want it. Marketing genius Seth Godin talks about offering services that are “remarkable” — so good that a person would cross the street to tell a friend.
Palliative care has that kind of value, so why doesn’t our message travel upstream through word of mouth? Would-be evangelists are often flummoxed by the fact that the phrase has still has different …
10 commandments to help with palliative care messaging
Sequels generally disappoint. Jason couldn’t match the fear he generated in the original Friday the 13th. The sequel to the “Parachute,” a satirical piece canvassing PubMed for randomized controlled trials (RCTs) comparing parachutes to placebo, matched its brilliance — and even exceeded it, though the margin can’t be confirmed with statistical significance. The “Parachute,” published in BMJ’s Christmas edition, will go down in …
Keeping the art of medical satire alive
More than two-thirds of Americans use social media, and 90 percent of adults in the U.S. have a cell phone. With these tools surrounding us, we must be more connected with one another than ever before. Right?
It doesn’t feel like we are. At least, the people who engage with the health care system don’t feel connected to the rest of us. They feel lonely. It feels like we send them …
Social isolation is a health risk
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Rudolf Virchow, a pioneering physician of the 1800s, once wrote that “politics is nothing but medicine on a large scale”. Over a century later, this nexus is as apparent as ever, and many doctors engage as practitioners of both.
Twitter erupted this past fall with photos of soiled scrubs, resuscitation room floors and surgically-removed bullets — all crimson with …
For future physician-activists: This is our lane
My wife and I once canoed across a glacial lake. There were twelve people in our 30-foot canoe. To reach the shore of the Mendenhall Glacier, we had to paddle two miles across a lake. All twelve of us had to paddle together to reach the shore. But what if we had different goals? What if the right side of the canoe wanted to paddle east and the left side …
Health care workers and administrators aren’t rowing in the same direction
Apocryphal story from residency:
On morning rounds in the critical care unit, the post-call resident starts to present a complicated patient admitted overnight with chest pain, and after the first bits of the history have been presented, the wise old cardiology attending turns to the gathered medical students who are just starting their first clinical rotation and asks them what they …
What if EMRs can never capture the clinical experience?
When it comes to communication in the hospital setting, I have seen many iterations. My favorite version was at the VA on the inpatient medicine unit. Every morning, we all met in the medicine team room to discuss patients on the floor. The team’s social worker, nurses, residents, students, and the attending ran down the list to identify individual patient goals, what’s needed for safe and effective discharges home, and …
Communication in the hospital setting from a medical student perspective
A guest column by the American College of Physicians, exclusive to KevinMD.com.
The aim of medical education is not only to transfer scientific knowledge, but also impart the wisdom accumulated over the long history of medicine that equips us to apply this knowledge for the betterment of our patients.
Although much of medical wisdom transmitted in …
Physicians need to be better judges of science
For many months, artificial intelligence has been in my peripheral vision, just sitting there, ignored by me because it seemed too far in the future to be interesting now.
And then, there were all these terms — Big Data, machine learning, data science — which circled the subject and, frankly, gave me a bit of a headache.
Artificial intelligence is upon us, unleashed and unbridled in its ability to transform the world. …
The truth about artificial intelligence in medicine
I met Mr. B during my week on the endocrine service of my internal medicine rotation. My attending told me we were being consulted for this patient’s high sugars and a foot ulcer, and asked me to take the history.
I walked into Mr. B’s room and was immediately struck by its stench. Mr. B had undergone a resection of his bladder tumor the day before and as a result was …
The hidden curriculum of medical school can be overwhelming and unforgiving
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