I met a young man in my clinic recently, who came for treatment of obesity.
He was only 26, yet suffered from obesity throughout his life — now reaching a debilitating 420 pounds. His explanation for how he developed obesity was a reflection of the issues surrounding nutrition health policy in the U.S. He said that “it would have been easier to not put the weight on to begin with,” that …
How can we really stop obesity?
It’s no secret that in today’s health care market, insurance companies are calling the shots. As a pediatrician in private practice for almost two decades, I’ve seen insurance companies transform into perhaps the single most powerful player in today’s health care landscape — final arbiters whose decisions about which procedures or medications to authorize effectively end up determining the course of patient care.
Decisions made by insurers, such as MassHealth, have …
How an insurance company auditor tried to destroy a physician’s career
A guest column by the American College of Physicians, exclusive to KevinMD.com.
Much has been discussed in recent years around the concept of “practicing at the top of your license.” But what does this really mean?
The most common definition is that each medical professional’s routine activities should utilize the full extent of their education, training, …
Practice at the top of your license: What does that really mean?
Transformation of health care is underway: The landscape is filled with innovation, and the horizon is dotted with technological possibilities of “Star Trek” ilk. In a recent New England Journal of Medicine Catalyst article, there was a compelling argument for how artificial intelligence (AI) of the future will help deliver us from a high cost, high variability, poorly resourced state and help deliver the IHI triple aim quest we in …
Will artificial intelligence be able to have this conversation?
When I was a third-year resident, I was invited to join a practice owned by a doctor who had once been my chief resident. This was considered by all of my fellow residents to be the plum job in town, and I was thrilled. The doctor, whom I shall call “John,” was smart and funny and had a huge practice that he had purchased from a retiring physician. We figured …
A physician’s ex-business partner is in prison. Here’s what this doctor learned.
The numbers are in. Medscape National Physician Burnout, Depression & Suicide Report 2019 indicates that the rate of physician burnout is still at an all-time high. Forty-four percent of physicians reported feeling burnt out.
According to the report, 50 percent of women reported experiencing burnout versus 38 percent of men. Carol Bernstein, MD, a psychiatrist at NYU Langone Medical Center, states that the reasons for the difference …
2 questions every physician should ask themselves
Perhaps the most important aspect of a physician’s role is our diagnostic capabilities. Truly, if we cannot identify and diagnose a patient’s pathology with reasonable accuracy, we cannot effectively treat them and may even cause greater harm.
Let’s look back. The year is 1816, and you are a physician evaluating a patient with shortness of breath. The common practice of the time was direct auscultation by placement of the practitioner’s ear …
It’s time to update the stethoscope
“Ms. Taylor*?”
“Yes, it’s me. I’m so deeply sorry to you and the team. You all helped me so much when I was here. But I started drinking a day after I left and blacked out.”
Two weeks ago, Ms. Taylor was found by her sister lying unconscious on the bathroom floor after a week-long alcohol binge. Next to her was a suicide note.
“My depression is robbing me of my freedom. I …
Do whatever it takes to conquer this depression. Now and forever.
Chances are that if you have kids, you’ve had at least one unplanned visit to the hospital. Taking care of children in the emergency department (ED) is a special challenge for many reasons including the fact that the child’s parents don’t choose to see me specifically, they are usually meeting me for the first time, and they’re meeting me under very stressful circumstances.
When I started practicing medicine 20 years ago, …
The unsung heroes of sick kids
A male interventional radiologist who is active in the #HeForShe campaign recently told me that he is being pressured to stop advocating for women. My first instinct was the biggest sigh and eyeroll of my life followed by thoughts of locker room peer pressure and boys’ club type discussions.
But the criticism did not just come from men; many women are asking him to stop. That they don’t need a knight …
Why would any woman discourage a man’s advocacy or support?
During my third year of medical school, I completed a clinical rotation in surgery. I was certain that it would be horrible. I envisioned myself in the OR, getting lightheaded, passing out onto the sterile field and being yelled at by my attending physician. I worried that the medical knowledge I’d worked so hard to learn would be neglected in favor of memorizing the steps of surgical procedures. My parents, …
Do you know why you’re having surgery?
There is a lot of discussion about what to do about physician burnout. The conversation includes debates on the actual incidence of burnout, why it varies among specialties and work environments, who is responsible for it and what can be done to combat it.
What matters is the solution for the physician on the front line, who is experiencing disconnection and disillusionment with a career they spent most of their life …
5 ways for physicians to fight burnout
“Come on, bring it on! Come on, bring it on!” the little girl repeatedly chanted behind the drawn curtain in the pre-op holding area. I pulled the curtain back and peered in to see my young patient in the bed and happy as a lark, her mother was sitting next to her trying to contain her laughter. Other patients and staff members giggled as they passed by, hearing this mantra …
Where’s the humor in medicine?
ADVERTISEMENT
I cannot begin to count the number of misspellings that I have witnessed of my first name. The number of “As” and the pronunciation confuse both first-timers and my closest friends. Its spelling on my first elementary school report card set the rhythm for things to come, from high school diplomas to wedding tabletop cards. And as I wandered around stateside for college and medical training, different interpretations led to …
What happened to the first name in medicine?
A rapidly escalating measles outbreak near Portland, OR has led local health officials to declare a public health emergency, with 44 confirmed cases, almost all in unimmunized children. Meanwhile, New York and New Jersey have been facing a similar crisis over the past few months, with over 200 confirmed cases of the measles tearing through the ultra-orthodox Jewish communities in the area, …
The measles outbreak, media imagery, and the thoughtful focus of fear
It seems you can’t open a magazine or surf the web these days without reading about Marie Kondo, the author of the New York Times bestseller, The Life Changing Magic of Tidying Up. Kondo has attained a cult-like status for her ability to help people improve their lives by radically reducing their stuff, and her new show on Netflix has inspired a national decluttering frenzy.
For those of …
What Marie Kondo can teach us about physician burnout
To do the math right, you have to get your numerator and denominator correct, or else things just don’t work.
Recently, in the midst of a large patient safety and quality improvement project trying to bridge gaps in breast cancer screening among our patients, we discovered that one of the large databases of patients who were attributed to us contained innumerable …
How one insurer’s mistake wrecked a practice’s quality score
Marie Kondo, the best-selling guru of organization and “sparking joy” has established the foundation of getting a space organized and functional. Her do-it-all-once method, known as the KonMari Method, is considered healthy and life-altering for those seeking organization and productivity in their space. One of the ideal places to organize is the home office especially for doctors, nurses and medical professionals who have reading, studying and research to do. You …
How physicians can use Marie Kondo’s KonMari Method
This article is sponsored by Careers by KevinMD.com.
Academic and education environments tend to use the word curriculum vitae, or CV, more frequently than resume. But, a CV’s purpose is the same: to get you a job.
Although a CV generally contains more information than a standard resume, the keys to a successful CV are still brevity and …
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 66-year-old man is evaluated in the hospital following ST-elevation myocardial infarction treated with primary percutaneous coronary intervention of the left anterior descending artery 4 days ago. His initial presentation was complicated by the presence of heart failure and pulmonary edema. He is asymptomatic and ambulating, and he is …
MKSAP: 66-year-old man with ST-elevation myocardial infarction
Get free updates delivered free to your inbox.
