I’ve been mean to my body lately. And since I know better, I talk negatively to myself about why I continue to be mean to my body. Lately, I’ve been considering why I do this — why we do this — and how to think about ourselves differently.
Several months ago I had immobilizing low back pain. I broke my low back in high school, and this pain was similar. After …
How to spark the attention of patients
I recently attended a small dinner hosting Robert Lefkowitz, MD, the winner of the 2012 Nobel Prize in Chemistry for his discovery for G-protein coupled receptors. Throughout the night, the conversation traversed a diverse range of topics — from his adventures in Stockholm, Sweden to his work-life balance — but his remarks on one particular subject stuck with me. It turns out that Dr. Lefkowitz, when interviewing candidates to work in …
Standing on the shoulders of the basic science researchers who came before us
A few days ago, I made a call to my neurologist’s office. The fourth call about the same issue. I needed my migraine medication and wasn’t able to get it. I was almost ready to give up and give in to having migraines on a daily basis. None of the usual preventative medications have worked for me, so I am on one of the new, hi-tech injectable medications for migraine …
Too many moving parts: Physicians can’t own it all anymore
This weekend was bliss. I went from Friday night to Monday morning without a single phone call. No nursing homes were needing to send a patient to the emergency room: no new fevers or unexpected falls. I can honestly say that it is the first time in more than a decade that I have gone a whole weekend without doing some work. The thing about my half retirement is …
After a partial retirement, what this physician misses the most
I prescribe heartburn medicines every day. There’s a gaggle of them now — Prilosec, Nexium, Prevacid, Protonix — to name a few. As far as experts know, their primary effect is to reduce the production of stomach acid. This is why they are so effective at putting out your heartburn fire. In simple terms: no acid, no heartburn.
I am quite sure that well-meaning physicians like myself do not understand or …
Seasoned medical professionals prescribe new medicines sparingly
How do we change the way we think about taking care of patients, particularly when it comes to not the individual patient sitting in front of us, but a whole population of patients just like them (or somewhat like them)?
In our practice, we have been struggling with how to best do population health, trying to find the best ways to …
To do population health right, think about individuals
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.
I imagine every physician anesthesiologist has experienced drug or equipment shortages in the last year. How frustrating that even in the world’s largest health care system, basic medications can be unavailable. However, when I step back and look at the big picture, I …
Reflecting on the state of global anesthesia
“Red” McDougall had terrible leg pains soon after going to bed. He did have a bad back, and some mild spinal stenosis, but I hadn’t heard much about that in the past few years. He was dealing with the ache in his legs when he was on his feet too long.
A few months ago he saw his vascular surgeon for a routine followup. He’d had a femoral-popliteal bypass to restore …
When the buck stops with primary care
So many people are suggesting that if only doctors practice self-care we could deflect burnout before it overtakes us. Yes, physicians are probably the worst professionals for taking care of ourselves. We work long hours, answer calls at all hours of the night, take little vacation, work in stressful situations, and often face hostility in the workplace. But this is not the reason we are burning out at high rates; …
Solving physician burnout requires so much more than self-care
I was having dinner with somebody not so long ago, and the conversation turned to what life is like as a physician. I always find it interesting to have these conversations with people who are not in the medical field, especially those who have got their ideas from watching medical shows on television! The person I was speaking to on this occasion, however, wasn’t about to go down that route, …
Health care professionals must always be on their A game
The term “physician compensation” could be among the top phrases in health care this year.
Though it’s always been a hot topic, it got hotter when the Trump administration announced a proposal that would affect nearly 40 percent of Medicare payments. That plan would replace a fee scale that compensated doctors more for seeing sicker patients with …
5 anomalies about compensation physicians should know about
An excerpt from Doctor Brooklyn: Love & Life at the End of a Knife.
“Goddamn, you’re getting married? Are you outta your mind?”
“I’m going to tell Goldie your advice on marriage. I predict you will spend the next twenty years sleeping on that very lumpy couch you own,” Zach said to …
“I don’t want to get to the end of my life and find that I lived just the length of it. I want to have lived the width of it as well.”
– Diane Ackerman
Nathan picks up a pen from the tray next to the dry erase boards.
“OK,” he says. “Here’s what he showed us.”
The rest of our small group watches. Nathan is one of the more intense medical students I …
Medical students and physicians are forever looking to milestones
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To err is human, and in the health care arena, avoiding errors is crucial. Efforts to address communication-related or “soft skill” failures have been ongoing since about 20 years ago when the Institute of Medicine (IOM) published reports titled To Err Is Human and Crossing the Quality Chasm. When we rely on …
3 surprising links to medical errors
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 55-year-old man is evaluated in follow-up for severe COPD, which was diagnosed 2 years ago. He has had two exacerbations in the past year requiring hospitalization, and his baseline exercise tolerance is low. He completed pulmonary rehabilitation 3 months ago without much improvement in exercise capacity. He quit smoking 1 year ago. …
MKSAP: 55-year-old man with severe COPD
Asset protection is a term that gets tossed around quite a bit when we discuss how long and difficult the journey is for doctors to establish their careers. You always want to protect what you’ve worked hard for, right? The principles for asset protection apply not only to doctors but essentially anyone who wishes to have some sort of security for their assets. The key is to make sure you don’t over …
What physicians should know about umbrella insurance
Career burnout is becoming increasingly common and is a hot topic lately, particularly for physicians and other health care workers.
The causes are many. Increased demands. Decreased reimbursement and recognition. Longer hours and lower benefits. The feeling that you’re just another wheel in the cog.
In medicine, it’s the ever-thickening red tape. Clumsy electronic health records (EHRs). Prior authorizations. In-baskets that fill up with dozens or hundreds of messages any time you’re …
Personal finance strategies to combat physician burnout
In the last year of medical school, all medical students are faced with important decisions about where they would like to complete their residency. For osteopathic students, one key element of this decision is to what extent do they want to be a minority within their program. I am an osteopathic physician. Osteopathy is core to my identity and pride as a physician. I am one of two osteopathic physicians …
Applying to residency as an osteopathic medical student: myths and realities
It has been suggested that once leadership of an organization is made up of 30 percent women, integration and increased success are enjoyed. As an orthopaedic surgeon, the feeling of being surrounded by so many women is not something that I have experienced. But last week I felt something close.
The International Pediatric Orthopaedic Symposium (IPOS) has been held in Orlando, Florida, for the past 12 …
A tipping point for women physicians at the podium
Veterans do not only matter one day of the year. Beyond Veterans Day, it is not only important to reflect on the lives lost and the sacrifices made by those who served our country, but to ask: are we doing enough as a nation to give veterans the support and care that they need? Veterans deserve to be more than a political football. We discuss “supporting our troops” and “honoring …
Leaving no veteran behind when it comes to health care access
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