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Burnout: Don’t blame the clinicians; blame the system

Anh Le, MD

Physician

May 14, 2018

Physician burnout is the depression of the medical world. We are aware of its presence and the detriment it can cause, but yet, we don’t really like to talk about it. The problem is, just like depression, if we don’t talk about it or seek to address it, it persists and leads to a number of unwanted outcomes including decreased productivity, decreased patient satisfaction, and increase in medical errors. And …

What matters in an optimal consumer health care market

Richard Reece, MD

Health Policy

May 14, 2018

An excerpt from Are We There Yet?: The Road to Universal Health Care.

Getting your business matters. Much of what’s happening now in health care and retail markets concerns pleasing you, health care consumers and patients, and getting your business.

The internet matters. You’re almost all wired now. The internet is shortest and quickest route to your heart, mind, and pocketbook (84 percent of you are now making purchases on …

Avoid second-guessing: Investing doesn’t have to be complicated

Wall Street Physician, MD

Physician Finance

May 14, 2018

There are a lot of what-ifs in life.

If only I had made that putt on 14, I could have shot my best score ever.

If only I had taken a different job or performed better at the interview, I would be so much happier at my job.

For decisions large and small, there are ample opportunities to second-guess yourself.

I’m sure you have your own what-ifs when it comes to investing.

If only I …

A better way of using Lyft and Uber in health care

Peter F. Nichol, MD, PhD

Health Policy

May 13, 2018

Recently there was an article in the Washington Post titled, “Uber and Lyft think they can solve one of medicine’s biggest problems,” in which these two companies are angling to provide better, safer more reliable transportation for patients. While I applaud this mission, given the depth and reach of both companies, I think they may be underselling their abilities to improve health care delivery and reduce cost.

Recently, one of my …

Fight depression during residency by fostering connections

Jessica K. Willett, MD

Physician

May 13, 2018

The words were like bitter candies that I had been sucking on, hoping to come to a sweet center. I had walked the hallways of the hospital holding them in the silky pocket of my cheek for weeks. Finally, afraid I would choke, I spit them out into the middle of the dinner table.

“I think I’m depressed.”

I stared down at the tablecloth, moisture collecting on the base of my water …

Comfort in my final hours

Debbie Moore-Black, RN

Conditions and Diseases

May 13, 2018

My name is Lucy.

I have stage IV liver cancer. I wanted everything done — even though the doctors told me this disease is terminal. My family, my church and my friends were praying for “the cure.”

Though I believed in God and the hereafter, I wasn’t ready to go. 74-years-old with beautiful children, grandchildren, and a great-granddaughter.

I woke up confused. In the background — wherever I was — I could hear …

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Comfort in my final hours

10 reasons why doctors spend too much money

James M. Dahle, MD

Physician Finance

May 13, 2018

Once every couple of years I have medical students from the local medical school over for dinner. At some point, the conversation usually turns to finance, and I commiserate with them about their loan burdens. I typically toss them a few pearls of wisdom, wish them good luck, and we move on to something else. They always think it’s funny when I say, “If you can’t live on $200K, you …

Physician burnout shouldn’t be linked to resilience

Nisha Mehta, MD

Physician

May 12, 2018

Recently, I was asked to give a talk on resilience and its role in reducing physician burnout. I was excited by the opportunity, but asked if I could focus more on cultural change and institutional solutions for burnout. When they said no, I declined. Why?

Well, it’s not that I don’t see the value in resilience. A lot of physicians that I really respect write and speak about resilience. I think …

To Paxil, with love

Jennifer L. Barkin, PhD

Medications

May 12, 2018

In 1994, Penguin Books published what would become a national bestseller titled, Listening to Prozac written by Dr. Peter Kramer, a Clinical Professor of Psychiatry at Brown University at the time. Throughout the book, he debates the ethics of “cosmetic pharmacology” a term associated with the transformation of personality traits through medication. Kramer describes several patients as becoming “better than well” on Prozac — more socially adept, less inhibited, and …

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To Paxil, with love

Health care is not a service commodity

Peter Spence, MD, MBA

Health Policy

May 12, 2018

As we continue to attempt to restructure how health care is measured, reimbursed and organized, we must hold true to the idea that health care is simply not a service commodity.

“A commodity is any good or service (“products” or “activities”) produced by human labor and offered as a product for general sale on the market.” Our health care delivery model continues to evolve as we move away from the fee-for-service (FFS) model …

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Health care is not a service commodity

MKSAP: 35-year-old woman is evaluated for intermittent fever

mksap

Conditions and Diseases

May 12, 2018

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

A 35-year-old woman is evaluated for intermittent fever, sweats, fatigue, and dull midchest pain of 2 weeks’ duration. Medical history is significant for liver transplantation 6 months ago for primary biliary cirrhosis; she was seronegative for cytomegalovirus and Epstein-Barr virus, and her donor was positive for both. Results of pretransplant testing for tuberculosis …

Answering your questions about the mental health benefits of psychotherapy

Peggy A. Rothbaum, PhD

Conditions and Diseases

May 11, 2018

The interviewees in my book talked about declining quality of health care. Do people even know or remember what it is like to get quality health care? Doctor visits are often too short to be adequately through. Psychotherapy is too often too brief, with a focus on “quick fix.” Psychotherapy isn’t just about talking. It involves careful, thorough study and application of knowledge to the issues that patients bring with them. …

Children shouldn’t worry about being hungry in school

Melinda Stoops, PhD

Health Policy

May 11, 2018

Last fall, my nine-year-old daughter asked me to buy some extra lunch items at the grocery store because she and a friend of hers were going to take turns bringing in food for a classmate who couldn’t afford to purchase lunch at school. I was reminded of this conversation last week, when the school committee in my city voted to no longer deny middle- and high-school students lunch if they …

What makes you an effective change agent in health care?

Ashwini M. Zenooz, MD

Physician

May 11, 2018

Change and health care are closely interconnected. Health care organizations are continually faced with the need to adapt to change, whether it be advances in medical care or technology, growing demand for care delivery, a patient population that is increasingly active and involved in their own health and well-being, or evolving reimbursement and cost models. By recognizing that change is inevitable in the health care sphere, organizations can focus on …

When the nurses’ work goes unnoticed in the ER

Raj Waghmare, MD

Physician

May 11, 2018

The two-page letter of complaint was typed on crested letterhead. The words “utter disappointment” jumped off the page, bold-faced and caps-locked. “The doctors left me to bleed,” she wrote, banging on the exclamation key as if she was firing lasers in a game of Space Invaders. “I was hemorrhaging, and they did nothing except pop in and tell me it would stop.” The tirade was directed toward me and the …

Obstetric physician anesthesiologists aim to provide a happy Mother’s Day to all patients

James Lozada, DO

Physician

May 11, 2018

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

I love to see the pure joy that floods over mothers as they hear their new baby’s first cry! The ability to help make childbirth safer for mothers and babies led me to a career in obstetric anesthesiology — in the high-risk, high-reward …

The one-word secret to happiness

Cory Fawcett, MD

Physician Finance

May 11, 2018

I was recently asked what I thought was the number one problem that caused unhappiness in America. We are one of the most prosperous nations in history. You might think that with all that prosperity and wealth, Americans would be happy. Obviously, wealth does not equal happiness.

Many would argue that since America has a lot of poor people, it can’t be considered a wealthy nation. But our poor are still …

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The one-word secret to happiness

Barbara Bush: The First Lady of palliative care

Michael A. Salvatore, MD

Physician

May 10, 2018

The “Great Man Theory” of history was popularized by the Scottish author Thomas Carlyle in the mid-19th century. In his 1840 “Lectures on Heroes,” he famously wrote: “The history of the world is the biography of great men.” Carlyle claimed that history was made by “great men” possessing personal courage, vision, charisma and political or military genius. Our more egalitarian age has favored mass movements, social forces and “great ideas” …

Premed? Here are 3 things to consider.

Candice Williams, MD

Medical Education

May 10, 2018

Hello, premeds!

There’s so much advice out there from so many sources. Your aunt, cousin, and grandpa think they know what to do to be successful in your pursuit of medicine. All of your friends are experts — and why aren’t you a doctor already?

I know, I know … This time in life is hard. You are comparing yourself, and you are hearing so many messages.

So, I’ll make it simple.

Here are …

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Premed? Here are 3 things to consider.

This medical student wants to be a radiologist. Does the field have a future?

Lewis Jordan

Medical Education

May 10, 2018

Artificial intelligence, or AI, is a term that is often associated with robots or computers that “learn” by having material introduced to them. Different people have different reactions to the idea of AI, especially with its potential use in medicine. AI can perform many tasks at the same time and in the same way producing results that will always be precise, but not necessarily accurate. This is relevant to fields …

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