| KevinMD.com

Having access to health care saved this patient’s life

Patient

May 16, 2017

Now more than ever, health insurance is a staple story in the 24-hour news cycle. Opinions vary widely on the issue, as do politician’s thoughts on the matter. Debates rage, tensions grow, and deeper divides are formed as our government wrestles with this colossal dispute. Nestled at the heart of it all though is a basic question:

Is health insurance a right or a privilege in the United States?

I’m alive today …

Hospice and palliative care are bringing dying back to life

Thomas Birch, MD

Physician

May 16, 2017

My friend and neighbor died last week. In his early eighties, wiry, opinionated, well-read, he never tolerated schooling. He built an excavating business with a perfected aesthetic for contouring soil and also built a few homes in town including mine. When he saw the architect’s lower pitched roof framed on the garage, he had it torn off because: “It just wasn’t right. It looks like a tiny bowler hat on …

I had depression, and my fellow doctors treated me horribly

Anonymous

Physician

May 16, 2017

I have lived for some time with depression. Most of the time, it is nagging in the background, helped by exercise, family and friends. But a few times, despite my best efforts, it has gotten out of control.

At the middle of my chief year in November, it came to a head. I was under tremendous pressure to apply for fellowship when I didn’t think it was what was best for …

Real physician voices, twice a week

Join 100,000+ subscribers. Free, and one click to unsubscribe.

No, I’m not settling for family medicine

Lauren Abdul-Majeed

Physician

May 16, 2017

During a recent internal medicine rotation, a senior resident expressed disappointment that I’ve chosen a career in family medicine. He was concerned that my talents would be wasted, because — in his words — I wouldn’t get to care for the “more complex patients” he sees in internal medicine. Although I appreciated his confidence in my abilities, I felt my heart sink, as it does each time I am faced …

Can women be empowered and avoid burnout?

Simone Kantola, MD

Physician

May 16, 2017

Women surgeons all over the globe have been recreating the “Operating Theatre” cover of the New Yorker through the #NYerORCoverChallenge. The public recognition of women in what has been a male-dominated field has rallied female surgeons’ spirits everywhere.

Except, perhaps, mine. While I am fiercely proud of my surgical sisters, I also feel a twinge of sadness, because I know so many of the untold …

Why medical professionals have potty mouths

Kristin Prentiss Ott, MD

Physician

May 15, 2017

While Muzak plays (think Kenny G covering John Mayer) and courteous expressions like “excuse me” and “thank you” are exchanged in hospital waiting rooms, behind the front desk, angry patients are firing curse words into the hallway like their mouths are assault rifles with an endless supply of ammunition. Nurses are being cussed out by patients who sound like characters in “Platoon.” And medical professionals are dropping f-bombs. All of …

Unpaid medical bills are an invitation to negotiate

Peter Ubel, MD

Patient

May 15, 2017

When Lorie Duff was pregnant with her third child, she did what all good moms are supposed to do. She went to the OB/GYN clinic for prenatal care. But she fell behind on the clinic payments. She only made about $25,000 a year managing an auto parts store while her husband stayed home with their kids. The out-of-pocket expenses were outpacing her ability to pay.

That’s when she …

Malaria is not just a tropical disease

Patricia Walker, MD

Conditions and Diseases

May 15, 2017

Nearly 30 years ago, I attended the labor of a Vietnamese woman on an island off the coast of Thailand. The woman had malaria. She died a few hours after giving birth to her stillborn child.

That experience has never left me. It has fueled in me a passion for global health, and especially for alleviating suffering and death from tropical diseases such as malaria.

It is also worth remembering, however, that …

Read more…

Malaria is not just a tropical disease

Dear President Trump: What you should do about your health care plan

Niran S. Al-Agba, MD

Health Policy

May 15, 2017

I hope you read this letter. I doubt you will. I know you’re busy rebuilding Washington, reshaping the international order and doing a lot of other weighty stuff. Full disclosure, I voted for you. Not because you promised to repeal the Affordable Care Act, or because you tweeted at me about it, but because our health care system is hopelessly broken and requires an overhaul that does not simply convert …

A letter from a doctor to her child

Valerie A. Jones, MD

Physician

May 15, 2017

It was the end of my third year in OB/GYN residency. I was 39 weeks pregnant with you and doing a hysterectomy, my gravid abdomen being utilized as an “extra hand” to displace the large clamp nicely to the side as I pressed my belly gently against the table. I was doing surgery all day and loved operating and feeling your occasional gentle movements when in the quiet operating room as …

Read more…

A letter from a doctor to her child

We should not ask the FDA to reduce its oversight of medication

Janice Boughton, MD

Medications

May 15, 2017

There is enthusiasm in politics about reducing regulation to stimulate creativity and economic growth.

Maybe. But reduction in oversight of medication and medical devices by the Food and Drug Administration (FDA) will probably lead to a proliferation of expensive potions and gadgets that don’t actually help.

The New England Journal of Medicine published an article detailing the near miss associated with an injectable monoclonal antibody for Alzheimer’s disease. …

It is time for physicians to fight back. Now.

Matthew Hahn, MD

Physician

May 14, 2017

The American health care system is broken, but it is not really “health care” that is the problem.|

The science of medicine, the tests, and the treatments available are better than ever. It is health care bureaucracy that is the problem. But doctors, nurses, and patients bear the brunt of the dysfunction. Medical professionals are unable to practice, and patients are denied the care they need, even though it is readily …

What’s wrong with health care leaders today

Suneel Dhand, MD

Physician

May 14, 2017

The world of health care continues to change at a breathtaking pace. For reasons too long to go into during a short article, there’s been a huge shift of power away from individual doctors and patients, and towards administrators and big corporations. Health care in its most raw primary form used to be about Dr. Johnson’s small office around the corner,which would serve you and your …

Being superhuman in the most human circumstance

Chiduzie Madubata, MD

Physician

May 14, 2017

As we enter into the hospital each day, our goal is giving patients the best care we can provide. We get a list of patients that we will take care of each day, and as we get that list, we start thinking about what we should monitor in terms of their physical exam, lab results, and vital signs to ensure that their hospital course runs smoothly for the day. However, …

Becoming a millennial mother: 3 tips for labor and delivery

Mark Zakowski, MD

Conditions and Diseases

May 14, 2017

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

Expecting a baby? Congratulations! Giving birth today is not the same as when your mother gave birth. You have new options and different choices to make. You will recover faster than even before, and your participation will be requested. Ready? Let’s talk about …

When patients personally know their anesthesiologist

Dawn Baker, MD

Physician

May 13, 2017

One of the things I most enjoy about being an anesthesiologist is the wide variety of patients that I see. You never know who you’re going to have the privilege to care for on a given day. Although my group is large, I will occasionally be assigned to a patient that I personally know. And occasionally, someone I know will request me as their anesthesiologist.

Last month I took care of …

Tomorrow, we may fail you: Vignettes of pre-existing conditions

Amanda Guarniere, CRNP

Conditions and Diseases

May 13, 2017

Today, I cleaned the laceration above your eye from where he punched you with a closed fist. As I was stitching up the gaping wound with two layers of sutures, I told you that the scar would fade into the line of your eyebrow. I helped you apply your foundation on your neck to cover the bruising from where he strangled you. I monitored you for any swelling of your …

A physician’s response to Jimmy Kimmel’s monologue

Jonathan Kohler, MD

Health Policy

May 13, 2017

Jimmy Kimmel recently delivered a 13-minute monologue that transfixed the nation. He told the story of how his newborn son, Billy, was diagnosed with a potentially fatal cardiac anomaly, tetralogy of Fallot, and had undergone emergency surgery. He painted the picture of a sick child and a terrified family, who have the benefit of excellent care that ends well. He complimented the nurses and physicians who had …

MKSAP: 28-year-old man is evaluated for recurrent nephrolithiasis

mksap

Conditions and Diseases

May 13, 2017

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

A 28-year-old man is evaluated for recurrent nephrolithiasis. Medical history is significant for Crohn disease complicated by multiple small bowel strictures requiring resection. He began developing kidney stones 3 years ago following his last bowel surgery. Analysis of the stones has consistently shown calcium oxalate, and he has been adherent to a …