| KevinMD.com

A surgeon is humbled by unexpected feedback

Medical Education

June 8, 2016

“Hey, Doc!” I heard the patient say as I blazed by bed A.

Bed A is the “door” bed. My patient was in bed B, the “window” bed. I had just met him; it was a new inpatient consult. For all the rules and regulations surrounding patient confidentiality, the curtains between beds do little to protect privacy since inevitably there will be audible conversations about symptoms, diagnosis, and management between patients and …

Are you the physician who yells?

Edwin Leap, MD

Physician

June 7, 2016

I’ve never been the doctor who yells. However, if you work in medicine, you’ve met him or her. I’ll call this physician “Dr. Barkus Yellby.” Dr. Yellby is angry. A lot. In the old days (and not so old days), he threw instruments in the OR when they weren’t what he wanted. Or if the charts and labs weren’t ready for rounds, he slammed things on the desk and berated …

Read more…

Are you the physician who yells?

Nothing can cultivate humility like medicine

Hamsika Chandrasekar

Medical Education

June 7, 2016

There was a morning where I felt like the smallest human being on earth. It was a morning spent in the OR, where it seemed like I could do nothing right. I placed the Foley incorrectly on my first attempt, and then ended up removing it incorrectly as well. I nonchalantly brushed past the robot we were using for the case, which was already draped and prepped, and whose sterility I …

Real physician voices, twice a week

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

As physicians, we learn much from our patients

Robert Pearl, MD

Physician

June 7, 2016

When I first met Mary, already in her forties, she had suffered throughout her life from an arteriovenous malformation of the face. As a result, from early childhood, she had endured the discomfort and humiliation that accompanies the stares of strangers. She came to me hoping I could improve her appearance.

The abnormal connection between the arterial and venous halves of her circulatory system caused her cheek, jaw, and neck to …

The first shower after surgery

Kristen Knott

Patient

June 7, 2016

“Do you need help getting undressed?” Jon asks from the doorway of our bedroom, one hand holding his BlackBerry, the other tucked into the front pocket of his baggy jeans. His head is slightly tilted, his eyebrows arched, highlighting his forehead wrinkles.

His phone vibrates, drawing his eyes from me to the incoming message. I wait.

Jon reads, ponders and then looks up, half-absorbed in what he’s just read, and registers that …

Read more…

The first shower after surgery

Physicians as innovators: 6 ways we help and hurt ourselves

Nicole Van Groningen, MD

Physician

June 6, 2016

The U.S. health care system is the world’s top in health care spending per capita, but in terms of performance, we’re dead last among developed countries. As a young physician embarking on a career in this landscape, it’s glaringly obvious that we need disruptive innovation to create better health at a lower cost. Physicians are uniquely positioned to make critical contributions to medical innovation, but even among …

Freestanding emergency departments: The model we need to study

Joshua Elder, MD, MPH

Health Policy

June 6, 2016

I recently took care of a woman in her 50s that came to our emergency department (ED) complaining of chest pain. The pain had started shortly before arriving in the ED but within minutes, we performed a battery of tests, treated her pain, and gave her an aspirin. Still concerned about heart disease being the cause of her pain, I observed her overnight in our EDs observation unit and completed …

We cured her, but the result was unacceptable

Don S. Dizon, MD

Physician

June 6, 2016

I still remember her clearly. She was a wonderfully vibrant 68-year-old woman from Haiti. She was always impeccably dressed, loved to talk, and had an incredibly infectious laugh. Whenever I walked in to the clinic to see her, her eyes always seemed to smile as broadly as she did.

“Nice to see you, Doc!” she would say. I …

We let our professionalism suffer when faced with a difficult patient

Briana Buckner, MD

Physician

June 6, 2016

“Be careful. He’s violent.” That was the way sign out began for Mr. T. The intern continued, “He has been in the hospital forever because he was kicked out of his nursing home. Good luck. And, oh yeah … he’s blind.” Puzzled, I looked at my list of patients and, not sure whether I should write “violent” by this patient’s name, I decided instead to write “blind.” I paused. The …

Medical homes weren’t supposed to be this way. What went wrong?

Hans Duvefelt, MD

Physician

June 5, 2016

We have a problem in our clinic.

Between our EMR implementation a few years ago and our PCMH recognition shortly after that, our office visit documentation has become bloated and our cycle time has almost doubled.

There are no brief visits anymore, since every visit entails screening for multiple psychosocial conditions and consideration of various immunization and health maintenance reminders.

Nobody sees over thirty patients a day anymore; we’re lucky to exceed twenty.

That …

Blame the politicians and bureaucrats for our opioid abuse crisis

Richard Young, MD

Physician

June 5, 2016

Prescription opioid abuse is on the political radar. “Painkillers” are a recognized cause of thousands of deaths a year. But what to do about it?

A FDA panel recently recommended mandatory training for physicians who prescribe opioids. Congress passed a bill calling for more education, presumably physicians as a prime target. We’ve actually been down this road before, but possibly not how you think.

The politicians and pundits used to …

5 things we can learn from the NHS doctor strike

Suneel Dhand, MD

Physician

June 5, 2016

The United Kingdom’s National Health Service has been facing something of a crisis over the last several months. For those of you unfamiliar with what’s been happening (the issue hasn’t really gained any media traction here in the U.S.), a majority of the country’s 55,000 junior doctors have been holding regular strikes. In the U.K., the way in which doctors train is very different from the U.S., with often over …

Why young physicians should consider locum tenens

Val Jones, MD

Physician

June 5, 2016

When doctors complete their residency training, they are under a lot of pressure to land their first “real job” quickly. Student loan deferments end shortly after training, and whopping debt faces many of them. But choosing a job that is a good long-term fit can be difficult, and gaining a broader exposure to the wide variety of options is key to success. That’s why “try before you buy” can be …

The opioid crisis: Does empathy make physicians more vulnerable?

Jay Baruch, MD

Physician

June 4, 2016

It was Saturday evening, and Audrey G lay awkwardly on an emergency department stretcher in search of a comfortable position. She suffered from chronic hip pain, the unfortunate and unexpected effect of pelvic surgery. But her real chief complaint involved her drug-abusing husband, who that morning stole her recently filled bottle of oxycodone, an opioid pain medicine. Her story included the surgeon who doubted her pain and a year of …

It’s time for academic medicine to embrace direct primary care

James Breen, MD

Physician

June 4, 2016

As a mid-career faculty physician in a family medicine residency program, I have taken a keen interest in the big picture of what is happening to the way our graduates and colleagues practice in the real world. I’ve watched our residents as they prepare to graduate, deliberating among the most prevalent practice options presented to them in our region, usually as an employed doctor in a large multi-specialty practice, or …

Compassionate care is at it’s best when selflessly focused on helping others

Jeffrey McWilliams, MD

Physician

June 4, 2016

I’ve noticed, as I get older life seems to travel full circle no matter your path or destination. I find myself trying to teach my son Grant things that my father attempted to teach me not so long ago.

“Don’t do that, you’ll fall and hurt yourself, or try it this way, and the process will be much easier.”

There is that brief moment of acknowledgment often followed by scraped knees or …

MKSAP: 32-year-old man with a rash on his face and midchest

mksap

Conditions and Diseases

June 4, 2016

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

A 32-year-old man is evaluated for a 2-week history of a rash on his face and midchest. He describes the rash as consisting of small, reddish “lumps” that are intensely itchy; they develop and begin to resolve with development of new lesions. He otherwise feels well.

Medical history is significant for a recent diagnosis …

An open letter to Macklemore about the opioid epidemic

Eric Beam, MD

Physician

June 3, 2016

Dear Macklemore,

Recently, you — the white-rapping, thrift-shopping, LGBT-activist-ing, Grammy-winning 2013 phenom — teamed up with President Obama to deliver a message to the country about the current opioid epidemic. Now let me preface this by saying, I like you, Macklemore. I like the mixture of equal parts political, earnest and downright goofy that you bring to your music. I like that you seem genuinely …

I’m a better doctor than any computer

Keith Pochick, MD

Physician

June 3, 2016

“I love you,” she said as I was leaving the room.

Although I was stunned for a second or two, I wasn’t really surprised. She and I had gotten along famously from the beginning of our 15 minutes together. She didn’t “love me” in the way a patient with borderline personality disorder “loves” her enabling prescriber. She loved me because I was there, I was experienced, I was kind, and I …

Read more…

I’m a better doctor than any computer

Health insurance must be driven by physicians. Here’s why.

Tony Barnes, PhD, MBA

Health Policy

June 3, 2016

I am a scientist and a medical economist. I have been privileged to work beside doctors in both their caregiving role and their research role for 20 years. I have seen their challenges and tried to build products and services to help. I have deep respect for the challenge of medicine and the committed practitioners.

When I left graduate school in 1988, it was the beginning of the movement from fee …

Real physician voices, twice a week

The Podcast

Latest episodes

The Podcast

Latest episodes