Physicians writing on KevinMD about the diseases they treat and the people who have them: cancer and its screening arguments, pain and the drugs that treat it, diabetes and the obesity argument, mental illness and who gets treated for it, and the decisions at the end of a life. Five maintained records draw on this archive: Cancer: what physicians say, in their own words, Opioids: what physicians and pain patients say, in their own words, End of life: what physicians say, in their own words, Diabetes and obesity: what physicians say, in their own words, and Mental health: what psychiatrists and physicians say, in their own words.
Every claims executive handling medical malpractice claims has seen it. So has every lawyer who defends physicians in med mal cases. They know how destructive this phenomenon can be to the defendant and their case, just as hospital administrators know how damaging it can be to an entire practice group.
With more than half the physicians surveyed in a recent study reporting having been sued at some point in their careers, …
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Recognizing and addressing medical malpractice stress syndrome (MMSS)
Modern medicine, a system originally designed to fix acute health care problems, now creates more chronic health care problems than helping to solve them. I see the dangers of over-testing and over-prescribing taking place each day in my day-to-day pediatric clinical practice.
It scares me to see how many doctors reflexively prescribe pills designed to merely mask symptoms rather than take time to understand the underlying cause or that most chronic …
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A call to action for my medical colleagues
High on my list of favorite operations was surgery on the stomach: The anatomy is neat, the re-plumbing alternatives clever, technical challenges rewarding, and, because it’s well-supplied with blood, complication-free healing is pretty predictable. Also, several procedures were invented by and named for history’s pioneer surgeons, and it’s nice to feel the connection, heir to the discoveries and invention of the greats. Let me tell you about one of my …
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A surgeon’s favorite stomach surgery patient
Minority and marginalized communities have historically been underrepresented in local and federal governments and in dozens of private sectors globally. Pharma is no different; there exists a steep chasm that drugmakers have yet to bridge concerning research and trials. The longer this gulf exists, the harder it becomes to address – the feelings of mistrust, resentment, and disenfranchisement only get harder to overcome with time.
Over the last decade, the pharmaceutical …
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A path toward clinical trial diversity
The saga of distancers and pursuers in relationships exists in many different forms. Perhaps the most common version is the man as distancer and woman as pursuer.
It would seem that hardly any adult with some experience in the world of romance has not encountered this theme, at least to some degree. It is apparent that, generally speaking, men and women travel a different relationship path.
In the United States, most researchers …
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Love: Stepping forward or hanging back?
Guess what? The mouth is attached to the rest of the body. And though dentistry and medicine are typically separated from the very beginning of professional training, they are irrevocably linked for patients and have an impact on each other. Here’s some foundational knowledge that will help set the stage for discussing the connection between overall health and oral health: Our mouths are teeming with bacteria – mostly the good, …
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The connection between oral health and overall health
It’s a standard instruction during safety demonstrations on airplanes: “In the event of a sudden loss in cabin pressure, an oxygen mask will drop down in front of you. Put your mask on before helping others.”
But why is that? Wouldn’t it make more sense to help those who are most vulnerable?
The answer has to do with the way our bodies react to a lack of oxygen.
When cabin pressure drops, the …
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What does living with COVID really mean?
I was at my gym last night. Billy Joel’s ballad about trust was the metronome to my squats. Though vaccinated and boosted, I was wearing my mask. I know the latest evidence about vaccines and natural immunity, the dramatic transmissibility but mild virulence of the latest Omicron variant.
So my mask was only for optics. Someone might recognize me as a doctor in the local hospital where masking is still mandated. …
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A matter of trust: Bill Maher loses trust in medical professionals
There are not many situations in general medicine where a doctor can affect an instant cure, and the patient will call them a “miracle worker.” Most patient visits end with a prescription or two or some instructions along with the admonition, “You’ll feel better in a few days.”
One exception to this rule: dislocations.
A simple dislocation happens when the end of a bone is pulled out of its socket (or niche) …
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Dislocations: an exception to the rule
This spring, kids will be returning to extra-curricular activities and organized sports in the community, much of which was canceled over the past two years due to the COVID-19 pandemic. As these activities resume, now is a good time to learn what to do in the event of a concussion.
Concussions are one of the most common sports injuries in children and youth. Canadian data show there are nearly …
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What to do when your child suffers a concussion
In the early days of the COVID-19 pandemic, governments and communities had to take rapid and decisive action to protect their citizens against this novel virus. While it was yet unclear how dangerous the COVID-19 infection may be to children, their teachers, and their families, governments quickly shut down schools and activities to slow the spread among the population at large.
Before the pandemic, childhood obesity was already a crisis with …
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Reversing the impact of the pandemic on childhood obesity
In his bestselling book How Not to Die, physician Michael Greger described how his grandmother, diagnosed with advanced heart disease at 65, transformed her health and lived for many years after switching to a whole-food, plant-based diet.
It was a seminal event for Dr. Greger that inspired a career dedicated to promoting the impact of lifestyle behavior on health. As lifestyle medicine-certified clinicians practicing in a palliative medicine …
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The surprising role for lifestyle medicine in palliative care
They were everywhere. Headlines to the effect of “Health care workers face mental health crisis” were all too common for a majority of 2020 when the COVID-19 pandemic began. Even though they have mostly disappeared, with the exception of an appearance here and there, the problems that these types of articles and news stories covered have not. More specifically, burnout has been an issue in health care …
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Prevention of health care burnout in the COVID era
Maintaining a relationship during nursing school takes some effort. Your time is taken up by studying, classes, clinicals and labs. Oh, did I mention studying? At the end of the day, there is just not much time left for significant others. Now, I am referring to romantic relationships here, but the same concept also applies to friendships.
I’ve put together a list of tips from my own experience to hopefully …
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How to maintain your relationships during nursing school
I thought it would be easier than ICU nursing. After 33 years as an ICU nurse, I had to leave. I just couldn’t take the pounding on the chests of little old men and women. Hearing and feeling their ribs crack while CPR was performed. I couldn’t handle these poor patients who should have had a peaceful death when the inevitable was near.
Family members with expectations of miracles. Denial. Rationalization.
And …
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A patient hit me: Why I say anti-assault prayers
Tuesday night, March 29 into March 30, I started to feel that sensation I associate with the start of a cold. It was a feeling in the back of my throat that’s almost hard to describe. I haven’t had that sensation in years. Because I have been wearing an N95 mask every time I come into contact with people outside of my inner circle, I hadn’t had any sort of …
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This doctor got COVID. Here’s what it taught him.
Moving into the pandemic’s third year, as many settle into the notorious “new normal” of COVID, the challenge now is avoiding complacency and keeping attention and vaccination rates high enough to maintain protection against the still-evolving virus.
Six months after approving a first vaccine booster, the FDA has now authorized a second booster dose for older and immunocompromised people at greater risk of serious illness. With new variants …
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Done with COVID? Not so fast.
“Death would not be called bad, O people, if one knew how to truly die.”
— Nanak
Her funeral was yesterday, and there was a huge turn-out. She was 67 and never cussed or said a bad word about anyone. She was much-friended and well-loved. In late January 2022, she was diagnosed with stage-4 cancer in her lungs, which metastasized to her liver and bones. At first, some medico used the word …
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A bad death: the importance of truth-telling at end-of-life
A small piece of lint is tickling my nose as I am desperately trying not to sneeze into the tight-fitting mask on my face. I know that I will not be able to adjust the mask as my gloves are sterile, and I am standing suspended over a patient’s body with my gloves patinaed with small drips of blood mixed with an antiseptic. The procedure is challenging as the patient …
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Looking across the glass door: a COVID-19 vigil
