In a recent podcast conversation with Kevin Pho, MD, we talked about the importance of assertiveness in health care, including the ability to say “No” and the significance of culture in supporting it.
One of the topics we touched on was the influence of both top-down and bottom-up factors, which I want to elaborate on here.
Organizational culture refers to how and why things are done at work and the rules …
When we think of symptoms or ailments, they are often a signal to us that there’s something off with our health. Yet, many of us, as well as doctors, often don’t think so much outside the traditional box when it comes to what may be influencing or causing these health issues. I have even experienced this personally in my life.
Some people may even experience ongoing frustrations with concerns failing to …
Just a few weeks ago, the President’s Council of Advisors on Science and Technology (PCAST) issued a report, “A Transformational Effort on Patient Safety.” This was both a “surprise” and “not a surprise” to me because I’m a nurse, a subject matter expert in patient safety, and a shop teacher’s daughter.
PCAST’s call for action was not a surprise because in 2023, care intended to help patients harms them at an …
During my early years as a pediatric hospitalist in the U.K. during the ’80s, a figure that loomed large was the chemical pathologist (CP).
The CP was the guardian of the laboratory, and every hospital had one. This fearsome beast was approached with trepidation, as the outcome was likely to be a unique but bruising “educational experience.”
Interaction was common because almost every lab test apart from the CBC, ESR, chem 20, …
I like to thrift shop. Aisle after aisle weaves a story of people and their lives. Pieces of trinkets I’ll never need. But I can feel the hidden simple beauty, and then I have to have it. My children can line my gravesite with the thousands of collectible pottery… those awkward, strange gems I know I can’t take with me.
And then …
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.
Do no harm. We learn this throughout our medical education and training, and in practice it is a keystone for clinical decision making. This principle continues to inspire patient safety, quality improvement, and better patient care. Do no harm also applies to …
Mental health in children and teens is worsening, and there are not enough providers to support them. This is a cause for significant concern.
As a teenager who has experienced firsthand the challenges of maintaining positive mental health amidst a demanding school environment, I strongly advocate for the inclusion of mental health days as a means to support the well-being of students nationwide. May has been observed as …
On my first day of inpatient rounds during intern year, I was taken aback when the attending stated, “Let’s stop outside the room and just spend a few moments watching the child and mom.” I started my residency on my community rotation site in Chester, PA, where several of the Philadelphia training programs at that time were sending residents. It was a nice introduction to pediatrics with a smaller inpatient …
The concept of epigenetic inheritance is fairly recent, having emerged in the late twentieth century. Yet, epigenetic inheritance is gaining more and more attention and interest in the scientific community. Research on epigenetic inheritance continues to be published in the world’s foremost scientific journals, such as a study recently published in the journal Nature Communications. What is epigenetic inheritance, and what makes it so interesting to the scientific community?
A …
Older adults have borne the brunt of the COVID-19 pandemic. While Canadians aged 60 years and older make up only 20 percent of the population, they account for 69.5 percent of all COVID-19 hospitalizations, and most — 91.7 percent — of all COVID-19 deaths.
One aspect of health care during the pandemic that has received considerably less attention is the failure of effective delirium care.
Imagine you are in a bad car accident. You are in and out of consciousness. There are lights and sirens and the smell of gasoline. Everything hurts more than you can bear. Hands pull you from the car and place you on a hard backboard with a rigid cervical collar around your neck. You bump down the road in the back of an ambulance as you start feeling like you …
I recently had an incident involving a long-time patient. This particular encounter proved to be challenging. The patient had chronic pain for years and had already exhausted all conventional treatment options. Ironically, he was otherwise healthy and fit. His recalcitrant condition made him a prime candidate to be treated with a spinal sord stimulator (SCS).
An SCS is an implantable device with two electrode leads connected to a battery-powered pulse generator. …
You’ve probably had friends and family corner you to look at a rash or talk about medications. With social media exploding about Ozempic, these questions and even curbsides from physicians have boomed. We all want to know more about weight.
As a bariatric surgeon, here are five things every physician should know about weight:
Have you noticed that when you try to make an appointment with your primary care physician, you have to wait much longer these days to be seen? And when you do finally walk into the exam room for the appointment, it seems the countdown clock is already in motion. Have you also noticed that the face you last saw opposite you for your previous check-up is not necessarily the same …
The definition of addiction, now called substance use disorder, has varied greatly over time. The first edition of the Diagnostic and Statistical Manual, from 1952, didn’t include specific diagnostic criteria for this condition. Over the next sixty years, the DSM went through six revisions, with a slow evolution of the terms “substance abuse” and “dependence.” The first was limited to substance use causing social and occupational problems, while the last …
Our increasing maternal mortality rate is gathering attention both nationally and internationally. The U.S. is 33rd among developed nations, and the rate is increasing. Indeed, as Neel Shah notes:
Americans today are 50 percent more likely to die in the period surrounding childbirth than their own mothers.
In 1974, the U.S. maternal mortality rate was 9 per 100,000 live births. By 1980, the rate was 8 maternal deaths per 100,000 births. …
Recently, I received a call from an old friend. We had drifted apart over the years, but his purpose in calling wasn’t rooted in a desire to rekindle the embers of yesteryears. No. Rather, it was an explicit inquiry into whether I could assist him in obtaining the elusive elixir of contemporary weight loss. In revealing tones, he shared that the specter of obesity loomed heavily in his family lineage, …
To compliment and complement the KevinMD article “Why physicians need to write,” by Dr. Louise Aronson, I’ll share why patients, at least this patient, write. I wrote What Patients Want: Anecdotes and Advice because I had been “adrift in a draft, if you get my drift,” in doctors’ offices, and I thought I could share the perspective of the patient in the white paper sack, with health care …
The development of COVID-19 vaccines has been an extraordinary scientific achievement in the face of a global health crisis. However, an unfortunate consequence has been the emergence of misinformed claims by non-medical individuals who assert that these vaccines were not appropriately vetted for human use. This essay aims to highlight the fatigue and offensiveness caused by such assertions, considering the extensive research, rigorous testing, and regulatory oversight involved in the …
Research reveals that most caregivers of people living with schizophrenia are family members (94 percent), and oftentimes, the journey of the caregiver can be just as challenging as that of the patient, whether they’re newly diagnosed or have been managing the condition for years.
As they navigate the journey together, it’s important that patients have a support system and that caregivers are educated on the disease and treatment options, and …
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