Doctors as organizational stewards

Physician
May 31, 2022

COVID-19 melted down the world at a very inopportune time in history. Just as medicine was getting a handle on previously intractable conditions, from sophisticated diabetes management to less invasive surgical procedures, a new threat that devastates our population with few good treatments overwhelms health care.

Medical workers come to the rescue, as we always do, though at a personal and communal price. Somebody else keeps our food available, allows our …

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Doctors as organizational stewards

Warehouses for the elderly?

Physician
May 30, 2022

Bringing in the mail recently, I was pleased to see a thick 5-by-7-inch booklet among the catalogs and bills. The anticipation of reading a few Reader’s Digest short stories and “Humor in Uniform” made the evening seem pleasurable. But when I opened the 244-page Reader’s Digest-sized booklet, I found the “Senior’s Blue Book for Greater Boston.” Here was page after page of assisted living communities, retirement communities, skilled nursing facilities, …

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Warehouses for the elderly?

To scribe or not to scribe? That is the question.

Physician
May 29, 2022

By this title, I mean whether it is a good idea or not to hire a scribe to enter data into the electronic medical record (EMR) system.

I favor having a scribe. I came of age with paper charts, and I found the transition to EMR tricky and time-consuming.

My chief argument favoring scribes is that scribes can save doctors a lot of time. And by saving time, scribes can also help …

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To scribe or not to scribe? That is the question.

Reproductive and abortion care is health care

Physician
May 29, 2022

It is getting very crowded in my exam room. As a practicing obstetrician, I have counseled women for more than the past 36 years and our conversations have always been private. Suddenly, for the first time in 50 years, judges and politicians are vying to join me in these intimate moments that can involve the life or death of the mother. This is impossible for me to comprehend or accept.

The …

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Reproductive and abortion care is health care

A physician mom’s take on telemedicine

Physician
May 29, 2022

I know most of us have started adapting to the new way of life in our practice. However, some of us are still skeptical. I’m hoping to reach out to the skeptical ones among us.

The reason I say that is I was in your shoes as I started my career in a brick-and-mortar practice. In 2017 when my twins were born and after a short parental leave, I returned to …

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A physician mom’s take on telemedicine

A physician returns to creativity

Physician
May 28, 2022

Medicine as art appealed to me as a child. Working with families to achieve a state of health was an admirable goal—if naïve. I only went to the physician for immunizations and obligatory school physicals during childhood. My mom employed home remedies and time if I became ill, which fortunately worked.

I had no concept of what a career in medicine involved. Over twenty-five years, I explored every avenue available to …

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A physician returns to creativity

A choice of maternal compassion

Physician
May 27, 2022

It was supposed to be a routine 20-week ultrasound appointment. The specialist abruptly knocked and entered. The next few hours of my life went by in choppy, disconnected segments. The specialist said he was sorry. Her bones were not growing properly. Her rib cage was small. Her lungs were underdeveloped. This baby, whom I had allowed myself to love and believe in after my normal prenatal testing and ultrasounds, living …

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A choice of maternal compassion

Mothers and sweaters: the gifts of letting go

Physician
May 27, 2022

I sifted through both cars, my own and my husband’s, underneath our boys’ baseball equipment, candy wrappers, and empty water bottles. The felt bag was nowhere to be found.

I was finally ready to take this bag of a dozen sweaters, some of which were my fancy cashmeres, to the dry cleaners. Why a dozen, you may ask? Well, these were essentially all the nice sweaters I owned. I waited a …

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Mothers and sweaters: the gifts of letting go

Warning: Your words can kill

Physician
May 25, 2022

Over the years, I’ve had many medical office assistants. Most were good. Some were outstanding.

Today, I’d like to tell you the story of one who was exemplary. He was never late to work. He never came in and insisted on finishing his breakfast at his desk before rooming our first patient. He was so personable that they would pour their hearts out to him while rooming patients. They would tell …

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Warning: Your words can kill

11 questions physicians should ask during a job interview

Physician
May 24, 2022

One of the hardest questions to answer in a job interview is, “Do you have any questions for me?”

The question itself is not hard — as physicians, we can come up with plenty of questions. What makes it challenging is that we understand the timing and depth of any question we ask and can say a lot more than we want it to. We do not want to ask too …

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11 questions physicians should ask during a job interview

A small intern in a big hospital

Physician
May 23, 2022

I am a gopher. See my tiny paws. See them furiously digging and digging and digging. Little puffs of dirt and soil are thrown haphazardly over my little shoulders. My tiny brain was completely absorbed in the digging of that very inconsequential, very little, very specific hole. Tail in the air, head down, no breaks. Dig, dig, dig.

As a small intern in a big hospital, that’s me. Day after day …

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A small intern in a big hospital

Attorney generals are not qualified to set medical practice guidance

Physician
May 22, 2022

Eleven attorneys general (AGs) have responded to a long-awaited draft update on a nationwide opioid-prescribing guideline by asking that drafters do more to prevent prescription opioid diversion. Logically focused on law enforcement, the AGs, unfortunately, suggest reviving policies the Centers for Disease Control and Prevention (CDC) has already cited as potentially harmful to patients. In doing so, the AGs step into the practice of medicine which they are not qualified …

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Attorney generals are not qualified to set medical practice guidance

LGBTQ+ basics: 10 things your queer patient wishes you knew

Physician
May 22, 2022

Several months ago, I wrote a post on a Facebook community of over 17K Black physicians. The post asked them what they would do and how they would react if their child told them they were gay. The responses I received ranged from “I will love and accept them” to “Heaven forbid!” to “I will beat it out of him!”

When I got over my shock, I realized that even as …

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LGBTQ+ basics: 10 things your queer patient wishes you knew

The visionary pediatrician may soon be an endangered species

Physician
May 21, 2022

If I were writing a book about what it’s like to be a visionary pediatrician speaking up for children’s health, I would title it, The Hate We Get.

A few months ago, I received a death threat comment on a TikTok video I posted advocating for COVID vaccines.

My college-aged daughter called me, “Mom, I saw your TikTok video.  That’s so scary. I’m so sorry.”

“I expected it.  I’ve had worse.”

I did a …

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The visionary pediatrician may soon be an endangered species

Shame can no longer be accepted as a rite of passage in medicine

Physician
May 19, 2022

“Then why did this patient come to the hospital? You haven’t done anything to help this patient,” the attending physician said angrily during our morning rounds, upset that the patient had not met their urination output goals during treatment for heart failure exacerbation.

A hot flush crept up my face. Tightness clenching my chest and stomach. What was this feeling I felt? Shame. The entire team attended morning rounds — the …

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Shame can no longer be accepted as a rite of passage in medicine

It is time to end the stigma of mental health. Let us all talk about it.

Physician
May 18, 2022

The first time I heard the song “Truth Be Told” by Matthew West, tears welled up, and I cried. I was driving home after a long day at the clinic. The song resonated with me in more ways than I could soak in.

Lie number one: You’re supposed to have it all together
And when they ask how you’re doing, just smile and tell them, “Never better” …

I had this mental construct …

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It is time to end the stigma of mental health. Let us all talk about it.

You have the right to boundaries

Physician
May 17, 2022

World events have me thinking about boundaries. Countries have boundaries. Often they are based on the land’s physical features, but not always. Boundaries are created over time and may need to change for various reasons. So too with our personal human boundaries.

When we speak of personal boundaries, we can mean the physical boundaries of our skin. Or we may mean the psychological or social boundaries that we live with and …

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You have the right to boundaries

3 solutions to combat rising drug overdoses during COVID-19

Physician
May 16, 2022

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

Recent data from the Drug Enforcement Administration (DEA) has shown a sharp increase in drug-related overdoses attributed to fentanyl and other synthetic opioids, deepening the tragedies of the already challenged opioid epidemic and COVID-19 pandemic.

Unraveling the snowball effect of these public health …

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3 solutions to combat rising drug overdoses during COVID-19

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