Anyone close to me knows orthopedics has never been my cup of tea. I rarely studied it properly; somehow, my enthusiasm always remained low. No offence to the subject, but maybe it started the day I saw my best friend’s forearm break. Fractures have always made me uncomfortable. During one of our postings, we were asked to do a case presentation. A patient was assigned to us, and it happened …
A lesson in empathy from a young patient
Have you ever wondered how a single online comment might shape your reputation as a physician? I have, especially after reading a review that sardonically suggested I had earned my medical degree from Amazon (the company, not the rainforest). The jab was clearly meant to sting. Although I regret the dissatisfaction behind it, it gave me pause. How much weight do we give these offhand remarks, and what do they …
How online physician reviews impact your medical career
Most midlife men don’t walk into our clinics asking for help. They walk in asking for labs.
They’ll tell us they’re “just tired,” “not as sharp,” or “feeling off.” They’ll blame work or age. They’ll ask for hormone testing or a quick fix. What they rarely say (and what most of us rarely ask about) is the deeper truth underneath the symptoms.
There is a silent crisis unfolding in midlife men, and …
Why midlife men feel unanchored and exhausted
My mother’s life was defined by silence. She was born in India. In a world where a woman’s worth was measured in duty: how well she cared for others, how quietly she endured. She was obedient. Her dreams were practical, her voice gentle. Never shared an opinion.
I used to think that by becoming a doctor (a woman with a career, a passport, a voice) I had escaped that silence for …
How medicine reflects women’s silence
During health care encounters with patients from diverse linguistic and cultural backgrounds, there is always a concern about information getting lost in translation between health care providers and their patients. Language and cultural concordance significantly affect the quality and effectiveness of health care delivery. Although phone-in interpreters, with or without video capabilities, are accessible online, none can match in-person interpretation. Even if high-profile political conversations have adapted to artificially intelligent …
Language doulas bridge care gaps
“No medical malpractice lawsuit is frivolous,” is the narrative echoed by plaintiff attorneys. Medical malpractice lawsuits are vastly underrepresented. Also, because frivolous lawsuits are too expensive to litigate, expense is a natural deterrent for filing one. Plaintiff attorneys have controlled this narrative for as long as I’ve been in practice since 1972.
Recently, I examined the veracity of this claim. Indeed, there are 66 million civil lawsuits filed in the …
The myth of no frivolous medical lawsuits
Keeping my head down and working through intern year was all I had known. My days blurred into nights, and my weeks into months. The dreary Pacific Northwest winters had only compounded this. Despite a quiet yearning for connection and community, I declined most social invitations. My sense of obligation did not end at the hospital doors. It followed me home, where expectations and emotional responsibilities lingered. I often felt …
Divorced during residency: a story of clarity
The British tend to use the term “carer” for the people who help other persons with needs. It seems to emphasize its root word, care, with implications for family members, volunteer helpers, and professionals who fill that role. The American term tends to be “caregiver;” its usage has become more common.
Even when I worked in health care, I had never used either of those terms. But over the last fifteen …
A husband’s story of end-of-life care at home
In the vast, undulating expanse of rural America (those counties where the horizon stretches like a taut bowstring, evoking the stoic endurance of Steinbeck’s Joads) one might expect the pulse of health care to beat with the resilient rhythm of native ingenuity. Yet, as a recent study in the Journal of the American Medical Association reveals, physicians sponsored under the H-1B visa program are twice as prevalent in these bucolic …
The H-1B crutch in rural health care
I strongly believe that working harder in medicine is making us as doctors poorer, and it’s quietly harming patients too. Not because we don’t care, but because rushing destroys the very thing patients need most: Time, attention, and real care.
Let me explain.
If you’re a medical doctor or another primary care clinician, you’ve probably heard this your whole career: “Work harder. Work faster. See more patients. Push more. Do more.” And …
Physician income vs. burnout: Why working harder fails
I have often heard people speak of numerology, weaving destinies around digits. They say that behind every event in a person’s life lies the hidden hand of numbers. I do not know if such beliefs hold scientific truth. Yet, in medicine, numbers certainly matter. Numbers fill our trial registers, power our statistics, shape our protocols. In research, life is reduced to codes, columns, and counts.
As a medical student, the jargon …
The human element in clinical trials
Not long ago, a friend told me, “I switched insurance and can’t find a doctor who will take me.” Another said, “I left Kaiser after going on Medicare and now no one will see me.” These aren’t isolated complaints. They’ve become the new reality in Silicon Valley: It’s easier to buy a multimillion-dollar home than to find a new primary care doctor.
I saw this problem firsthand before I retired from …
The Silicon Valley primary care doctor shortage
We entered medicine with a shared calling (to heal, to serve, and to make a difference). Yet somewhere along the journey, between the never-ending charting, late-night calls, and invisible emotional burdens, many of us forgot how to heal ourselves.
Every few months, another survey or report confirms what so many of us already sense in our bones: physicians are burning out at staggering rates. But what remains under-discussed, and perhaps even …
How relationships predict physician burnout risk
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My fourth year of OB/GYN residency there was an essay contest about what it meant to be an advocate for women’s health while preserving your sense of self. I sent a screenshot of the contest to my then-boyfriend, now-husband. He replied, “You want to add something else to your to-do list?” He was joking, but he wasn’t wrong. Just a few days prior, I was hyperventilating from all the things …
Preserving your sense of self as a doctor
For most of my training, I assumed communication was a straight line. Say the thing. The other person hears the thing. Why complicate it? Only much later, in a small seminar room at St. John’s College in Santa Fe, did a tutor named Charlie Fasanaro loosen that idea. He walked us through Euclid the way you might guide a child who is learning to see. I had no sense then …
The geometry of communication in medicine
One of the first questions you’re asked when applying to medical school is: Why do you want to be a doctor? For most, the answer is some version of “I want to help people.” But for me, that was never the real question. It was always “Why do you want to be a pediatrician?”
I’ve known since I was very young that I wanted to work with children. I’ve always loved …
Why I became a pediatrician: a doctor’s story
When I was a resident, the trauma surgeon was the go-to person for anything complicated. It seemed like they could do everything, and do it well. That’s what drew me to the field. There was a confidence, decisiveness, and scope that made trauma surgery feel like the pinnacle of surgical mastery.
For most of my career, I’ve worked as a trauma and critical care surgeon, from busy academic Level I trauma …
Is trauma surgery a dying field?
The average KevinMD reader may wonder why I’m so prolific in my commentary on pediatric medicine and the systemic reforms it demands. The answer is simple: I go to the source. Always.
That habit was forged nearly 30 years ago when the American Academy of Pediatrics invited me to serve as contributing section editor for Developmental-Behavioral Pediatrics in AAP Grand Rounds. My role: select key studies, critique methodology, and distill bottom-line …
Why we fund unproven autism therapies
Leadership is often discussed in broad strokes: some leaders are structured and precise, while others are flexible and improvisational. But behind those visible styles lie quiet personal and generational histories, the emotional terrain that shaped how we learned safety, trust, and control. I’ve come to see that these histories profoundly influence how we lead and how we’re perceived as leaders, especially in health care, where the stakes are high and …
How your past shapes the way you lead
Early in the pandemic, we began using yellow cloth isolation gowns, environmentally superior, perhaps, to the paper gowns that preceded them, but not without complications. The strings at the neck were invariably tied and tightly knotted after going through the wash. If you’re a smallish doctor or nurse, the pre-tied neckline hung down around the tip of the xiphoid. I stood outside my patients’ rooms on long, weary days and …
How private equity harms community hospitals
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