Florence Nightingale was among the first nurses who started wearing a nurse’s cap.
The cap was derived by nuns and represented those caring for the sick. Hair was neatly tightened into a bun and covered by the cap.
Back then becoming a nurse was typically seen as a female profession, but men were allowed to become nurses too. In 1930, only one percent of RNs nationwide were male.
Growing up in the 1950s …
My battle against the nurse’s cap
In a New York Post article dated January 23, 2019, the author states how Americans without health care insurance hit 13.7 percent. This 2.8 percent increase means an additional seven-million Americans lack health coverage as noted by the Gallup survey period.
This is not far behind the 18 percent recorded just before the Obamacare mandate in 2014.
Everyone is blamed in this article except the culprits. Do you think for one moment …
The true cost of being uninsured in America
Recently, a child was on a waitlist for five months to get into my practice. For this article, I will call him Tiny Tim.
Tiny Tim, now five years old, has a skin condition known as eczema or atopic dermatitis. When we first met, virtuously every area of his body was covered with wounds from constant scratching. Skin that breaks easily and heals poorly can give bacteria access to other parts …
Why is Medicaid reimbursement below sustainability?
Patient access to care is a high priority for all neurosurgeons. Unfortunately, many of our practices are thwarted in these efforts from unwarranted insurance denials. Know, you are not alone. Take this common scenario:
When Ms. Mary Smith (not the patient’s real name) started her new job several years ago, she purchased the premium insurance policy that her company provided. Recently, she developed severe neck and left arm pain. Imaging of …
An approach to prior authorization insurance denials
One time, I applied for an emergency department (ED) nurse manager position. I thought I had the job locked up until I was asked during the interview how I would “enforce metrics.”
“Enforce.”
My holistic, qualitative research-based response to this authoritarian-style question was: “I’ll find more organic ways to achieve your metrics without shoving numbers down their throats.”
I didn’t get the job. Someone told me I wasn’t “MBA enough.”
Yet, I stand by …
Stop shoving metrics down nurses’ throats
I spent my early and mid-career years working in a pediatric intensive care unit (PICU) at a large academic center. We did almost everything except for a few things esoteric at the time — small bowel transplants, a few kinds of experimental surgery. I’m now in my late career (but have no plans to quit anytime soon!) and work in a smaller PICU. I am frequently confronted with the issue …
The Wild West approach to PICU practice
Have you ever been to a doctor’s office and felt that your evaluation was rushed? Have you been seen in the emergency room and felt that you were just a number in a long series of patients? Have you ever seen the same doctor for years and felt like the doctor just met you for the first time each visit?
Chances are we’ve all experienced this as patients. If we’re honest, …
Here’s what the corporatization of medicine is doing
Moving to the Bay Area from the Midwest was a culture shock in many ways. I was amazed by the diversity, the food, the openness of opinions. And I was struck by the traffic, the stark differences driving from one community to another and the homelessness — you could see signs of it everywhere. As time went on, I acclimated to these changes. Working in the hospital, I got used …
The problem with mental health funding and prisons
Corporate health care mentality set up nurses up to be inhuman while holding us to superhuman expectations. We’re told to be caring — but not allowed to do it. It’s time to demand that we stop being abandoned and dismissed by dysfunctional leadership.
Early in my nursing career, I was assigned to the pediatric area for one shift in a busy emergency department (ED). Our team received notification of an incoming …
In 1976 I graduated from medical school and proudly joined the medical profession. Thirty-seven years later, I retired as an employee of the biggest business in the country. In 2016 the medical industry was responsible for 3.3 trillion dollars of expenditure, comprising 18 percent of the United States GDP. For perspective, there are only four countries with a GDP more than the amount spent on health care in the United …
Medicine: noble profession or big business?
Early voting began recently in Texas with unprecedented excitement, as a record 15 million registered voters made their way to the polls. Reports say polls are looking more like Black Friday shopping lines than early voting locations. Although we cannot predict the results of the election, one thing is clear: healthcare is the top issue. This is hardly surprising given …
It’s time we start voting at our local hospitals
To me, my white coat symbolizes a willingness to care for my fellow man, and every day I strive to fulfill that challenge. But even the brightest white coat has a few stains. Growing up in a small Midwestern town, I just didn’t “get” the homeless community. They were completely isolated from my day to day life. Surrounded by my local community, I just assumed that the homeless were either …
The paths to homelessness are more complicated than we think
Will physicians go extinct? Artificial intelligence, legislation, profit motives in the health care industry, and clever lobbying by non-physician providers may all contribute to our demise. However, I believe the existential threat to our profession stems from the ranks of physicians themselves.
1. Unwillingness to embrace activism
Pathologist and writer Rudolph Virchow once said: “The physician is the natural attorney of the poor.” Like most physicians, my goal is to provide evidence-based …
4 reasons why physicians will become extinct
Have you ever been the only customer in your local supermarket? Although the experience can be a bit unnerving, at first, you soon start to notice the advantages: No line at the deli, no pushy shoppers, no carts jamming up the produce section. As you breeze through checkout, you think to yourself, “Gee, I could get used to this.”
Now, imagine walking into an empty waiting area at your local emergency …
3 ways to decrease emergency department wait times
It’s easy to get excited about technological advances such as nanobots that swim in blood to deliver drugs or 3-D printers that print human tissues. However, in our enthusiasm to find the next fix, we are failing to notice the ground slipping underneath the health care industry.
Here are four trends that are changing health care but on the surface are too unsexy for us to care about.
Trend 1: The doctor-patient …
4 disturbing trends in health care
Health care is buzzing as Atul Gawande has been selected as CEO of the Berkshire-Hathaway/Amazon/JP Morgan strategic venture. I was thrilled they picked a physician, like myself, in the trenches to run their gig. After hearing the news, I remembered Gawande’s TED Talk from 2012 and decided to catch up on it during my flight to the Healthcare Finance Management Association Annual Meeting and Innovation Lab.
After watching the …
Atul Gawande’s prescient 2012 TED talk
A guest column by the American College of Physicians, exclusive to KevinMD.com.
Trust is the belief that another person or entity will act in your best interest, and it serves as the foundation upon which the doctor-patient relationship and our health care system are built.
But we have a significant trust paradox in American medicine. As …
Restoring the trust in the medical profession
On May 15, President Trump attempted to kill not just two, but three birds with one tweet, simultaneously denouncing the Media and the Mueller investigation, and crowing about his approval ratings. “Can you believe that with all of the made up, unsourced stories I get from the Fake News Media, together with the $10,000,000 Russian Witch Hunt (there is no Collusion), I now have my best …
Political polarization is harming America’s health
The following are intended to inspire to medical students and residents to learn more about organized medicine. Whether it be at the national, state, county, or specialty level, there are numerous societies with opportunities for contribution.
1. To pull back the curtain. Many physicians are innately curious and like to “see how the sausage is made,” so to speak. There is a great deal of policy behind the scenes of our …
5 reasons to get involved in organized medicine
When we think of bullying, we’re usually worrying about our school-age kids or remembering bad experiences from high school.
We learn quickly in the health care field that bullies don’t change once they enter the clinical world. Health care, with its incredible differential in knowledge, authority and pay creates large power differentials and easily generates subordinate/superior relationship dynamics.
Bullying occurs within professions between trainees and trainers and faculty, and across clinical areas …
How to fix bullying in health care
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