A while ago, I asked an 8-year-old patient of mine what she wanted to be when she grew up. She replied, “I’m not sure because right now I want to be a doctor, a firefighter, and a teacher … so maybe I’ll do all three … I’m not quite sure.”
Uncertain about how to respond, I mumbled something like, “I don’t think you’ll have much free time.” Adulthood tends to make …
What’s happening in Syria is a conversation we need to have
An excerpt from How to Live Well with Chronic Pain and Illness: A Mindful Guide. Copyright 2015 by Toni Bernhard. Excerpted with permission from Wisdom Publications.
“Remembrance of things past is not necessarily the remembrance of things as they were.”
– Marcel Proust
For the most part, I’ve adjusted to my new life but, occasionally, I still catch myself engaged in distorted thinking about the past. I’ve taken to calling …
Beware of “Good Old Days Syndrome”
On the business side of health care, doctors are at a disadvantage. Because of their training, or lack therein, and native personality, they often fail to understand the realities of the market place, take confrontation personally and are suckers for an aggressive sales pitch. They feel that their motives are pure and because they sacrifice themselves and their families, over many years, they should receive respect and success. “I build …
For doctors to survive today, they need emotional intelligence
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Part of a series.
PCPs in the current reimbursement model are obliged for business reasons to see many patients per day which, of course, means less time per patient. PCPs are frustrated, and patients are less satisfied. With less time, it is hard to build a strong doctor–patient relationship and without it there is less opportunity to build trust. Readers of my posts at KevinMD know that I …
Can an insurer actually improve the plight of the PCP?
Planned Parenthood is under attack, and certainly not for the first time. The organization, federally funded by the Family Planning Services and Population Research Act since 1970, provides a wide range of medical services to women (and men), including routine physical exams, STI screenings, contraception, and abortion. This latest movement against the organization gained traction following a series of heavily-edited videos from the so-called Center of Medical Progress, …
Why the the cost of Planned Parenthood is worth it
It’s been over a year since my older sister Anna died, so I choke up less readily while speaking about it. The raw anger is less, but the frustration of losing someone to a preventable medical mistake will always remain with me. Anna was five years older than me, my only sister, and the one I often turned to for advice. We were close despite living 600+ miles apart. She …
It’s time for health care to stand up to medical errors. Will we?
I always wondered what the saying “the apple falls so closely to the tree” meant. I never bought into the concept of similar cliché sayings of “like father like son” or “mother like daughter.” I viewed these ideas as being founded upon by poorly defined concepts of traits and inheritance. Such notions completely undermine the ideology of “I think, therefore I am” as coined by Rene Descartes. I maintain that …
Preventive medicine requires us to lead by example
I cracked a Budweiser and flipped on Spotify radio for what I was told would be a challenge. On my computer screen, Minnesota’s health insurance exchange website waited expectantly, to which I submitted the Holy Trinity of health information — age, date of birth, and tobacco usage — and waited. The next page loaded slowly, evidence of the voluminous information that would soon surface. I had hoped for simplicity, instead, …
I just turned 26. Here’s what I learned while buying health insurance.
An excerpt from Black Man in a White Coat: A Doctor’s Reflections on Race and Medicine.
On a humid Tuesday morning, Chester arrived at a busy Durham emergency room. While the other patients around him made the usual requests for pain medications, diagnostic tests, and reassurance that they were not about to die, Chester gave an entirely different kind of demand.
“I don’t want no nigger doctor,” he said …
Bracing myself for racially tinged criticism, I was surprised by what happened next
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.
“Social media engagement” is a buzzword in today’s business world. There is no clear definition of this term, but most agree that it involves some measure that those looking at your online content are actually interested in what you have to say. In other …
Find your social media voice. Patients are listening.
Dear health care industry:
I think we have a serious problem, and I think we both deserve some of the blame. Over the last couple of decades, I the patient have been demanding many things of you: reduced wait times, increased access to medications and procedures, more luxurious and colorful accommodations, and numerous scheduling conveniences among other things.
Meanwhile, I have watched as an industry long-based on the revered call of service …
Dear health care industry: Give me what I need, not what I want
The federal government is currently debating whether the big six health insurance companies in the U.S. will soon become the big four. Aetna and Humana have announced plans to merge, as have Anthem and Cigna. The American Hospital Association and the American Medical Association strongly oppose the mergers, saying they will reduce competition in consumer markets.
Meanwhile, health care provider groups continue to consolidate. Small hospitals either get swallowed up by …
What will be the consequence of health care consolidation?
An excerpt from 11 out of 10: A Collection of Humorous Medical Short Stories.
When I was 16, I got a job as a “standardized patient.” My neighbor worked for a medical school, and they needed standardized patients for their medical students to practice talking to. Because apparently you can make it through four years of undergraduate, a rigorous medical school application process, and, you know, normal life experiences, but …
The time I was a 16-year-old standardized patient
A colleague recently told me of a patient encounter he had in an emergency room. When he picked up the chart, it described the patient as a 62-year-old woman complaining of epistaxis, or a nosebleed.
He walked into the room and saw a perfectly well appearing 62-year-old woman. There was no blood on her clothes and none on her face. Her nose was not bleeding. When he asked her what could he do for her, she said …
Should there be limits to patient-centeredness?
In the arms of every parent who waited on the long line outside the clinic in Mexico was a child born with a facial deformity, usually a cleft lip or palate. Many of these mothers and fathers had walked long distances, carrying their child. Some families included grandparents, aunts and uncles, and others, just a mother, and her baby. Most of these …
Here’s what doctors can learn from global volunteering
Recently, two significant pharmaceutical breakthroughs have resulted in a renewed debate about the costs of drug therapy. In the last year, a new drug class for the treatment of hepatitis C has been released by two different manufacturers and has been found to cure a once incurable chronic liver disease for nearly 90 percent of patients who are treated with a full course of therapy. The drug appears to be …
Find a cost-effective way for drug companies to innovate
ICD-10 is not a character in an upcoming fall TV show, but instead something far less glamorous. ICD stands for International Classification of Diseases and is a list of codes used by doctors and hospitals when billing insurance companies.
It’s been around since 1946, with the 10th iteration going into effect on October 1st. And it may be an unpleasant October surprise for doctors and hospitals. Don’t blame Obamacare. Don’t blame …
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 58-year-old man is evaluated during a routine appointment. He is asymptomatic. He was diagnosed with type 2 diabetes mellitus 4 years ago and has hypertension, dyslipidemia, and obesity. His medications are enteric-coated low-dose aspirin, lisinopril, fluvastatin (20 mg/d), and metformin.
His calculated 10-year risk of atherosclerotic cardiovascular disease (ASCVD) using the Pooled Cohort Equations is …
Test your medicine knowledge: 58-year-old man with type 2 diabetes
When the daytime soaps As The World Turns and All My Children went off the air, I stopped watching any daytime TV. So before their infamy this week, I’d never heard the name, Joy Behar. And maybe I’d heard the name Michelle Collins, but I’m thinking that name was my niece’s friend’s cousin or someone-or-other. And certainly, I’m not familiar with the …
Nurses have been my best teachers
First, I’d like to thank you for taking the time to read this; I know you’re busy fund-raising and campaigning, so I’ll try to keep this brief. It’s recently become quite apparent that several of you have some misconceptions about our immunization program. That’s unfortunate for people who are seeking such a prominent position. …
A pediatrician gives vaccine advice to presidential candidates
