Regret is a harmful emotion. Regrets are best avoided. Its one thing to regret buying a stock that plummets. It’s another to regret that you ever smoked because your chest x-ray shows a large tumor.
People often don’t appreciate what they have until they’ve lost it. When you’ve lost your health, you will regret its loss for the rest of your (shortened) life. Imagine that you were supposed to take your …
Regrets after patients have lost their health
Despite this culture’s obsession with good health, people get sick.
This piece is based on a story I tell in my book.
In 2001, I got sick with what the doctors initially thought was an acute viral infection. I have yet to recover. Diagnosis: Chronic Fatigue Syndrome—a little-understood illness that is as debilitating as its more justly named cousins that also compromise the immune and neurological systems. My case is particularly …
How not to treat yourself when chronic illness strikes
A response to Concierge Practice: Unjust for Patients and Doctors Alike.
Like the shots fired at Concord and Lexington in 1776, concierge medicine and direct pay practices are the initial shots fired by concerned primary care physicians in the revolution against health care systems which limit access to physicians and destroy the doctor / patient relationship. Concierge medicine arose as a result of government, private insurance, and employer intrusion into …
Why concierge and direct pay medicine is not unethical
As a patient, and reader of KevinMD.com, I’d like to respond to a recent piece, Doctors face difficult choices to save Medicare.
The funny thing about this entire situation is that people refer to numbers. Numbers that consist of how much doctors are in debt when actually entering into the working world, how much Medicare reimburses or pays annually, how many patients are actually on Medicare, and how much …
Our country fails to view physicians as humans
The science of nutrition is changing and not in the way you might expect. After years of “reductionist” thinking — where food has been viewed as the sum of its parts – a call to treat food as food has been sounded. No more poring over nutrition labels to calculate grams of fat or chasing down the latest go-to chemical – be it vitamin E, fish oil or omega-3. …
The entire approach to food based on nutrients is wrong
Clinical content refers to the various checklists, documents, and forms that address an area of medicine when using an EHR. For example, a pediatric practice would be interested in documentation tools for a newborn visit. Not all EHRs have clinical content for all areas of medicine. For example, some EHRs have clinical content for internal medicine, but lack the details needed for dermatology or cardiology.
A disturbing number of practices …
Practices have failed to analyze the clinical content of their EHR
So many times we feel so overwhelmed by the crush of medical school that we forget to share the really amazing moments that come along each day. One of the incredible gifts you get as a medical student is that you get to step inside medicine as a worker and observer. Often, you get overwhelmed with being the “worker” and do not remember to be an “observer” of the …
A medical student experience in the newborn nursery
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
An 89-year-old woman is evaluated for dizziness that she has had for the past year, mainly while standing and ambulating. The dizziness is described as a sense of unsteadiness. The symptoms can last for minutes to hours, and she has at least 4 to 5 episodes …
MKSAP: 89-year-old woman is evaluated for dizziness
Every year, according to a recent study from the New England Journal of Medicine, a typical physician has about a 7% chance of being sued for medical malpractice.
Surgeons almost certainly will face a malpractice claim sometime during their career. Neurosurgeons, for instance, have a 19.1% chance of being sued in a given year, while that number is 18.9% for …
The emotional costs of malpractice mean more to doctors than money
There are some important new recommendations about tonsillectomy — taking out the tonsils — as a treatment for recurrent strep throats.
Some of us can recall a time when getting your tonsils out was one of the rites of passage of childhood. Usually a related procedure is added — an adenoidectomy, removing the adenoids as well. It’s called a T&A in the medical world, and it’s one of the …
What do tonsils do and why would we take them out?
This year, total federal spending in the U.S. is projected to be $3.6 trillion. The top three budgetary categories are:
Medicare and Medicaid costs alone account for 23% of total federal spending.
If the magnitude of these projections does not alarm you, let’s look at it from a revenue perspective. This year, the total U.S.tax revenue is projected to be $2.2 …
Why physicians will be sacrificial lambs in future Medicare cuts
As a physician, I was inspired by the Lesley Alderman article –”The Doctor Will See You … Eventually” – that appeared in the New York Times recently.
There is a great deal of emotion in this country surrounding the debate over waiting-room delays in physicians’ offices. Doctors feel as though they are being unjustly blamed for making patients wait when physicians are now forced to see more patients in less time, and …
Are doctors to blame for long waiting room times?
Innovation in medical devices has been profound in recent years – cardiac devices are a good example. The combination of engineering advances to create small, strong and wear-resistant devices and computational advances with smaller and smaller semiconductors loaded with more and more information have led to truly amazing advances. With more and more people with more and more chronic illnesses, the need is great and the opportunities for innovators is …
Medical device innovation saves lives but often at a high cost
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Picture this: A medical journal receives an unsolicited manuscript from an unknown author, and then … Type 1 medical journal.
The peer review process employed by Type 1 medical journals uses secret, anonymous peer reviewers working behind an opaque shield hiding clueless and spineless editors who may use either no reviewers, or a few cronies, or those reviewers known to be opposed or known to be in favor of some …
Peer review at medical journals, from a former JAMA editor
I am an enigma. I always have been. Some doctors think of me as a challenge while others make it clear they dislike dealing with my case. I’ve had gastroparesis since I was born. Idiopathic gastroparesis. I’ve had debilitating migraines since I was 3. Idiopathic migraines. I’ve had several-month bouts of low grade fevers for years. Idiopathic fevers. Over the past 6 months I’ve started going into anaphylaxis. Idiopathic anaphylaxis.
Every …
A note to doctors from a patient labelled as idiopathic
It is in this arena that the public treasury has been most abused by government ineptitude, institutional inertia and Congressional negligence. The waste and fraud in the Medicare and Medicaid system is scandalous and is now the target of well-organized international crime. Estimations of the extent of this waste and fraud run as high as $150 billion.
The United States Government has done nothing to effectively stop it. Excuses run …
How basic healthcare can be provided to the truly needy
I usually write about healthcare reform from a pediatrician’s viewpoint, but what grabbed my attention recently was a story my husband, Randy, told me about an adult in his practice – a patient on Medicaid.
Randy is a neurologist in a private practice, and Medicaid patients come from every corner of Rhode Island to see him. They make this cumbersome pilgrimage because he is a member of a dying breed: …
Why cutting Medicaid will cost more in the long run
Some hospitalists are in denial. Some hospitalists have become methodologic critics. But all hospitalists should take the findings of the recent Annals of Internal Medicine article seriously. We should not argue about the article, but rather ask whether these findings point out a weak point in our care of patients.
This article provides an opportunity, not a scolding:
In an accompanying editorial, two other researchers from the VA Medical Center in …
An opportunity for hospitalists to improve patient care
I was working as a PA in an internal medicine office seeing patients. One afternoon, I was in the clinic hallway when I saw an elderly looking wife in her 60s actually pushing her husband into the next exam room. He had his heels dug into the floor, but she was winning, due to his obvious shortness of breath and audible wheezing.
I walked in behind the medical assistant who …
Without wives, men’s health suffers
Last summer, I joined millions of others in the deluge of social media. I committed one year of effort to see if social would enhance or distract from my pediatric practice.
That was my goal, just one year.
At that time, I wanted to dip my foot in the pool, and see if it made any ripples. The unexpected consequence was how much social media has changed my medical practice, and …
How social media has changed my medical practice
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