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We sit down with Paula Muto, a vascular surgeon, who discusses the challenges she’s faced in a health care system on the brink of collapse. From hospital closures driven by private equity to …
How to fix our broken health care system from the inside [PODCAST]
I lost an inspiration—my relative (Dr. PBA), a dedicated and talented doctor, who succumbed after a long and courageous battle with metastatic breast cancer and brain metastasis. She was the driving force behind my passion for oncology research, especially in breast cancer. Her journey began with a late and missed diagnosis, leading her across borders in search of evidence-based care, from one health care provider to another, and through relentless …
As an OB/GYN for the past 22 years, I have loved delivering babies, performing surgeries, and having long-term relationships with my patients. Now, I am on the other side of things, as a patient myself. I was diagnosed with adult polyglucosan body disease (APBD) in April of 2023 at the age of 59.
APBD is an ultra-rare, neurodegenerative disorder characterized by a deficiency of glycogen-branching enzyme. The result: an accumulation of …
When a physician gets a rare disease diagnosis
I am a surgeon from a family of surgeons, all based in Massachusetts. Throughout my career, I have faced many challenges, both in and outside of the operating room. Like most doctors, I am saddened by the current collapse of our system in general and my own hospital in particular, which is facing closure due to mounting debt owed to private equity. For the record, I have been warning my …
A physician’s perspective on the crisis in Massachusetts health care
All physicians are leaders, not just those with designated leadership titles, such as department chief, chief medical officer, or CEO. Leadership – i.e., influencing behavior to achieve a desired result – is foundational to the role of doctor.
But we aren’t routinely trained as leaders. More critically, as brand-new physicians, we aren’t explicitly told we are leaders. Typically, we think a “physician leader” is someone who has been promoted to an …
How better physician leadership can benefit our health care systems
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We dive deep into the evolving role of artificial intelligence in health care with Muhamad Aly Rifai, a practicing internist and psychiatrist. We explore how AI is not only shaping clinical care but …
How AI could disrupt the future of health care regulations [PODCAST]
Up until a few years ago, I was living my life entirely in fear. In my earliest years, I remember lying awake at night judging if the creak I heard was significant enough to mean someone was breaking in. I was scared of basements, scared of strangers, worried if my parents would come home safely—the usual collection of childhood fears. During adolescent years, the fears of my approval-seeking self focused …
How I conquered fear and reclaimed my life—a doctor’s story
This year, the world was shocked by the tragic death of 33-year-old Rebecca Cheptegei, who had just completed the women’s marathon at the Olympics in Paris. She succumbed to her injuries in a Kenyan hospital after her partner’s brutal attack left 80 percent of her body burned. This horrific incident is not isolated; it is part of a disturbing global pattern of gender-based violence (GBV).
Gender-based violence and the life-changing power of reconstructive surgery for survivors
An excerpt from Our Connected Lives by permission of Texas Tech University Press. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
I used to think that as an active oncologist for thirty-five years, I was well-versed on the subject of empathy. But I was wrong. It was only when, in a matter of seconds, I went from doctor …
From doctor to patient: a life-changing lesson in empathy
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In this episode, nurse consultant Beth Boynton joins us to discuss the transformative power of the Medical Improv Toolkit in clinical settings. We dive into how playful, experiential activities can enhance communication, reduce …
Transforming health care communication with simple playful activities [PODCAST]
For decades, patients with restless legs syndrome (RLS) have been prescribed medications that, unbeknownst to them, were making their symptoms worse. Many doctors who have been prescribing these drugs are unaware that these treatments—primarily ropinirole and pramipexole—are exacerbating the condition. Thankfully, this is about to change.
In September, the American Academy of Sleep Medicine (AASM) released new clinical practice guidelines that recommend against these drugs (marketed as Requip and Mirapex, respectively) …
The unexpected truth about restless legs syndrome treatments
I spend most of my working hours trying to unlock superpowers. When I chose to pursue medicine—pediatrics, and later, developmental behavioral pediatrics—I didn’t realize I would be learning to decode languages. These languages aren’t always spoken, yet over time, I’ve developed a sharp instinct for reading them. Every time I step into an exam room, my task is to slowly unravel how a child sees the world, communicates with it, …
Bridging worlds through the language of neurodiversity
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We dive into the power of expressive writing with guest Aine M. Greaney, an accomplished writer. Aine shares her personal journey through caregiving, journaling, and emotional healing during a difficult time in her …
How journaling transforms emotional turmoil into healing for caregivers [PODCAST]
From defibrillators and ventilators to infusion pumps and dialysis equipment, Internet of Things (IoT) medical devices significantly enhance outpatient care. Patients can record and send measurements remotely, eliminating the need for follow-up visits. At the same time, these devices help understaffed outpatient facilities that might not have the capacity to send caregivers for home visits. However, to ensure the optimal functionality of these IoT outpatient devices, original equipment manufacturers (OEMs) …
Ensuring optimal functionality for IoT devices in outpatient care
Over the past several months, I’ve’ been busy assembling various essays into a book—essays I’ve written and published here on KevinMD and elsewhere. The manuscript is now complete. Here’s a brief pitch I’ve given to about two dozen publishers (I do not have an agent):
Dear Acquisitions Editor:
I am writing to ascertain your interest in publishing my manuscript tentatively titled Narrative Rx: A Quick Guide to Narrative Medicine for Students, Residents, …
The challenges and triumphs of self-publishing in a conventional world
Noticing the local physicians who practiced in your area, stayed for two years or so, and then moved to a “different place to practice” (cover story—meaning they never made enough income to stay in practice in your area) involves thousands of physicians across our nation annually, which has led to the physician attrition crisis today. Not enough money or income is most often the cause.
You may not know that you …
If you think the labyrinth of U.S. government agencies and congressional subcommittees is complicated, be grateful you are not a pharmacy owner! Just to get your drugs reimbursed, you must navigate a river of upstream, midstream, and downstream suppliers, health plans and insurers, employers and other payers (including federal and state governments), rebate aggregators, “white and brown baggers,” and an alphabet soup of entities/concepts called things like PSAOs, GPOs, NADACs, …
Are you taking FDA-unapproved drugs without knowing it?
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We sit down with anesthesiologist Kolleen Dougherty as she reflects on her experience of career burnout after two decades at a Level 1 hospital. Kolleen shares the internal struggles that kept her in …
Is staying worth it? How one physician broke free from the “sunk cost fallacy” [PODCAST]
As shown in my earlier post, when prosecuting Byrom vs. Johns Hopkins Bayview Hospital with inductive reasoning, as is traditional, the medical intervention is compared to the standard of care in a very general and subjective way. The medical intervention “more likely than not” departs from the standard of care. “More likely than not” corresponds to a level of confidence of around 51 percent and a type-1 error of …
Shortcomings of plaintiff attorneys in Byrom vs. Johns Hopkins
As physicians, we spend years mastering our craft—learning how to diagnose, treat, and care for patients. But there’s another area that demands mastery if we want to secure our futures: wealth building. The truth is, despite the high earning potential that comes with a medical career, far too many doctors retire with less than they imagined. Why? Because earning is one thing, but building sustainable wealth that lasts is an …
Leveraging your medical career for long-term wealth building
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