Palliative and hospice care in hospitals and clinics: the good, the bad, and the ugly

Physician
April 1, 2024

I walk into the patient’s hospital room during evening rounds. He looks pale and tired, having recently completed a round of chemotherapy for his stage IV pancreatic cancer. His wife is at the bedside, scared and concerned about her husband’s rapid decline. I sit down to discuss goals of care when the patient immediately says, “I can’t do this anymore.” His wife responds immediately to the patient: “Of course you …

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Hospital retaliation and my fight for patient rights

Conditions
April 1, 2024

I found myself compelled into the complex world of health care advocacy under extraordinary circumstances last year when I went to my university administration to request a table to do a free speech petition because of a personal and troubling experience. My mother, a respected pediatric intensive care doctor, had been abruptly terminated from her workplace after she raised concerns about patient safety.

Throughout my studies as an undergraduate, I frequently …

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A surgeon’s journey with Taylor Swift [PODCAST]

Podcast
March 31, 2024
YouTube video

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Join us as we sit down with Andrea L. Merrill, an assistant professor of surgery, to explore the powerful intersection of music and surgery. From her early days as a trainee to navigating …

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From numbness to empathy: a reflection on medical practice

Education
March 31, 2024

I’m not sad – I’m numb.

My friend, a seasoned internal medicine resident, revealed a chilling truth after grappling with eight patient codes – three lives eluded salvation. The gravity of his words froze me. When did the mourning for human existence transform into a necessity to numb our very core? I found myself pondering the onset of this desensitization, this “numbing.”

I thought back to my own experiences as a third-year …

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The unspoken skill of touch in health care

Education
March 31, 2024

What drew me to spending my gap year as a medical assistant was the advertised “direct patient care experience.” While patient care is my favorite part of the job, it comes with its own unique challenges for a first-time health care worker.

An unexpected challenge that I had to overcome with patient care was learning how to touch patients. I am tasked daily with removing sutures, staples, assisting with wound care, …

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Low-frequency ultrasound for pain relief [PODCAST]

Podcast
March 30, 2024
YouTube video

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We welcome L. Joseph Parker, a research physician, as we delve into a study that explores the potential of low-frequency ultrasound waves in pain management. Joseph will guide us through the intriguing findings …

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Microskills to be a team player: workplace violence

Physician
March 30, 2024

A patient, intoxicated with alcohol, comes into the emergency department complaining of chest pain. The nurse and the ECG tech need help as the patient is yelling, flailing his arms, and trying to stand up out of bed while stumbling. The nurse puts a blood pressure cuff on his arm and a pulse oximeter probe on his finger. With his other hand, he tries to grab her, pull her toward …

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The battle of the bulge: The struggle is real

Conditions
March 30, 2024

The economic impact of obesity looms large, casting a shadow over both individual well-being and national prosperity. Beyond the personal struggles and societal pressures surrounding weight management, the financial ramifications of obesity ripple through health care systems, labor markets, and various sectors of the economy. In the United States alone, the annual health care costs attributed to obesity-related conditions soar into the hundreds of billions of dollars, placing a significant …

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Beyond safety whistles and pizza: On National Doctor’s Day and every day, physicians deserve humanity

Physician
March 30, 2024

Recently, on an average workday, my hand brushed against the small safety whistle clipped beside my ID badge. Most days, I don’t even remember the whistle is there, a “Happy Doctor’s Day” gift from a few years ago. I dutifully clipped it on, but I can’t say it makes me feel safer.

I remember shrugging when I received it and thinking, well, it’s more practical than pizza.

I also …

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Lessons for a doctor on the Ski Patrol

Physician
March 30, 2024

Is the scene safe?

This is the first thing that you, as a member of the National Ski Patrol, need to ask and assess when coming upon a scene.

As a doctor, I can tell you: they do not teach you this in med school.

When becoming a doctor, you learn how the body works as best we currently understand it. You study how substances affect the body, from illegal drugs to those …

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Patient engagement: Can tech help? [PODCAST]

Podcast
March 29, 2024
YouTube video

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Join Joshua Reischer, a physician executive, as we delve into the complexities of modern health care delivery. Explore the challenges physicians face in obtaining essential patient information, the frustrations experienced by both patients …

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Addressing mental health in the medical field

Conditions
March 29, 2024

In the heart of a bustling hospital, where the relentless pace of saving lives never wanes, lies an unseen battle that rages quietly within the souls of those who care for us. Health care professionals, heralded as heroes, especially in the wake of a global pandemic, face an array of mental health challenges, often overlooked and underaddressed. This article delves into the psychological toll of working in high-stress medical environments …

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Real pain deserves real treatment

Conditions
March 29, 2024

When a patient comes to us and describes confusing symptoms that don’t seem to fit into any immediate category, we can see it in two different ways: as a challenge, we can rise to, a riddle to solve … or we can see it as an opportunity to denigrate the patient, to imply that they are malingering or that it’s “all in their head.” This tendency is amplified when we …

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How my sister’s rights were taken away, like thousands of others with developmental disabilities

Conditions
March 29, 2024

Teresa has Down syndrome and was 49 when the capacity assessment took place in Ontario.

I saw her as happy, healthy, and active. She enjoyed living nearby with my 91-year-old father, who often said, “We’re a team. We help each other.”

But that’s not how the social worker saw her.

Teresa didn’t understand what the assessment was for, and according to the records, she did not agree to be …

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How AI can save lives by simplifying communication

Tech
March 29, 2024

Artificial intelligence is here. While the hype is new, it has existed longer than most think. With a history rooted in the mid-20th century, technologies like natural language processing (NLP) and machine learning (ML) spent decades in an academic chrysalis before emerging to revolutionize our daily lives. Both were introduced in the 1950s and 1960s but have only taken off in the last decade.

The latest of these is LLM, which …

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Health care waste exposed [PODCAST]

Podcast
March 28, 2024
YouTube video

Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes!

We are joined by Edward Hoffer, an internal medicine physician, to explore the alarming levels of waste plaguing the U.S. health care system. Together, we shine a light on the various culprits behind …

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When the doctor’s office becomes a confession booth

Physician
March 28, 2024

“I made a big mistake a long time ago.”

These words snapped my concentration. I squinted at the computer screen, and even though it had been stable, I waited for Cindy’s pancytopenia to collapse entirely. I enjoyed seeing Cindy, the kind of patient who trusted my counsel and, just as importantly, needed my help. Sweet and cute, she gave me a real hug and a genuine smile every time I saw …

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How Enhanced Recovery After Surgery solves our opioid problems

Meds
March 28, 2024

In retrospect, we were an addicted nation waiting to happen. Not from a self-indulgent culture, not from an unwillingness to suffer hardship, nor any of the generational criticisms of lack of grit. Our opioid crisis derives from an impatient culture that fears loss of health more than health care profit. With pain as most people’s proxy for health, we were …

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Princess and the pauper: Both deserve health privacy

Physician
March 28, 2024

The sad news of Princess Kate Middleton’s cancer diagnosis is a sound reminder of the sanctity of a person’s health status and their right to privacy.

I wasn’t sure which adjective I should use to describe Kate’s diagnosis – “sad,” “tragic,” or “devastating.” All are equally true, depending on whose perspective you consider. No doubt a cancer diagnosis is “sad” in the public’s eyes and even harsher in Kate’s. In my …

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Finding peace in the face of loss: a father’s journey with hospice

Physician
March 28, 2024

How do you make sense of someone dying? The only way I know is to put it into some context so that, if possible, some good can come of it.

Some of you may have known about my dad’s Parkinson’s disease. He’s had a fairly rapid decline over the past four months, and now he’s rapidly declining again. He has been on home hospice for the past three months. He has …

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