Leaving The House of God
To paraphrase Fat Man’s Law Number Three, “At a code, the first pulse you take is your own.”
Enduring advice, as true today as it was in the early ’70s when Roy G. Basch, MD, and his gang of hapless interns roamed the airless wards of The House of God, the mythical hospital in the infamous novel by Samuel Shem, although almost everything else about practicing medicine seems …
It’s time for a reckoning in pain medicine
More than a million Americans have died since the late 1990s from drug overdoses, with the vast majority dying from an opioid overdose. This trend started with the heavy marketing of opioids to physicians as nonaddictive and effective. The number of deaths from overdose has escalated significantly in the past few years. Although many of the recent opioid-related deaths are from fentanyl, substance abuse treatment providers report that …
The story of a physician, after a year sober
My first COVID vacation last year was spectacular, except that I barely remember three days because I was drinking to the point of amnesia.
I am a physician from a multigenerational family of alcoholics, and I never wanted to struggle with alcohol use disorder. Instead, I discovered that I could avoid feelings of discomfort by overworking, achieving, and staying perpetually busy. Workaholism became my drug of choice. As an adult, I …
My 5-minute conversation with a suicide hotline expert
Sandy was sent to me by her primary care physician for evaluation of anemia. As I reviewed her chart, I explained to the medical student that the blood work showed a lifelong benign condition called alpha thalassemia trait that she was born with. It had no potential to harm her. This would be a quick consult, meaning we would have some extra time to enjoy our lunch.
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What it means to leave clinical medicine [PODCAST]
Integrated care is the key to optimizing cancer outcomes
The American Cancer Society released its annual report on cancer statistics, showing that we have made clear and significant progress in treating numerous forms of cancer. The overall rate of death has declined steadily since 1991, translating to over 3 million lives saved.
Despite this progress, I still see room for improvement in a care model where patients too often slip through the cracks.
The National Cancer Institute identified that …
Let’s focus more on caring, rather than coding
Risk adjustment is a statistical method used by health plans to predict an individual’s use of health care services and the associated cost of care. Unlike traditional fee-for-service Medicare, Medicare Advantage (MA) plans receive a flat monthly payment for the individual beneficiary’s cost of care, with payments partially based on risk score.
Higher risk scores mean higher payments, and plans have financial incentives linked to more thorough documentation (coding) of their …
Design thinking in health care: Physicians already have the training to be innovators
Compared to the Silicon Valley world of moving fast and breaking things, health care change often happens slowly. Some of the reasons for the inertia of our industry make sense. Change impacting patients requires a vetting process to ensure we are creating net benefit.
But this inertia also exists partly because many believe our field is so uniquely complicated that it cannot be improved using lessons from other industries. But the …
Common open enrollment considerations for doctors
Similar to most financial topics, benefit elections are not a one-size-fits-all recommendation. Open enrollment occurs at the end of each year and remains open for a month and a half. During this time, you can sign up for health insurance, flexible spending accounts (FSA) for health care and/or dependent care, health savings accounts (HSA), retirement plans, as well as other benefits. Be aware that employers often use the open enrollment …
Preparing for fall and winter: Importance of COVID-19 vaccination during the flu season [PODCAST]
This article is sponsored by Novavax.
In this special sponsored episode. I’m joined by Dr. Filip Dubovsky, chief medical officer at Novavax, to discuss topics like COVID-19 and influenza in the fall and winter seasons, the importance of education to understand your vaccine …
Be a shining example for your weight loss patients
How can you be an example of what’s possible for your patients on their weight loss journey? I got this question recently in a doctor’s social media group I like. The answer is simpler than you think. As their doctor, you aspire to perfection in your medical care for them, but you can be an example of what’s possible in weight loss as a plain regular human being. Sharing …
Why does it take 10 years to diagnose this common disease?
Every day, patients with the same story walk into my office. Young people in their teens, 20s or 30s are exasperated and seeking help for constant painful boils that drain the pus in underarms, groin, and around breasts — a condition called hidradenitis suppurativa (HS). This disease often makes their lives a nightmare. Despite being a more common condition than once thought, many patients see providers for 7 to 10 …
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Keeping rural hospitals in the game [PODCAST]
The environmental impact of the diabetes epidemic
The superior doctor prevents sickness. The mediocre doctor attends to impending sickness. The inferior doctor treats actual sickness.”
– Chinese Proverb
The management of diabetes today requires an understanding of the concept of the circular economy in eliminating waste and pollution, circulating products and materials at their highest level, and regenerating nature.
Today, we saw a 64-year-old woman for her follow-up visit to the diabetes clinic. She is our typical Oklahoma patient with …
If growing a hospital pediatric program was only this easy
The goal of making a hospital pediatric program a greater presence in the community hinges upon two areas, building community and alliance with local pediatricians and creating more visibility in the public arena. Both are not mutually exclusive, and each affects the other. The goal is to create a positive experience for both areas that will enhance each individually as they connect with one another.
Unfortunately, if not done correctly, negative …
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Physicians are only good for 90 days
“Nothing is certain except death and taxes.”
Physicians are commonly offered one, two, and three-year employment contracts that appear ironclad and have automatic renewal clauses. The length of these contracts encourages us to believe we can confidently make major financial decisions based on expected income. Moreover, we want to believe that enduring years of training and oppressive loans have finally resulted in financial success. So, we read contracts hoping these agreements …
Urging patience with patient self-advocacy [PODCAST]
The powerful role of administrative leaders in high-value primary care
The market for health administrators in the U.S. is projected to grow 28 percent from 2021 to 2031, growing more rapidly than the average for all other occupations.
Traditionally, those in health administration work in hospitals, large health systems, health plan organizations, and consulting firms. However, health administration has the potential to contribute value to every component of the U.S. health care …
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Investing today in early-career physicians’ unique needs fuels tomorrow’s health care leaders
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.
My physician grandfather believed medicine was the noblest profession, a career that combined making an honest living with a meaningful difference. Inspired by his passion, I followed in his footsteps, believing I was on the path to a lucrative life of helping people in need.
The reality has …
Past Week
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What’s driving medical students away from primary care?
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Make cognitive testing as routine as a blood pressure check
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The hidden cost of delaying back surgery
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The dreaded question: Do you have boys or girls?
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Rethinking patient payments: Why billing is the new frontline of patient care [PODCAST]
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The broken health care system doesn’t have to break you
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Past 6 Months
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What’s driving medical students away from primary care?
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The silent crisis hurting pain patients and their doctors
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What happened to real care in health care?
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Internal Medicine 2025: inspiration at the annual meeting
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The hidden bias in how we treat chronic pain
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Residency as rehearsal: the new pediatric hospitalist fellowship requirement scam
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Recent Posts
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Does silence as a faculty retention strategy in academic medicine and health sciences work?
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Why personal responsibility is not enough in the fight against nicotine addiction
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How dismantling DEI endangers the future of medical care
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Past Week
-
What’s driving medical students away from primary care?
-
Make cognitive testing as routine as a blood pressure check
-
The hidden cost of delaying back surgery
-
The dreaded question: Do you have boys or girls?
-
Rethinking patient payments: Why billing is the new frontline of patient care [PODCAST]
-
The broken health care system doesn’t have to break you
-
Past 6 Months
-
What’s driving medical students away from primary care?
-
The silent crisis hurting pain patients and their doctors
-
What happened to real care in health care?
-
Internal Medicine 2025: inspiration at the annual meeting
-
The hidden bias in how we treat chronic pain
-
Residency as rehearsal: the new pediatric hospitalist fellowship requirement scam
-
Recent Posts
-
Does silence as a faculty retention strategy in academic medicine and health sciences work?
-
Why personal responsibility is not enough in the fight against nicotine addiction
-
How dismantling DEI endangers the future of medical care
-
Alzheimer’s and the family: Opening the conversation with children [PODCAST]
-
AI in mental health: a new frontier for therapy and support
-
What prostate cancer taught this physician about being a patient
-
