A personal mission to get obese patients on GLP-1 agonists

Conditions
October 19, 2022

Admittedly, this comes to you from a place of concussion-inducing-head-banging-against-brick-walls-level frustration.

For the past year, I have made it a personal mission to get people suffering from obesity on GLP-1 agonists. These drugs are all in the same class, have identical mechanisms, and three are the same generics. (Ozempic, Wegovy, and Rybelsus are all semaglutide.)

They are advertised as Wegovy, Ozempic, Rybelsus, Saxenda, Trulicity, and Mounjaro.

To say these are life savers is …

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How major depression strengthened my practice and my faith in God

Physician
October 19, 2022

I had a fairytale courtship, engagement, and wedding to my Prince Charming. We came home, starry-eyed, ready to start our forever together. Within weeks, I began to struggle. Always an extrovert, suddenly going to my family medicine rotation took extraordinary effort. I began to worry about my every word and action. Some days, I said nothing — unsure whether I could form a coherent sentence. I decided to take time …

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26 hours in a day: the impossible math and timing of providing quality care

Physician
October 19, 2022

You recently told me that I have the physician’s group’s highest patient satisfaction scores. This doesn’t surprise me. I know what makes me great: I take time. I let patients tell their stories. I listen, educate and collaborate. When I don’t know something, I find the answer. I am the poster woman for “AIDET.”

Recognizing that time is finite, I strive for efficiency. I delegate. I refer. I use order sets. …

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Using simulations to improve medical decision making [PODCAST]

Podcast
October 18, 2022
YouTube video

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“The scenario is preset, and hence based on a lot of constraints, but when it is run, there is freedom for everyone to operate. This freedom to take part in the defined context is the same as …

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Gun violence during residency: Run. Hide. Fight.

Policy
October 18, 2022

I no longer react to the chiming from my phone when a push notification alerts me of another mass shooting. I have become numb to such alarms. Perhaps it is the increasing frequency of these alerts or a feeling of inevitability, made even starker by my personal and multiple encounters with gun violence in the last year. The gun violence epidemic is ubiquitous.

Ten months ago, there was an active shooter …

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The middleman mentality is killing American medicine

Physician
October 18, 2022

Between producers and consumers, you’ll find a cadre of professionals who broker deals, facilitate transactions, and move goods and services along.

They’re called “middlemen,” and they thrive in virtually every industry — from real estate and retail to finance and travel services. If not for middlemen, houses and blouses wouldn’t sell. Banks and online booking sites wouldn’t exist. Middlemen are the reason a tomato grown in South America makes it aboard …

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The perioperative surgical home: a model to tackle today’s pressing health care issues

Physician
October 18, 2022

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

The health care landscape has never been more complex. A deadly and enduring pandemic; health care delivery challenges that leave some communities at higher risk for adverse outcomes; an opioid crisis that takes nearly 200 American lives per day; and an ever-evolving regulatory …

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We are lost and forgotten in the immensity, waiting in the shadows

Conditions
October 17, 2022

We traverse parallel paths, you and I. Paths that intersect during times of stress, loss, and illness. Each of us searching for truth, understanding, and resolution.

Our stories need to be heard, but in these trying times, we are but mere specks in the immensity of the corporate orb of health care which rolls and overpowers all in its path. Its hunger seems not to be satiated, its grasp ever stretching.

The …

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Physician burnout: a lack of resilience or a lack of control?

Physician
October 17, 2022

When I quit my clinic job after four waves of the COVID-19 pandemic as an intensivist, I decided not to work in direct patient care for a while. I expected harsh criticism from my colleagues. Surprisingly, that never happened. The feedback was unexpected, at least for me. Most of my colleagues admired my decision. They called me brave for taking the leap, and many admitted thinking about the same for …

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I wanted to care for people, so I became a direct primary care doctor [PODCAST]

Podcast
October 16, 2022
YouTube video

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“I’ve started to understand many aspects of business, and although we’ve done some pretty amazing things in the past two years, we’ve also made people frustrated and mad while trying to care for them. And so, I …

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Telemedicine is not medicine

Physician
October 16, 2022

The COVID-19 pandemic ushered in many insidious handmaidens among its foul equipage. From Zoom meetings and school closures to masks and lockdowns, our world was torn asunder and, eventually, rendered anew into a place where almost everything has been changed, by large degrees and small, perceptibly and imperceptibly. It will come as no surprise that medicine is foremost among the more obviously perceptible areas of life that have been irrevocably …

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A story that changed this pediatrician forever

Physician
October 16, 2022

I’m a pediatrician and have been practicing for 29 years. I currently own a solo practice.

Here is a story I wrote years after a patient encounter during my residency in 1993. I didn’t know it at the time, but it was an experience that would shape my career in general pediatrics.

Marcus is the worst case of child abuse I’ve seen to date. He’s two years old. His mom’s boyfriend dips …

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Emotional eating: Why you always want food [PODCAST]

Podcast
October 15, 2022
YouTube video

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“I’ve consistently found that most of the doctors who want coaching help feel like I did when I struggled with my weight: They weren’t feeling like their lives were completely out of control or their problems were …

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Practicing great medicine got a lot simpler. It’s health care that’s getting in the way.

Policy
October 15, 2022

We pay more than any other nation for health care, yet we have suffered the single biggest decline in life expectancy since WWII. Something went wrong. At a time of record inflation and rising taxes, isn’t it time we stopped to ask where the money is going, what exactly we are paying for, and why?

Astonishingly, nearly half the federal budget goes to health care in one way or another. Either …

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Invest in your child. Invest in their future: ESG funds and 529 plans

Finance
October 15, 2022

For parents looking to fund their child’s education, a 529 plan is an optimal way to grow savings through investments and gain significant tax breaks in the process. But as we have previously explored, investments that grow your own portfolio may be causing harm to others by supporting companies that don’t take their social or environmental impact into as much consideration as their bottom line.

In recent years, “environmental, social, …

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Tips to be a more productive, less stressed physician

Physician
October 15, 2022

Why should you be more productive? Because time is money? Not only that. I prefer time is family or time is go-home-sooner.

Being more productive in medicine isn’t working more hours or faster; it means working better.

Take breaks. Doctors rarely take breaks during their workday. Yet most employees do take two 15 minutes breaks each day. Do you feel like 15 minutes is too long? Take at least five minutes per …

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Batman catching babies

Physician
October 15, 2022

Whenever asked, I hesitate to tell people what I do because when a young man says: “I’m a gynecologist,” he never seems to be taken quite so seriously. “No, really, I am” – “Oh.” Instead, I opt for the more charming “I deliver babies” line. Works every time.

And why is that? What about birth and babies triggers a sense of astonishment in people? Whatever it is, it seems to magically …

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How discovering trauma changed this doctor’s life [PODCAST]

Podcast
October 14, 2022
YouTube video

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“In some ways, my diagnosis was the beginning of the rest of my life. I’m now a health coach, helping women struggling with chronic stress and anxiety. And I love what I do. I am able to …

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