American health care: the best of times and the worst of times
An excerpt from Healthcare Upside Down: A Critical Examination of Policy and Practice.
“It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, it was …
Urging patience with patient self-advocacy
One conundrum patients face is the dichotomy of trusting our doctors whilst deep diving in web searches and seeking additional opinions. Another is when our findings and experiences do not align with our doctors or established practices and guidelines.
How would you react in the first consultation with a new patient who presented as I did: with a radiation oncologist in Houston, outcome data on three curative attempts, a graph of …
The internet broke parenting. This pediatrician can fix it.
An excerpt from Parent Like a Pediatrician: All of the Facts, None of the Fear.
The internet broke parenting. In the “good old days,” parents followed a few basic pediatrician-approved rules—send your kid to school, give them healthy food, say “I love you”—and felt confident that they were raising their children …
Why I did not want to become a leader, and why accidentally becoming one was the best thing that happened to me
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.
There are some moments in life that, when you look back years later, you see a pivot. The fork in the road you didn’t recognize at the time, that looking back, changed the trajectory of your life.
One of those moments in my life …
A doctor for LGBTQ+ health needs [PODCAST]
As we get older and the world changes, it’s not always an easy task to say “where”
“Where does it hurt?”
As a child, I can remember this ubiquitous question being frequently asked of me. Having grown up on a farm, there was always some trouble for me to get into. A common hazard was my older sister’s 26-inch bicycle, which had no training wheels.
At age 5, if I was to be a “big kid,” I had to master the art of riding the “big” bike on our …
When medicine surrenders to the body
I still get chills thinking about the moment I decided to go to medical school. I was bored in my college physiology class, watching the minute hand on the round lecture hall clock.
There were just a few minutes remaining in the class, and students were starting to pack up. The professor, Dr. Adams, said, “I want to talk about hemorrhage before you go.” His voice was getting lost in the …
Improving communication requires tough soft skill development
If we are going to take on the challenge of improving communication and related behavior, a.k.a. “soft” skills among health care professionals, we should be realistic. As nurses, doctors, and other health care professionals, we are keenly aware of how difficult changing behavior can be. We see it daily in our patients’ efforts regarding healthy choices and lifestyles. For example, it can be hard to lose weight, exercise regularly, or …
Who gets to go to medical school?
I knew I wanted to be a doctor when I was seven years old. I excelled in school, attended a good college, scored well on the MCAT, and was accepted into medical school just as I always knew I would be. It was only as I progressed in my career as a physician that I realized that being a white, middle-class individual had given me an advantage—I had access that …
Why you need to care about oral health [PODCAST]
Putting on the mask of professionalism causes burnout
In medical school, we are not just taught the scientific information that doctors should know, we are also taught how doctors should look and behave.
I remember being shown a video on “professionalism” during our first day of orientation. It was meant to be humorous, demonstrating more extreme examples of dress code and behavioral violations.
Medical students walk into exam rooms with their bra straps hanging out.
Smacking on gum and blowing bubbles …
Releasing survivor’s guilt
Wednesday, August 10, 2016. You called to check-in. You knew I was struggling.
Months before, I shared with you that I developed suicidal ideation and was not sure I should continue residency. The forced sleeplessness and self-doubt were getting to me.
Did I deserve to be a surgical resident? I felt worthless.
I was so damn tired.
You knew I was afraid to leave the surgery and what that would mean for my military …
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Withdrawing life-sustaining treatment over family objections
“We can keep your loved one alive. but we won’t. Even though you think their life is worth living, we do not.”
The first time I helped a hospital convey this type of offensive message to a patient’s family, it deeply humbled me. My service on a hospital medical appropriateness review committee forged charitable respect for alternative viewpoints that now pervades my work to protect patient rights.
Hospital review committees adjudicate medical …
When should you consider surgery for scoliosis?
Most people with scoliosis will never require surgery. But who does need surgery, and how do you know?
Often diagnosed in childhood, scoliosis is characterized by an abnormal curve in the spine that can range from as small as 10 degrees to more than 100 degrees. In pediatric patients, this can result in pulmonary problems if the curve is severe.
However, pediatric patients’ complaints are mostly centered around their appearance due to …
Contract advice for physicians leaving the military [PODCAST]
Subscribe to The Podcast by KevinMD. Catch up on old episodes!
“Military physicians should also realize that not all employers are equal or treat their physicians equally.
Military physicians entering the civilian job market are in a ‘seller’s market.’ They should get a reasonable employment agreement. It is important …
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Advancing health equity conversations through cultural humility
In 1998, Drs. Tervalon and Murray-Garcia created the concept of “cultural humility” as a way to transcend the prevailing but limiting concept of cultural competence in teaching medical students and trainees how to respectfully deliver health care to the increasingly diverse populations of the U.S. The cultural competence paradigm leads health care professionals to assign patient group traits or labels. On the other hand, cultural humility incorporates a lifelong commitment …
How hearing is connected to well-being
As an audiologist, treating hearing loss is a part of my everyday life. Even still, I’m sometimes amazed at the difference hearing aids can make in patients’ lives. For example, recently, when an older patient with longstanding hearing loss was fitted with a pair of hearing aids, he was suddenly able to participate in conversation with his son again. The smile across his face said everything.
Hearing well can slow cognitive …
Management of acute postoperative pain reveals systemic flaws in health care policy
Medical care in the United States is broken. The pandemic contributed, but we were well along this misdirected journey. There is a pathological push/pull between financial pressures applied by payors and health care systems to decrease costs, thereby generating profits versus the desire of providers to deliver outstanding care to patients. This is ingrained into our system as it is designed. The dynamic is further muddled by our unique medicolegal …
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Melting the iron triangle: health equity in innovative health care landscapes [PODCAST]
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Past Week
-
The silent crisis hurting pain patients and their doctors
-
What happened to real care in health care?
-
How doctors can thrive despite declining reimbursements
-
Pope Francis dies at 88. What his care reveals about America’s failing hospitals.
-
Medical school admissions are racing toward an AI-driven disaster
-
Fat guy in a little coat: Preventing childhood obesity
-
Past 6 Months
-
How trade wars could destroy the U.S. health care system
-
The hidden bias young female physicians face every day
-
How hospitals are quietly taking control of physicians
-
How to advocate for your transgender child’s health care
-
Doctors don’t need yoga, they need time to smoke
-
How the system hunts physicians who refuse to kneel
-
Recent Posts
-
Fat guy in a little coat: Preventing childhood obesity
-
Taking a break from medicine: a physician assistant’s journey from burnout to world travel [PODCAST]
-
Gen Z is already transforming mental health care—are we listening?
-
Why nurses are the true heroes of my 25-year medical journey
-
What independent bookstores and private practice doctors teach us about human connection
-
How fake news about transgender mice is hurting real patients
-
