Corruption in health care: when the mice mind the cheese

Policy
July 17, 2022

That the United States spends the most on health care is unsurprising.

What’s questionable is paying so much for the worst health care system amongst high-income countries and being far behind many countries that could not be considered high-income by any stretch of the imagination.

Other than doing brilliantly at mammograms and seasonal flu vaccines, the U.S. is found appalling. Not just Canada and Mexico, but when the likes of Chile, Saudi …

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Historical lessons to improve health care today [PODCAST]

Podcast
July 16, 2022
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“Medical advances can often stir up ethical issues, which ripple into two courts: the court of law and the court of public opinion. These news articles described a public relations nightmare brewing at the National Pituitary Agency (NPA), which operated with NIH funding. …

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Fat acceptance is a human acceptance movement

Conditions
July 16, 2022

The recent article by Danielle Crittenden, “The Danger of Fat Acceptance: The Average American Woman Is Now a Size 18” is more of the same perpetuation of our society’s deeply internalized diet culture, weight blaming, and shaming of the individual and collective pursuit of thin privilege.

The article was sent to me by a friend, but I didn’t need to read it because I’m so familiar with the …

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Activism is a part of medicine and we cannot remain neutral

Physician
July 16, 2022

From a new attending and the former resident and fellow physician union president, congratulations on starting your residency! You’ve dedicated decades of your life to medicine, and your years of studying and extracurricular achievement have brought you to this moment.

As you are well aware, residency will be tough. You will likely work long hours while being exploited by your employer as cheap labor, but you’ll be expected to drink from …

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Top 10 things new interns should do

Education
July 16, 2022

New resident physicians who have earned their MD degrees will be heading to hospitals to start their residencies during the last two week in June and the first week in July. What can a beginning doctor do during the first month of internship to get his or her career off to a good start, and in so doing, also learn to provide the best care to patients? Here are 10 …

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Why the new 988 hotline has the potential to transform mental health care [PODCAST]

Podcast
July 15, 2022
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“The federal 988 hotline represents a promising new approach to alleviating the nation’s growing mental health crisis, but several key challenges loom that could derail this well-intentioned initiative.

One significant information technology challenge the hotline will face involves how to uniformly store and interpret …

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Abortion debates need to happen, but both sides need some ground rules

Policy
July 15, 2022

On June 24, 2022, the Supreme Court ruled 6–3 to uphold Mississippi’s Gestational Age Act and 5–4 to overrule Roe v. Wade and Planned Parenthood v. Casey. The political temperature was already heightened because Politico released a leaked draft opinion on May 2, 2022.

The pending ruling threw the United States into an emotional pressure cooker spurred on by heavy (some would say irresponsible) news coverage and social media fervor that …

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What is the narrative that you hear when faced with uncertainty?

Physician
July 15, 2022

The first week of my big attending job, I saw a patient with fever, sore throat, no cough, and tonsillar exudates. Well-trained to manage septic shock, but having no idea how to practice in a primary care clinic, I crafted a vast array of infectious and inflammatory diagnoses. With a quick glance, my senior partner said, “You don’t know that this is strep?” Flushed and wanting to hide, I thought, …

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Should your child try for medical school?

Education
July 15, 2022

An essay from 1989.

Some day one of my children will likely ask what I once asked my stepfather, “Dad, do you think I should try for med school?” I feel that it will most likely be our inquisitive middle child, Clayton John (“CJ”). And, when that time comes, what will I say to Mr. CJ?

For many physicians in the past, the answer to this question would have been a resounding, …

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Using inquiry-based stress reduction to treat medical malpractice stress syndrome [PODCAST]

Podcast
July 14, 2022
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“We are busy people who have had much success; looking at our painful thoughts is not something we have had the need or opportunity to do. We may be a little anxious, neurotic, even, but we are respected, helpful, and successful. We tell …

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These are the women who are being told they are not a priority

Policy
July 14, 2022

There are situations where I have told a patient they had no options: a cancer recurrence not responding to any treatment, detecting no heartbeat in a 37-week pregnancy, or telling someone their family member coded and didn’t survive. The worst part of these situations wasn’t just the diagnosis but the lack of options to improve the outcome. Let’s not remove choice in situations where a patient has a chance to …

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How did quality and safety become 4-letter words?

Policy
July 14, 2022

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

A decade of working in quality and patient safety has taught me a painful lesson: Don’t say “quality” or “patient safety” to frontline health care workers. Too often, they become immediately defensive or evasive. How did q#^l&ty and s^f*ty become four-letter words? …

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The building blocks of a cancer risk management strategy

Conditions
July 14, 2022

According to data gathered by the American Cancer Society (ACS), more than 1.9 million new cancers are projected to be diagnosed in 2022. In addition, missed cancer screenings due to the pandemic are expected to potentially increase the number of cancers that are diagnosed at a more advanced stage. But the ACS data also highlight an important fact—approximately 42% of the new cancers projected to be diagnosed …

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How to tackle the physician shortage [PODCAST]

Podcast
July 13, 2022
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“The national physician shortage is an urgent issue that requires immediate attention. Otherwise, the next time you seek medical care, you might be treated by a non-physician for a condition that requires physician attention. This could be expensive and detrimental unless we solve …

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A hard lesson for new attending physicians

Physician
July 13, 2022

It is the time of the year in which freshly graduated residents and fellows finally enter the health care systems as an attending after years of hard work and training. A time of celebrating and reflection, and a time to stop and think of what you have done and what lies ahead of you. I am sorry, this may not be what you want to hear, but I am tired …

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The new 988 hotline has the potential to transform mental health care, but challenges loom

Conditions
July 13, 2022

The federal 988 hotline represents a promising new approach to alleviating the nation’s growing mental health crisis, but several key challenges loom that could derail this well-intentioned initiative.

One significant information technology challenge the hotline will face involves how to uniformly store and interpret mental health data (more on that later) but the most immediate roadblock is a lack of awareness.

Though the hotline is scheduled to debut in July, the program, …

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Protect the rights of licensed health care workers to take buprenorphine

Meds
July 13, 2022

Early in my addiction medicine fellowship, I met a patient for the second time while shadowing another physician in their practice. The patient was a former nurse with opioid use disorder on maintenance therapy with buprenorphine (commonly called Suboxone, the original brand name of a formulation combined with naloxone), a partial opioid agonist that is FDA-approved for the treatment of opioid use disorder and can be conveniently prescribed in the …

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Not a cancer survivor or previvor, but a cancer preventer [PODCAST]

Podcast
July 12, 2022
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“I know how different my experience is. I am not facing potentially debilitating treatment(s) or the fear of death. Still, I am experiencing a physical transformation, a redefining of my feminine self, yet I do not feel as if I have the ‘right’ …

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I have survived every tragedy that comes with nursing

Conditions
July 12, 2022

If mommy dearest only knew.

There I was, sitting in the banquet room — a room full of retired nurses celebrating with upper management. They were praising us for our retirement and praising us for our blood, sweat and tears and massive overtime hours with little to no potty breaks. They were praising us for our missed time with our families, like Christmas, Easter and Thanksgiving.

It was nice.

With their white gloves, …

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How the culture of health care perpetuates racism

Physician
July 12, 2022

Many health care professionals go into health care to help people, no matter their race, socioeconomic status, or other identities. Even as white health care professionals start to learn about the systemic nature of racism, something that our Black and other colleagues of color have experienced their whole lives, we may still see health care as “different” from all those other systems out there that are racist. Because we care …

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