The rise and fall of telepsychiatry

Physician
December 25, 2024

Telepsychiatry is a private audio (telephony) or video (video with sound) conference connection through which most psychiatric services can be provided to patients. I have been an early adopter and advocate for providing services, through telepsychiatry, to our patients who are experiencing mental health issues and psychiatric illnesses. The road leading to where we are right now in the field of telehealth has been treacherous and filled with regulatory landmines …

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Christmas in a children’s hospital

Physician
December 25, 2024

In December, the questions parents ask in the hospital are different. Instead of “Will my child be OK?” we pediatric hospitalists hear:

“We have plane tickets to go skiing for Christmas. Will he be well by then?”

“She’ll be home for Christmas, right? We’ve never been away from home for Christmas.”

“It’s his first Christmas. He’ll be discharged by then, right?”

And every other variation you can think of. The hospital for Christmas is …

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Rethinking shift work: Why “job sharing” is the key to happier, healthier doctors

Physician
December 25, 2024

In the realm of shift-based health care, the term “job sharing” doesn’t technically exist—after all, shifts aren’t a single continuous job to split. Yet, still, a full-time workload is considered the norm, and the concept of dividing the workload among multiple physicians rather than relying on one overburdened individual feels revolutionary in a field where burnout is rampant.

For independent contractors, who often enjoy the flexibility to choose when and how …

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Breaking the silence on physician burnout and suicide

Conditions
December 25, 2024

KevinMD has been publishing multiple reports about the current widespread, deeply worrisome physician burnout and suicide phenomena. As a card-carrying epidemiologist, I have sought to categorize these reports into the three overarching factors we might see in any epidemic, namely: agent, host, and environment. If we were to use this conceptual framework for research, we could gain a better understanding of how much each of its various facets contributes to …

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Extracorporeal CPR: the next evolution of cardiac arrest care [PODCAST]

Podcast
December 24, 2024
YouTube video

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Join critical care physician Jon Marinaro as we explore the transformative potential of extracorporeal cardiopulmonary resuscitation (ECPR) in revolutionizing cardiac arrest outcomes. Discover why traditional CPR’s limitations demand a paradigm shift and how …

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The oxygen mask principle: a critical lesson in health care self-preservation

Physician
December 24, 2024

In the high-stakes world of health care, medical professionals are renowned for their selfless dedication to patient care. They work long hours, navigate complex medical challenges, and consistently prioritize the needs of others. Yet, within this culture of compassion, there exists a profound and often overlooked truth: to provide optimal care, health care workers must first care for themselves.

The oxygen mask principle, famously demonstrated during pre-flight safety instructions on commercial …

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Beware of these talking points in medical malpractice litigation

Physician
December 24, 2024

A medical liability litigation industrial complex manipulates medical liability litigation with three talking points. As a result, 85,000 lawsuits are filed per year. Of these, 56,000 are summarily dropped; 28,000 are settled; 300 are plaintiff verdicts, and 700 are defense verdicts. The cost of health care is $60 billion per year, and the medical liability litigation industrial complex takes a chunk of the action. There is considerable uncertainty. Facilities close …

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A framework to deliver higher-value care [PODCAST]

Podcast
December 23, 2024
YouTube video

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Join us as we dive into the Healthcare Incentives Framework with internal medicine physician and health policy researcher Taylor J. Christensen. Discover how this innovative approach identifies barriers to high-value care and explores …

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Evaluating the performance of health care artificial intelligence (AI): the role of AUPRC, AUROC, and average precision

Tech
December 23, 2024

As artificial intelligence (AI) becomes more embedded in health care, the ability to accurately evaluate AI models is critical. In medical applications, where early diagnosis and anomaly detection are often key, selecting the right performance AI metrics can determine the clinical success or failure of AI tools. If a health care AI tool claims to predict disease risk or guide treatment options, it must be rigorously validated to ensure its …

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Emergency medicine: Balancing challenges, rewards, and well-being

Physician
December 23, 2024

Emergency medicine is one of the most challenging and rewarding specialties in health care. We are required to be clear-headed enough to make quick decisions while sleeping when we can, hugging our families while we can, and forming unshakable bonds with our colleagues over shared triumph and tragedy.

For many emergency physicians, these challenges come at the expense of their own health and well-being, yet we don’t see it. At least …

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Forgiveness: Why it’s the hardest and most rewarding act of humanity

Physician
December 23, 2024

I believe in forgiveness and not hating anyone, no matter what. But, ultimately, we are all human. I believe in karma, and we should not hurt or push people to their limits so much that they become damaged beyond repair. I’ve seen cruel people end up in miserable lives. Some people excel at concealing their sorrows, while others struggle. But we indeed reap what we sow. Those who are cruel …

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Can AI medical scribes solve clinician burnout? [PODCAST]

Podcast
December 22, 2024
YouTube video

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Join us as we delve into the transformative potential of AI medical scribes in health care with family nurse practitioner Erica Dorn. Discover how this technology is reshaping clinical workflows, improving work-life balance, …

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How a doctor’s clever approach restored a life—and a marriage

Physician
December 22, 2024

An excerpt from Yankee Doctor in the Bible Belt: A Memoir.

Doctoring in the mountains of Eastern Kentucky, I met Mrs. Snoop, a new patient at the clinic. She is 38 years old. Her chief complaint, according to her husband, is “not wanting to have sex.” He speaks on her behalf, sitting in the corner in grease-spattered overalls and heavy work boots.

On examination, Mrs. Snoop …

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Long COVID and sleep: an urgent call to action

Conditions
December 22, 2024

Long COVID is real. For millions of people who contracted COVID-19, recovery has been a long and uncertain road. While many regained their health in weeks, others continue to face persistent symptoms and health problems for months or even years after the acute infection. Patients, caregivers, and clinicians alike have named this condition “long COVID,” while scientists often refer to it as post-acute sequelae of SARS-CoV-2 (PASC).

The long-term effects of …

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The burnout crisis runs deeper than you think

Conditions
December 22, 2024

The recently growing attention to the burnout crisis in health care has begun a much-overdue conversation. However, the discussion has thus far been focused primarily on physicians and nurses and has not yet considered the larger health care team enduring the same environments. This includes receptionists, pharmacy assistants, medical scribes, personal support workers (PSWs), rehabilitation support workers (RSWs), and many more. These are the unregistered health care personnel (HCPs) that …

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How early intervention changes the game for children with developmental delays [PODCAST]

Podcast
December 21, 2024
YouTube video

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We explore the critical role of early intervention programs in supporting children with developmental delays. Pediatrician Maria Mba Wright shares insights into recognizing red flags like poor joint attention, navigating therapy options, and …

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Are new blood tests for Alzheimer’s and cancer worth the hype?

Conditions
December 21, 2024

Recently, consumer articles heralded that blood tests for detecting Alzheimer’s dementia (AD) and many cancers were close to clinical availability. Given the narrow window in which AD must be diagnosed for present treatments to be effective, and questions regarding the utility of early cancer detection, will these tests provide any patient advantage?

Presently, there are two medications to treat AD. Neither is curative, but they slow disease progress by about five …

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AI’s cognitive gap: Why human doctors remain irreplaceable

Tech
December 21, 2024

Around Christmas time every year, The BMJ publishes lighthearted feature articles and original, peer-reviewed research intended to ease physicians into the holiday season and help them escape the drudgery of practice. The 2024 collection of articles is no exception, with enticing papers like “How to transport a polar bear, and other idiosyncrasies in providing emergency medical services in the Arctic” and “Living happily ever after? The hidden health risks of Disney princesses.”

My favorite …

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Society is obsessed with weight loss

Physician
December 21, 2024

Society is obsessed with weight loss. Part of my brain is, too, albeit I am well aware that there will be no number low enough on the scale to satisfy that part of me.

Anorexia nervosa is a poorly understood and mismanaged condition from my perspective as a health care professional and patient with lived experience. Society seems to glorify anorexia, and people compliment what may often be maladaptive behaviors (such …

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Long-term impacts of physician suicide on patients and doctors

Physician
December 21, 2024

Kim Downey:

Pulling into my driveway, I grabbed a handful of envelopes from the mailbox, one of which was from my doctor’s office. I could tell it wasn’t a bill, and I became anxious. Upon opening it, I was relieved to find that it wasn’t about my doctor leaving his practice or that anything had happened to him. Rather, it was a notification that another doctor I’d seen once was leaving. …

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