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, …
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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“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 …
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 …
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? …
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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“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 …
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 …
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, …
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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“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’ …
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, …
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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Inspired by an essay published in Iowa Law Review by Bartlett and Gulati from Duke Law School that succinctly elaborated on underexplored discrimination by customers.
Now, we will elaborate our thoughts as they correspond to health care.
While practicing clinical medicine, health care professionals, including physicians, may encounter implicit bias of their patients even when the payments for the services rendered to patients are by third-party payers as regulated …
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“Unlike my dad, I grew up with very different feelings about my own longevity. I have always believed that I would live to a ripe old age. This belief has colored my approach to career and finances. In many ways, I was able …
“Your worst enemy cannot hurt you as much as your own unguarded thoughts.”
– The Buddha.
On her 44th birthday, Dr. Maya Williams took in all she had accomplished: her recent partnership in her radiology practice, two beautiful middle-school daughters, and the enduring marriage to her medical school sweetheart.
It was devastating when she opened a registered letter outlining a malpractice case against her later that day. Allegedly, she had failed to communicate …
Although this is a politically charged topic in our space in medicine, this isn’t political. For many of us, it’s doing our job — taking care of a patient’s mental and physical health. Making sure they are safe and doing no harm. Living in the Midwest, I had the realization today that in the near future, I will need to refer a patient in need of some reproductive services out …
This morning I had a migraine. I should have known it was coming. I now have complex migraines and was having word-finding difficulty yesterday, which is a harbinger for me. How could I have known that my soul had known before my mind had, that it had known we were about to rip away a standing protection for half of the U.S. population and dress it up as a state’s …
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“To a reasonable degree of medical probability, it was my opinion that the long hours the client spent typing, in addition to the poor ergonomics of his workstation, contributed to him being pre-disposed to a cervical injury sustained after lifting heavy boxes for …
Physicians are getting their asses kicked by technology, but this is reversible if they integrate technology as they do laboratory science.
Medicine needs specialized doctors who only focus on technology. This will combat burnout and take control of a system that has no other incentive to adapt to clinical needs.
In 2013, I graduated medical school and went to Silicon Valley to acquire high-tech skills.
During med school, an investigation …
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