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“Our primary care systems should be designed for all the kids and families they are intended to serve. Incorporating system navigators to support the needs of our most vulnerable families is a feasible step in the right …
Why Black and brown kids are falling through the cracks [PODCAST]
I screen patients for skin cancer on a regular basis, and one of my research interests is to find new biomarkers of cancer prognosis – to be able to separate out cancers that won’t actually do someone any harm versus cancers that could very well spread, grow unchecked and uncontrolled, and potentially end a life. I know that cancer treatments have advanced beyond my imagination in recent years, with …
Sweet bitter: a doctor’s cancer diagnosis
When I married my husband, I had no idea there would be a mistress one day.
When I met the man who would become my husband, he was not yet a doctor. He was 22, a black belt, a waiter in a fancy restaurant, and very handsome. He knew all kinds of things about champagne and paté, cocktails, and sushi.
We met in our college martial arts club. I was 19 and …
In a report published by the Commonwealth Fund and released in August 2021, the performance of the U.S. health care system was compared to that of other high-income countries. The results were stunning: despite investing far more of its gross domestic product in health care, the U.S. ranks dead last overall and last on access to care, administrative efficiency, health equity, and health …
The solution to a crumbling primary care foundation is direct primary care
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“A good history and physical, including screening, can prevent consequences that burden a patient’s daily life and increase health care costs. Assessing cardiovascular risk is a key part of the evaluation. Transgender individuals may have a compounded …
You need to ask these questions to teens starting hormone therapy [PODCAST]
At least two million people in the United States are incarcerated in 122 United States prisons. Little is known about the prisoners themselves. Did their background condemn them to bad behavior? Or did they just make grievous mistakes? Do they suffer from a mental illness masquerading as criminal behavior? Can they change their life path? A mental health specialist with 25 years of direct …
Employers need lawyers. This doesn’t just apply in medicine — it’s true everywhere. For a recent high-profile example, let’s consider Twitter. If massive layoffs had been made without adequate notice as required by California law, they could be on the hook for millions of dollars in damages.
However, medicine likes to consider itself as different from other businesses. It’s a nice idea, this fantasy of the country doctor who delivers babies …
Don’t be like Elon Musk. Get a lawyer for your clinic.
Among the many definitions and meanings of the terms “woke” and “wokeism,” the two that capture the ideology best are contrasting meanings. The definitions are:
“The behavior and attitudes of people who are sensitive to social and political injustice” (Collins English Dictionary),
and:
“A system of thought and behavior characterized by intolerance, policing the speech of others and proving one’s own superiority by denouncing others” (Psychology Today).
The first implies a benevolent society that …
Is it really a woke nightmare for medical schools?
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“As I’ve been coaching physicians, I’ve realized that many of us have a tendency to just ‘grin and bear it’ when it comes to the challenges and stresses of the medical profession. We often tell ourselves that …
What my 10 year old is teaching me about boundaries [PODCAST]
It does not behoove us to mince words in a politically charged climate. To productively discuss any controversial topic, we must first define terms and get past the jargon and doublespeak that commonly muddles conversations on serious issues. The Oxford Dictionary defines euphemism as “a mild or indirect word or expression substituted for one considered too harsh or blunt when referring to something unpleasant or embarrassing.” We often use euphemisms …
Drop the euphemisms and get uncomfortable when talking about abortion
There is no one prototypical physician. Every physician has their own practice style, their own knowledge base, and their own preferred method of communication. In my role as medical director for case management at my community hospital, I was given 30 minutes during new nursing orientation to provide nurses tips when communicating with doctors.
I put together this list of things that physicians wished hospital nurses knew about them, both good …
Physician secrets that nurses need to know
For the first time, primary care physicians (PCPs) are being urged to screen their patients, above and below age 65, for mental health concerns alongside screening for physical health conditions. The United States Preventive Services Task Force has published its first recommendation for PCPs to screen adults for anxiety as standard practice. This recommendation followed a peak in the prevalence of mental illnesses in 2020. During this time and …
U.S. adults should get routine anxiety screening. But then what?
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“One of the biggest misconceptions about timeshares is the idea that you have to visit the same location every year. In reality, timeshare owners have access to a wide range of properties and destinations through timeshare exchange …
Every physician should own a timeshare [PODCAST]
An excerpt from The Mumbo Jumbo Fix: A Survival Guide for Effective Doctor-Patient-Nurse Communication.
Team building is a popular trend in health care. It promotes cooperation, trust and respect, improves communication, and enhances patient outcomes. Most of the time.
But the camaraderie and familiarity of working with the same group of people …
Communication protocols exist for a reason
Over the last three years, we have faced the original COVID-19, followed by Omicron, Delta, and monkeypox.
It is apropos that on the third anniversary of COVID-19, we are facing the tripledemic of COVID, influenza, and RSV.
After almost three years of not getting COVID-19, I started believing that my childhood fantasies about me being superman were true and that my immune system was superpowered with bullet-proof antibodies that would keep me …
A physician in denial after being diagnosed with COVID-19
Every doctor wants to be perfect. We want to make sure our diagnosis is perfect. Our treatment plan is perfect, and our outcome will be perfect. Patients want the perfect doctor. They want us to get it right on the first try, each and every time. The problem is perfectionism, as hard as we try to achieve it or wish for it, is not attainable. Perfectionism will kill you.
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“As a nurse, I know how difficult and demanding the job can be. I’ve had patients try to physically attack me and it’s frustrating and disheartening to face such hostility. When I talk to people outside of the health …
All I ever wanted to be was a nurse [PODCAST]
There has been a lot of talk about physician burnout over the past few years, and as an occupational medicine physician, I’m happy to see that conversation is taking place. For too long, we just saw burnout as an acceptable hazard that just comes with the job.
But it’s become clear to me that there’s a big missing piece in the discussion of burnout — particularly when we try to answer …
How female social conditioning leads to burnout
I read KevinMD regularly. I see a lot of stories about how broken medicine is: how doctors are retiring, leaving early because they are overworked or underappreciated, or being manipulated by corporate medicine. All these complaints are valid. There are also articles about how residency is brutal and causes mental distress to trainees, with the onerous hours and unrealistic expectations. That, too, is true. Medical training, at least in my experience, is …
I love listening to podcasts on my way to work, and I was most excited when the second season of Dr. Death started. If you didn’t listen to the first season, it was about Dr. C. Duntsch, a neurosurgeon in the Dallas area who should never have been operating on people. He even left his best friend paralyzed from the neck down due to a botched surgery.
The second season follows …
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