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Hope, with a ribbon of uncertainty curling gently around it

Richard D. Sontheimer, MD

Physician

August 27, 2022

A tall, thin, down-glancing man slumped in a chair in the corner of the exam room.

His gray-haired wife sat primly next to him.

They were here with their adult wheelchair-bound daughter.

For the past two decades, the daughter had been under their constant care at home.

A chronic progressive illness had wreaked havoc on this young woman’s body.

Her adult life had been held prisoner by an insidious neurologic disorder.

She was having a problem …

Getting an appointment with primary care is the Achilles’ heel of medicine [PODCAST]

The Podcast by KevinMD

Podcast

August 26, 2022

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“‘Doctor, it’s taken so long to get this appointment with you!’ This is the opening line of so many medical visits, and I find myself constantly apologizing to my patients on behalf of our system. After the …

American health care: the best of times and the worst of times

Henry Buchwald, MD, PhD

Policy

August 26, 2022

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

Murray Keith Wadsworth

Conditions

August 26, 2022

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.

Rebekah Diamond, MD

Physician

August 26, 2022

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

Asha Padmanabhan, MD

Physician

August 26, 2022

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]

The Podcast by KevinMD

Podcast

August 25, 2022

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“It is uncomfortable to be publically vulnerable with my story. I wish the statistics and research were enough to change the field of medicine for patients and physicians. I want people to care about the experience of …

As we get older and the world changes, it’s not always an easy task to say “where”

Michele Luckenbaugh

Conditions

August 25, 2022

“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

Eleanor Tanno, MD

Physician

August 25, 2022

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 …

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When medicine surrenders to the body

Improving communication requires tough soft skill development

Beth Boynton, RN, MS, CP

Conditions

August 25, 2022

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?

Heidi Chumley, MD, MBA

Education

August 25, 2022

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 …

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Who gets to go to medical school?

Why you need to care about oral health [PODCAST]

The Podcast by KevinMD

Podcast

August 24, 2022

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“Guess what? The mouth is attached to the rest of the body. And though dentistry and medicine are typically separated from the very beginning of professional training, they are irrevocably linked for patients and have an impact …

Putting on the mask of professionalism causes burnout

Chelsea Turgeon, MD

Physician

August 24, 2022

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

Jillian Rigert, MD, DMD

Physician

August 24, 2022

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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Releasing survivor’s guilt

Withdrawing life-sustaining treatment over family objections

Thaddeus Mason Pope, JD, PhD

Conditions

August 24, 2022

“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?

Hoag Memorial Hospital Presbyterian

Conditions

August 24, 2022

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]

The Podcast by KevinMD

Podcast

August 23, 2022

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“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 …

Advancing health equity conversations through cultural humility

Sylk Sotto-Santiago, EdD, MBA and Erik Fernández y García, MD, MPH

Policy

August 23, 2022

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

Amy Sarow, AuD

Conditions

August 23, 2022

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 …

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How hearing is connected to well-being

Management of acute postoperative pain reveals systemic flaws in health care policy

Ross Zbar, MD

Physician

August 23, 2022

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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