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What’s the sense of having a living will if it’s not honored?

Conditions

December 25, 2022

‘This victory ensures that advance planning documents are legally enforceable and will be respected by doctors; if they are not, individuals can hold providers accountable for violating their health care decisions.”
– Greenberg decision, 2022

Dr. Gerald Greenberg was a New York dentist when in 2010, he was diagnosed with early-onset dementia. In 2011, he executed a living will stating the medical staff was to provide comfort measures only and no medical …

The vampire, phlebotomy, and advocating for my care

Emily Raffensberger

Conditions

December 25, 2022

Every five weeks, I see a different vampire from the phlebotomy and give this collective of blood-suckers consent to take my blood. The crimson-filled, turquoise-capped vacutainer is destined for analysis to see how fast my blood coagulates. If the vampires read my chart, they would see the graph showing values dating back to 2015, marking my third open-heart surgery when I got my mechanical aortic valve. My lab testing is …

Can Medicare advance directives be simple?

Kevin Haselhorst, MD

Physician

December 25, 2022

Consider Medicare enrollment with the end in mind. In case of emergency, do seniors prefer medical care or holistic care? Might they designate a medical power of attorney or a merciful power of attorney? Do they oblige CPR or sign a DNR order?

The JAMA Network just published Death and End-of-Life Care in Emergency Departments in the U.S. This retrospective cohort study concludes that,

Robust systems of emergency care …

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Can Medicare advance directives be simple?

Being a physician and a son at the same time [PODCAST]

The Podcast by KevinMD

Podcast

December 24, 2022

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“As we continue this journey as a family in what will likely be an even more challenging six months ahead, the last six months have provided lifelong lessons. Equipped with these learnings, a new exciting professional opportunity …

The solution to America’s primary care shortage is direct primary care

Sara Pastoor, MD

Physician

December 24, 2022

Primary care in the United States is on the brink of collapse. Primary care providers suffer existential burnout, are the lowest compensated among all medical specialties, and there is a crisis-level shortage of primary care physicians, especially in health professional shortage areas. Despite strong evidence linking primary care (unlike any other medical specialty) to a better quality of life, longer life expectancy, better patient experience, and lower total …

When contentment falls short

Claire Unis, MD

Physician

December 24, 2022

Sliding toward another solstice, I feel myself yearning. I want the daylight to stay a little longer, soft like this, gentle warmth and lovely shadows, lazy breezes, the illusion of contentment.

But I am not content. Or perhaps I am, but whereas I once thought contentment was the goal, the sentiment makes me uneasy now.

“Nothing gold can stay,” Robert Frost wrote. To stay content would be to embrace the shift in …

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When contentment falls short

What consumers want from telehealth

Lyle Berkowitz, MD

Tech

December 24, 2022

After becoming more familiar with telehealth during the COVID-19 pandemic, a growing number of consumers today are realizing the value and convenience of virtual visits for minor urgent issues, chronic disease management, and mental health services.

At the same time, an overwhelming majority of consumers believe it is important that both their regular doctor and their telehealth provider have access to their health records for sharing critical data such as current …

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What consumers want from telehealth

26 hours in a day: the impossible math of providing quality care [PODCAST]

The Podcast by KevinMD

Podcast

December 23, 2022

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“Until I have dedicated time during the week to tend to administrative tasks, I must work 12 to 14 hours most days just to stay afloat. If I fail to work at least 12 hours per day, my in-basket …

A medical student’s greatest mistake

Emily Kahoud

Education

December 23, 2022

I made a mistake.

I almost failed out of undergrad as a premed. Yet this wasn’t the greatest mistake, the one that’s only now dawning on me as I stand at a crossroads in considerable decision-making despair.

Growing up in a loving yet highly dysfunctional home, I turned down a full presidential scholarship to attend a highly coveted college to make my parents, who grew up impoverished, proud. Yet the lingering trauma …

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A medical student’s greatest mistake

Who’s holding space for you?

Faryal Michaud, DO

Physician

December 23, 2022

The first time I saw someone die was when I volunteered in the ER as an undergraduate student.

That day I was helping in the trauma bay, and my job was to quickly run STAT or urgent blood specimens to the lab.

The year was 1994. It was winter time, and the tension of the people sitting in the waiting room was palpable to me every time I would go through those …

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Who’s holding space for you?

How accelerated learning platforms are pushing surgical education forward

Ruchi Thanawala, MD

Tech

December 23, 2022

Surgical training has long been confined to traditional models of Halstedian apprenticeship, where trainees are guided—but also potentially limited—by their superiors. Within this dynamic, the transfer of knowledge from expert to learner is dependent on individual educators, which can then be easily affected by personal circumstances and potential unconscious biases.

Physicians are often busy and rightly focused on patient care, but this can lead to uncaptured and delayed feedback for …

Coaching or mentorship: What is the solution for physicians? [PODCAST]

The Podcast by KevinMD

Podcast

December 22, 2022

Subscribe to The Podcast by KevinMD. Catch up on old episodes!

“Over the years, I have mentored a lot of trainees. After discovering coaching and seeing my career transform after I started working with a coach, I have become a coach myself. I definitely use coaching techniques with …

Psychic numbing: Why we would prefer to save a single dog instead of thousands of humans

Brian Angus and Recha Bergstrom, MD

Physician

December 22, 2022

In 2002 a fire broke out on an oil tanker hundreds of miles south of Hawaii. All eight of the crew members were successfully rescued, but, as it was later realized, the captain’s dog, Hokget, was left behind. The two-year-old terrier was alone on the tanker, floating around in the Pacific Ocean.

The lost dog story made headlines, and people donated thousands of dollars to the Hawaiian Humane Society to save …

The promise of patient-centered biotechnology

James Geraghty, JD

Meds

December 22, 2022

An excerpt from Inside The Orphan Drug Revolution: The Promise of Patient-Centered Biotechnology.

Pre-revolutionary stirrings

Every revolution rises up against an order in need of reform. For the orphan drug revolution, that order was the pharmaceutical industry of the 1970s. Most pharma companies had been founded by entrepreneurial chemists or pharmacists decades …

The holidays can open up a range of emotions

Jennifer Shaer, MD

Physician

December 22, 2022

Physician suicide rates are unacceptably high at baseline and go even higher during the holidays. The holiday increase in suicide rates is not unique to physicians, though. According to the National Alliance on Mental Illness (NAMI), A 2021 survey showed that 3 in 5 Americans feel their mental health is negatively impacted by the holidays.

And suicide is a problem that goes beyond the …

Wisdom from 50 years a doctor [PODCAST]

The Podcast by KevinMD

Podcast

December 21, 2022

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“This last doctor was also the happiest doctor I have ever met. He was not a youngster but had a wonderful following of patients and was loved by the entire hospital staff. And he had a very …

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Wisdom from 50 years a doctor [PODCAST]

Don’t make this mistake with gratitude

Cindy Tsai, MD

Physician

December 21, 2022

We hear it all the time.

Practice gratitude. Be thankful for what you have.

The evidence is clear. Being grateful does offer numerous scientifically proven benefits.

It makes sense why gratitude is good for you, from improved relationships to decreased physical pain to better sleep to increased happiness and self-esteem.

In fact, it’s one of the keys to leading an abundant life full of what you desire and deserve.

But gratitude is not just …

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Don’t make this mistake with gratitude

Gil Scott-Heron’s “Winter in America” is upon us

Arthur Lazarus, MD, MBA

Physician

December 21, 2022

For me, the cheerful musical sounds of the holiday season invariably give way to a somber song: Gil Scott-Heron’s “Winter in America.” Dubbed the “Godfather of Rap,” Gil Scott-Heron (1949-2011) embraced diverse musical styles alternating between jazz, blues, soul, and hip-hop. He wasn’t known for delivering good tidings as much as he was for sermonizing and engaging in “Small Talk at …

Suicide isn’t painless for those left behind

Veronica Bonales, MD

Physician

December 21, 2022

Suicide isn’t beautiful. It’s not glamorous. It’s not Virginia Woolf, with pockets full of stones walking calmly into the water surrounded by trees and dappled sunlight with string music playing in the background as you slowly sink under the water.

Suicide is blood and vomit pouring out of your nose. It’s losing control of your bladder and bowels and soiling yourself. It’s blood all over the bathroom floor. Or, it’s bits …

When was the last time you wore a white coat?

Janet Chao, MD and Yan Lee, MD

Physician

December 21, 2022

When the COVID-19 pandemic began to dominate all aspects of health care, many of our colleagues opted to wear scrubs instead of their routine work attire and white coats. They cited concerns about personal infectious risk and not wanting to bring the virus home to their loved ones on their clothes. This reluctance aligned with research on the white coat as a nidus for infection, but it conflicted with the …

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