An excerpt from Tornado of Life: A Doctor’s Journey Through Constraints and Creativity in the ER. Reprinted with permission from The MIT Press. Copyright 2022.
The appendix is a body part with an image problem. Derived from the Latin word for “hanging on,” the term can mean a bodily outgrowth or …
The appendix: an ancient organ for the modern age
International medical school graduates (IMGs) play an integral role in the health care system of the United States and constitute approximately one-quarter of the physician workforce. In 2022, fewer IMGs registered for Match than in 2021, with a match rate of 58.1 percent. The transition to USMLE Step 1 pass/fail, elimination of Step 2 Clinical Science, and implementation of secondary application will likely impact IMGs in their 2023 Match. Here …
9 ways international medical graduates can boost their residency match outcomes
“Well, you may think you want to be a surgeon, now that you’re young and think you can do it all, but that will change — once children are in the picture. You’ll see how hard it is to leave them and wish you could be with them all the time.”
As a young female medical student, I seriously considered the physician’s words. I imagined what it would be like to …
Just as medicine is rooted in relationships, so too is good advising
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 …
Hope, with a ribbon of uncertainty curling gently around it
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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 …
Getting an appointment with primary care is the Achilles’ heel of medicine [PODCAST]
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 …
American health care: the best of times and the worst of times
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 …
Urging patience with patient self-advocacy
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 …
The internet broke parenting. This pediatrician can fix it.
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 …
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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 …
A doctor for LGBTQ+ health needs [PODCAST]
“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 …
As we get older and the world changes, it’s not always an easy task to say “where”
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 …
When medicine surrenders to the body
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 …
Improving communication requires tough soft skill development
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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 …
Who gets to go to medical school?
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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 …
Why you need to care about oral health [PODCAST]
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 …
Putting on the mask of professionalism causes burnout
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 …
“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 …
Withdrawing life-sustaining treatment over family objections
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 …
When should you consider surgery for scoliosis?
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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 …
Contract advice for physicians leaving the military [PODCAST]
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