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“I think about my preeclampsia-specific and general knowledge gaps. I could not recall learning about postpartum preeclampsia in my prenatal classes. I wasn’t given any written instructions on what symptoms to expect with my blood pressure returning …
My postpartum blood pressure spike [PODCAST]
I wondered whether to recommend Nuedexta for my elderly relative with worsening Alzheimer’s disease and daily spontaneous crying. Often she would deny feeling sad and couldn’t account for her sobbing. Avanir Pharmaceuticals released Nuedexta in 2010 to treat pseudobulbar affect: involuntary emotional outbursts due to certain neurologic conditions or brain injury. I wasn’t sure if these crying bouts qualified as pseudobulbar affect. But my biggest hesitation was the breathtaking …
How drug prices are manipulated
As a physicians’ attorney who focuses his practice on physician contract review, I have seen some truly horrendous results after physicians have signed agreements they did not understand. Here are just a few of the “war stories” I have experienced.
24/7 call “for a few years”
One physician employment agreement I reviewed had several points that I felt should be clarified. The employer’s attorney accommodated most of my requests for clarification in …
Physician contract horror stories
Many people assume that there is a tradeoff between making money and making an impact—that you can’t do both at the same time, or at least not to a high level. This has been the prevailing thinking, especially in the business sector.
But over the past few decades, a new field of “social entrepreneurship” has proven this assumption wrong. A spectrum of possibilities now exists for people aspiring to reap profits …
Social entrepreneurship: business that’s good for people
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“Despite these high numbers, we cardiologists often look to genetic screening last in our diagnostic workup. But without genetic screening, we can’t always see the whole picture in our cardiomyopathy patients. Once we’ve excluded coronary disease as …
Think about genetics in heart disease [PODCAST]
A recent JAMA Pediatrics study confirmed what I see in practice as a pediatric primary care psychologist in Texas, one of four minority-majority states. The study reported alarming gaps between Black and Hispanic kids compared to white kids in attendance at primary care wellness visits—important appointments where children and parents can receive preventative and developmental services, timely immunizations, and answers to common questions. …
One in four Americans carry a diagnosis of arthritis, a significant cause of limitation from basic life activities to disability. One in ten adults has to limit their activities due to pain caused by this disease. Yet, a massive shortage of specialist physicians and geographical and licensure barriers restrict access to specialized medical care, especially in rheumatology offices. Also, the cost of arthritis is 303 billion dollars yearly …
Why expand telemedicine for arthritis patients?
Brain matter was spilling out the top of the patient’s head in the trauma bay. It doesn’t take a neurosurgeon to know that this is not normal. My pager screamed, “GSW to head – ED Room 1.” Gunshot wound to head – Emergency Department Room 1. As the neurosurgery resident physician on call that night, it was my job to evaluate this patient STAT. I wish I could say this …
Ending gun violence in America should be a no-brainer
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“Lacking a supreme being in which to place our faith, my wife and I decided to make the most difficult decision of our lives and discontinue life support. I still wonder if we made the right decision, …
A physician’s reflections with certainty in medicine [PODCAST]
I came out as transgender in my post-baccalaureate years. I grew up in California and was enjoying my time in college at Boulder. Although I had been severely bullied in middle school, there were never any problems for me in the adult world.
Discrimination was not something I thought really existed because I had not seen it.
Blissfully discovering my new self, I began my social transition. I was finally coming into …
Where do trans and visibly queer people go to residency?
As Americans, we live in one of the most affluent countries in the world. Outwardly, many of our citizens seem to possess the necessities of life: shelter, food, job employment, and world-class health care. But what happens when we take a closer look? Do we see cracks in the foundation?
If we are honest, the answer is a resounding yes. When one looks at the area of health care, there is …
Is our health care system based on untruths?
“The patient has a severe infection of the hand and is not improving on the current antibiotics,” I explained to the medical director at the insurance company.
“I understand. However, the patient has no elevated white count or fever, and I cannot get it to meet the criteria, so I will have to deny the necessity for the patient to stay in the hospital,” she explained.
I felt my voice rising and …
The slippery slope of utilization management
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“Take the time to invest in yourself; it is the best investment you can make. Work to improve your communication, negotiation skills, and financial literacy skills. Think twice before accepting the first offer at face value; you …
We are all responsible for women physicians’ pay discrepancy [PODCAST]
Patients running rampant- unmasked, hand unwashed, undistanced. You stand in the nurse’s workstation, watching the chaos ensue while holding the positive COVID test results in your hands. The world slows as you think, “How am I ever going to control this one?”
This scene is unfortunately ever present in our current health system. Since March 2020, the COVID-19 pandemic has put constant pressure on the medical system, uniquely affecting health care …
COVID-19 and psychiatric units: Keeping clinicians and patients safe throughout the pandemic
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.
Approximately 30 percent of the world’s population reports living with some form of pain, ranging from headaches to joint pain to cancer-related pain. Unfortunately, pain medicine expertise and the medications and non-drug therapies available to relieve pain are not as widely distributed as …
The heartbreak and joy of missions-based pain medicine: a pain physician’s perspective
Currently, U.S. officials are considering expanding eligibility for the monkeypox vaccine. Yet, elsewhere, people are still struggling to get access to the COVID-19 vaccine. In many low-income countries, less than half of the population is fully vaccinated against the novel coronavirus – sometimes far fewer.
In Haiti, for instance, only 1.4 percent of the population has been fully vaccinated, and only 2.2 percent …
We must work harder to provide COVID relief to other countries
This article is sponsored by the Academy for Continued Healthcare Learning, an independently owned and operated full-service medical education company that has been developing certified health care education for nearly twenty years.
Visit the tools and …
Practical solutions to prevent and prepare for hypoglycemia [PODCAST]
The stigma of addiction is alive and destructive in Nebraska. I can speak to the truth of this statement because I am an opioid addict in recovery. And if you happen to be a physician like I am, you better be prepared to have your profession and life destroyed. The Nebraska Medical Board and our legal system aggressively work to punish, not heal. This article intends to use my story …
Let doctors in recovery be able to recover their careers
Bang!
A pulsing pain surged through my head. As I floated in the water of the makeshift pond, it became apparent. I was concussed.
That day, June 16, 2018, is what I consider the most significant day of my life. For a long time, that injury led me to live in constant fear. It was unlike anything that had ever happened to me before. I jumbled my words. My movements were uncoordinated. …
The desire to be challenged is one of the most important aspects of an effective doctor
I have been at my current hospital for 12-plus years now. Like many of you, I have gotten to know some of my patients very well. I have known some of them since I first started out here. We talk about my dogs and cows, our newest grandkids, and politics if we feel adventurous. This is an extraordinary relationship built on the intangible magic generated over time, known as rapport …
The elephant in the room: end-of-life discussion with patients
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