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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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“When Lauren came to my office as a 16-year-old, she had been diagnosed with postural orthostatic tachycardia syndrome (POTS) and a few other chronic illnesses. By the end of the appointment, she left with a diagnosis of …
If you can’t connect the issues, think connective tissues [PODCAST]
Big Tech has had a surprisingly small impact on U.S. health care, so far.
Artificial intelligence, for example, outperforms physicians in many complex tasks (like reading mammograms and analyzing chest X-rays), yet AI remains woefully underused. Meanwhile, many have tried to spur operational efficiency using big-data analytics, but care delivery remains as inconsistent and ineffective as ever. Perhaps the most telling example of Big Tech’s struggles in medicine: 9 in 10 …
Amazon vs. Apple: Only one will rewrite the rules of health care
Sometimes hiding things can work to our advantage: an early pregnancy, a disfiguring scar, public speaking anxiety … Easter eggs! But, more often, they are just temporarily hidden from public view, and, in the grand scheme of things, it can actually be a relief when they are “found.”
Enter the world of chronic disease, and things rapidly become much more complex. Chronic disease can often become manifest without any external visual …
The hidden world of chronic disease
“I just moved here from Portland two weeks ago,” said Ms. Shelly in a weak voice.
When I walked into the room, I immediately noticed her blood pressure was 224/108. The patient was mostly sleeping, but when I started speaking with her, it was apparent to me something was wrong.
“Do you have a history of any heart problems?” I asked Ms. Shelly.
“I had aorta surgery two times…” she murmured before falling …
My patient with an aortic dissection almost died
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“Depression involves withdrawal, withdrawal from oneself and others. Feeling safe enough in a relationship to reveal our innermost feelings safely is connective and should be considered a valued part of the anti-depressant lifestyle. Continued relationship satisfaction is …
A 15-minute relationship fix [PODCAST]
In my first bioethics class, the components of health education (HE) were just being developed, and despite the passage of time, full understanding remains elusive as HE proved far more complex than originally conceived. We learned, simplistically, by present standards, that the provider (MD, DO, PA, NP) only needed to deliver information at a patient’s level of understanding, and the patient would provide a reasoned response. The constant over the …
Literacy and patients’ understanding of health education
An excerpt from A Short Primer on Why Cancer Still Sucks.
The United States has the world’s most expensive health care system. It spends about twice as much each year on every American as the Canadian system spends on Canadians. Per capita, the U.S. spends far more than Canada on drugs …
A stark contract between American and Canadian health care
As physicians, we equate terms like “disorder” and “syndrome” with pathology. If a diagnosis is listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM) IV, it’s considered a “problem.” In the case of neurodevelopmental diagnoses, I am becoming increasingly aware that this may not be the case. As a neurodiverse individual with many neurodiverse family members and friends, I believe there is nothing “wrong” with our brains. Different …
Who are the neurodiverse people in your life?
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