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Remembering my grandmother in the ICU

Physician

August 18, 2022

ICU psychosis is a common phenomenon in hospitals. Most of us as clinicians deal with it well.

However, the ordeal changes when your loved one is struck with it. My grandmother, always admired for her storytelling skills, is now admitted with intestinal obstruction, and her worsening Parkinson’s has just escalated the intensity of her psychosis.

Now she tells me a story of a woman carrying knives, seeing blood everywhere, selling half the …

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Remembering my grandmother in the ICU

Does patient-centered care really meet human-centered care?

Dr. Vivek Podder

Physician

August 18, 2022

This episode was during my elective time in India in the late winter of 2017. It was a patient-centered learning opportunity for students around the world who has an interest in medicine. I was excited about this because of my earliest clinical exposure to patient encounters as a medical student. I was excited to meet the patients, talk to them, and help them despite the uncertainty and emptiness in my …

What you need to know about monkeypox [PODCAST]

The Podcast by KevinMD

Podcast

August 17, 2022

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“What is currently known is that monkeypox is transmitted primarily through close contact with skin lesions, bodily fluids, and respiratory droplets. Men aged between 20 and 50 years, many of whom have sex with other men (MSM), …

Ayman al-Zawahri: the doctor who dispensed death

Osmund Agbo, MD

Physician

August 17, 2022

On May 2, 2011, a few minutes past 1 a.m. Pakistan Standard Time, a U.S. Navy SEAL Team Six left the Bagram Air Base in the Parwan Province of Afghanistan and headed for the compound of a high-value target in Abbottabad, Pakistan, located just a few miles away from that nation’s military academy.

It was an operation that lasted 38 minutes, following which U.S. forces returned to Afghanistan with the slain …

The true art of medicine

Susan J. Baumgaertel, MD

Physician

August 17, 2022

There have been countless references to the art and science of medicine over the years. I, for one, certainly have embraced both in my long career as a physician in internal medicine. However, I have always had a special connection to the art part.

My late mother was an artist, so I grew up with …

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The true art of medicine

An experience of shame in training

Brett Linzer, MD

Physician

August 17, 2022

Early one morning in 1996, after a sleepless night on call, I stood with my team in the VA hospital, outside room 102. I was a 28-year-old intern in the general medicine service. We were making rounds on twelve patients that my intern partner, myself, and our supervising resident had admitted overnight. We would walk room to room, and the intern would present the information regarding the patient by gathering …

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An experience of shame in training

Misaligned expectations lead to conflict, burnout, and disillusioned physician leaders [PODCAST]

The Podcast by KevinMD

Podcast

August 16, 2022

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“Would you expect the chef at a restaurant to be told that they are not only required to prepare the food in the kitchen but also deliver it to each of the tables and manage the billing? …

How privileged a physician’s knowledge is

Cia Bishop, MD

Physician

August 16, 2022

I was warned about it before we walked into the room.

So when I did walk in, I made sure my eyes stayed focused on his eyes, my gaze high and attentive. I smiled, possibly more than normal, to make sure he felt comfortable. Like a puppeteer holding up his doll, I knew it wasn’t time for me to drop down my eyes yet.

The resident with me began the routine visit …

Financial survival for physicians in private medical practice

Curtis G. Graham, MD

Physician

August 16, 2022

There are two valuable reasons why all physicians, especially medical students, should obtain or demand from their medical school academic business education.

About 98 percent of physicians and medical students have never had an academic business education. About 30 to 50 percent of graduating medical students prefer private medical practice—which requires business and marketing knowledge to reach their optimal potential in private medical practice as described below.

Private medical practice is a …

A health economist acknowledges how financing experiments failed our health system

James G. Kahn, MD, MPH

Policy

August 16, 2022

I read a superb commentary in STAT, “Value-based payment has produced little value. It needs a time-out,” that reviews the failures of “value-based care” and the failure of its promoters to acknowledge those failures. Ideas conceived, tested and found lacking, and used as the basis for more of the same. Distracting from real health system reform.

So I thought, wouldn’t it be terrific if the originators of flawed health …

A medical student’s advocacy journey [PODCAST]

The Podcast by KevinMD

Podcast

August 15, 2022

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“As I looked across the boxes on my screen, I saw the gleaming faces of my peers. Just as it did then, and as it has for countless of my peers since, involvement in the Student Osteopathic …

How every doctor should address a patient’s pain

Ton La, Jr., MD, JD

Conditions

August 15, 2022

From medical school to residency, I’ve worked with colleagues who don’t prescribe pain medications for their patients who truly need them. Or they are just very hesitant about doing so. Some simply don’t believe in them. Others fear the legal implications like being named to a med mal or wrongful death lawsuit. And several avoid pain meds, specifically opioids, like the plague because of possible addiction risk even when their …

Academic medicine on life support: a letter to a newly appointed CEO of a leading academic medical institution

Anonymous

Physician

August 15, 2022

Congratulations on our leading academic medical institution (LAMI) yet again making it to the top ten list of the U.S. News & World Report!

You have taken the reins in perilous times (globally and domestically), and what you do and what you stand for will determine if this great hospital will not just survive but survive with its brand and reputation intact. Getting hired as a physician who grew up in …

Trauma and burnout among frontline health care workers

Naheed Ali, MD, PhD

Physician

August 15, 2022

Thinking back to 2020, concerning the emergence of COVID-19 and the first hard lockdowns all over the world. Individuals from all walks of life were frightened, locking themselves in their homes for fear of being infected. Yet, frontline providers and health care workers had to carry on with their daily jobs. Were they less scared than the nonmedical layman or immune to the virus? Unfortunately, they weren’t. They were just …

Are you ready to hear the truths about perfectionism? [PODCAST]

The Podcast by KevinMD

Podcast

August 14, 2022

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“Are you a perfectionist?

Did you know that perfectionists are actually some of the biggest procrastinators? Yes, really.

In theory, perfectionism sounds like a good thing. Who doesn’t want to do and be their best? It can even seem …

How doctors can regain control of their software

Drea Burbank, MD

Physician

August 14, 2022

I spent a year as a UCSF postdoc with the leaked tobacco documents. And this article is taken directly from the tobacco-control playbook. In the tobacco wars, we learned that: when a disease is caused by a for-profit industry, the only successful approach is regulation first, followed by treatment.

Here is exactly how and why doctors should regulate EHR and regain control of their cognitive …

I didn’t know her name until it was over

Sid Schwab, MD

Physician

August 14, 2022

I didn’t know her name until it was over, much too late. What I knew was she was thirteen and that on this winter day, someone in her family had been pulling her behind their car on a sled. No doubt laughing and looking in the rear-view mirror, the person driving had whipsawed around a corner, and the young girl — probably screaming (fear? delight?) — held onto the sled …

A pervasive culture of time constraints in health care

Hannah T. Todd, PT, DPT

Conditions

August 14, 2022

Picture this. A patient in a hospital or rehab facility has just finished exercising with therapy. He is thirsty, and he thinks he might as well ask for a snack now because he will be hungry in 30 minutes. His therapist sets him up in his wheelchair (brakes locked), tray table with all necessities positioned in front of him, with his call bell within reach. As she approaches the door …

Preserving humanity in the ICU [PODCAST]

The Podcast by KevinMD

Podcast

August 13, 2022

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“Five days before this story begins, where everything is upside down, and the end is the beginning.

Me, standing in my PICU, slowly approaching that cradle, then removing the medication, one by one, turning off the syringe pumps. …

Our Shakespearean love affair with BMI

Karla Lester, MD

Conditions

August 13, 2022

I’m standing outside the exam room, reviewing Marcus, my 16-year-old patient’s growth chart, specifically his BMI. It’s up again, and my heart sinks. I feel that all too common rush of frustration and disappointment and, “Why am I here and what is the point?”

“Am I just here to document weight gain in my patients?”

Marcus has been coming to my pediatric weight management clinic for over two years and has high …

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Our Shakespearean love affair with BMI