“Our patients go through some very predictable fears and responses to illness and injury. In turn, medical students and residents also think and respond with some thought distortions and misunderstandings about their patients and themselves. Armed with awareness and familiarity with the typical patterns, we learn more about what …
Changing how we think about “difficult” patients [PODCAST]
I’m an RN and clinical informaticist. When I was studying health care informatics, I learned about physician resistance. The idea is that physicians are uniquely resistant to EHRs and health care information technology (HIT) apps. If only they went to more training or spent more of their limited time customizing their preferences, they would get the benefits of the EHR. For years, I believed this to be true.
Yet, I had …
The myth of physician resistance
For many of us, the term self-care is synonymous with self-indulgence. I used to think so too. Our thoughts immediately race towards behavior requiring us to take time away from our loved ones or shortchange them of our responsibilities.
As a child, I looked to my parents as prime role models. They were first-generation immigrants from Iran who were trying to uphold their …
How this physician’s self-care awakening helped her lose weight and take control of her health
Have you ever really appreciated the silence? The true silence that transports you to the root of it all. Our lives are a perpetual hamster wheel, chasing aspirations with underlying motivations that I often don’t completely understand. Good intentions and acts of kindness, seemingly altruistic, have hidden motivations of affirmation or appreciation. Why do you do what you do? It seems so obvious on the surface, but like an onion …
True happiness and fulfillment come in servitude of others
“Overall, the health system in the United States is still not tilting its axes in favor of either primary care or family doctor. What is worse, family doctors as a collective are more balkanized and less cohesive than ever. There is a sense among those in the field that …
Family medicine and the fight for the soul of health care [PODCAST]
While everyone faces some risk of experiencing a delayed diagnosis or misdiagnosis, some studies have found that the problem is more common for women. Women are 50 percent more likely than men to receive an incorrect diagnosis when they’re having a heart attack and nearly 30 percent more likely to receive an incorrect diagnosis for stroke. They are also diagnosed with cancer more than two years later …
Strategies to help women advocate for themselves and avoid misdiagnosis
So here I am. I just finished updating my CV so I can apply for associate professor this fall.
And I hadn’t touched it since last year. It needed a lot of work.
I look at this, and I think, “Wow.”
And then I also think: What about all the “stuff” that’s not on there?
The difficult pregnancies.
My son’s struggles his first 36 months of life.
My husband’s year-long deployment as a new mother of …
Raising the white flag isn’t about surrendering to a broken system
We all need hope. It is powerful and its absence is devastating. Hope allows us to move forward and to dream. Over decades of practice, I have found it to be the most powerful medication I can give a patient.
When we dispense hope, we must be as honest as we are with any treatment. False hope must be vigorously avoided. It is lying. In giving false hope, we might deprive …
“Our children are not OK. Our pediatricians are not OK. Please, let us not further ignore and jeopardize the future health of our society. Pediatrics needs a transformational change to direct primary care and other models that transition from transactional care to relational care. Encourage your employer to embrace …
Kids are not OK: Health care is failing them [PODCAST]
What is it about the documentation of patient encounters that is so aggravating? I was ecstatic to be part of the generation that entered the computer age in medicine. The first day I opened a chart on a pull-down menu within a pixelated screen I felt like I was ushering in the future. We would be able to mine charts for clinical gold!
As a clinician, I value the …
How an AI bot transformed my EHR experience
Until recently, I have remained relatively silent in the realm of eating disorder advocacy and silenced by the exhaustion of my own lived experience with an eating disorder. However, my silence further contributed to the pain. So now, I speak. And as I speak, I will reflect on the issues that led to my former silence and why we must use our voices.
The need for this work was validated during …
Why it’s time to use our voices
“I had sent an email to some key people in my organization about managing patients’ expectations and how that needed to be addressed differently on an organizational level. The truth of the matter is that I am powerless to change the way the system handles a lot of things. The …
Managing expectations during COVID-19 [PODCAST]
Since the beginning of COVID-19, we have recognized the truth of philosopher George Santayana’s oft-quoted 1905 writing — “Those who cannot remember the past are condemned to repeat it” — and looked for lessons from the 1918 Spanish flu, the deadliest pandemic of the 20th century. Much was different, yet so much the same. There was no testing, treatments, or ability to prevent the virus then beyond shutdowns, masking, distancing, …
Looking back on 2 years of uncertainty, adversity and more than a few silver linings
ADVERTISEMENT
Even before I turned 16, I knew I liked girls. I also knew I liked boys. I didn’t understand it. Why was I drawn to women? During that period of my life (between 11 and 16 years of age), I was also in a boarding school. An all-girl boarding school, for that matter. It was torture. It went against everything I knew to be “right.”
That was the first time that …
When the government comes for your trans kid
March is Colorectal Cancer Awareness Month. Share these gems with your family, friends, and patients. Take the time to reflect on your personal history and encourage yourself and others to get screened when appropriate.
1. The large intestine or the large bowel consists of the colon, rectum, and anus. The colon and rectum have a cumulative length of 150 cm or 4.9 feet.
2. Gastrointestinal contents are received from the small bowel …
10 colorectal pearls for Colorectal Cancer Awareness Month
Keeping someone alive? I could do that. After all, that’s what medical school taught, ways to save lives. Give me a disease, and I could find the algorithm. Death, however, was murky, messy, and confusing. An algorithm does not exist. There is no uniform response to provide grieving family members at bedside. Death was its own master, chose its own rules, and decided its own course. Death was something I …
“There is a small amount of literature about secondary trauma. This means that the people who respond to trauma (firefighters, police, doctors, EMTs, etc.) experience PTSD from experiences they were not the primary victims of. I haven’t read the literature, and I don’t know what qualifies. I do know …
How a code profoundly affected this physician [PODCAST]
Staffing shortages and turnover rates have recently become a pertinent topic for hospitals. However, these personnel challenges have haunted certified nursing facilities since the 1970s. Even before the COVID-19 pandemic, the turnover rate for total nursing staff in nursing homes was about 128 percent. While increasing transparency on these atrociously high turnover rates has been a commonly proposed solution, it has only recently been …
The nursing home staffing crisis will not be fixed through transparency
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.
The refrigerated trucks had not yet left our parking lot when I got an email from the IT department. It was late spring 2020, and deploying a new electronic health record system for the anesthesia department was not front of mind. We …
Prioritizing patient safety during a global pandemic
In health care circles these days, you hear about the social determinants of health (SDOH) almost as often as you hear: “You’re on mute!” SDOH are the conditions in the places where people are born, live, learn, work, play, worship, and age that affect health outcomes. These non-medical factors like income, socioeconomic status and access to health care, safe housing, and reliable transportation drive …
Coding for social determinants of health and unmet social needs
Get free updates delivered free to your inbox.
