“Is the ACA perfect? Not by a long shot. In Kentucky, where I live, there are only 2 insurers selling individual policies on the exchange. A Silver plan for my husband and myself costs $1,800 per month in premiums, with a $13,600 deductible and an out-of-pocket maximum of $14,600. Therefore, the total …
Why the preservation of the Affordable Care Act should matter to you [PODCAST]
A mid-life crisis, re-assessment, re-envision. Hollywood’s cliché version epitomized by Chevy Chase driving the “family truckster” while flirting with Christie Brinkley and later trying to skinny-dip with her. Of course, it is more than that.
Researcher, Brene Brown, calls it the unraveling. It is a pause. Turning off auto-pilot. A re-evaluation of goals. Clinically, it is called a mid-life transition or stage of adult development. It can be midlife or mid-career …
A physician’s mid-career and mid-life success
Applause every evening, volunteers sewing masks, personal phone calls, and check-ins – these are a few examples of the support that helped us get through the initial, brutal onslaught of COVID in New York City last spring.
A year later, many hospitals across the country are full to bursting, the staff is exhausted, and medical science is still unable to save thousands of patients from dying in isolation. And we know …
In the midst of our COVID crisis, we must learn to take care of ourselves. And each other.
“Being a neonatologist and a mother is living with the knowledge that the question ‘What would you do?’ could so easily become real, not hypothetical. And so what would I do? I don’t know, heartbroken mama. Because I feel too much, but I don’t feel enough. Because I know too well, but …
Being a neonatologist and a mother [PODCAST]
In the COVID-19 environment, wearing personal protective equipment (PPE) is the norm for clinicians. Monthly, U.S. health care workers use 89 million masks. While these masks help prevent the spread of disease, PPE creates barriers to effective communication that is requiring clinicians to learn new techniques for interacting with patients. Learning new verbal and non-verbal techniques to overcome PPE communication barriers is especially important for conveying …
Overcoming PPE barriers to compassionate communication
“As the mother of a child born with hypoplastic left heart syndrome, besides going through four open-heart surgeries and coding, my son has also had eight abdominal surgeries, including a Ladd’s procedure and resection of his colon. William also functions without his appendix, spleen, and gall bladder. In addition to every …
Thank you pediatric medical professionals [PODCAST]
“But if thought corrupts language, language can also corrupt thought.”
– George Orwell
The “difficult” family
At 2 a.m., on my first night shift as a pediatric resident, a patient, Casey, transferred from another hospital. She had a rare, progressive chronic illness, was medically complex, and was currently receiving treatment for an acute systemic infection. Shortly after she arrived, she became difficult to arouse. When I asked her mother questions, I was …
Maybe life is happening: the power of language in patient hand-offs
Every death related to anesthesia is a tragedy; even more so when a minor procedure such as a colonoscopy leads to a completely unexpected death. Everyone knows that open heart surgery carries a mortality risk, but few of us walk into the hospital for a colonoscopy thinking that death is a plausible outcome.
We know so few facts at this point about what happened on January 21 at Beaumont Royal Oak …
How could a patient die from anesthesia for a colonoscopy?
“Rumor has it that the SARS-CoV 2 virus was brought into prison via inmates who were on a work-release program. Allegedly, they boarded a city bus with a driver who was ill. From there, it crept beyond the work-release camp and wafted over to the general prison population. The pandemic had …
Prison medicine during the pandemic [PODCAST]
A guest column by the American College of Physicians, exclusive to KevinMD.
Political divisiveness has always been part of the fabric of America. Even as our Founders laid the groundwork for the United States, they understood the challenges of seeking to assemble a unified and functional country from such a wide geographic and culturally diverse …
The destructive health consequences of political polarization
The intensive care unit nurse was worried the COVID-19 vaccine would kill her.
In the past, just minutes after getting the influenza vaccine, she had hives, wheezing, and throat swelling. Her life-threatening reaction only resolved after an epinephrine injection and monitoring in the emergency room. She vowed never to get another vaccine.
With the arrival of the COVID-19 vaccine, she reconsidered her stance. Now she was in my clinic, …
COVID-19 vaccines are safe for people with severe allergies
“What form the incoming winter will take depends on the location and status of the COVID-19 pandemic. Each city must find a method that will provide the most relief and assistance for their homeless population. Analyzing the results of the measures already taken by shelters in the country will prove vital to …
Stuck between a virus and a cold place: A choice for homeless Americans [PODCAST]
I got married the day after I graduated from medical school to someone I thought I’d spend the rest of my life with. Seven years later, we were divorced.
Even though a high percentage of marriages end in divorce, there is still a stigma that many of us who divorce feel. I had already completed residency and was an attending by the time I got divorced, and I remember feeling so …
How divorce helped this physician
Patients often comment on my attire other than my white coat, particularly my impractical footwear, until I finally broke down and purchased Danskos to avoid being called out for my truthful impracticality. It is amazing how patients care more about my orthotics than remembering the reason they scheduled a visit with me, and God bless them for that.
I am in family medicine, and I thrive on personal and genuine relationships where …
Yes, your doctor was a sorority girl
Over 100,000 medical and surgical resident physicians and fellows (combined, “house staff”) are the first-line physicians for most patients in the nation’s 1,100+ teaching hospitals. Maximum weekly work hours regulated by the Accreditation Council for Graduate Medical Education (ACGME) are colloquially cited to be 80 per week. Notably, however, they are 80 hours averaged over 4 weeks (88 with “sound educational rationale”), without maximum weekly hour …
The impact of current work hour restrictions and OSHA misclassification on house staff health
“At first, it may seem strange that ‘physician’ and ‘side gig’ are even used in the same sentence. After all, the average physician in the United States is already working more than a 40 hour work week and struggling with issues related to work-life balance. As someone who talks about physician …
Nisha Mehta, MD on why physicians should consider side gigs [PODCAST]
This article is sponsored by Augmedix: Ambient medical documentation and live clinical support powered by virtual scribes.
2020 was a remarkable year by almost any standard. In health care especially, we’ve seen COVID-19 catalyze years of growth and innovation in less than 12 months. Assistive technologies were developed to meet challenges in record time, and encouragingly positive changes in how we practice medicine …
2021: 10 health care trends to watch in the New Year
Years and years ago, everyone always walked up a mountain of snow and ice barefoot while dragging a carriage behind them to get to school, and their stethoscopes were made of bamboo. They were hard, hard times, and it was a time-honored tradition to hear the talk from our attendings about how hard training used to be and always elicited an internal groan. The follow up refrain frequently heard in …
Instead of comparing, let’s nurture the next generation of physicians
An excerpt from Breaking the Silence: Why Opening Up About Your Sex Life Is the Best Medicine for Your Health, Relationships, and Overall Happiness.
I have been practicing medicine for forty-five years, and it has become clear to me that many of the mental and physical problems …
The power sexuality has over our happiness
“In Wooster, Ohio, where I practiced, a small not-for-profit hospice agency relied on local physicians, clergy, and many other volunteers to supplement the skills and dedication of their employed staff. It was through this work with Hospice of Wayne County, in making home visits when needed, that I learned the immeasurable value …
Death is personal for this physician [PODCAST]
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