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Why health care fails to deliver better value in patient care

Kristan Langdon, DNP and Timothy Lee, MPH

Policy

February 8, 2021

There is a strong push for health care to move towards greater value-based care (VBC) arrangements. The prospect of VBC holds the opportunity to re-create partnerships designed to increase health care sustainability by strategically improving processes, care delivery, and patient outcomes to achieve higher quality output at a decreased cost. Furthermore, the held potential will not be optimized until providers, payers, patients, and communities are connected in this common goal …

Stop the us vs. them mentality in medicine

Dr. Mrinalini Garv

Physician

February 8, 2021

As a foreign medical graduate and a multiple-time career changer — from being a doctor to a hospital process improvement and leadership coach to a business professor to a transformational career coach for female physicians — I have closely examined the U.S. health care industry from various lenses.

The one thing that stands out for me is the us vs. them attitude. Us being physicians and them being administrators.

I have seen …

Doctors are killing themselves, and who is taking notice? [PODCAST]

The Podcast by KevinMD

Podcast

February 7, 2021

“I can do better. We can do better. Please partner with me and advocate for the ability for doctors and residents in our profession to receive medical and psychiatric care without fear of losing our licenses or having to face stigma and judgment. It can save lives. Please, we are more …

A story of esophageal variceal rupture

Ron Whitchurch, CRNA

Conditions

February 7, 2021

An excerpt from 50 Years in the OR: True Stories of Life, Loss, and Laughter While Giving Anesthesia.

Chronic long-term alcoholism causes many health problems, not the least of which is cirrhosis of the liver. In advanced cases of cirrhosis, the liver becomes full of …

Read more…

A story of esophageal variceal rupture

Why the preservation of the Affordable Care Act should matter to you [PODCAST]

The Podcast by KevinMD

Podcast

February 6, 2021

“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 …

A physician’s mid-career and mid-life success

Saloni Sharma, MD

Physician

February 6, 2021

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 …

In the midst of our COVID crisis, we must learn to take care of ourselves. And each other.

Ira Nash, MD and Jacqueline M. Moline, MD

Physician

February 6, 2021

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 …

Being a neonatologist and a mother [PODCAST]

The Podcast by KevinMD

Podcast

February 5, 2021

“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 …

Overcoming PPE barriers to compassionate communication

Anthony Orsini, DO

Physician

February 5, 2021

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 …

Thank you pediatric medical professionals [PODCAST]

The Podcast by KevinMD

Podcast

February 4, 2021

“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 …

Maybe life is happening: the power of language in patient hand-offs

Aleks Olszewski, MD

Physician

February 4, 2021

“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 …

How could a patient die from anesthesia for a colonoscopy?

Karen S. Sibert, MD

Physician

February 4, 2021

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 …

Prison medicine during the pandemic [PODCAST]

The Podcast by KevinMD

Podcast

February 3, 2021

“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 …

The destructive health consequences of political polarization

Philip A. Masters, MD

Physician

February 3, 2021

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 …

COVID-19 vaccines are safe for people with severe allergies

Charles Feng, MD

Conditions

February 3, 2021

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, …

Stuck between a virus and a cold place: A choice for homeless Americans [PODCAST]

The Podcast by KevinMD

Podcast

February 2, 2021

“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 …

How divorce helped this physician

Trina E. Dorrah, MD

Physician

February 2, 2021

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 …

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How divorce helped this physician

Yes, your doctor was a sorority girl

Erika Visser Aragona, DO

Physician

February 2, 2021

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 …

Read more…

Yes, your doctor was a sorority girl

The impact of current work hour restrictions and OSHA misclassification on house staff health

Arielle Gerard, MD, MPH

Education

February 2, 2021

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 …

Nisha Mehta, MD on why physicians should consider side gigs [PODCAST]

The Podcast by KevinMD

Podcast

February 1, 2021

“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 …

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