“COVID-19 wreaks havoc on multiple areas of the body, and myself and my fellow frontline workers across the globe have been forced to quickly identify what tools work best in our quest to keep our patients alive.
While we’re working to identify which technologies can improve our patients’ outcomes, it’s encouraging that …
Nephrology and kidney care during the pandemic [PODCAST]
“I think I’m having a stroke.”
The words struggled to leave my mouth as I spoke to the 9-1-1 operator. Emotionally in disbelief, the words seemed so unusual to say in the first person. Ten minutes earlier, overwhelming nausea and drenching sweats woke me abruptly from sleep. Thinking it was something I ate, I immediately regretted the preceding meal that must have been responsible. My attempt to get to the bathroom …
After a stroke, a physician experiences true vulnerability
It’s been almost a year since nursing home workers began fighting on the front lines of COVID-19. They’ve witnessed and experienced extreme trauma. They’ve seen seniors they care for suffer in fear and loneliness during prolonged and repeated lockdowns. They’ve seen residents fall catastrophically ill and too many of them die.
More than 17,000 seniors are dead from COVID-19 in Canada; Read more…
Nursing home workers at catastrophic levels of burnout and trauma
“The peer-review process is fallible, slow, and biased, and it takes advantage of the scientific community’s altruism. We need to keep pushing the conversation forward about making publishing more equitable, timely, accessible, and fair. An obvious and easy way to begin is to pay the experts who perform the peer reviews. …
Reforming the peer review process [PODCAST]
I love metaphors. I think they can be so powerful and can convey so much, sometimes with just a few words.
One metaphor we use in coaching to describe the coach’s role in a session with their client is that of a swimming pool. The client is in the swimming pool, and as the coach we have the job of not jumping in the pool with them.
Imagine you …
The case for physician peer coaching
During a casual scroll through social media, I often hear the voice of my friend and fellow pediatrician warning, “Do not engage!”
Generally speaking, this is almost always the correct advice. The rise of various social media platforms, the ability to rapidly share information and disinformation, the growing culture of doing one’s own “research,” and the apparent difficulty in separating reputable from non-reputable sources online has created the perfect storm. In …
How physicians can engage on social media
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 …
Why health care fails to deliver better value in patient care
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 …
Stop the us vs. them mentality in medicine
“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 …
Doctors are killing themselves, and who is taking notice? [PODCAST]
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 …
A story of esophageal variceal rupture
“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
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