When I told my colleagues that I was going to try to create the first psychiatry review course at the University of Toronto, I received the same two responses: “It’s about time somebody did that!” and “What is wrong with you?” — sometimes from the same person!
The first reaction taps into the excellence of our department. With approximately 1,000 faculty with diverse expertise and the largest residency program in Canada, …
The U.S. health care “system” is completely and utterly broken. According to the World Health Organization (WHO), the U.S. system ranks 37th in the world, all while spending dramatically more on health care than other wealthy countries. Tens of millions remain without any health insurance coverage. For many, medical bills can mean economic ruin — some surveys show that up to Read more…
“I have the CPAP machine. I’ve had it for a year, but I don’t have electricity in my house. I stayed with my aunt who has electricity but things didn’t work out,” said the young Navajo man, his massive belly protruding out from underneath the tray table.
The old Navajo man with Parkinson’s disease, unable to walk fast enough to make it to the outhouse in time, had started taking anti-diarrheal …
Dear colleagues, I know you have seen these questions:
Do you currently have any physical or mental impairment that could limit your clinical practice?
Are you currently taking any medication?
Have you ever been hospitalized for any reason?
Have you ever been hospitalized for, or diagnosed with, a psychiatric disorder to include substance abuse?
Ugh! I hate, hate, HATE these questions! “It is none of their business,” or at least that is what I told …
Whenever I discuss matters of money and business with medical students and residents, I‘m surprised by the responses: “Zilch, nothing,” or “Are you kidding?” Sadly, our doctors-in-training still receive little to no education in this arena.
There’s a stigma surrounding physicians and money, based largely on fact, which has become a beacon for all sorts of disingenuous, exploitive people who view doctors as over-stuffed pinatas, belly-full of money, ready to be …
I sat across the table from my physician client and listened to her story. She asks, “How can it be that after four years of medical school and three years of residency training in my chosen field, I feel so disillusioned and disconnected?”
Instead of seeing the excitement of starting a new chapter in her career or even acknowledging some trepidation about becoming an attending with the increasing pressures of this …
Anyone can exhibit narcissism or narcissistic personality traits or types from time to time in different forms from mild to severe. When doctors are under stress, they can “act out,” or their behavior can worsen. Greater awareness of damaging behaviors is therefore important. The more we recognize the traits in ourselves and others, the less likely they become a problem. However, unfairly labeling or stereotyping doctors as narcissists is to …
During college and medical school, my summer employment acquainted me with members of organized crime families. Now, reflecting on my full career as a primary care clinician, geriatrician, and researcher on health care delivery improvement, I have discovered that several insights from organized crime could guide medical professionals’ responses to our country’s health care crisis.
Organized crime and the U.S. health care industry have more in common than might be immediately …
One big life event for me was having my son Matthew during medical school. It has been a fulfilling and interesting journey.
I met my husband Andrew during college, and we were lucky to matriculate together at the University of Minnesota Medical School. I decided to do a dermatology research year between the third and fourth years of medical school, and Andrew did a neurology research year at the same time. …
A swimming pool. Most of a Tesla. Not nearly enough to have your kid swapped out during their sham SAT test. Nor would an ICU bill for a stay that resulted in survival — $48,744 is the cost of that. What costs an alarming amount more is the bill the US Government pays annually on erectile dysfunction medications for servicemen — a whopping $8.7 million according to a 2016 Rand …
A guest column by the American College of Physicians, exclusive to KevinMD.com.
We are just now beginning to recognize the impact of isolation and loneliness on the health of our patients. Recent cultural and societal changes have led to markedly increased levels of isolation of our patients with a dwindling size and activity of their …
If you have worked in the hospital setting for any length of time, you likely are aware of the physicians’ lounge. It’s the protected space where the hard-working medical staff can escape to catch a break or grab a hot beverage. The physicians’ lounge is absolutely necessary. Medical staff members need a space where they can refuel and exhale the stresses that caring for the sick and dying will often …
Growing up, I was discouraged from becoming a doctor; I was too emotional. My mother, a geriatrician, worried about my attachment to patients and the volatility of inpatient medicine. To some degree, I understood her concerns; I’m tearful during goodbyes and inconsolable at funerals. Yet my interest in medicine persisted, and I began medical school. In my third-year, I experienced the innumerable emotions associated with witnessing patients’ deaths. I was …
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My interest in understanding burnout among medical trainees started during my second year of medical school. With Step 1 nearing, I noticed a dynamic shift in my classmates. The growing tension, petty arguments, and constant worry surrounding our futures took over. This led to a research project assessing burnout risk factors that stood out like a red flag on my application for residency. I found most of my interviewers were …
Physicians actually make good pilots. But, in 1966 they received a bad rap due to a report published by the FAA’s Chief of Aviation Medicine, Dr. Stanley Mohler. Mohler had a point. Physicians were crashing planes at a higher rate as opposed to the general aviation population. His report would be a cautionary tale for all of us. It would be three decades before we even began to understand why …
A wag once said: “There is no such thing as a healthy person, just one who has not had enough tests.”
As we make every minor deviation from the average into a disease, that jest is becoming uncomfortably close to the way our current medical system behaves.
Part of the problem is that many diseases represent an arbitrary cut-off of a number. Thus, hypertension is defined as a blood pressure above a …
The following is something I wrote for our annual memorial service for children who have died at our Children’s Hospital. But these same thoughts are with me every day.
It’s an honor to be here with you to celebrate the lives of our patients. Thank you for being here. Thank you for sharing your children’s lives with all of us. Speaking for the staff of the children’s hospital, thank you for …
How is it possible that endemic bullying persists in medicine despite myriad initiatives to improve awareness, mutual respect and medical culture?
In some cases, we can blame health systems issues, such as medical workforce shortages, lack of funding and unsafe hours. But in other cases, we must take collective responsibility for failing to hold individual doctors to account for their damaging behaviors.
Most doctors readily change after being counseled about poor social …
The April 18, 2019 CNN headline was a prime example of clickbait: “Feds charge doctors in 8 states in opioid bust, including ‘Rock Doc’ accused of trading pills for sex.”
The only problem with this headline? Of the 60 individuals charged, half were not physicians. More importantly, Jeffrey Young, the so-called “Rock Doc” who prescribed nearly 1.5 million pills of opioids and benzos often in exchange for …
The biggest change in medical practice that has occurred during my 25 years as a physician is the open acceptance of physician employment. Compared to this change, the ACA, EMRs, “Gorillacillins,” and the latest sepsis protocol, combined, aren’t even worth mentioning.
Physician employment was, and is, obviously an intrinsically flawed structure that was considered absolutely unacceptable for obvious reasons for the entire history of medical practice! Now, suddenly physician employment is …
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