How can we possibly get to standardization in medicine? And is that a good thing?
Standardized checklists save lives; rigid procedures for sterilization of equipment saves lives; universal compliance with recommended beneficial treatments saves lives. And while it’s sometimes a wonderful thing to let a surgeon solve a problem creatively or to allow a patient visit to go overtime in order …
I’m an ER doc, and proud of it. But I never mention it when I meet new people. Unless someone’s fixing to die, I avoid it like the plague. “I work in a hospital,” I say. “Where in the hospital?” “The ER. How about you?” That’s a topic changer, since most people would rather talk about themselves.
Why not own it, you ask? There’s no shame in being a doctor. It’s not like …
Recent polls show a majority of Americans support Medicare for all, but few seem to realize that no other system in the world operates like the current single-payer proposals in Congress. I addressed the concept of single-payer health care, with Cuba’s system as an example. Today I’m writing more about the ideas being discussed now in our country and how those compare to other nations that provide …
A guest column by the American College of Physicians, exclusive to KevinMD.com.
Of all medical specialties, perhaps the most difficult to understand is internal medicine.
While the name suggests that those who practice internal medicine focus primarily on non-dermatologic diseases of “Internal” organ systems (which in many ways is true), unlike other medical fields whose names …
A professor recently romanticized my idea of clinical reasoning as he began our session by saying, “When you’re a physician, you’re a detective.” He elaborated: “Every fact you have, every piece of evidence you have, must be consistent with your leading diagnosis.” As he said this, my eyes narrowed, and I sat up a little taller.
My fellow first-year medical students and I have begun our official training in clinical reasoning, …
No one I knew had food allergy, let alone peanut allergy, when I was a child. I grew up at a time when peanuts were given freely on airplanes, and there was no such thing as a peanut-free table at school. Fast forward to today and the world has changed, with food allergies taking on almost epidemic-like proportions.
I am an allergist and became interested in food allergies …
Pain and suffering together is a universal language. It is unspoken, one that a person of any age feels when they see a loved one die, or when someone sees another human being suffer when nothing more medically can be done.
I once saw a Vietnam War veteran who, within a few years of returning home, suffered from a hemorrhagic stroke. He was robbed of his ability to walk, to talk, …
Spoiler alert: Plot points of the movie “Joker” are revealed.
“Joker” opened to a mix of rave reviews and criticism on October 2, 2019, amid fears of mass-shootings at theaters in the U.S.
This left law enforcement agencies scrambling to beef up security at movie theaters to prevent any untoward incidents. Quite ironically, October 2, is also the 150th birthday of Mahatma Gandhi — the crusader and champion of non-violence.
Warner Brothers even …
Flu vaccination prevents millions of flu-related illnesses and deaths annually, but vaccination rates are low for many reasons.
During the 2018-2019 flu season, the Centers for Disease Control and Prevention reported that about 45% of U.S. adults received the flu vaccine. While this is an increase of 8% from 2017-2018, it falls way below the national goal of 70% of American adults …
Australian singer/songwriter Sia (born Sia Kate Isobelle Furler), 43, is known for wearing elaborate wigs and headpieces that hide her face. However, the “Chandelier” singer is not hiding the fact that she was recently diagnosed with the connective tissue disorder Ehlers-Danlos syndrome.
“Hey, I’m suffering with chronic pain, a …
“When you start seeing your worth, you will find it harder to stay around people who don’t.”
– Unknown
After graduating from my residency a few years ago, I accepted a job within my organization as a staff psychiatrist and a medical director.
The idea of familiarity was a big driver in my ambivalence towards pursuing alternate opportunities, even when they came knocking on my door. As the job started and progressed through …
Tuesday, getting ready for work. Standing in the shower, it hit me. I couldn’t remember the last time I wanted a drink.
I almost got a blob of conditioner in my mouth as I snorted out loud.
“Mom, you OK?”
“Yeah, baby, I’m great.”
Incredible, actually.
Like so many, my habit of using external things to feel better was well ingrained. As a kid, I’d sneak ziplock bags of homemade cookies. In residency, stress eating …
As I lay there awaiting my shock, the doctors milled in and out of my room over the course of several hours. It was a normal but hectic morning in the emergency department with ambulances and code blues pulling my doctor away.
Before pushing the Propofol and completing my cardioversion, the doctor flatly stated something I’d heard many times before. With a certain look in her eyes, she shared a personal …
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At a certain point, we’ve all got to go home.
Whether it’s the end of the shift when the factory whistle blows and the assembly line stops rolling for a brief period while new people take our place, or late in the day after the last patient has been seen and our notes are all written and our portal messages have …
This past August, I attended the American College of Obstetricians and Gynecologists (ACOG) District VI meeting in Wisconsin. The theme of this year’s meeting was “Bringing it Back Home,” with a keynote presentation focused on developing the emotional habits to influence others and “embody the inner attitude of a leader.”
After a day of much self-reflection, I decided to stop by the poster presentations during a break between the major talks. …
The Skeptical Cardiologist was recently greeted by headlines announcing that an international panel of 14 unbiased researchers had concluded that it was OK for humans to continue eating red meat and processed meat at current levels.
The startling news was a reversal of what the Dietary Guidelines for Americans, the American Heart Association, and the American Cancer Society …
“The music is not in the notes, but in the silence between them.”
– Achilles Charles Debussy
Silence is an important part of our everyday lives. Yet, we often don’t consider its critical importance in helping us to reflect on what we’re doing. This is especially important in medicine where we’re so busy sometimes that we forget that what we say and do actually has huge implications on people’s lives.
This is even …
In previous posts, we have reviewed the use of selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), as well as the off-label prescribing of gabapentinoids, for treating anxiety disorders. Anxiety is such a ubiquitous problem that it is not surprising that many other compounds have been used off-label as well. In this posting, we will review some of the common ones: propranolol, mirtazapine, and quetiapine. …
Returning from my week of vacation, I was greeted by the usual stack of mail, faxes, forms to be signed, throwaway journals, and a fully loaded group of in-basket messages that had piled up in the electronic medical record that needed attending to.
One of the pieces of mail was an unsolicited package with a bright red label on it, along with …
We all want to get home as quickly and safely as possible at the end of the day. The other day — as I braked for a red light and turned my right blinker on — I not only looked to see if cars were coming from the left but also checked my rearview mirror.
In a moment of introspection, I suddenly wondered: “Why am I doing that?” What difference would …
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