An excerpt from Understanding Medicines for Anxiety.
In addition to medicines with FDA indications for anxiety, such as benzodiazepines and some antidepressants, a number of drugs are frequently prescribed off-label. Among these are gabapentin and the related compound pregabalin, collectively known as gabapentinoids. Their popularity is remarkable: gabapentin has been …
Off-label use of gabapentin and pregabalin for anxiety
Many people use reviews to help decide how to choose products and services. However, it is not widely known that an online physician review may not reflect what we think it does.
I thought about sharing this information before — but now it is time.
Recently, a frustrated patient called my office to schedule an appointment.
She simply wanted a doctor who did not have awful online reviews.
Seriously?
This is truly a sad state …
How online physician reviews can be fake news
Whether you are starting a new job, like me, or extending the contract at your current one, part of the process may involve signing up for retirement accounts. Most people have heard of a 401(k), but you may have other options available to you such as a 403(b) and Roth IRA. Let me breakdown the pros and cons of each account, so you can better determine which one is best …
Which retirement account is best for physicians?
It is no secret that health care providers shoulder a lot of responsibility. As a whole, they take this on with both competence and kindness. Sacrificially, they go above and beyond in order to provide patients with the highest of quality care. They juggle a multitude of professional and personal responsibilities in creative and admirable ways. Meanwhile, each health care provider learns to adopt a unique combination of coping mechanisms …
How physicians become medical narcissists
Although pediatric (children’s) hospitals are not yet mandated (as are their general population counterparts) to participate in value-based contracts (VBCs), as competitive medical institutions they are very cognizant of the market changes toward value-based payment models while tirelessly seeking to increase value in pediatric health care delivery.
The push towards better alignment of payers and hospital systems continues to change the landscape of competitive health care. Children’s hospitals “are the backbone …
Are pediatric hospitals ready to embrace value-based payment models?
As Wei Wei Lee sat with her doctor to discuss starting a family, she felt a “distance” between them. The physician was busy on the computer and focused on the screen.
“It just didn’t feel very personal,” Lee said. “I didn’t feel heard.”
It seemed as though keeping a record of the conversation was more important to the doctor than making a connection with Lee.
It wasn’t the experience she wanted, but she …
When physicians focus more on screens than patients
You’re a clinician. You had a patient die under your care, and now your hospital is being sued. You are not named in the lawsuit, but you are being asked to give a deposition. How much of your time is this going to take? If some lawyer sends you thousands of pages to review before scheduling multiple phone calls …
What to do when physicians get subpoenaed as witnesses
Yesterday, I got just about the strangest version of “MD aware” I have ever had.
We all know what this is, the person who is relaying some critical clinical information (positive blood cultures, Mr. Smith in Room 402 is having chest pain, etc.), and then they ask for your name so they can write it down somewhere in the chart.
In this case, …
Physicians are overwhelmed by alarms and alerts
Our job as health care professionals is not just to diagnose our patients by applying our scientific knowledge and clinical skills, but also to be the “communicator-in-chief,” “listener-in-chief,” and “reassurer-in-chief.”
Any doctor who doesn’t fully grasp this, is not doing the best job they can or being the best doctor they can be. I truly believe that over 90 percent of our everyday job as a physician involves being a good …
5 powerful words you can say to patients
Following on the heels of The Creative Destruction of Medicine and The Patient Will See You Now, Dr. Eric Topol has published his newest book, Deep Medicine, earlier this year. While the first two books highlight how technological disruption will first digitize and then democratize medicine, his newest is about deep learning, and how artificial intelligence (AI) has the potential to ultimately deepen the patient-physician bond. It …
A medical student reviews Eric Topol’s Deep Medicine
One evening in the clinic’s bullpen provider office, a colleague of mine wondered aloud how to respond to a difficult question a patient asked via patient portal message. A physician within earshot responded, “Just because someone asks you a question doesn’t mean you have to answer that question.”
I tried to empathize with where the physician was coming from. Surely after decades of practicing medicine, one might become weary of spending …
Paltering: When the truth is used to deceive
Though the news at first stayed local in Philadelphia and the northeast, it’s gaining traction nationwide. ZDoggMD is on it. Bernie Sanders held a rally.
What happened? The venerable Hahnemann University Hospital, the main teaching hospital for Drexel University College of Medicine in Philadelphia, is bankrupt and will soon close its doors after more than 170 years as a safety-net hospital serving inner-city patients.
Why should we care? After all, there …
The disaster at Hahnemann University Hospital
Hitting a roadblock in your life and career? Don’t get frustrated. Use the resources that are readily available to you.
Not sure what they are? Think about it. You have had access to them all the time.
The moment you decided to become a doctor, you became unstoppable. You may have followed the traditional path and went from college into medical school and then residency. Maybe your path took a few turns before medical …
The experiences in medicine shape your future
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An excerpt from Understanding Medicines for Anxiety.
Although the SSRIs (selective serotonin reuptake inhibitors) are among the most widely prescribed medicines for depression, they also have a useful role to play in treating anxiety disorders. In this article, we will look at their benefits and limitations when used in this …
Think beyond benzodiazepines for anxiety
Physicians and health care providers across the world are trained to treat disease processes and disease states. Often, this approach becomes technical. And while directed towards the patient, it paradoxically distances itself from the patient. The distance created between the patient and the physician through diagnostic and therapeutic approaches is related to the patient’s dissatisfaction with their medical journey.
Being sick and ill, whether it is a major or minor illness, …
5 things I learned from being a “high-maintenance” patient
Literature surrounding the effects of social isolation and loneliness for older adults is no longer lacking. Studies and articles outlining the dreadful consequences of these epidemics have even pierced large media outlets like Time magazine, where they emphasize how one in three older adults are lonely.
While any attention brought to the fact that the age group containing people age of 85 and up is …
The suffocation of social isolation
An excerpt from Physician Employment Contracts, The Missing Module: A comprehensive introduction to physician agreements written for doctors.
Professional liability or “malpractice” insurance protects a physician and the employer from claims related to the negligent practice of medicine. Two common types of professional liability coverage carried by major insurance companies are “claims-made” …
Understanding professional liability insurance in physician employment contracts
A guest column by the American College of Physicians, exclusive to KevinMD.com.
In the late 1800s, William Osler stated, “… if you want a profession in which everything is certain, you had better give up medicine.” He made this observation at a time when the science underlying health care was nascent, and little was understood …
Why we must embrace medical uncertainty
Can you let things roll off your shoulders? Are you the tough, no-nonsense, tell-it-like-it-is, stand-your-ground type? Do you show up to work no matter what? Has no one ever seen you cry at work?
Are these things resilience?
We nurses openly divulge the issues that make us leave the bedside, even amid a vast shortage of nurses. Professional organizations report these issues, and academic, and research institutes aggregate data for a convenient …
Define what true resilience means for you
Thirty-six years ago, I arrived an hour early for my first medical school patient care rotation at the East Orange, NJ, VA hospital. Over the years, ‘I’ve seen and learned (and unfortunately also forgotten) a lot about medicine and life. I have been writing down wise nuggets since that first year and keep reviewing and adding at times.
Here are 36 random reflections in honor of these 36 years that I …
36 things I learned in 36 years of medicine
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