KevinMD.com

After child sexual abuse, being “physically intact” doesn’t tell the whole story

Physician

January 13, 2020

The recent pardon of a convicted child rapist by the ex-Kentucky Governor has sparked a lot of controversies. The basis of the pardon was- “the victim’s hymen was noted to be physically intact.” Evolving studies have continuously shown that the hymen is not a reliable or accurate means to conclude sexual assault.

But if physical damage is the only criterion used to assess …

In the midst of physician burnout, remember the privilege of being a doctor

Micah Long, MD

Physician

January 12, 2020

I read the recent article on KevinMD: “I’m sorry: Why I lost my love for medicine” with great sadness. My heart goes out to the author; many of their concerns echoed deeply within me. I am sorry that we, as physicians, haven’t effectively succeeded in solving the myriad of problems facing health care today. And the author is right: Health care as a system, in the …

A patient who touches your heart in unexpected ways

Ann F. Beach, MD

Physician

January 11, 2020

I’m a pediatric hospitalist, and I know that most days in the hospital are routine. But every once in a while, a patient pierces through your armor, and touches your heart in totally unexpected ways. Willow did that to me.

Willow was five days old and had been admitted because her breathing was not quite right. I first met her in her hospital room, with her dad hovering over her bassinet, …

Consumerism is killing us with the death of a thousand cuts

Cory Fawcett, MD

Finance

January 10, 2020

School has gotten back into full swing, and thus we begin another cycle. Will this cycle be better than the last? Every year we find ourselves in this same spot. Summer’s over, big vacations are in the bag, back to school shopping is complete, and we start recovering from our summer spending.

We often haven’t yet recovered from the summer splurges before it’s time to start Christmas shopping. Then we begin …

Doctors shouldn’t feel guilty about sick days

Navpreet Sahsi, MD

Physician

January 10, 2020

It’s 2 a.m. And I’m in the emergency room. There are beads of sweat dripping from my forehead. One of my nurses comments that I just don’t look quite right. I can feel the urge to vomit and know where the nearest trash can is at all times.

I’m clearly sick. Febrile. Shouldn’t be working. But it’s the middle of a night shift, and I’ve got patients to see. I place …

Doing extra for a patient or overstepping boundaries?

Jacques Balayla, MD, MPH

Physician

January 9, 2020

I wanted to go the extra mile for my patient. The resistance I found was unexpected.

She was young. Her life — an incredible journey in diplomatic circles — was crippled too soon by a recurring disease that would ultimately prevail. Day after day, I’d round on her in what seemed like a pointless exercise, waiting for the inevitable to come. Another round of chemotherapy would have to wait for her …

Corporate games have ruined the health care system

Osmund Agbo, MD

Policy

January 8, 2020

There are certain paradoxes of life that are beyond the realm of rational explanation. To me, one of such is that a country that figured out how to defy gravity and conquered the cosmos has time and time again proven to be incapable of taking care of the most basic human need, namely: a commonsense health care delivery system.

U.S. spending on health care in 2016 was estimated at about 17.2 …

Why intangible skills are so important for surgeons

Mara L. Schenker, MD

Physician

January 7, 2020

As a fourth-year orthopaedic surgery resident, we had some surgical autonomy. Always at arm’s length from the attending oversight, this was just enough to push us past our comfort zones.

My problem was I loved my comfort zone.

The single most influential day in my career happened late one evening as a PGY-4. I was about to start a complex ankle fracture by myself. The ankle fracture involved the fibula and the …

Why gratitude is a superpower

Michael Maddaus, MD

Physician

January 7, 2020

I found this note waiting for me this morning in the kitchen.

It was from my daughter, who is home for the holiday week from New York. I made her a cup of coffee yesterday morning, and it was waiting for her on the table when she woke up and meandered sleepily into the kitchen.

Seeing the warm and happy …

Read more…

Why gratitude is a superpower

A physician’s story of addiction, depression, hope, and recovery

Adam B. Hill, MD

Physician

January 6, 2020

An excerpt from Long Walk Out of the Woods: A Physician’s Story of Addiction, Depression, Hope, and Recovery.

As a young child’s heart rhythm faded to a stop, I walked off the hospital floor and got in my car with a plan to end my own life. …

The sad demise of an idealistic family physician

Cory Michael, MD

Physician

January 6, 2020

Graduation from my residency program was a bittersweet experience. At the time, my specialty was suffering from a crippling job shortage, so our futures were uncertain, and a dark mood had come to permeate my radiology residency. We were disgruntled with the specialty, with the system, and with medicine in general. I attended my graduation without any guests and only stayed long enough to receive my certificate.

I was, however, honored …

What’s the hardest part of a physician’s job?

Rada Jones, MD

Physician

January 5, 2020

I work in the ER. It’s not an easy job. Not glamorous either. At least not as glamorous as my mother-in-law used to think.

Years ago, when I declared I was going into emergency, she looked at me askance. She didn’t ask why. She looked at me with her wise old eyes. “Let me tell you about ER,” she said. “I know all about it. I watch every show.”

She was politely dismissive …

My dream as a physician

Kamala Tamirisa, MD

Physician

January 5, 2020

Everything in life starts as a dream. Big or small. My dream was to become a physician since I was quite young — the first one in my family to walk the path. I wanted to understand the science of the human body and help the sick. Heal with my skills, knowledge, and empathy. Hold my patients’ hands with care and confidence. My work was to be like none other. …

Read more…

My dream as a physician

What doctors can (and should) learn from patients

Philip A. Masters, MD

Physician

January 5, 2020

A guest column by the American College of Physicians, exclusive to KevinMD.com.

In many ways, the patient-physician relationship is seen as being mostly one-sided, with doctors possessing medical knowledge and wisdom, and patients with less medical information being in a position where they need a physician’s help and guidance in managing their health issues. Consequently, …

Most medical offices are hopelessly old fashioned

Hans Duvefelt, MD

Physician

January 4, 2020

Imagine if your bank handled all your online transactions for free but charged you only when you visited your local branch — and then kept pestering you to come in, pay money and chat with them every three months or at least once a year if you wanted to keep your accounts active.

Of course, that’s not how banks operate. There are small ongoing charges (or margins off the interest they …

How your mind can turn against you

Kyle Bradford Jones, MD

Conditions

January 4, 2020

An excerpt from Fallible: A Memoir of a Young Physician’s Struggle with Mental Illness.

Jason had an entire group of voices in his head that he called “the committee.” They talked nearly constantly, sometimes in a flat roar but often escalating to shouting. He described it as …

Read more…

How your mind can turn against you

5 tips on choosing the right medical specialty for you

Ara Feinstein, MD, MPH

Physician

January 4, 2020

As a practicing surgeon that has one foot in the world of teaching and the other in corporate health care delivery, I enjoy speaking to students and residents about the future. We often discuss topics like the shift from volume to value, consolidation, insurance models, and specialization.

Often this information is new to them, and overwhelmingly they ask some form of the question: “How will this affect my career?” The following …

8 things to do as a new attending that I didn’t learn as a resident

Cory Fawcett, MD

Finance

January 3, 2020

Here are eight things to do as a new attending that I didn’t learn as a resident (and wish I had).

Establish a budget

There are two times when a budget is a very important tool: when you are struggling financially and when you have a large income or expense change. Now that you have graduated to your new attending income, it’s important to intentionally decide how you will invest, save, pay …

The intern who knows everything

Jason Lizalek, MD

Conditions

January 3, 2020

What seems like a tidal wave of pages washes over you. Drowning in a torrential sea of order clarification, bowel regimens, and vital sign deviations — you struggle to stay afloat. Medical school did not prepare you for this. Patients and nurses are calling you, “doctor,” you wish to return to that minimal responsibility role as a medical student.

Welcome to your first on-call weekend.

These first few days, weeks, and months …

Read more…

The intern who knows everything

What makes the perfect doctor?

Rada Jones, MD

Physician

January 3, 2020

I’m an ER doc, and I spent my last two decades in the house of medicine. First, training to become a doctor. Then, trying to be a better doctor. No matter how hard I tried, I’ve never been the “perfect doctor.” I started wondering: what makes one a “perfect doctor”?

The perfect doctor lives in the moment, focusing on the here and now: This patient. This case. This encounter. They devote …

Read more…

What makes the perfect doctor?