A pediatrician speaks out against combining sibling appointments

Physician
September 13, 2019

Imagine your typical yearly physical. It’s probably booked for 20 to 40 minutes. Since you, like many of us, may see your physician only once a year, it is important for you to have your physician’s complete attention and to have all of your concerns addressed. Some of these concerns may be of a sensitive – even embarrassing – nature. Your physician may likewise ask you some probing questions about …

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A pediatrician speaks out against combining sibling appointments

Does marijuana really relieve pain? Here’s what anesthesiologists say.

Meds
September 13, 2019

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

Marijuana is made from the dried flowers of the cannabis plant. Made of more than 500 chemicals, including over 100 compounds called cannabinoids, the primary active compounds in the plant are tetrahydrocannabinol (THC) and cannabidiol (CBD). THC acts on specific brain cell receptors that …

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Does marijuana really relieve pain? Here’s what anesthesiologists say.

5 clinician concerns about OpenNotes

Tech
September 12, 2019

More than 200 health organizations have now implemented OpenNotes. Many more are piloting, are soon to implement — or have implemented, and we don’t know it! For more than three years I’ve been fortunate to represent OpenNotes to potential implementers, and I’m confident I’ve heard almost every clinician concern or anxiety regarding what might happen when patients read their own notes.

Here are the five most common concerns I’ve heard — …

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5 clinician concerns about OpenNotes

It’s time to abolish the MCAT

Education
September 12, 2019

The Medical College Admission Test (MCAT) should be abolished. This single test — which ranks students by the science they’ve learned before going to medical school — prevents the physician population in the U.S. from looking like the population it serves. Underrepresented minority students have lower scores on all standardized tests. And the MCAT is no exception. When medical school admission committees use the MCAT as a screening tool to …

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It’s time to abolish the MCAT

Never let your patients know you’re in a hurry

Physician
September 11, 2019

I was recently working in clinic on a Friday afternoon. I was on my last patient of the day, and it had been a particularly long clinic. I had big plans for the weekend and should have already finished. The gentleman entered the room, sat down, and we began the consultation. Because I was so behind, I went through everything a little quicker than I usually would, but still covering …

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Never let your patients know you’re in a hurry

A slow death by charting

Tech
September 10, 2019

It’s 10 p.m.

Seven days before Christmas.

I’m sitting at work “finishing” up some charts.

I am suddenly overcome with anger.

What am I doing here right now at this minute? I am helping no one.

This work I’m typing away at — trying so hard not to scream — it’s hoops. Fucki*g hoops … for insurance companies. So I can beg them to pay me. Pay me pennies for the hard, good, compassionate, humanitarian …

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A slow death by charting

Most of what you learned in medical school is wrong. And that’s OK.

Education
September 10, 2019

“90 percent of what you will learn over the next four years will be wrong in a couple of decades from now.”

Speaking to a lecture hall of 120 first-year medical students, our professor’s prophecy seemed to fall on deaf ears. Looking around, I saw no concerned students, no diminishment of our collective enthusiasm. For me, however, his words of caution struck a chord on that first day of medical school.

As …

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Most of what you learned in medical school is wrong. And that’s OK.

Medical schools cause burnout. Here’s how to fix that.

Education
September 9, 2019

STAT_Logo Students’ time in medical school should help them grow and become insightful, caring doctors. Instead, medical education is somehow turning smart, gifted, enthusiastic applicants into exhausted and unhappy students who become interns, residents, and physicians at increased risk of depression and burnout.

I’m no stranger to the demands of medical school. My father and father-in-law were both …

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Medical schools cause burnout. Here’s how to fix that.

Does the House of God stand the test of time?

Physician
September 9, 2019

As media coverage of the 50th anniversary of Woodstock shifted into high gear earlier this month, two articles in the “Arts and Medicine” section of JAMA called attention to another anniversary that transported me back in time.

It has been 40 years since the publication of The House of God — an unabashedly irreverent (some would say “borderline pathological”) fictionalized account of author Stephen Bergman’s …

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Does the House of God stand the test of time?

Meet the orthopedic surgeon who became a rapper

Physician
September 9, 2019

“Jeff, turn my headphones up.”

There is a peace and tranquility to the recording booth before the beat drops. A heavy bass and drum kick in, signaling me to bark gravelly lyrics into a state-of-the-art microphone with hopes that it sounds passable. Over the past year, my rhymes have gone from clunky to less clunky, and for a few moments, they weave between melodic insightfulness and relatable humor. Embedded within these …

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Meet the orthopedic surgeon who became a rapper

Why should you belong to a medical professional society?

Policy
September 8, 2019

acp new logoA guest column by the American College of Physicians, exclusive to KevinMD.com.

Because I work for a medical specialty society, I’m frequently asked by non-members why I believe they should belong to a medical professional society.  This is a particularly relevant question these days given the rapidly changing landscape of medicine and with physicians becoming …

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Why should you belong to a medical professional society?

How can we address retention in the era of physician burnout?

Physician
September 6, 2019

As we’ve seen, the lives of those working in the health care system has become overwhelmingly challenging, burdened by all of the excess nonmedical stuff that has been added into our lives as we try to take care of patients.

From prior authorizations, to clicking in the electronic medical record, to endless streams of regulatory requirements, to the continuous onslaught created by …

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How can we address retention in the era of physician burnout?

Physician coaching: the new normal?

Physician
September 6, 2019

What is coaching? It’s a conscious effort to notice and evaluate how our thinking impacts our experiences, how perspective shows up in the results of our life.

Coaching has been integral to fields other than medicine for many years. Yet, many physicians don’t know much about it — much less anything about its potential to radically transform the culture of medical training and our experiences in health care.

It’s time we caught …

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Physician coaching: the new normal?

The problem of overdiagnosis: What can patients do?

Conditions
September 5, 2019

An interesting article in the journal Pediatrics is both intriguing and sobering. It is intriguing because it lays bare something we don’t talk much about or teach our students about; it is sobering because it describes the potential harm that can come from it, harm I have personally witnessed. The issue is overdiagnosis, and it’s related to our relentless quest to explain everything.

Overdiagnosis is the term the authors use to describe …

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The problem of overdiagnosis: What can patients do?

A thank you from doctors to nurses

Physician
September 5, 2019

Earlier this year, I asked a group of nurses what gifts doctors could give that would help them know they are appreciated. There were hundreds of comments that included many I expected: Food (pizza, chocolate, cake, tacos, bourbon, Starbucks, healthy snacks), pens, cash, and/or gift cards for all shifts.

There were some interesting “high end” ideas: Massages or a massage chair. Trips. Cars. Stethoscopes.

Some still make me shake my head and …

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A thank you from doctors to nurses

Is overachieving a sign of past trauma?

Physician
September 5, 2019

Ever feel like you are always on the go, not feeling comfortable slowing down? All through school, college, medical school, residency, and then practicing medicine, the one thing that I got really good at was staying busy. Planning projects, test-taking, solving cases, treating patients, emails, meetings, joining boards, organizations, getting more certifications, a world of task lists, and checkboxes. What was often sacrificed was being a mom, wife, domestic duties, …

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Is overachieving a sign of past trauma?

Sharing mental health issues on social media

Social media
September 4, 2019

Susanna Harris was sitting in her lab class for her graduate program at the University of North Carolina at Chapel Hill when she received an email that told her she had failed what she describes as “the most important exam in grad school,” the doctoral qualifying exam. She took the rest of the day off, went home, and baked cookies.

Harris continued with her regular schedule: lab, work, home, repeat. Everything …

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Sharing mental health issues on social media

Want to crush USMLE Step 1? Here are some evidence-based study tips.

Education
September 4, 2019

Interleveling strategy

  • Interleveling is the process of studying/learning multiple unrelated concepts across different subjects during the same study session.
  • This can make studying appear difficult and more disjointed. However, research shows it yields better exam results. This is attributed to better simulation of the exam environment as questions are presented in random order, and concepts are scattered throughout the test.
  • A literature review rated interleveling as having …

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Want to crush USMLE Step 1? Here are some evidence-based study tips.

If a doctor has a bad day, someone dies. Remember that.

Physician
September 4, 2019

For what seemed like an hour, I stood staring at the flat lines scrolling endlessly across my monitor in the OR. The once pulsatile waves, rendered useless and flat due to the absence of a beating heart. After a frenzied six hours of pouring blood into the patient while it poured back out of her just as fast, the surgeons drowning in blood in their attempt to sew the new …

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If a doctor has a bad day, someone dies. Remember that.

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