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How physicians become medical narcissists

Physician

July 30, 2019

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 …

Are pediatric hospitals ready to embrace value-based payment models?

Johanna Vidal Phelan, MD, MBA

Policy

July 30, 2019

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 …

When physicians focus more on screens than patients

Carmen Heredia Rodriguez

Tech

July 29, 2019

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 …

What to do when physicians get subpoenaed as witnesses

Judy Melinek, MD

Physician

July 29, 2019

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 …

Physicians are overwhelmed by alarms and alerts

Fred N. Pelzman, MD

Physician

July 29, 2019

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, …

5 powerful words you can say to patients

Suneel Dhand, MD

Physician

July 28, 2019

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 …

A medical student reviews Eric Topol’s Deep Medicine

John Paul Mikhaiel, MD

Tech

July 28, 2019

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 …

Paltering: When the truth is used to deceive

Shannon Casey, PA-C

Conditions

July 28, 2019

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 …

The disaster at Hahnemann University Hospital

Karen S. Sibert, MD

Physician

July 26, 2019

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 experiences in medicine shape your future

Stephanie Wellington, MD

Physician

July 26, 2019

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 …

Think beyond benzodiazepines for anxiety

Wallace B. Mendelson, MD

Meds

July 25, 2019

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 …

5 things I learned from being a “high-maintenance” patient

Dhaval Desai, MD

Physician

July 25, 2019

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, …

The suffocation of social isolation

Harsh Moolani

Conditions

July 24, 2019

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 …

Read more…

The suffocation of social isolation

Understanding professional liability insurance in physician employment contracts

Elizabeth Shubov, JD

Policy

July 23, 2019

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” …

Why we must embrace medical uncertainty

Philip A. Masters, MD

Physician

July 23, 2019

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 …

Read more…

Why we must embrace medical uncertainty

Define what true resilience means for you

Sarah E. Jorgensen, RN

Policy

July 22, 2019

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 …

36 things I learned in 36 years of medicine

Joe Bocka, MD

Physician

July 22, 2019

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 …

To first-generation college pre-medical students: Your future patients need you

Jenny Ruiz, MD

Physician

July 22, 2019

Being a first-generation college student is hard. Being a first-generation college student and being pre-med is even harder. And since education and income are closely linked in the U.S., it’s no surprise that many first-generation college students also come from a low-income background.

I fell into this category.

My parents did not finish high school, and money was always tight. I had never heard of pre-med until I got to college. I …

The secret to ending cynicism in medicine

Roger Harrie, MD

Physician

July 19, 2019

To fill an assignment in an undergraduate medical sociology class, my friend and I made an appointment with the assistant administrator in a local hospital. After the interview, we proceeded towards the exit by cutting through the obstetrical wards. We passed an exhausted young doctor with a stethoscope draped over his neck and hunched over a stack of charts. He glanced up as we passed, and we introduced ourselves as …

The scourge of the pediatric urgent care fellowship

Ron Yalon, MD

Physician

July 19, 2019

I am one of those lucky souls who actually likes their job. Since I completed my pediatrics residency two years ago, I have been working in urgent care settings. What’s not to like? I get to see a wide variety of patients, I’m always learning something new, and I get to finish my encounters with a high-five from an overeager toddler. If you’re a general pediatrician like me, that’s the …

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