America’s “sick” secret and the need for a primary care czar
America has a systemic and pernicious problem: health care without primary care. Just a century ago, primary care physicians were the trusted cornerstone of the U.S. health care system, providing the first point of entry into health care, addressing most ailments, and managing patients across a lifespan. This primary care “first” system has gradually eroded over the ensuing decades, and unfortunately, many citizens have fallen victim to a modern culture …
Systemic collusion: How big business and government herd physicians into traditional employment
As a physician, I spent years training to care for patients, only to realize by the time I completed my education that I wasn’t truly in control of my career. Like so many of us, I had been funneled into a rigid system that pushes physicians toward employment with large health care systems rather than allowing for independent practice or entrepreneurial ventures. It felt like I had been herded—herded by …
Nurse practitioner reveals startling flaws in APRN education: Is patient safety at risk?
Recently, Bloomberg published an article titled “The Miseducation of America’s Nurse Practitioners” by Caleb Melby, Polly Mosendz, and Noah Buhayar, which brings to the public’s attention the dismal state of education for APRNs. I would like to share my own story and that of several other APRNs who attended my APRN program. This story will demonstrate many of the disturbing facts about the educational system designed to train APRNs.
I …
How AI could widen health disparities without stronger policies
In the realm of health care, artificial intelligence (AI) stands as a beacon of transformative potential. With its ability to process vast amounts of data, AI promises to streamline diagnostic processes, enhance treatment precision, and revolutionize patient care. Yet, it’s overshadowed by various ethical concerns about perpetuating existing biases and systemic discrimination.
AI development is ultimately influenced by the datasets it’s trained on, making it vulnerable to biases present in that …
How delayed gratification in medical school can make or break your career [PODCAST]
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We sit down with Ben Reinking, a board-certified pediatric cardiologist, medical educator, and certified physician development coach, to explore the challenges and rewards of medical training. We dive into themes of delayed gratification, …
The little boy who taught me the power of education in the Guatemalan highlands
Walking through the narrow alleyways and past artisanal businesses in the Lake Atitlán region of the Guatemalan highlands, a swarm of children followed us as if we were a parade or a moving tourist attraction. As a global fellow through the Stanford Freeman Spogli Institute (FSI), I served as an interpreter and interviewer in this underserved region with extreme poverty a few …
Doctors beware: the hidden legal risks of following CME guidelines
I have a problem with some of the continuing medical education courses offered by large health care institutions, even those like Harvard and Mayo, which have outstanding reputations for evidence-based medicine. That’s because what they teach, although scientifically sound and in line with the Department of Health and Human Services and CDC recommendations, can get you prosecuted and convicted by the DEA. If you get targeted for practicing the way …
How South Carolina’s eye care laws are blocking telemedicine innovation
People learned during the COVID pandemic that getting limited care online via telemedicine can be a great way to expand access, especially in rural areas. But Visibly, founded in 2014, was ahead of the curve.
The Chicago-based company invented technology that lets people renew eyeglass prescriptions from home or anywhere with an internet connection. No appointment is necessary, no driving, and no waiting in a lobby. Licensed ophthalmologists review results and …
How measurement-informed therapy is changing mental health [PODCAST]
When a doctor acts like one of the kids
Sue went to the operating room today, which was not at all what I recommended, not that we ever discussed my personal opinion on the matter. With a worsening small bowel obstruction, I woke up this morning and, realizing that matters had worsened overnight, I called her husband, Dave. I don’t think I woke him, but his voice, one complicated by little, if any, sleep and likely hours of talking …
Is your medical malpractice case just a coin toss?
If you are embroiled in a medical malpractice lawsuit today, you are in a difficult situation.
Your lawsuit is one of 85,000 medical malpractice cases filed each year. Regardless of what your defense counsel tells you about merit, no one truly knows how many lawsuits have merit. A prominent defense attorney has gone on record declaring that there is no such thing as a frivolous lawsuit and publicly disavows any notion …
How to regulate generative AI in health care
Generative AI is revolutionizing health care, particularly large language models (LLMs) like ChatGPT, Gemini, and Claude. The potential is immense, from advanced diagnostic tools to predictive analytics and decision-support systems. However, our regulatory landscape has not kept pace. Traditional frameworks for new drugs and devices are inadequate for the unique characteristics of generative AI.
This article outlines a comprehensive framework to effectively regulate generative AI in health care, striking a crucial …
Medicine’s race dilemma: What science says about genetics and health [PODCAST]
Why representation alone won’t solve health care equity issues
I attended a workshop on developing equitable health information materials, emphasizing that people are more responsive to data when individuals of similar complexion and/or features are represented. This concept originated in education, where research indicated that youth learned better from teachers with similar characteristics, and it was subsequently extended to health care. However, universal application is unrealistic, as Black children will not always have Black teachers, and patients of color …
A day in the life of a medical student on a neurosurgery rotation
As a fourth-year medical student applying to neurosurgery residency, my rotation in neurosurgery has been one of the most intense and rewarding experiences of my medical education. The days are long, the cases complex, and the learning curve steep, but every day reaffirms my passion for the specialty. Here is a glimpse into a typical day on my neurosurgery rotation—a day that starts before the sun rises and is filled …
Why is our health care system going down the drain and no one seems to care?
I want to express my frustration with the state of health care in the United States, particularly in the context of my own experiences within the system. Over the past 12 years, I have submitted articles to KevinMD advocating for quality patient care and fair working conditions for health care professionals. I have urged hospital administrators to reevaluate their operations to improve patient and staff satisfaction and the overall efficiency …
How biased medical experts are destroying doctors’ lives and careers in the opioid crisis
As a U.S. health care writer and patient advocate for almost 30 years, I read a lot. Recently, some of that reading is in court transcripts of doctors being persecuted out of medicine or into jail by various prosecutors and their hired “experts.” I use the term “persecuted” intentionally. I believe that “medical experts” in many court or Medical Board proceedings are simply “hired guns” – clinical predators hired for …
Heal your heart from the inside out [PODCAST]
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In this episode, we sit down with Jonathan Fisher, a cardiologist, mindfulness teacher, and expert in holistic heart health. Drawing from his personal journey through anxiety and burnout, Jonathan shares insights from his …
Why endocrinologists need to rethink CME: the secret to a healthier conference
As endocrinologists, we spend our days balancing hormones and fine-tuning metabolism, but when it comes to our own continuing medical education (CME) conferences, it seems our ability to maintain equilibrium goes out the window. We advocate for healthy living, yet our CME events are a hormonal disaster, like a cortisol spike right after a sugar crash.
Picture the scene: you roll out of bed before the sun, which is already a …
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