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How non-video telehealth can be a cure for overprescribing antibiotics

Health Technology

May 15, 2019

When Dr. Fleming found penicillin mold in his Petri dishes in 1928, he had no idea of the impact he — and it — would have on global health. Penicillin and the antibiotic revolution that it triggered have saved countless lives and change world history.

Less than a century later, though, antibiotics occupy a space between savior and sinner. This complicated reputation is mostly due to how …

Share your stories and experiences, in written, visual, or media form. Stories matter.

Alya Ahmad, MD

Physician

May 15, 2019

Narrative medicine: I have heard of that, but what is it? I often get asked this question. As a master’s student of narrative medicine, I am still trying to hone in on the best response to that question.

For many, narrative medicine (NM) is not a novel concept. We have watched movies or read books of doctors helping, listening or learning from patients as they wrestle with their illness. Many writers …

Our broken health system is your fault

Anonymous

Health Policy

May 15, 2019

“I don’t know what happened” is probably one of the most common phrases any parent hears. Last weekend, while wrapping my son’s bleeding head in gauze from our first aid kit, this was the best explanation my daughter could muster as to why her two-year-old brother was screaming, holding tightly to a blood-covered plastic ice cream cone. In the end, it was a complete accident (he hit his head on …

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Our broken health system is your fault

Fee for service is not the root of all evil

Richard Young, MD

Physician

May 14, 2019

Some people think that the solution to better-supported primary care is in direct primary care/salaried physician payment models. I don’t think it is the best answer. I realize money is not the only motivator explaining why people perform work. Meaningful work matters too. But meaningful work that is not respected and paid for will not sustain or be the source of burnout and resignation, not only for physicians. I think …

You are the average of the 5 physicians you spend the most time with

Passive Income, MD

Physician Finance

May 14, 2019

”You are the average of the five people you spend the most time with.”

You may have heard this quote, from famous motivational speaker Jim Rohn, many times before. Taken at face value, the quote relates to how we are influenced. But it’s also a sentiment that really sums up how we live and interact with our closest friends and family.

Tony Robbins takes it a step further, saying that “the quality of …

Electronic medical record interoperability is a total mess

Fred N. Pelzman, MD

Health Technology

May 14, 2019

Just the other day, while I was in the middle of seeing a morning schedule full of patients, I opened one patient’s chart and was thrilled to see a whole bunch of new icons in Chart Review in the electronic health record that I had never seen before.

These apparently indicate office visits and other health care encounters with outside providers.

Sometime during …

The benefits of compassion always outweigh its risks

Nidhi Desai

Medical Education

May 14, 2019

It was an ordinary afternoon in my outpatient internal medicine rotation. I prepared to enter a room for a congestive heart failure hospital follow-up patient. I mentally prepared myself. I was going to ask for his hospital records (particularly looking for the echocardiogram), make sure he was started on an ACE inhibitor and a beta-blocker, and ensure he had a follow up with a cardiologist in the coming weeks. “This …

Burnout vs. moral injury: Does it matter what we call it?

Camille Adair, RN, William Norcross, MD, Sam Slishman, MD, and Tami Berry, MD

Physician

May 14, 2019

Yes, we think it does. And the time to act has come. The time is now.

We — physicians and nurses — work side-by-side caring for patients, every single hour of every single day. But we don’t often talk to each other about the (seemingly insurmountable) deep and serious issues and challenges we as clinicians face, practicing in today’s broken health care system. That has to end. We must unite.

We are …

Treating a VIP benefactor of a hospital

Steven Reznick, MD

Physician

May 13, 2019

My local hospital has been petitioning the local city zoning board for permission to build an on-site parking garage for years now. The city zoning board is very strict about the height of buildings and has turned the requests down repeatedly.

This past fall, the hospital administration announced that it needed a capital partner to expand and stay solvent. Most of the members of the hospital medical staff have absolutely no …

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Treating a VIP benefactor of a hospital

Why would adult children disapprove of their parent’s happiness?

Anne Katz, RN, PhD

Physician

May 13, 2019

Going through the process of diagnosis, treatment decision making, and often lengthy treatment without a partner can be challenging. While children, friends, and other family members are supportive, for the single individual, there is no one to talk to in the middle of the night when fear and doubt often surface. I often counsel people who have finished treatment for their …

The new aspirin guidelines: The media does a disservice to patients

Olubadewa A. Fatunde, MD, MPH

Medications

May 13, 2019

Much media attention has been paid to the new guidelines from American College of Cardiology/American Heart Association (ACC/AHA) on the primary prevention of cardiovascular disease. Based on new clinical trial data, ACC/AHA no longer recommends that healthy adults without cardiovascular disease — emphasis on without cardiovascular disease — take daily aspirin for the primary prevention of cardiovascular disease.

This change, while significant, is highly nuanced and dependent on …

Physicians: Don’t let administration intimidate you

Suneel Dhand, MD

Physician

May 13, 2019

One of the things I am most grateful for, as a doctor who has worked in at least a dozen different hospitals over the last decade, is the broad range of experiences I’ve had and the variety of physicians I’ve met and gotten to know. I enjoy hearing experienced physicians’ perspectives on how the practice of medicine has changed from what it used to be in the 1970s to 1990s.

I …

3 ways physicians can ensure an early retirement

Cameron Wood

Physician Finance

May 13, 2019

Owning a medical business is like being a CEO, patient advocate, accountant, human resources manager, medical healer, and office manager all rolled into one. One job title that most physicians put last in their ever-growing list of roles is that of retirement planner. Ensuring that you have your long term financial house in order is often neglected in favor of dealing with all the short term problems that a medical …

The problem of disbelieving doctors

Christopher Johnson, MD

Physician

May 13, 2019

All good doctors learn to filter what parents say to them during history taking, to examine each parental statement for reliability, likelihood, and sheer outlandishness. Parents of sick children are a cross-section of humanity and, like all of us, vary in their observational skills, their ability to express themselves, and their tendency to exaggerate or minimize what they see. Parents, not being physicians, may not notice and comment on things …

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The problem of disbelieving doctors

Questions about physician disability insurance answered

Altelisha Taylor, MD, MPH

Physician Finance

May 12, 2019

As resident physicians with a tight budget, one of the last things on our mind is paying for added insurance. Trust me; I get it. However, as a [future] high-income earners, long-term disability insurance is essential. It may not be at the top of our priority list, but it should be.

What is it and who needs it?

Unless you are already financially independent or were lucky enough to have a trust …

Are we making artificial intelligence biased?

Iyesatta Massaquoi Emeli, MD

Health Technology

May 12, 2019

The tale is told of a large realm, of 1.4 billion, the largest nation in the world. It has a culture that is old, rich and grounded. A citizen’s worth can be understood, determined, exalted or decried. In modern times said country has a visionary leader for life. His foresight includes the automation of culture through the use of big datasets, mass surveillance, facial recognition, and artificial intelligence. A citizen’s …

The brutal emotional challenge of medical training

Nyembezi L. Dhliwayo, MD

Physician

May 12, 2019

I can vividly remember the day the phone call came. My cousin screaming over the phone, trying to make out words but unable to speak, disbelief, horror, the fear in her voice palpable even though she was thousands of miles away. It was barely 5:30 a.m., I was frantically rushing out to beat traffic, hoping to get a head start on pre rounding since I was on call. Confused, I …

Protecting women from maternal mortality

James Lozada, DO

Physician

May 12, 2019

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

I vividly remember the first time I saw someone who had died. She was in her late 20s, wearing tattered clothes, and alone. Her friends and family never came. I watched from a distance as police and crime scene investigators worked. I had just …

Why aren’t you treating opioid addiction?

Kathleen A. Hallinan, MD

Medications

May 11, 2019

Our community had one of “those” providers — a midlevel who was the local pain person. If you had pain, go to her. She would write you for anything you could want and more. It’s unclear if she was unscrupulous or just inept. But last year, the DEA finally figured out what she was doing and yanked her license. There was nothing in the news. Nothing on the internet. We …

Want to create a review course? Here’s how this physician did it.

Mary Preisman, MD

Medical Education

May 11, 2019

When I told my colleagues that I was going to try to create the first psychiatry review course at the University of Toronto, I received the same two responses: “It’s about time somebody did that!” and “What is wrong with you?” — sometimes from the same person!

The first reaction taps into the excellence of our department. With approximately 1,000 faculty with diverse expertise and the largest residency program in Canada, …

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