I haven’t counted how many times this happens every month, but I find it annoying.
I send a prescription for a drug (sometimes not even expensive) to the pharmacy and soon after, I get a fax asking me (or my medical assistant) to go online and print a prior authorization form to complete and fax to the insurer, or answer numerous qualifying questions on the screen, or (worst of all) Read more…
We need RVUs for obtaining a prior authorization
Practicing medicine at the frontlines is hard. It’s damn hard. Every minute you need to be alert, ready to respond to a potential life or death situation, and be called to another important problem. The current medical practice environment — with excessive bureaucracy, suboptimal information technology, and extreme time pressure with patients — adds exponentially to the mix, and can make for a very stressful job. Make no mistake, even …
3 health tips to help busy physicians
Wealth seems to be an elusive dream for many people. They desire to become wealthy, but feel they don’t earn enough money to reach that goal, as if earning more would make the difference. A study of 10,000 millionaires presented in Chris Hogan’s new book, Everyday Millionaires, showed that 69% of these millionaires reached that level of affluence on a household income of less than $100,000 a year. If all …
Why many doctors live paycheck to paycheck
Back when I was a third-year medical student, I would sometimes bike to the hospital campus early enough to catch the groundskeepers cleaning the promenade in front of the medical school before the foot traffic arrived. Discovery Walk, as it’s called, is a beautiful promenade with stone murals commemorating the significant discoveries made at Stanford. It’s a beautiful scene, especially during sunrise or sunset, which many of my classmates have …
The difference between learning medicine and doing medicine
Proof of concept is important because accountability is a tenuous thing. One can pretty much say whatever they want on the internet. They can boast. Spin half-truths. Tell a tale. The most deadly of these are the ones that are just a slight variation of reality. Personal finance is no different. Net worth projections, budgets, the acumen of a business venture or …
Is the physician financial independence community preaching to the choir?
A excerpt from From Reading to Healing: Teaching Medical Professionalism through Literature (Literature and Medicine).
There are several traditional ways to teach about professionalism. Some training programs have didactic lectures on this issue. These typically focus on principle-based ethics and “rules” about professionalism. “Do this. Don’t do that.” Most educators and students will agree that lecturing about this topic has some (but limited) value. Applying concrete, principle-based concepts in …
Teaching medical professionalism through literature
People often say that they can die happy if …
Well, I have no intention of dying, but one of my goals in life was achieved recently. Historically, Facebook moms groups have been the bane of existence for many physicians, particularly pediatricians. We are often rated and compared like hotel mattresses. Well, last night one of my friends texted me, “Your practice is getting a lot of love on Facebook.” Now, …
The tide is turning: a pro-vaccine Facebook thread
Burnout is a myth. Dedicated clinicians, working under circumstances that connect their skills and compassion with opportunities to impact patients, won’t experience burnout any more often than they might by doing other jobs. The story we tell — the one that dissatisfaction is this system’s inevitable byproduct — perpetuates more harm than we know.
This is what I’d like to believe. I’d like to write about the many opportunities to do …
Refuse to accept that burnout is a natural experience in health care
“Hey, you’re a med student. Right?”
“Yes, I am. Do you need me to scrub in?”
“That would be wonderful, yes! Everyone is either out on vacation or is sick. It’s just me and the resident.”
“OK, I’ll be back in a few minutes.”
I was on my OB/GYN rotation, and once a week I follow one of the surgeons. It was 7:20 a.m., and a patient was coming in for an unplanned, stat …
The story of an attending’s empathy
Very few things in the universe are 100 percent good or 100 percent bad. Cannabis is perfectly ordinary in having a mixture of good qualities (medical benefits) and bad qualities (medical risks). The people who want to make money – lots of money, by the way – from selling marijuana do a perfectly fine job of pointing out the good. But they don’t educate the public about the possible risks. They know it will …
America has seen medical marijuana before: This is what we learned (and forgot)
This article is sponsored by Careers by KevinMD.com.
“Sometimes you want to go where everybody knows your name.” So go the famous lyrics from the theme song for “Cheers,” the iconic sitcom of the 1980s. The name thing can get really personal in medicine — and everyone has an opinion — as evidenced by a plaintive blog posting …
“Doctor” or first name: Which do you prefer?
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 79-year-old man is evaluated for a 2-month history of progressively worsening headaches, nausea, visual disturbance, and difficulty speaking. He also has hypertension and gastroesophageal reflux disease. Medications are lisinopril and omeprazole.
On physical examination, vital signs are normal. Right oculomotor nerve (cranial nerve III) and bilateral abducens nerve (cranial …
MKSAP: 79-year-old man with headaches, nausea, visual disturbance, and difficulty speaking
On January 28, 1986, the space shuttle Challenger disintegrated shortly after liftoff, resulting in the death of the entire seven-person crew. The subsequent investigation revealed that a joint in the right solid rocket booster failed during liftoff, which occurred due to the inadequacy of the O-ring seals. It was about 28-degrees on the morning of the space shuttle launch, and the O-ring seals were not designed to perform at such …
What do the Challenger disaster and medicine have in common?
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If you throw a pebble today, it’s likely to land on an article that talks about how artificial intelligence and its brother — machine learning — are changing health care.
Yes, I get it broadly. But I was curious to explore how exactly health care’s trends are shaping a single medical specialty. I chose gastroenterology (GI) because I’m most familiar with the space. And here’s what I found.
Trend #1: Manipulating bacteria …
Understanding 6 trends shaping health care through gastroenterology
It was a beautiful warm mid-July morning in Minnesota. And I was taken by surprise by my feeling of complete and utter contentment. I was with my family bicycling around a lake on a smooth groomed gravel path surrounded by trees, ferns and so many shades of green my breath was taken away. The cool riparian air mixed with the warmth of the sun, and the laughter of children up …
3 tools doctors can use to prevent burnout
Parents often ask me about snacks for their children once they are eating table food. Should they even give them snacks? If so, what kinds are good for them, and how often? In general, after age one I recommend three kid-size meals and 1 to 2 snacks to help them get their daily nutritional requirements. Try not to stress or obsess at each feeding about them eating all that you …
A pediatrician’s tips for your kids’ snacking habits
As a sports medicine orthopaedic surgeon, I often see patients with complaints at their elbow. One of the more common diagnoses is tennis elbow, otherwise known as lateral epicondylitis. Surprisingly, most of my patients with this condition don’t even play tennis! Many types of repetitive arm movement can lead to tennis elbow. It all has to do with the tendons in our arms.
Tendons are the structures that hold muscle to …
An orthopedic surgeon’s guide to tennis elbow
Say you want to know which baseball players provide the most value for the big dollars they’re being paid. A Google search quickly yields analytics. But suppose your primary care physician just diagnosed you with cancer. What will a search for a “high value” cancer doctor tell you?
Not much.
Public concern over bloated and …
Want to find the best doctor? Don’t rely on price tags.
An important part of advancing medical research and drug development is making participation in clinical trials easier and more inclusive. To develop treatments that work on men, women, and children of all ages and different ethnicities we need to have clinical trial data that represents our diverse population. Right now, when the FDA approves a new drug we know that it will be effective in some – but not all …
How telemedicine is increasing diversity in clinical trials
The pediatric emergency department’s fluorescent light cast its glow on our heads, drifting and drooping, at 3 a.m.
Torn between taking a chance on rest and anticipating the next fever, headache, abdominal pain, wheezing or rash that came through the doors, we sat suspended.
The nurses tried to stay awake with a parade of old cat videos and Kardashian memes, their Facebook feeds stale – no one really posts much at that …
All corners of the world meet in the hospital
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