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Medicine is a word with 3 meanings

Physician

October 9, 2018

Everybody is a stakeholder these days in what we broadly call medicine, or health care. But there is little agreement on what medicine is and what the priorities of the health care “industry” should be.

I propose this breakdown of medicine into three separate phenomena.

1. Micromedicine
2. Macromedicine
3. Metamedicine

Let me explain:

Micromedicine: one on one, real doctoring

Doctors from antiquity have served their patients one on one, as individuals. Osler, the father of modern …

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Medicine is a word with 3 meanings

Meditation, yoga, and mindfulness aren’t going to solve physician burnout

Linda Girgis, MD

Physician

October 9, 2018

Recently, my inbox has been overfilled with offers for programs, yoga, meditation, and a whole host of mindfulness training opportunities to combat physician burnout. I think by now everyone knows that doctors are fighting high burnout rates. But, those sending these “special offers” don’t get the root of the problem. We’re not burned out because we work long hours in a stressful job with limited time off. Rather, we are …

How medical school saved this student’s life

Natasha Abadilla

Medical Education

October 9, 2018

Note: This article contains language about physical assault that could be upsetting to some readers.

Stanford Medical School saved my life. Not in the metaphorical way, but in a very literal way. If I didn’t start medical school when I did, there is a high chance I wouldn’t be alive today.

I struggled writing this piece because only a small handful of people know my story. By the time you’re done reading …

Live your life the best you can, and don’t spend it all in the hospital

Cory Fawcett, MD

Physician Finance

October 9, 2018

If you have been following my writing, you know I have been out of the surgical workforce for a year and a half. I have settled into a much more relaxing lifestyle as an author who can set his own work schedule. This week I got a flashback of what my old life was like as a general surgeon when I attended a four-day conference called FinCon.

Each morning of the …

Avoid the power drain of life

DocG, MD

Physician Finance

October 9, 2018

I believe we have power. That deep inside each of us resides a unique purpose and identity that are unstoppable. That embracing this power leads to lifelong contentedness. Finding this well of vitality is complicated. Certainly it starts by telling ourselves the right stories about our lives. By becoming the protagonist of our own unique narrative, we dive deeper into ourselves. In the past I have even gone as …

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Avoid the power drain of life

A scrum master for primary care

C. Todd Staub, MD

Physician

October 9, 2018

We should consider a new position in our primary care teams — that of the scrum master. “Scrum” is a rugby term that comes from agile, a work methodology for software development that now is being applied to industry and health care.

In rugby, a scrum is a huddle where the teams come together with interlocked arms to regroup and start play again. In agile, scrum masters facilitate team huddles and …

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A scrum master for primary care

I learned how to be a good doctor in theater school

Lauren Klingman

Medical Education

October 8, 2018

It’s hard for me to believe that a few years ago, I completely turned my back on an acting career I had spent almost two decades building and instead decided to forge into an unknown world of medicine. Even now, with nearly seven years of experience in the medical field and currently in my fourth year of medical school, I sometimes feel lost for an identity.

At the time of my …

The decision to not vaccinate is driven by fear and misinformation

Lubna Mirza, MD

Conditions and Diseases

October 8, 2018

I was browsing the internet one day and came across a photo of a group of women who appeared educated and influential. They were wearing blue T-shirts with claims that vaccines cause autoimmune diseases, seizures, ADHD or attention deficit hyperactivity disorder, learning disabilities, death, autism, sudden infant death syndrome and infertility.

I couldn’t help but laugh at them! I shared this photo on my Facebook page. To my surprise, one of …

How to plan for an uncertain financial future

Wall Street Physician, MD

Physician Finance

October 8, 2018

The tricky part about retirement planning is uncertainty.

Uncertainty in retirement planning comes from three major sources.

1. Current and future income

Doctors are fortunate in that they have very high job security. Even if you were to be let go from your current position, there will almost always be another position somewhere in the country (although you might have to move out of your current metropolitan area).

However, the high income doctors currently …

Considering the recent setbacks of evidence-based medicine

Kenneth Lin, MD

Health Policy

October 8, 2018

For my students in 2018, it’s difficult to imagine an era when there was no such thing as evidence-based medicine (EBM). When I started medical school in 1997, though, the term had only been in use for six years, having been introduced by Dr. Gordon Guyatt at McMaster University (though EBM’s intellectual origins can be traced to several key individuals). When I tell trainees how recently EBM …

Imagine yourself treating a celebrity

Suneel Dhand, MD

Physician

October 8, 2018

A few weeks ago, I was giving a day-long seminar in California on improving communication skills, optimizing the patient experience, and how this is all ultimately linked to better proven outcomes. Part of the day involved doing role plays, playing the part of doctors and patients in various difficult hypothetical scenarios.

My experience of this type of group exercise is that all clinicians usually really enjoy it, when it’s done in …

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Imagine yourself treating a celebrity

Why it’s important to give your children the talk about marriage

Edwin Leap, MD

Physician

October 8, 2018

School is back in full swing. The kids are packed up, scheduled and loaded with notebooks, pens, pencils, computers, and calculators. Long lines form outside school drop-off areas. Tired, pajama-clad parents drop off bleary-eyed children, accustomed to sleeping and playing all day, now headed off to fill their little brains with knowledge.

Of course, it isn’t just the little ones. All of our children were home over the Summer. Now our daughter is a high school …

Clicking checkboxes doesn’t meaningfully improve care

Fred N. Pelzman, MD

Physician

October 7, 2018

Earlier this week, I was pleased to learn that my practice had achieved a statistically significant increase in box clicking.

In reviewing data from our accountable care organization, graphs were shown to us demonstrating improved compliance with several of the measures that they’ve instituted institution-wide for the purpose of reporting back to Medicare on how well we are taking care of our patients.

One of these measures is the ever popular “falls …

How to survive a medical liability lawsuit

Anonymous

Physician

October 7, 2018

I do not feel that I truly survived my lawsuit. Sure, I am alive, but the emotional toll it took on me during the four years that we co-existed was tremendous. That being said, I do feel that it taught me several things that may be helpful to others.

My lawsuit occurred very early in my career. The series of events that led up to it happened when I was a …

When doctors behave badly: a call for civility

Philip A. Masters, MD

Physician

October 7, 2018

A guest column by the American College of Physicians, exclusive to KevinMD.com.

It can be as blatant as a public argument between a hospitalist and emergency medicine physician about whether a patient requires admission. But most commonly it is more nuanced and subtle. Such as members of one speciality “bad-mouthing” another or a subspecialist criticizing …

What you need to know as a non-medical spouse to a surgeon

Megan N. Brown-Vilson, MPW

Physician

October 7, 2018

Combating loneliness as a non-medical spouse to a surgical resident is my current struggle.

I do not just mean the absence of his physical self — which do not get me wrong is frustrating– but the complete absence of his mind when he gets home from a long day at the hospital.

Absolutely no one gave me the proper and direct heads up that I needed as to what it would feel …

A patient’s open letter to aspiring physicians

David Penner

Patient

October 6, 2018

As a patient who has had extensive dealings with five prestigious Manhattan medical institutions, I have taken the liberty of writing this letter from the perspective of one who has spent many long and arduous years in the underbelly of our deeply troubled health care system, and one who has seen firsthand how the doctor-patient relationship has steadily eroded over time. This relationship, so foundational to the practice of medicine, …

It’s time to advocate for a new culture in medicine

Dianne Ansari-Winn, MD, MPH

Physician

October 6, 2018

The National Taskforce of Humanity in Healthcare recently published research showing physician burnout is impacting quality safety, and health care system performance — estimating that “costs for burnout-related turnover may be as high as $1.7B annually among hospital-employed physicians, and $17 billion across all U.S. physicians.” At Stanford Medicine, physician burnout costs at least $7.75M yearly.

These numbers are staggering. Growing numbers of physicians are leaving medicine (surely impacting the physician …

The issues physicians face when changing their name

Maria Perez-Johnson, DO

Physician

October 6, 2018

It’s my first day at a new facility — and I’m prepped with food, snacks and a closed-lid container for my morning coffee and to refill it in the afternoon with water. You never really know how stringent the policies will be for water containers at your new workstation or whether food or snacks are allowed. You might even be lucky enough to get a surprise Joint Commission inspection, or …

MKSAP: 56-year-old man with a family history of hypertrophic cardiomyopathy (HCM)

mksap

Conditions and Diseases

October 6, 2018

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 56-year-old man is being evaluated after his 18-year-old son had a syncopal episode during a high school basketball game and was diagnosed with hypertrophic cardiomyopathy (HCM). The patient has had no symptoms, including with physical activity such as golfing or playing tennis. Medical history is unremarkable, and a review of family history …

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