My parents were married at the College of Physicians.
They picked a location that was not tied to either of their family’s religions but still sated a ceremonial need. A justice of the peace filled the role of a rabbi or priest, and they got married under the only doctrine they both held sacred: the Hippocratic Oath.
I never knew that this was an unconventional wedding location. I used to watch their …
My future as both a mother and a physician
I remember when I started nursing school about a decade ago, that there was a near militant attitude describing the nursing shortage. School administrators, politicians, and journalists hopped on this easy bandwagon and talking point. Research and polls of dubious quality rode the tidal wave of popular opinion. Unsurprisingly, their genesis in an echo chamber yielded predictably confirmatory responses. As graduation time was fast approaching, the class began to job …
The nursing shortage: then and now
An excerpt from The Pharmacist is a Whore: How Pharmacists Lost Control of Their Profession and Why You Should Care.
The day patients became customers was a black day for us all. Don’t get me wrong, pharmacy has always been a service profession, and we take that very seriously. However, by virtue of our degree in Pharmacy and our license in the state in which we practice, we are …
How pharmacists lost control of their profession and why you should care
As you sit here in the office, waiting for this visit to be over, I wonder if you would let me share just a few things with you. Despite your impeccable eyeshadow, your impressive GPA, and the smile you flash so readily, I sense that there are things left unsaid. I am curious if there is more to your story that you wish could be told. But I know that …
You are more than an eating disorder
I sat in seat 23F next to the window, took out my leftover dinner from my backpack, and furiously started eating. A few minutes later, a man wearing an Astros baseball cap sat next to me with a puzzled look.
“You sure look hungry.”
“I am, can’t beat fried noodles with chicken. My name’s T.J. Pleasure to meet you.”
“My name’s Mike, Mike Jordan.”
“Are you related to the Michael Jordan?”
“Ha ha! I sure …
Dealing with prejudice as a cancer patient
The stories are disturbing. A pregnant emergency physician assaulted in a hallway. A patient leaping from the bed, wielding medical equipment as a weapon against the care team. A security guard intervening in a tense waiting room confrontation late at night. Most people find the violence hard to fathom, but for emergency physicians, these threats are part of life on the job every day.
A new poll by the American College …
Violence in the emergency department puts patients and physicians at risk
When I talk to medical practices about hierarchical condition category (HCC) and risk-adjusted diagnosis coding, I receive a lot of questions that point to the existence of persistent urban legends!
Let’s separate fact from fiction.
Urban legend #1: CPT fee-for-service coding will be a distant memory when we switch from volume to value
Not anytime soon. Medicare’s newer payment models starting with Medicare Shared Savings Programs (MSSP) and Accountable Care Organizations (ACOs) are …
5 urban legends about risk-adjusted diagnosis coding
I spent my first two years of medical school collecting stories. I journaled about my thoughts in the anatomy lab. I wrote about what it was like to learn how to interview and examine patients, about the immense honor and privilege I felt just being able to don a white coat with a stethoscope around my neck. I wrote about the patients that touched my heart – the patient with …
One of the biggest lessons medical school can teach you
“There’s no heartbeat.”
Three words no one ever wants to hear.
Three words no one ever wants to deliver.
And yet, as a community of physicians, we deliver those crushing words on a daily basis. None of us would ever take the task of bearing this piece of news lightly, but for me, it was not until I was on the receiving end of them that I truly grasped how profoundly a physician …
Humanity in medicine is in crisis
I cannot get behind fat acceptance, or better stated in medical lingo as “normalizing obesity.” As a physician and as someone who has been obese or morbidly obese my adult life, I know first hand what it’s like to hate my body and feel ashamed of it. I still do this very moment as I type this, that’s something I have to work on.
Funny thing is, I am much more …
Don’t sign off on fat acceptance. Don’t normalize obesity.
The California Department of Justice mandate to consult CURES (Controlled Substance Utilization Review and Evaluation) prior to prescribing, ordering, administering, or furnishing a Schedule II, II or IV controlled substance becomes effective on October 2, 2018.
The law states that CURES must be consulted the first time a patient is prescribed, ordered or administered a Schedule II, III or IV controlled substance. CURES must be consulted every four months thereafter if the …
CURES is not a fix for the opioid crisis
I’m proud to announce that I have partnered with Health eCareers to launch Careers by KevinMD.com: a new, dedicated career center ready to support your career at every stage.
Whether you’re ready to make the leap to a new job or just keeping your ear to the ground, there’s something here for every medical professional.
Here are some …
Welcome to your new career center!
Prior authorizations (PAs) have become increasingly burdensome for providers — they contribute to 92 percent of care delays and an estimated 77 million are submitted manually each year. In fact, the process has become so burdensome that many physicians get fed up with the process end up writing for less-effective prescriptions because they know the preferred drug will require a prior …
The answer to your prior authorization problem is simpler than you think
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Despite meticulous time management and delegation as a doctor, there were times when I found cobwebs on the laundry left on the clothesline too long, or a moldy school lunch or squashed banana forgotten at the bottom of a school bag at home. I would ensure all the important school dates were in my diary, but I was often tripped up by the curriculum day when school was suddenly off …
What my young patients taught me about parenting
As I sat in a frozen yogurt store a couple of years back, I watched as two young men pulled up in an expensive vehicle. They were wearing athletic attire from a private faith-affiliated university in the neighborhood. Both grabbed sample cups and cup-by-cup consumed about ten dollars-worth of yogurt each before jestfully yelling “Gracias” to the Latin store employee and walking out the door without paying for anything. Then …
Sometimes the most entitled people aren’t those you expect
Does the flu shot cause the flu?
Let me tell you, without a doubt, that the flu shot does not give you the flu. This is perhaps one of the most common misconceptions I hear as a physician. People absolutely swear by it. I’ve even had people tell me that family members got the flu shot and then died suddenly. I’m sympathetic, but how misguided!
Before we talk more about the flu …
No, the flu shot doesn’t cause the flu
When you or a loved one is sick or injured, health care decisions are fundamentally a matter of trust. You trust your physician will have the answers you need, because you know that, as a highly-trained medical professional, they’re qualified to make the best recommendation for each and every patient under their care.
Physicians receive some of the most rigorous education and training of any profession. They spend the better part …
The practice of medicine has experienced its own version of climate change
The beverage industry derailed the movement for soda taxes in California by convincing state elected officials to pre-empt local taxing authority in exchange for cancelling a ballot initiative that would have made all new taxes difficult to pass. But taxes are not the only way to reduce sugary beverage consumption in California or the U.S. as a whole.
The beverage industry has come up with several ideas on how to …
A new way to reduce sugary beverage consumption
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 56-year-old man is evaluated for painless intermittent bloody urine of 6 weeks’ duration. History is significant for granulomatosis with polyangiitis (formerly known as Wegener granulomatosis) diagnosed 10 years ago, which is now in remission; he was treated with prednisone for 3 years and oral cyclophosphamide for 1 year. He also has hypertension …
MKSAP: 56-year-old man with painless intermittent bloody urine
The children of survivors are important to the Holocaust story. The children are the future of the past. For a time, it seemed that no one would be left to create a future. That history has been so carefully, lovingly chronicled. It must be preserved. If it is preserved and told, the possibility exists that there will be no more war. That is always the hope of the survivors.
This is …
Children of war: inherited bereavement
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