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Being a commodity takes away the joy of medicine

Edwin Leap, MD

Physician

July 22, 2018

It’s peculiar, I think, that we live in a time of physician shortage and yet some things remain abundantly clear:

1. Physicians can’t work together to fight, either for their own good or the good of their patients.

2. Like hostages, or abused spouses, they just keep going back for more of whatever bad policies they endure.

3. They are devalued.

Now, this isn’t about money. I’m not enough of a medical economics expert …

What health care can learn from what’s happening at Target

Suneel Dhand, MD

Physician

July 21, 2018

I was recently doing some home shopping in Target. It was peak time and fairly busy. After I was done, I walked towards the front of the store and approached the counter area to pay. But alas, there appeared to be hardly any manned registers. Lots of people were strolling up and down, trying to do the same as me: find a real person to help us check out. We …

Never underestimate the power of a smile

Weijie Violet Lin

Conditions and Diseases

July 21, 2018

He was a young patient with AIDS and Pneumocystis jiroveci pneumonia (PJP). Maybe that should have scared me from the start, but it didn’t. In hindsight, I keep wondering when the fear really set in. But downstairs under the glaring lights and the swooshing bustle in the ER, I only remember that he looked slightly bored as he took shallow, quick breaths. There was no blood, no screams of pain. …

Who named our bones? And what were they thinking?

Roy A. Meals, MD

Conditions and Diseases

July 21, 2018

All of our 200+ bones have names, which facilitates describing them when we cannot actually hold them or point directly at them. It might be easier to remember the names if they were familiar ones like Robert, Sally, and Kevin, but no such luck. Latin was the original language of science, so the bones received Latin names. Some of those were …

MKSAP: 70-year-old man with heartburn

mksap

Conditions and Diseases

July 21, 2018

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

A 70-year-old man is evaluated in follow-up for heartburn of 7 years’ duration. He has frequent nocturnal reflux but has not had odynophagia or dysphagia, and his weight has been stable. He was recently started on once-daily omeprazole with good control of his symptoms. He has a 30-pack-year history of cigarette smoking and continues to …

Read more…

MKSAP: 70-year-old man with heartburn

Not all depression is alike. Here are the differences.

Wallace B. Mendelson, MD

Conditions and Diseases

July 20, 2018

Adapted from Understanding Antidepressants.

In his often-quoted beginning of Anna Karenina, Tolstoy wrote, “All happy families are alike; each unhappy family is unhappy in its own way.” If we stretch this notion a little — going from families to individuals, and from unhappiness to depression — we come up with an interesting question, which is the …

Tips to manage chronic pain on summer vacation

John Dombrowski, MD

Conditions and Diseases

July 20, 2018

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

It’s officially that time of year. Summer is in full-swing, and all of America is getting ready to take a much-needed holiday.

However, some Americans, particularly those who suffer from chronic pain, often dread getting away. They are afraid their chronic pain might prevent …

Burnout in the male physician

Nisha Mehta, MD

Physician

July 20, 2018

When I first started writing and speaking about physician burnout, I focused most of my efforts on the female physician — after all, most of my work stems from personal anecdotes, and I am of course a female physician. I could probably give a talk about women physicians and burnout in my sleep at this point.

Rightfully so, though, as my work spread to wider audiences, more and more men started …

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Burnout in the male physician

When someone claims something is healthy, be skeptical

Jamie Katuna

Conditions and Diseases

July 20, 2018

I stood in line at the grocery store waiting to pay for my items. The woman behind me, who would be categorized as obese, was eyeing some of the snacks so conveniently placed in the checkout aisle. She grabbed a meal bar and analyzed it for a few seconds, then said aloud to me: “You ever had one of these? They’re pretty good. And they’re gluten-free, that’s how you know they’re healthy.”

Healthy.

What …

How a physician found success and fulfillment living outside the box

Nii-Daako Darko, MD, MBA

Physician

July 20, 2018

An excerpt from the Docs Outside the Box podcast, episode 2: How a physician found success and fulfillment living outside the box

Dr. Nii: I have an exciting guest that I want to showcase for you. Her name is Dr. Melanie Watkins. She’s a psychiatrist who’s practicing in California. I’ve been following Melanie for quite some time on Twitter. She’s been known to have very poignant Twitter messages — whether they are …

Medical training is over. What’s the next chapter?

Manu Prativadi, MD

Medical Education

July 19, 2018

Today is a strange day.

I treated myself to a slice of nondescript doughy hospital pizza for lunch today. If this was an actual pizza place, and I had a choice, I would never order this pizza. But today, the pizza tasted fantastic. In fact, it tasted like the best pizza I’ve ever had.

Why you ask?

Because this would likely be the last time I’d ever eat this hospital pizza. I enjoyed …

A physician’s mistakes as a rookie MD

Rebecca E. MacDonell-Yilmaz, MD, MPH

Physician

July 19, 2018

July is upon us again: that New Year celebrated only by those in the medical field. A time when medical students begin as doctors, interns become residents, residents become fellows and, basically, everyone in every position is one year less experienced at it than the person who held that position the day before.

This July marks the end of my first year of pediatric hematology/oncology fellowship. Finally, after college, grad school, …

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A physician’s mistakes as a rookie MD

Medical students: Welcome to the wards

Zainab Mabizari

Medical Education

July 19, 2018

Dear third-year medical students,

Welcome to the wards.

I remember this stage — basking in the glory of completing pre-clinicals, in the excitement of finally switching heavy textbooks for living, breathing people, in the realization that medical education now lies in the hands of those I wanted to heal. I would be sleeping less, but living more, because this was my purpose.

Remember this moment because this will be the most difficult year …

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Medical students: Welcome to the wards

Make a commitment to ask patients about firearms

John Hunninghake

Health Policy

July 19, 2018

Author’s note: My personal reflection about the Sutherland Springs mass shooting was written before the horrific events at Stoneman Douglas High School and Santa Fe High School. The chorus of voices has only increased in amplitude regarding the calls to responsible action on firearm safety. While a larger debate continues in Washington, DC, I ask myself again: What can I do now as a medical provider to make a difference? …

A physician’s attempt to seek psychiatric help

Anonymous

Physician

July 19, 2018

Physicians all around us are dying from suicide. For me, some deceased colleagues I knew more closely, others were faces that you would pass on the wards. Even two physicians that I knew peripherally died just this past week.

The issue of physician suicide is in the news now, and facts are available. At least a whole medical school class worth of physicians dies by suicide each year. The suicide rate …

The case against physician side hustles is weak

DocG, MD

Physician Finance

July 19, 2018

As many of you know, I am a big fan of side hustles. I see them as a financial independence superpower that not only leads to increased revenue and diversification, but also joy and passion. I am not, however, unaware of the fact that many feel they are a waste of time. The case against side hustles is real. There are many reasons why an individual may decide …

How do you come back after losing a battle?

Andrea Bischoff, MD

Physician

July 18, 2018

During my pediatric surgery training, I could easily point out which was the hardest day for the three fellows that were under training on that specific year. It was late evening when I received a call that one of our patients had coded. I was at home, and the drive usually took me exactly seven minutes.

Due to social reasons, this patient was in the hospital with us for months (at …

Managing your freedom after residency

Allison Edwards, MD

Physician

July 18, 2018

The first time I was asked to provide a bio — in this case, it was to appear on my residency’s website — I wasn’t sure what to include. It was supposed to be short, not really an autobiography or memoir and it was supposed to make our program look approachable, impressive and balanced. I gave a quick summary of my background, my education, my interests, why I picked the …

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Managing your freedom after residency

Physician suicide: Putting words into action

Joshua Goldman, MD

Physician

July 18, 2018

“The parts of me that used to think I was different or smarter or whatever, almost made me die. ”
— David Foster Wallace in an interview by David Lipsky

Recent physician-suicides and all those before were committed by people; people caught in an organization rigged against them — one that breeds new and exacerbates existing, mental health issues. Physicians are people. Doctors are people. They happen to be people who care, which makes …

Both physicians and CEOs need time to think

Hans Duvefelt, MD

Physician

July 18, 2018

I’ve always likened the job of a primary care physician to that of a chief executive officer of a small business. Family doctors manage the “business” of delivering and coordinating care for more than a thousand patients at an average cost, in the United States, of $8,500 per year: an $8 to $12 million business. Because the actions or inactions of the PCP impact the need for, and cost of, …

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