A couple of weeks ago, I met my new medical students. These 10-12 trainees will be my small group for the next two years. We will meet monthly to discuss the soft stuff of medical training — hierarchy, tribalism, death and dying, medical errors, difficult patients, etc. Some call it “third-year medical student support group.” This is my 6th year of the pleasure and privilege (I inherited my first group …
A teacher’s job is to show love first
In the past few weeks, there has been a question regarding my use of the hashtag #Nof1 along with how I end the majority of my posts and tweets: Health care is delivered at the N of 1.
One person even believed there might be a trademark infringement with the company N-of-1 who provides molecular testing for patients and then delivers evidenced-based medical recommendations for oncology patients. The reality is that, …
“You find joy that people are doing better because of what you did for them.” #BornToHeal
Courtesy of the American Medical Association (AMA).
This resident’s childhood friend inspired him to help other children as a physician
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What is it like living in pain? Those of us who have ever experienced unremitting pain for months or years know that it is enveloping and all consuming. I struggled with intractable pain for several difficult years, and I am fortunate because my pain finally got better — what if your pain never did?
That is a horrible reality millions of people are living in right now. The chronic pain population …
Want to stop the opioid epidemic? Stop prescribing opioids.
Approximately 12 years ago, I hired my first physician in recovery. He had temporarily lost his license following a bout with alcohol. After a stint in a rehabilitation clinic, he was ultimately reinstated. My journey to hire this physician was arduous at best. During the interviewing process, I narrowed the field down to two candidates: one with a past and one without. I wrestled with the “in recovery” situation and …
Help me help doctors in recovery
Health care reform continues to make national headlines as Republican senators have failed to pass a bill in the Senate with enough support to repeal and replace the Affordable Care Act (ACA). How did we get here, and why do so many Republicans want to make the ACA go away badly? To answer this question, you have to first understand the history of health care reform in the United States …
A history of health care reform
Yesterday, we had a meeting about leakage.
No, it was not about urinary or fecal incontinence, but it was about care that could have been provided within our institution that ended up, for a multitude of reasons, happening with providers beyond the walls of our institution.
Representatives from our accountable care organization had requested a meeting to go over some issues they’ve been having with our practice, including low levels of usage …
Stop the patient leakage in primary care practices
For many, American football is a beautiful game that is simple to enjoy but complex to master. Choreographed with a mixture of artistry and brutality, it features the occasional “big hit” or bone-jarring tackle, forcing a fumble and turning the tide of the game.
But with this part of football comes justified concern about the long-term health effects of engaging in this type of activity over time, concerns that abound in …
Concussions and CTE are more complicated than even the experts know
My older sister, Jan, visited me in San Francisco last spring. “You look great,” I told her, noticing that her clothes were hanging loose; she’d been heavy most of her life. “I’ve lost 60 pounds,” she said, and I automatically congratulated her.
“I wasn’t trying,” she replied.
It hit me then that something was very wrong, first with …
Can doctors see beyond a patient’s weight?
A guest column by the American College of Physicians, exclusive to KevinMD.com.
In April, the American College of Physicians (ACP) released a position paper titled Putting Patients First by Reducing Administrative Tasks in Health Care, published in the Annals of Internal Medicine. The paper, part of ACP’s Patients Before …
Improving physician satisfaction by eliminating unnecessary practice burdens
The patient looked at me and said that he did not remember the name of the specialist, only that she was a “woman doctor.” As this was completely unhelpful, I pondered the fact that a doctor who was male is never referred to as a “man doctor.” Why is it that woman physicians need the added label, as if the norm is a doctor who is supposed to be a …
Is the end of disparities in medicine near?
Last November, we wrote an op-ed for STAT, as medical students, lamenting how politicized our future profession has become in recent years. In the aftermath of a divisive election that we argued may well have been a “referendum on the Affordable Care Act,” we implored policymakers and other stakeholders to take politics out of health care before attempting to reform it. We believe that partisanship has infected …
The vision forward for health care should be bipartisan
Last month, thousands of medical students donned their white coats as they took their first steps into hospitals nationwide to begin clinical rotations. This marks an important transition from the classroom into an actual inpatient setting to demonstrate the knowledge they’ve accumulated over the past two years. For most students, this means pretending to hear and correctly identify heart and breath sounds while agreeing with whatever the attending says. During …
10 things that weren’t advertised to me before I started medical school
Owning a business is not some pie in the sky deal where you take a phone call when you make the turn at the country club every day. The public at large, however, thinks that is exactly what business owners do.
Owners are the people that collect money while others work right? They are rich people that just happened to be rich, so they bought a business for other people to …
Traditional private practice needs to change
I am an interventional pain physician. I spend most of my days doing spine injections with a fair amount of kyphoplasties and spinal cord stimulators thrown in as well. It seems to me that these are minor procedures that shouldn’t evoke anxiety in patients, but they do. Patients get nervous. They get anxious.
I am also a singer. I had the privilege of being classically trained through my college years. Like …
This doctor sings to her patients. And the results are beautiful.
There is a feeling that you get when you’re out at a dinner party standing and smiling at strangers as they walk by you — a temptation to rest on the “wow” factor of your medical training. Partly because peacocking is inherent to social events such as these, but partly because you fear that you’re inherently boring to people outside your field. The surest way, you think, is to announce …
A medical student confronts life outside the hospital
A tired but beaming mom greeted me as I entered the room. In her lap was a content appearing, slightly chubby, cherubic faced baby.
“This is Caleb … isn’t he beautiful” mom gushed. “He is named after his dad …” but then added in a softer voice, “but I’m not sure how much he plans to be involved.” Mom’s smile waned for a moment but quickly came back. “Looking forward to …
Why a pediatrician does what he does: Lessons from Caleb
I had a great day in the office today. Not that I came up with any brilliant diagnosis nor cured anyone. I was able to just be a physician. No time wasted on the phone with insurance companies. No prior authorizations to do. It was a reminder of how much I love my job. I love my actual job — the one I trained for — being a physician. Listening …
Our noble profession is being destroyed by legislators and administrators
In an era of increasing transparency in medicine, the Centers for Medicare & Medicaid Services (CMS) has been publishing data annually on payments to individual physicians since 2014. The database, officially called the Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File, has been a window (albeit a cracked and opaque window) into the practice patterns and reimbursement of individual physicians.
It includes most payments for services …
Compare your own practice patterns to the national average. Here’s how.
Medical and surgical research is breaking boundaries at an astounding pace. From genetic modification and stem cell therapy to robotic and 3-D printing technology, scientific advancement is finding novel, unique and unprecedented solutions to complex, challenging diseases. Indeed, such is the rate of change that I am certain the last eight years of my surgical training in the UK will likely be rendered obsolete within the next twenty years of …
This frontier of medicine and surgery has been largely ignored for many years
