KevinMD.com: Social media’s leading physician voice

The KevinMD newsletterReal physician voices, twice a weekFree, and one click to unsubscribe.
Subscribe free →

Medical Education

How medical students can game Match Day

On March 17 at noon, about 18,000 medical students will open envelopes telling them where they will spend the next several years of their lives. It’s residency Match Day, and for many, that letter is one of the most important…

STAT_LogoOn March 17 at noon, about 18,000 medical students will open envelopes telling them where they will spend the next several years of their lives. It’s residency Match Day, and for many, that letter is one of the most important they will ever receive.

The process is supposed to be straightforward. Medical students, like me, submit applications to hospitals and health …

Read more…

How medical students can game Match Day

Conditions and Diseases

MKSAP: 67-year-old man with primary hyperparathyroidism

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 67-year-old man is evaluated for a recent diagnosis of primary hyperparathyroidism after an elevated serum calcium level was incidentally detected on laboratory testing.…

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

A 67-year-old man is evaluated for a recent diagnosis of primary hyperparathyroidism after an elevated serum calcium level was incidentally detected on laboratory testing. Medical history is significant only for hypertension, and his only medication is ramipril.

On physical examination, temperature is 35.8 °C (96.4 °F), blood pressure is 120/68 mm Hg, pulse rate …

Read more…

MKSAP: 67-year-old man with primary hyperparathyroidism

Physician

Why being a female physician matters

A recent publication in JAMA Internal Medicine clearly demonstrated that female physicians were able to provide better care when compared with their male counterparts. Researchers from Harvard University studied the relationship between physician sex and 30-day mortality and readmission rates…

A recent publication in JAMA Internal Medicine clearly demonstrated that female physicians were able to provide better care when compared with their male counterparts. Researchers from Harvard University studied the relationship between physician sex and 30-day mortality and readmission rates of over 1.5 million Medicare patients between the year of 2011 and 2014. What they discovered was that female physicians had lower mortality and readmission rates …

Read more…

Why being a female physician matters

Real physician voices, twice a week

Free, and one click to unsubscribe.

No spam. We never share your email.

Physician

What this physician learned from a medical mission

In August of 1991, I became a family practitioner in the United States Air Force and was sent to Clark Air Force Base in the Philippines. During my time there, I was asked to go on a medical mission. This…

In August of 1991, I became a family practitioner in the United States Air Force and was sent to Clark Air Force Base in the Philippines. During my time there, I was asked to go on a medical mission. This experience struck me with the missionary bug to provide my talents and to care for others in another country. With medications that were near expiration date in USAF stock and …

Read more…

What this physician learned from a medical mission

Health Technology

EMRs are dangerous. Let’s change that.

The SOAP note isn’t what it used to be. And what it has become needs to be scrapped, because it has made the office practice of medicine cumbersome and unsafe. In simpler times, when medical records were written by and…

The SOAP note isn’t what it used to be. And what it has become needs to be scrapped, because it has made the office practice of medicine cumbersome and unsafe.

In simpler times, when medical records were written by and for doctors, the SOAP note represented a significant leap forward in expanding and organizing office notes and also notes from emergency rooms and walk-in clinics. Before that notes sometimes only documented …

Read more…

EMRs are dangerous. Let’s change that.

Physician Finance

Debt should have an ICD-10 code

Debt is destroying the lives of doctors everywhere. The cost of getting an education has moved into the ridiculous range. Many doctors are now starting their practice so far in the hole, that they do not see the way out.…

Debt is destroying the lives of doctors everywhere. The cost of getting an education has moved into the ridiculous range. Many doctors are now starting their practice so far in the hole, that they do not see the way out.

I would not have been able to start on my debt-free journey (I peaked at more than $600,000) if I had not developed a new attitude toward debt. Putting debt into …

Read more…

Debt should have an ICD-10 code

Medical Education

I’m retired, but I’m disgusted with medical schools. Here’s why.

The year was 1976. I was graduating from a small branch of my state university with a bachelor's in chemistry when I first applied to medical school. I was living at home and paying my own tuition. There were no…

The year was 1976. I was graduating from a small branch of my state university with a bachelor’s in chemistry when I first applied to medical school. I was living at home and paying my own tuition. There were no physicians in my family, but I became interested in medicine after I was impressed with a surgeon who had operated on my shoulder. I had a better-than-the-medical-school-acceptance-rate average on my …

Read more…

I’m retired, but I’m disgusted with medical schools. Here’s why.

Physician

The one last thing he experienced before he died

An excerpt from Five Moments: Short Works of Fiction. “Dad ... you can let go now.” Thomas heard his daughter’s voice from a distance. It awakened him from his reverie. He relived those five moments of life and took their…

An excerpt from Five Moments: Short Works of Fiction.

“Dad … you can let go now.”

Thomas heard his daughter’s voice from a distance. It awakened him from his reverie. He relived those five moments of life and took their lessons seriously.

  1. Rejoice in the ordinary as if you were a child seeing everything for the first time.
  2. Unconditional love can lift you up.
  3. Forgive yourself over and over again.
  4. No …

    Read more…

The one last thing he experienced before he died

Physician

It’s time to fight against outdated gender stereotypes

We are writing to condemn James Green’s letter “Equal Pay for Women has Consequences” in which he suggested women be paid less than men as a matter of “simple economics.” This letter is heavily laden with bias against both women…

(This letter was jointly written by members of the American Association of Women Emergency Physicians.)

We are writing to condemn James Green’s letter “Equal Pay for Women has Consequences” in which he suggested women be paid less than men as a matter of “simple economics.” This letter is heavily laden with bias against both women and men. The assumption that men need to …

Read more…

It’s time to fight against outdated gender stereotypes

Physician

A letter from a grateful physician to his patients

To my beloved patients and your families, Over the years, it has been an incredible experience and honor to be allowed to enter into your world. It is a world that I know few people are privy to, and it…

To my beloved patients and your families,

Over the years, it has been an incredible experience and honor to be allowed to enter into your world. It is a world that I know few people are privy to, and it is an intimate world where the deepest questions about life tend to arise. I know that when you are confronted with sickness that leads you into this world, it can be …

Read more…

A letter from a grateful physician to his patients

Physician

High medical costs? Blame the insurance industry.

After writing about the coming demise of the Affordable Care Act, I began to think, again, about why it costs so much to deliver health care in this country. If it were cheaper, legislation to make health care a right,…

After writing about the coming demise of the Affordable Care Act, I began to think, again, about why it costs so much to deliver health care in this country. If it were cheaper, legislation to make health care a right, rather than the randomly distributed privilege it is now, would be so much easier.

Medical costs doubled every decade from 1960 through 2000. This happened in tandem …

Read more…

High medical costs? Blame the insurance industry.

Health Policy

Obamacare cost Hillary the presidency

A month into Donald Trump’s presidency, it is clear we are in for a wild and dizzying ride. As is typical in matters of opinion, post-mortem analyses on how we got here are frequent and varied. However, I believe the…

A month into Donald Trump’s presidency, it is clear we are in for a wild and dizzying ride.  As is typical in matters of opinion, post-mortem analyses on how we got here are frequent and varied.

However, I believe the Affordable Care Act was the iceberg which sunk Hillary Clinton’s ship.  Sure, there were both real and fabricated scandals which dampened enthusiasm among potential Clinton voters.  There were the emails.  There …

Read more…

Obamacare cost Hillary the presidency

Conditions and Diseases

Why aren’t women receiving appropriate genetic counseling?

A report in the Journal of the American Medical Association (JAMA) shows that too few women with recently diagnosed breast cancer and at high risk of a BRCA genetic mutation received appropriate genetic counseling. And that testing for the mutation…

A report in the Journal of the American Medical Association (JAMA) shows that too few women with recently diagnosed breast cancer and at high risk of a BRCA genetic mutation received appropriate genetic counseling. And that testing for the mutation is a missed opportunity not only to improve treatment for these patients but also to prevent some breast, Read more…

Why aren’t women receiving appropriate genetic counseling?

Physician

Retired at 37: Breaking up with a career in medicine

Leaving your career in medicine is like breaking up in a long term relationship. It may have all started out with lofty expectations, excitement about the future, and becoming your best self. However, somewhere along the way, things got messy…

Leaving your career in medicine is like breaking up in a long term relationship. It may have all started out with lofty expectations, excitement about the future, and becoming your best self. However, somewhere along the way, things got messy and twisted and not what you signed up for.

There were hiccups along the way, signs that maybe it wasn’t good for you. There was the time you fell asleep at …

Read more…

Retired at 37: Breaking up with a career in medicine

Physician

What I do for thirty seven dollars and five cents

The building contractor chatted pleasantly while I checked his blood pressure, waist circumference, cholesterol levels, fasting glucose and urine protein. We discussed bowel and prostate cancer screening in detail, and I gave him written information as we were out of…

The building contractor chatted pleasantly while I checked his blood pressure, waist circumference, cholesterol levels, fasting glucose and urine protein. We discussed bowel and prostate cancer screening in detail, and I gave him written information as we were out of time. As I signed his script for the blood pressure medication, he winked.

“That was easy money for you, wasn’t it?”

Thirty-seven dollars and five cents is the value the government places …

Read more…

What I do for thirty seven dollars and five cents

Physician

Doctors have to become greedy dogs to survive

I have only been able to make it back to my hometown once a year for many years now, but I recall my father having a very friendly dog many years back, a black Labrador mix named Abby. She was…

I have only been able to make it back to my hometown once a year for many years now, but I recall my father having a very friendly dog many years back, a black Labrador mix named Abby. She was well behaved, would stay in the yard if you let her outside, didn’t cause problems, and was great with children.

Then about ten years ago, another dog was added to the …

Read more…

Doctors have to become greedy dogs to survive

Physician

How this physician learned to cry

With thousands of cancers, thousands of families and thousands of deaths, I came to see deep time. I absorbed the finite nature of existence and gained a long view. Not just yesterday’s tests, today’s battle and tomorrow’s treatment, but the…

With thousands of cancers, thousands of families and thousands of deaths, I came to see deep time. I absorbed the finite nature of existence and gained a long view. Not just yesterday’s tests, today’s battle and tomorrow’s treatment, but the loss to come. I do not know when the reaper will arrive, but understand he will. I mourn each patient before we meet. I have learned not to cry.

Call it …

Read more…

How this physician learned to cry

Physician

This physician isn’t a victim. She’s a survivor.

If I have to hear, "There is always a third victim in these situations, don't forget to take care of yourself," one more time, I may go crazy. I wish people would be cognizant of the language they use. According…

If I have to hear, “There is always a third victim in these situations, don’t forget to take care of yourself,” one more time, I may go crazy.

I wish people would be cognizant of the language they use. According to the dictionary, a victim is, “a person who suffers from a destructive or injurious action or agency.”

Don’t call me a victim. I go home afterwards, completely broken by what just …

Read more…

This physician isn’t a victim. She’s a survivor.

Medical Education

The truth about Caribbean medical schools

Dear Dr. Wible, I want to fill you in on what really goes on behind the scenes at my medical school and maybe you can help inform other students about what happens here before they make a huge mistake. If…

Dear Dr. Wible,

I want to fill you in on what really goes on behind the scenes at my medical school and maybe you can help inform other students about what happens here before they make a huge mistake. If students slip through the cracks of a U.S. medical school, then international med schools in the Caribbean may be the next choice. Some have better residency match rates than others so …

Read more…

The truth about Caribbean medical schools

Health Policy

Obamacare was poorly constructed. The Republican plan is worse.

It won't work. Obamacare works for the poorest that have affordable health insurance because all of the program's subsidies tilt in their favor. Obamacare doesn't work well for the working and middle class who get much less support -- particularly…

It won’t work.

Obamacare works for the poorest that have affordable health insurance because all of the program’s subsidies tilt in their favor.

Obamacare doesn’t work well for the working and middle class who get much less support — particularly those who earn more than 400 percent of the federal poverty level, who constitute 40 percent of the population and don’t get any help.

Because so many don’t do well under the law, …

Read more…

Obamacare was poorly constructed. The Republican plan is worse.

1564
pages