KevinMD.com

February 15, 2017Feb 15, 2017

G1P0 or Gravida 1, Para 0. Well, turns out that’s me. It’s very common in the medical field to use this phrase to describe women who have been pregnant but do not have any living children. This could have been due to miscarriage or worse yet, intrauterine fetal demise at later staged pregnancies. Or it could be due to an elective termination. For me, it was the latter.

I had never …

Health Technology

3 reasons why health care IT will always be terrible

Suneel Dhand, MD

February 15, 2017Feb 15, 2017

One of the topics I write most about and have also done a considerable amount of consulting work on is improving and optimizing health care information technology. I hate to say it, but after a few years of doing this, I’m starting to despair a little from what I’m seeing. It’s a question I never thought I’d ask: But will health care IT ever really get to where it should …

Medications

The reckoning of medicine in the post-fact world

Anonymous

February 15, 2017Feb 15, 2017

“Our son doesn’t get the flu shot, no one in our family does,” she said, with some emphasis on the "no one," inviting me to take a swing. Anticipating futility, I reminded myself that our pediatrics clinic was already forty-five…

“Our son doesn’t get the flu shot, no one in our family does,” she said, with some emphasis on the “no one,” inviting me to take a swing. Anticipating futility, I reminded myself that our pediatrics clinic was already forty-five minutes late. This was a scrap better deferred.

“Alright,” I said flatly as I moved on with the encounter. This was of course not explicitly, but indeed, implicitly, approving the mother’s …

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Physician

Why the physician workforce needs to be rejuvenated

Walker Ray, MD and Tim Norbeck

February 14, 2017Feb 14, 2017

U.S. physicians continue to struggle to maintain morale levels, adapt to changing delivery and payment models, and provide patients with reasonable access to care. This finding from our biennial physician survey reverberated amongst the members of the Physicians Foundation. But what amazed us the most were the over 10,000 physicians who took the additional time to provide written comment on the concerns they felt most passionate about. That act alone demonstrates …

Physician

How much are patients to blame for ER overuse?

Sam Slishman, MD

February 14, 2017Feb 14, 2017

The U.S. rings the bell on health care spending, and some point fingers at patients themselves. But why do patients choose the paths they choose? Just about every shift, I and my coworkers shake our heads, and wonder what may…

The U.S. rings the bell on health care spending, and some point fingers at patients themselves.

But why do patients choose the paths they choose? Just about every shift, I and my coworkers shake our heads, and wonder what may be driving our patients’ decisions. Parents who haven’t yet tried a drop of acetaminophen bring kids in at 2 a.m. with fevers. Patients show up with nose bleeds that …

Health Policy

Here’s what’s really scary about Trump’s health care

Margalit Gur-Arie

February 14, 2017Feb 14, 2017

It has come to pass: President Donald J. Trump. Are you scared? Are you planning to “resist” the policies you imagine President Trump will pursue by tweeting furiously with clever hashtags galore? Would you prefer to move my fastidious quotation marks from “resist” to “President”? This is, after all, the first President in a very long time to take office without the blessings and financial support of established “world order” …

Physician

The blame game: It’s not alright to blame the patient

Nancy Collins, PhD, RDN

February 14, 2017Feb 14, 2017

Most of the lawsuits I deal with have more than one named defendant. For example, the plaintiff (typically a deceased patient’s next of kin) might sue a hospital, a nursing home, and the attending physician at each facility. Sometimes they go a bit further and may even include the administrator, the director of nursing, and individual HCPs, such as the wound care nurse or the registered dietitian nutritionist.

When a lawsuit …

Physician

4 reasons why being a doctor is worth it

Jean Robey, MD

February 14, 2017Feb 14, 2017

2016 closed around a continued effort to "salvage" the medical profession's reputation, but the notion that it's broken continues to be counterproductive. The brightest students, for example, question the long journey and delayed gratification being a physician entails. They do…

2016 closed around a continued effort to “salvage” the medical profession’s reputation, but the notion that it’s broken continues to be counterproductive.

The brightest students, for example, question the long journey and delayed gratification being a physician entails. They do the math and continue to engage in other professions that are medical but not specifically Medical Doctorate degrees or Doctor of Osteopathic degrees. These same students conclude there is no longer …

Physician

Stories matter in today’s world

Mary Pan, MD

February 14, 2017Feb 14, 2017

As I struggle with how best to respond to recent events, one thing has become clear to me: narrative matters. People’s stories matter. Words and how they are presented in written and spoken form matter. I am just a mother, just a doctor, just a writer. My daily life consists of changing diapers, getting my kids to school, managing diabetes in my patients, picking up scattered toys, treating depression, doing …

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Stories matter in today’s world

Medical Education

Words of wisdom for new nurses

Debbie Moore-Black, RN

February 13, 2017Feb 13, 2017

Welcome to the land of happiness, sadness, confusion, self-doubt, defeat and heroism. You have only just begun. This is not an easy job. And countless times you will say, "What was I thinking?" Or "Why did I do this?" But…

Welcome to the land of happiness, sadness, confusion, self-doubt, defeat and heroism. You have only just begun. This is not an easy job. And countless times you will say, “What was I thinking?” Or “Why did I do this?”

But it’s not really a job. It is a lifelong sentence. It can be insanely gratifying, or you can throw in the towel.

But be patient. It will consume you, and you will …

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Words of wisdom for new nurses

Physician

Medical errors are not the third leading cause of death

Cory Fawcett, MD

February 13, 2017Feb 13, 2017

I read it again this week, and I wonder why the editors of our medical journals continue to perpetuating this falsehood. An article in a prominent journal stated again that medical errors are the third leading cause of death in the United States. We all know this is not the case, and yet editors continue to let this be stated in their journals as if it were fact.

Ever since the …

Physician

Making medical decisions without accountability

Gene Uzawa Dorio, MD

February 13, 2017Feb 13, 2017

A pediatrician decides a struggling teen with mental illness needs hospitalization to neutralize psychologic demons impacting their personal and social life. A workers’ compensation doctor requests a neck MRI in a powerline worker with growing right arm numbness and weakness…

A pediatrician decides a struggling teen with mental illness needs hospitalization to neutralize psychologic demons impacting their personal and social life.

A workers’ compensation doctor requests a neck MRI in a powerline worker with growing right arm numbness and weakness to search for potential paralyzing nerve impingement.

An orthopedist orders special testing to determine if an elder patient with right hip pain which limits walking and driving might need surgery to improve …

Physician

The big picture is critical, but so are the details

Hans Duvefelt, MD

February 13, 2017Feb 13, 2017

When I read a case report in a journal or whenever a patient comes in to see me about a new symptom, all my senses are tuned in, and I know there is a diagnosis to be made. But on…

When I read a case report in a journal or whenever a patient comes in to see me about a new symptom, all my senses are tuned in, and I know there is a diagnosis to be made.

But on regular clinic days with “routine” follow ups, I find myself not being as tuned in as I would like to be. I know my patients well; we are all growing older …

Physician

Immigrants make America great

Alexi Gharib Nazem, MD, MBA

February 13, 2017Feb 13, 2017

In 1949, my maternal grandparents left everything and everyone they knew -- a happy family, a comfortable home, a thriving medical practice -- to travel further across the Earth than any of their family ever had before, to come through…

In 1949, my maternal grandparents left everything and everyone they knew — a happy family, a comfortable home, a thriving medical practice — to travel further across the Earth than any of their family ever had before, to come through Ellis Island, and to trek to the Mayo Clinic so my grandfather could become a pioneering anesthesiologist.

Twenty-one of my aunts, uncles, and cousins have since followed in their footsteps and …

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Immigrants make America great

Physician

We need to start talking about what comes after physician burnout

Anonymous

February 12, 2017Feb 12, 2017

I burned out, big and bad. I can see that now. My practice environment had become gradually untenable and every attempt I made to change it was blocked. My call schedule was inflexible and a lot more frequent than when I started my job. The hospitalists and ED kept sending me cases I didn’t feel qualified to manage, but as it was usually the middle of the night and I …

Physician

Why don’t more doctors hire coaches?

Maiysha Clairborne, MD

February 12, 2017Feb 12, 2017

The benefits of coaching have long been shown in research, yet is widely underused in the physician community. For decades, executive coaching has been used to in the corporate world for executives, and their teams to increase efficiency and performance. Business and marketing coaching frequently used by small business professionals helps grow and expand their business. Wellness and life coaching is frequently used by individuals to improve balance and well-being. …

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Why don’t more doctors hire coaches?

Medical Education

Why it’s important to talk about mental wellness in medical school

Eric Peeler

February 12, 2017Feb 12, 2017

Why do I think it is important to discuss mental wellness in regards to medical school? Because a publication from December 2016 says 27.2 percent of medical students demonstrate depression or depressive symptoms and 11.1 percent indicate suicidal ideation. Because a 2015 publication says 28.8 percent of resident physicians experience depression or depressive symptoms. Most of these people suffer silently. Too afraid to speak up because others might see them …

Medical Education

Your doctors may be lying about how long they worked today

Christopher Lee Bennett, MD

February 11, 2017Feb 11, 2017

America’s resident physicians have strict limits on how many hours they can work in the hospital. Many break that limit and keep quiet about it. Others lie. Resident physicians are the doctors-in-training that millions of Americans come into contact with…

America’s resident physicians have strict limits on how many hours they can work in the hospital. Many break that limit and keep quiet about it. Others lie.

Resident physicians are the doctors-in-training that millions of Americans come into contact with at teaching hospitals across the country. We work for three to seven years (it depends on the medical specialty) …

Physician

Be careful of the labels we assign our patients

Ethan L. Bernstein, MD

February 11, 2017Feb 11, 2017

Reducing the essence of a human being to a single sentence is impossible, but in taking care of patients, we doctors do it all the time The one-liner attempts to summarize an individual and an illness into a single, typically…

Reducing the essence of a human being to a single sentence is impossible, but in taking care of patients, we doctors do it all the time

The one-liner attempts to summarize an individual and an illness into a single, typically run-on, sentence to expedite communication. It is a thesis statement for your diagnosis. Word choice and omission are critical. By the end of this thesis statement, your audience, in spite of …

Real physician voices, twice a week

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