A former ICU nurse and close friend told me tonight that she wanted to start the new year on a positive note. I nodded, trying to absorb her optimism, but deep down, it felt like an impossible belief to hold onto.
Earlier in the evening, I finished watching Selena: The Series on Netflix. Tears streamed down my face, not just for Selena but for all those whose greatness was taken too …
My father wanted me to get an MBA from the Harvard Business School, but I wanted to be a doctor, so I am more attuned to the MBA’s excellence in many areas but differences in ethical principles from medicine. Nowhere does maximizing returns for stockholders or returns for nonprofits also include the principles of beneficence and nonmaleficence for our patients. But this principle is foundational in medicine and has been …
Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes!
Join emergency physician Maureen Gibbons as they explore the concept of rethinking shift work in health care. They discuss how distributing shifts among multiple physicians can reduce burnout, enhance job satisfaction, and improve …
Emergency medicine is a career defined by its urgency, unpredictability, and intense human connection. But for those of us who work in the emergency department, it’s also a career shaped by the weight of the people we’ve cared for—the ones we’ve saved, the ones we’ve lost, and the ones whose stories stay with us long after our shifts end.
When I talk with colleagues about stepping back from clinical responsibilities, one …
I am a family physician by training, and I thank God every day for that foundation. About a decade ago, I transitioned to emergency medicine, thinking I’d left primary care behind. Back then, primary care problems—hypertension, diabetes, routine medication refills—would occasionally show up in the ER, but they weren’t the norm. Fast forward to today, and they’ve become a central part of my shift.
It’s not because people suddenly decided the …
Particularly over the last 10 to 20 years, medical care has been vertically integrated so that many of us—most of us—are now working for larger health conglomerates. As part of this transition, more and more of our management is professional, with MBAs or their health care equivalent, running our working environments and collecting our billings from which they generate our salaries.
The Economist, a British journal, tells us that in 2022, …
Emergency medicine is one of the most challenging and rewarding specialties in health care. We are required to be clear-headed enough to make quick decisions while sleeping when we can, hugging our families while we can, and forming unshakable bonds with our colleagues over shared triumph and tragedy.
For many emergency physicians, these challenges come at the expense of their own health and well-being, yet we don’t see it. At least …
Though many of the dollar-driven decision makers within health care would have us believe otherwise, we can’t AI, blood tests, or high-tech image our way out of our current U.S. health care mess. I learned this from having spent 40 years as a board-certified emergency physician and 50+ years as a chronic autoimmune disease patient. We must overtly acknowledge that all three of the above are simply supplemental tools. They …
The emergency room is my domain. As a paramedic and a PA, I have spent much of my life in and out of emergency rooms—maybe more time in ERs than at home over 40 years in this business. Yet, let me say I am not a fan of ERs for many reasons, mainly due to the providers who seem to staff them. Beyond the nurses’ and the providers’ jabs of …
If you make a wrong turn and end up in the heart of it all, there’s a light brown hue over things. The leftover mud. Sometimes on the trees. Other times on the asphalt. Up the rock walls while driving. A reminder that destruction happened here.
If you make a wrong (or right) turn, you can see piles of wreckage. An office chair. Metal debris. Plastic things. Relief and aid workers …
When a 26-year-old male with a history of tracheostomy arrived in our emergency department, the case appeared routine—until we uncovered an unusual detail. The patient’s sister had recently changed his tracheostomy tube at home but noticed something concerning afterward: the terminal piece, or the distal end of the tube, was missing. Despite searching, the piece couldn’t be found. This immediately raised concerns that it might be lodged within his trachea, …
Too often, language and cultural barriers prevent diverse immigrant patients from receiving the quality treatment they deserve. Hospitals frequently fail to provide basic translation services that are efficient and culturally complementary for immigrant patients or fail to train health care professionals on how to incorporate these services into treatments. This lack of proper care for immigrant patients is a discriminatory, biomedical issue that robs them of their voice and rights.
Imagine: …
For the second time in my life I visited the ER. I woke up early yesterday morning with unremitting, 7.8/10 left lower back pain accompanied by chills, nausea, and vomiting. Why 7.8? Well, I definitely could have imagined pain worse than an 8, but it seemed bad enough to go to the ER, so it surely must be worse than a 7, right? Just like all my patients, I have …
The war in Sudan, which began in April 2023, has created one of the world’s largest displacement crises, forcing more than 10 million people to flee their homes. The warring sides, the Sudanese Armed Forces and the Rapid Support Forces, are inflicting horrendous violence on people across the country. Hospitals have been attacked, markets bombed, and houses razed to the ground, leading to a catastrophic toll on the health of …
Today, most emergency departments (EDs) face overcrowding, high patient volumes and a strain on our increasingly limited staff and resources. As a result, the average patient experiences ED wait times of about two-and-a-half hours, with some reaching nearly four hours.
The possibility of sepsis makes these delays even trickier. More than one-third of all in-hospital deaths are attributed to sepsis, making it the Read more…
Continuous quality improvement undoubtedly contributes to the ongoing honing of best practices in medicine. This health care-specific parallel of total quality management programs in business helps us daily inch closer to the ultimate goal of eradicating patient harm. Health care professionals familiar with these variation-reducing processes are likely well-versed in the popular Ishikawa fishbone diagram. While the focus is intended to be spread across materials, processes, equipment, and …
The floods came and we were not ready. Miles from the ocean, flanked by mountainous sentinels, we never thought to build an ark.
The skies darkened and the deluge commenced. Rapturous winds splintered ancient oaks and rent open the heavens. Barbarous gusts cleaved power lines, fractured telephone poles, brought a power grid to its knees. The lights went out in the west. Feeble candlelights flickered to life as the rivers swelled. …
Walking through the narrow alleyways and past artisanal businesses in the Lake Atitlán region of the Guatemalan highlands, a swarm of children followed us as if we were a parade or a moving tourist attraction. As a global fellow through the Stanford Freeman Spogli Institute (FSI), I served as an interpreter and interviewer in this underserved region with extreme poverty a few …
Emergency department (ED) wait times are on the rise across the United States, a troubling trend that reflects deeper systemic challenges in the nation’s health care systems. According to data from the Centers for Medicare & Medicaid Services, the median time spent in the ED has increased from 2 hours and 15 minutes in 2018 to 2 hours and 40 minutes in recent years. Data from …
Get free updates delivered free to your inbox.
