KevinMD.com: Social media’s leading physician voice
The KevinMD newsletterReal physician voices, twice a weekFree, and one click to unsubscribe.
Subscribe free →
NEWExperts by KevinMDPhysicians and health care experts, by specialty.Amir FriedmanPain physicianJenny ShieldsClinical psychologistJill BeckerAddiction physicianMichael C. LucianoFamily physicianSteven E. WarrenLongevity physicianPaul PenderOphthalmologistCurtis G. GrahamObstetrician-gynecologistSameen FarooqInternistLori NelsonPhysiatristAngelika LuehrsConsultant psychiatristAli NovitskyObesity medicine physicianAlexandro VasquezNurse practitionerPaul HainPediatricianMelina MessingImmunologistSteve KaplanTechnology executiveNathaniel AranaHealth care CEOKaran KanwarTechnology CEOLianne MandelbaumAirline allergy advocateBrowse experts

Emergency medicine

2,327 articles · Since 2004

Articles, page 67

Physician voices

Emergency medicine: What is it exactly today?

10

I'm not old enough, in emergency medicine years, to identify with the struggle of those calling for the end of the term “ER.” The argument was about the “R” vs. the “D”: "It's not a room!” It’s a department!” was…

I’m not old enough, in emergency medicine years, to identify with the struggle of those calling for the end of the term “ER.”  The argument was about the “R” vs. the “D”: “It’s not a room!”  It’s a department!” was the war cry.  Then perceptions changed, battles were won, and along came the very popular TV show, “ER.”  The war hawks quieted …

Read more…

Emergency medicine: What is it exactly today?

Physician voices

The baby had a seizure: Why was the mother smiling?

9

My first night shift in a stretch of 7 was almost over. It was 6:15am and I had to keep moving otherwise the minute I would stop, my eyelids would drop like two ton shades and I’d fall asleep. That…

My first night shift in a stretch of 7 was almost over.  It was 6:15am and I had to keep moving otherwise the minute I would stop, my eyelids would drop like two ton shades and I’d fall asleep.  That never makes for a good drive home after a night shift.

“Got time to see one more?” asked Jenny the nurse.

“Do I have …

Read more…

The baby had a seizure: Why was the mother smiling?

Physician voices

What happens if the doctor isn’t sure?

An excerpt from When Doctors Don't Listen: How to Avoid Misdiagnoses and Unnecessary Tests. One Friday, Jerry got the scare of his life. Jerry is a 48-year old mechanic who is in good health. His parents are healthy, and he…

An excerpt from When Doctors Don’t Listen: How to Avoid Misdiagnoses and Unnecessary Tests.

One Friday, Jerry got the scare of his life.

Jerry is a 48-year old mechanic who is in good health. His parents are healthy, and he recently got a “clean bill of health” during his annual check-up. Over the weekend, he helped his brother move across town. Monday morning, he woke with tightness in his chest. He …

Read more…

What happens if the doctor isn’t sure?

Real physician voices, twice a week

Free, and one click to unsubscribe.

No spam. We never share your email.

Health technology

Technology is being held back from transforming healthcare

12

Right now, the technology exists to completely transform healthcare. A doctor should be able to walk into the room where a patient is waiting for them and get everything they need to make an informed decision about that patient’s care.…

Right now, the technology exists to completely transform healthcare.

A doctor should be able to walk into the room where a patient is waiting for them and get everything they need to make an informed decision about that patient’s care.

Location-based technology should sense the doctor approaching and already know which patient is waiting for them. A computer or a tablet in the room should have access to thousands of data points …

Read more…

Technology is being held back from transforming healthcare

Physician voices

Why the American problem with opioids and chronic pain is here to stay

39

America consumes 80% of the world opioid supply (99% of the world hydrocodone supply), but has about 5% of the world’s population. If you don’t think America has some kind of opioid problem, then move along because this rational, evidence-based,…

America consumes 80% of the world opioid supply (99% of the world hydrocodone supply), but has about 5% of the world’s population. If you don’t think America has some kind of opioid problem, then move along because this rational, evidence-based, experience-laden way in which I’m going to discuss opioid use and misuse will not interest you.

To combat our opioidification the …

Read more…

Why the American problem with opioids and chronic pain is here to stay

Physician voices

Is the goal of patient satisfaction to make patients happy?

9

The link to a recent article in Forbes magazine entitled, "Why Rating Your Doctor is Bad for Your Health" keeps showing up in my inbox with the subject, “thought you would find this interesting.” The reason is because I’m responsible…

The link to a recent article in Forbes magazine entitled, “Why Rating Your Doctor is Bad for Your Health” keeps showing up in my inbox with the subject, “thought you would find this interesting.” The reason is because I’m responsible for overseeing education and training related to physician communication and patient satisfaction for a large national hospitalist practice.

The article isn’t so much interesting as it is unfortunate.  Its …

Read more…

Is the goal of patient satisfaction to make patients happy?

Physician voices

6 tips for getting your doctor to listen to you

15

Have you ever gone to the doctor and felt like he wasn't listening to you? Have you tried to tell your story, only to have him interrupt with a checklist of questions: do you have chest pain, shortness of breath,…

Have you ever gone to the doctor and felt like he wasn’t listening to you? Have you tried to tell your story, only to have him interrupt with a checklist of questions: do you have chest pain, shortness of breath, fevers, cough, and so forth? Have you ever felt ignored, and left thinking that your doctor never understood why came to him in the first place?

Studies show that …

Read more…

6 tips for getting your doctor to listen to you

Physician voices

You’re still a doctor, even if you’re not on call

34

Christmas morning at 1:30 am the phone chimes away. What the … I’m not on call. “Please call Dr. Dred for patient Selma, perforated colon at local ER,” read the text message. Why are they calling me, I’m not on…

Christmas morning at 1:30 am the phone chimes away. What the … I’m not on call.

“Please call Dr. Dred for patient Selma, perforated colon at local ER,” read the text message.

Why are they calling me, I’m not on call. Dr. Young is. Maybe something’s happened and they can’t find him.

So, I called. It was just as reported. There was a fifty year old female with abdominal pain for three days, …

Read more…

You’re still a doctor, even if you’re not on call

Physician voices

A patient cheats death and changes two lives

2

Throughout the course of my career I have probably been with hundreds of people as they transitioned into and out of death. Although I am familiar with what this journey looks like, I have not yet been privy to the…

Throughout the course of my career I have probably been with hundreds of people as they transitioned into and out of death. Although I am familiar with what this journey looks like, I have not yet been privy to the journey myself. Rarely though, I have had the pleasure of listening to someone who has journeyed back from death and arrived with a story to tell. Regardless of your position …

Read more…

A patient cheats death and changes two lives

Physician voices

When patients feel trapped by doctors and the medical system

11

An excerpt from When Doctors Don't Listen: How to Avoid Misdiagnoses and Unnecessary Tests. Danielle is a 20-year old college student at the New England Conservatory. She came to the ER because of a headache. When she woke up this…

An excerpt from When Doctors Don’t Listen: How to Avoid Misdiagnoses and Unnecessary Tests.

Danielle is a 20-year old college student at the New England Conservatory. She came to the ER because of a headache. When she woke up this morning, her head hurt badly. Her mouth was dry, and when she tried to get up to go to the bathroom, she felt like she was getting faint.

She attributed all …

Read more…

When patients feel trapped by doctors and the medical system

Physician voices

Will Mayor Bloomberg win the war on prescription drug abuse?

2

Recently, there was a bit of hue and cry regarding Mayor Bloomberg's report on the matter of prescription drug abuse and restrictions on new prescriptions for painkillers through the emergency department. Initially, I was concerned. I completely agree with the…

Recently, there was a bit of hue and cry regarding Mayor Bloomberg’s report on the matter of prescription drug abuse and restrictions on new prescriptions for painkillers through the emergency department.

Initially, I was concerned. I completely agree with the comment from the linked article: “Here is my problem with legislative medicine,” said Dr. Alex Rosenau, president-elect of the American College of Emergency Physicians … “It prevents me …

Read more…

Will Mayor Bloomberg win the war on prescription drug abuse?

Health policy

What is observation care? Clearing up common misperceptions

3

To treat observation care as simply a loophole that allows hospitals to avoid the Medicare penalties from readmissions -- as Brad Wright, an assistant professor of health management and policy at the University of Iowa did earlier this month --…

To treat observation care as simply a loophole that allows hospitals to avoid the Medicare penalties from readmissions — as Brad Wright, an assistant professor of health management and policy at the University of Iowa did earlier this month — is to take a short-sighted approach to a complex health issue.

Observation care in fact aims to address several of healthcare’s thorniest challenges head on. In the process, …

Read more…

What is observation care? Clearing up common misperceptions

Physician voices

The cost of blaming doctors for prescription drug abuse

10

An article written by two physicians in Time questions whether we should blame doctors for the large number of chronic pain patients and the abuse of prescription pain medications. There are two frames of reference to this article. First, no…

An article written by two physicians in Time questions whether we should blame doctors for the large number of chronic pain patients and the abuse of prescription pain medications.

There are two frames of reference to this article.

First, no one can argue that prescriptions for pain medications in this country are excessive. The article notes that in 2011, “enough …

Read more…

The cost of blaming doctors for prescription drug abuse

Physician voices

The culture of ruling out leads to misdiagnosis

16

May is a recent divorcee in her early sixties. She was working out at the gym when she began to feel queasy and lightheaded. She awoke in the back of an ambulance, and soon, she was in an ER getting…

May is a recent divorcee in her early sixties. She was working out at the gym when she began to feel queasy and lightheaded. She awoke in the back of an ambulance, and soon, she was in an ER getting blood drawn. “We need to make sure you don’t have a heart attack,” she was told.

As the day went on, May underwent test after test to “rule …

Read more…

The culture of ruling out leads to misdiagnosis

Physician voices

Dear hospitalists, we emergency physicians appreciate you

33

Dear hospitalists, This is just a note to say that we, in emergency medicine, appreciate you. Like all of us, you are stuck in an endless loop of unending residency. Don’t worry, it isn’t an episode of The Twilight Zone.…

Dear hospitalists,

This is just a note to say that we, in emergency medicine, appreciate you.  Like all of us, you are stuck in an endless loop of unending residency.  Don’t worry, it isn’t an episode of The Twilight Zone.  It’s just your life.  No, it’s our life!

As specialty after specialty withdraws from the practice of medicine, you, and all of us, …

Read more…

Dear hospitalists, we emergency physicians appreciate you

Physician voices

Dealing with psychological stress of being a doctor

7

Chatting with some med students, a good question was raised: how do we, as doctors, deal with the emotional baggage we encounter in our profession? It's high stress, we see disturbing things, and sometimes we make mistakes that can result…

Chatting with some med students, a good question was raised: how do we, as doctors, deal with the emotional baggage we encounter in our profession? It’s high stress, we see disturbing things, and sometimes we make mistakes that can result in harm to patients. The pressure and responsibility can be very hard to handle.

These stresses, if unmanaged or poorly managed, can …

Read more…

Dealing with psychological stress of being a doctor

Medical education

The strong tradition of mentorship is unique to medicine

2

A friend was working an overnight shift in the ER for one of her mandatory rotations, so I popped in to observe. The ER was surprisingly quiet. A classmate was also observing that night, and like me, he was standing…

A friend was working an overnight shift in the ER for one of her mandatory rotations, so I popped in to observe. The ER was surprisingly quiet. A classmate was also observing that night, and like me, he was standing around, bored. We spotted an electrocardiogram (EKG) readout lying on a desk where a resident was working, and we asked him …

Read more…

The strong tradition of mentorship is unique to medicine

Physician voices

One fight that the patient wished he could lose

3

He used to be a boxer. Those days were long-gone, though. Now he was a shell of his former self. The hands that formerly knocked opponents to the mat were now contracted and full of arthritis. Dementia had taken away…

He used to be a boxer.

Those days were long-gone, though.

Now he was a shell of his former self.

The hands that formerly knocked opponents to the mat were now contracted and full of arthritis. Dementia had taken away his ability to tell the stories about his career. Metastatic lung cancer ravaged his body. Multiple bed sores ate away at his sacrum and …

Read more…

One fight that the patient wished he could lose

Health policy

After Sandy: Change needs to go beyond traditional disaster planning

Not long after posting a recent column which, admittedly, was somewhat critical of healthcare providers in and around New York City following Super Storm Sandy, I decided to get a clearer picture from someone intimately connected to the disaster –…

Not long after posting a recent column which, admittedly, was somewhat critical of healthcare providers in and around New York City following Super Storm Sandy, I decided to get a clearer picture from someone intimately connected to the disaster – my own brother.

A few months ago, Ira Nash, MD, was appointed Medical Director for Physician and Ambulatory Network Services at North Shore Long Island Jewish Health System (NSHS), a …

Read more…

After Sandy: Change needs to go beyond traditional disaster planning

Physician voices

Towards patient and family centered care: Bridging the gap

How can hospitals and clinics deliver care that is patient and family centered? As an emergency physician, I’ve often pondered this question after my mother died of an untreated systemic infection in an out-of-state hospital. The experience, which I write…

How can hospitals and clinics deliver care that is patient and family centered? As an emergency physician, I’ve often pondered this question after my mother died of an untreated systemic infection in an out-of-state hospital. The experience, which I write about in the January 1 edition of the Washington Post as well as the December issue of Health Affairs, convinced me that healthcare still has room to grow …

Read more…

Towards patient and family centered care: Bridging the gap

81
pages