Public Health & Policy

Full Medicaid expansion needed to retain Georgia’s physicians

Policy
September 26, 2024

Georgia was ranked 5th worst place to practice in a recent Medscape article (“Best and Worst Places to Practice 2024”), using five criteria: physician compensation, cost of living, malpractice premiums, the health of the state’s residents, and physician burnout levels. As current and future physicians and health advocates, this column will add context by detailing our experiences practicing in Georgia.

The article identified challenges that Georgia physicians encounter. Particularly concerning is …

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Climate change is exacerbating diseases in vulnerable populations in America and abroad

Policy
September 17, 2024

As climate change advances, it has amplified a variety of diseases globally, especially in under-resourced countries and communities. This article summarizes three of these consequential trends. The first is that wildfires and industrial pollution are worsening respiratory diseases. Second, hotter climates are increasing the incidence of infectious diseases such as malaria, and lastly, heat waves are increasing the risk of various diseases, disrupting public services, and causing unprecedented amounts of …

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Why is our health care system going down the drain and no one seems to care?

Policy
September 12, 2024

I want to express my frustration with the state of health care in the United States, particularly in the context of my own experiences within the system. Over the past 12 years, I have submitted articles to KevinMD advocating for quality patient care and fair working conditions for health care professionals. I have urged hospital administrators to reevaluate their operations to improve patient and staff satisfaction and the overall efficiency …

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The hidden estate tax: How the SECURE Act could impact your heirs

Finance
September 10, 2024

When planning for retirement, most of us focus on building a nest egg that will support us in our golden years. We diligently contribute to our 401(k)s, IRAs, and other retirement accounts, hoping to maximize our savings and minimize our tax burden. However, the passage of the SECURE Act and SECURE Act 2.0 have introduced new rules that could significantly affect how your retirement savings are passed on to your …

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Medicare’s cobra effect: How a well-intentioned policy spiraled into a health care crisis

Policy
September 6, 2024

In the sweltering heat of 19th-century colonial Delhi, legend has it that cobras were taking over the streets. To eliminate the dangerous snakes, British officials offered a bounty for every dead cobra brought to government offices. Soon, locals began breeding and killing cobras for profit. When British officers caught wind of the scheme, they ended the program immediately. In response, the breeders released their now-worthless snakes back into the streets, …

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How Australia’s deadliest creatures and groundbreaking medicine make it unique

Physician
September 2, 2024

Australia is a very beautiful and unique place. I first went to Sydney in 1996 to present some research I had accomplished together with a much more brilliant and capable research physician. I was able to ride the monorail, now gone I’m told, and travel to the Outback, or at least the edge of it. My wife and the two oldest still at home at that time went there a …

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A cardiologist’s urgent call to combat heat-related health risks

Physician
August 9, 2024

As I drive to work and back, my eyes are on the ambient temperature reading in my car—it has been creeping up every day. I routinely listen to NPR, and extreme heat in various parts of the world comes up in daily discussions.

As a heart failure cardiologist in the clinic, I routinely ask my patients about their activity levels. Most of them complain about the heat and how it impacts …

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21st century schizoid health care: the unseen crisis of our system

Physician
July 29, 2024

“21st Century Schizoid Man” is a 1969 antiwar song by the prog rock band King Crimson. It appeared as the lead cut on their debut album In the Court of the Crimson King. “Schizoid Man” is considered an epic, described by Rolling Stone as “a seven-and-a-half-minute statement of purpose: rock power, jazz spontaneity, and classical precision harnessed in the service of a common aim.”

Schizoid personality disorder is much …

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Prescribing data and efficiency: Harnessing technology to alleviate the physician shortage in the U.S.

Policy
July 29, 2024

Amidst the pressing challenges confronting the health care landscape in the United States, the physician shortage stands out as a critical issue demanding innovative solutions. The Association of American Medical College’s latest report projects that the nation’s physician shortage could reach up to 86,000 by 2036. Burnout, which was further exacerbated by the pandemic, a large portion of physicians nearing retirement, limited medical school enrollment, and population growth …

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Revitalizing rural health care with technology and policy

Physician
July 25, 2024

As a physician who grew up in a small town in central Illinois, I’ve witnessed firsthand the decline of rural health care in America. The hospital where I first became interested in medicine is now half its original size, merged with a larger health system, and struggling to stay afloat. This story is all too common across rural America, where health care access is becoming increasingly scarce, and the challenges …

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The truth behind the U.S. doctor shortage: Is it intentional or not?

Policy
July 20, 2024

My friend and colleague, Alex Berezow, wrote a piece titled “Is the U.S. doctor shortage intentional?” The writers at ACSH share their work before publication to get feedback, and in the case of Alex’s latest, we disagreed. While much of what he wrote is factual, without the nuance of the setting, it fails to tell the entire story. So here is not so much my rebuttal but the rest of …

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When judges influence the practice of medicine: How Braidwood v. Becerra jeopardizes public health

Physician
July 16, 2024

Pre-exposure prophylaxis (PrEP) is a medication regimen that effectively helps prevent the transmission of HIV. Under the Affordable Care Act (ACA), most private health insurance companies must cover preventive care services, including PrEP, without additional cost-sharing. In Braidwood v. Becerra, a for-profit corporation challenged the ACA’ s PrEP coverage mandate. The corporate plaintiff argued that compulsory PrEP coverage infringed upon its religious beliefs and violated the Religious Freedom Restoration …

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When protocols fail: lessons from Trump’s attempted assassination and medical errors

Physician
July 16, 2024

The breakdown in security leading to the attempted assassination of Donald Trump can be compared to the multifactorial failure inherent in medical errors. Both scenarios involve complex systems where multiple layers of defense and prevention are designed to avoid catastrophic outcomes. When these layers fail, it often results from a combination of human error, systemic issues, and procedural flaws.

Both presidential security and health care systems are highly complex and require …

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Health information censorship in prisons [PODCAST]

Podcast
July 13, 2024
YouTube video

Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes!

Join us as we explore the critical issue of carceral censorship and its impact on incarcerated individuals’ access to health information. Our guest is Brian Tuohy, an assistant professor of bioethics, who shares …

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Administrative harm is destroying the practice of medicine

Physician
July 13, 2024

“Rules and regulations, who needs them? Throw them out the door.”
— Graham Nash (lyrics), from “Chicago,” sung by Crosby, Stills, Nash & Young

Business entrepreneur and billionaire Michael B. Kim recently was quoted as saying: “Leadership without ethics is a body without a soul.” Kim donated $25 million to his alma mater, Haverford College in suburban Philadelphia, Pennsylvania, to start a new Institute for Ethical Inquiry and Leadership. His goal is …

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Can local health care survive in a world of mega-corporations? [PODCAST]

Podcast
July 7, 2024
YouTube video

Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes!

We delve into the evolution of health care with our guest, Brian R. Jackson, a pathologist. Once a local industry where doctors and hospitals were deeply integrated into their communities, health care has …

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Migrant health in crisis: How we can lead the way in inclusive care

Policy
June 24, 2024

“I’m sorry, but we’re unable to accept this patient into the program right now due to a shortage of Spanish-speaking workers.”

I have lost count of the number of times I’ve had to say this statement to the various referral sources that call me daily, requesting services for immigrant patients.

Jane is a single parent from Guyana. She traveled to New York to visit family with her daughter, who was …

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Navigating profit-driven metrics: Upholding core values in medicine

Physician
June 19, 2024

As physicians, many of us were drawn to the medical field by a profound desire to serve humanity and alleviate suffering. We hear buzzwords in corporate work about values-led teams, but in the house of medicine, we have always been led by a strong sense of values. This calling propelled us through the rigorous demands of medical training—endless hours of study, countless lectures, sleepless nights, and missed personal milestones. We …

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For treatment, please call Dr. Congressman

Policy
June 14, 2024

Recent regulatory changes create a national staffing level for nursing facilities. Despite the much-needed rule change and the well-known stench of understaffed nursing homes that many Americans dread going to, most of the news cycle has portrayed this as a negative development. This is but one example where our patients are being manipulated into beliefs and actions that are contrary to their best health care interests. Recently, the same lies …

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The unseen impact of Miami’s homeless crackdown

Policy
June 12, 2024

17th Street – nestled between Jackson Memorial, a major U.S. safety net hospital, and Camillus House, the largest homeless shelter in South Florida – is empty. There are no bicycles or tents belonging to the individuals who typically inhabit the area. There is no line outside of the Three Sisters where people usually wait for a meal. The street is quiet and desolate.

We visit 17th Street every Saturday morning with …

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