Public Health & Policy

Understanding the distinction between universal health care and a single-payer system is critical

Policy

July 4, 2019

The World Health Organization describes universal health coverage — a system coupling health care access with financial protection for all residents — as the “single most powerful concept that public health has to offer.” The goal of universal care is to give all people the equal opportunity to enjoy the best health possible.

I wholeheartedly endorse universal health care, though not a single-payer system like “Medicare for all” because there is …

Physicians: Do not be intimidated by administrators

Suneel Dhand, MD

Physician

June 28, 2019

A piece of advice I would give to any younger physician, especially one who is just graduating residency, would be to expect a whirlwind ride into the realities of frontline medical practice. It’s something that you are totally not prepared for in the controlled environment of education and residency training. A steep learning curve awaits you once you start practicing medicine. And one of the biggest things you will have …

How climate change affects your skin

Sultan H. Qiblawi and David Fivenson, MD

Conditions

June 27, 2019

Global climate change is reaching a critical mass.

Since the advent of the industrial revolution, we have seen the global mean temperatures increase by 1°C (1.8°F), and significant steps must be taken by 2030 to mitigate an even larger global temperature increase of 1.5 to 3C as predicted by 2030. In other words, we are in dire need of change.

This change is not only reliant on governmental policy change but is …

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How climate change affects your skin

A physician volunteers with migrants. Here’s what she saw.

Sheryl Recinos, MD

Physician

June 26, 2019

“At least seven children are known to have died in immigration custody since last year,” according to a NBC News report last month.

I recently spent a Saturday working with amnesty-seekers that had been detained at California detention centers in the desert. They were dropped off at bus and train stations in the desert in Southern California, most with no money and no ability to …

The power of advocacy: How doctors can be empowered physicians

Amaryllis Sánchez Wohlever, MD

Policy

June 16, 2019

An excerpt from Recapturing Joy in Medicine,

During my year as chief resident, I was also president of the Florida Association of Family Medicine Residents. The faculty at my residency program inspired me by their excellence as clinicians and teachers. I trusted their judgment and insight, so when they encouraged …

In our health system, who “owns” patients?

Philip A. Masters, MD

Policy

June 7, 2019

A guest column by the American College of Physicians, exclusive to KevinMD.com.

When talking with patients – particularly those with multiple, complicated medical issues – it often doesn’t take very long to hear about their increasingly suboptimal and sometimes harrowing interactions with our health care system.

Examples include inpatient experiences in which care is provided by …

When physician pay packages become hospital kickbacks

Jordan Rau

Policy

June 6, 2019

For a hospital that had once labored to break even, Wheeling Hospital displayed abnormally deep pockets when recruiting doctors.

To lure Dr. Adam Tune, an anesthesiologist from nearby Pittsburgh who specialized in pain management, the Catholic hospital built a clinic for him to run on its campus in Wheeling, W.Va. It paid Tune as much as $1.2 million a year — well above the salaries of 90% of pain management physicians …

The problem with burning health insurance down

Margalit Gur-Arie

Policy

May 16, 2019

Let’s burn health insurance down. Greedy corporate bastards should burn. Big Pharma and big hospitals should probably burn too. You know who else is really, really, bad? Wall Street. Let’s burn the banks. And let’s burn Big Tech and the entire Silicon Valley cartel. Let’s also burn Big Agribusiness that’s making us fat and sick. And let’s burn the Oil companies that are destroying the planet, and let’s burn the …

Nurses are striking. Where are the physicians?

Michael Pappas, MD

Policy

May 11, 2019

The U.S. health care “system” is completely and utterly broken. According to the World Health Organization (WHO), the U.S. system ranks 37th in the world, all while spending dramatically more on health care than other wealthy countries. Tens of millions remain without any health insurance coverage. For many, medical bills can mean economic ruin — some surveys show that up to Read more…

Nurses are striking. Where are the physicians?

The systemic poverty in Navajo Nation is a national travesty

Vincent DeGennaro, Jr., MD, MPH

Physician

May 10, 2019

“I have the CPAP machine. I’ve had it for a year, but I don’t have electricity in my house. I stayed with my aunt who has electricity but things didn’t work out,” said the young Navajo man, his massive belly protruding out from underneath the tray table.

The old Navajo man with Parkinson’s disease, unable to walk fast enough to make it to the outhouse in time, had started taking anti-diarrheal …

What do organized crime and health care have in common?

John H. Wasson, MD

Policy

May 8, 2019

During college and medical school, my summer employment acquainted me with members of organized crime families. Now, reflecting on my full career as a primary care clinician, geriatrician, and researcher on health care delivery improvement, I have discovered that several insights from organized crime could guide medical professionals’ responses to our country’s health care crisis.

Organized crime and the U.S. health care industry have more in common than might be immediately …

Why doctors crash planes

Phillip Stephens, DHSc, PA-C

Policy

May 6, 2019

Physicians actually make good pilots. But, in 1966 they received a bad rap due to a report published by the FAA’s Chief of Aviation Medicine, Dr. Stanley Mohler. Mohler had a point. Physicians were crashing planes at a higher rate as opposed to the general aviation population. His report would be a cautionary tale for all of us. It would be three decades before we even began to understand why …

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Why doctors crash planes

A medical student grew up without health insurance. Here’s why that matters.

Yoo Jung Kim, MD

Education

April 12, 2019

I’m constantly awed by the fact that I get to be part of one of the best hospitals in the world, especially because as a kid, I grew up without health insurance.

These were the days before the Affordable Care Act; there was no penalty for going without health coverage. As a non-citizen, I was ineligible for Medicaid, and private health care was prohibitively expensive for my family. Fortunately, I was …

The fallacy of patient-centered care

Myles Gart, MD

Physician

March 14, 2019

I often wonder what it was like before patient-centered care became a mainstream catchphrase. Was there a poor relationship between the patient and physician in the outpatient setting? Were hospitalized patients’ feelings, desires, goals, and therapy options ignored? It amazes me that we were able to care for patients more than ten years ago without using a “patient-centered” approach.

According to NEJM Catalyst, “Patient-and family-centered care encourages the …

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The fallacy of patient-centered care

For future physician-activists: This is our lane

Jake Fox, Alec Feuerbach, and Jordan Rook

Policy

March 12, 2019

Rudolf Virchow, a pioneering physician of the 1800s, once wrote that “politics is nothing but medicine on a large scale”. Over a century later, this nexus is as apparent as ever, and many doctors engage as practitioners of both.

Twitter erupted this past fall with photos of soiled scrubs, resuscitation room floors and surgically-removed bullets — all crimson with …

Medicare for all and the problem of health care on demand

Michael Brant-Zawadzki, MD

Policy

March 10, 2019

The evolving politics of single-payer health care conflate the concepts of universal coverage, health care on demand and free health care. To the indiscriminate progressive mind, all three are part of the holy grail. The fly in the ointment is that highly attractive and altruistic politics runs into the brick wall of reality. As Thomas Sowell — a noted Stanford economist — wrote: “The first lesson of economics is scarcity: …

The reason so many physicians are retiring early

Valerie A. Jones, MD

Physician

March 6, 2019

There has been a disturbing shift in how medical professionals feel about their career. I almost cringe every time I’m at a party or social gathering now and tell people I retired early from my medical practice. I try not to bring it up.

I don’t cringe out of fear for how they will perceive me or whether they will look down upon me with condescending scorn about how I left …

What physicians can learn from anthropologists

Carolina Severiche Mena, MD and Matt Artz, MS, MBA

Tech

March 3, 2019

Since the passing of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009, it has been said that health tech would dramatically revolutionize health care and the patient experience. Advocates have claimed time and time again that it would advance disease diagnosis capabilities, improve patient outcomes, and increase patient satisfaction. Belief in this narrative can be seen in the sharp increase in health tech investments, with …

My battle against the nurse’s cap

Debbie Moore-Black, RN

Policy

February 10, 2019

Florence Nightingale was among the first nurses who started wearing a nurse’s cap.

The cap was derived by nuns and represented those caring for the sick. Hair was neatly tightened into a bun and covered by the cap.
Back then becoming a nurse was typically seen as a female profession, but men were allowed to become nurses too. In 1930, only one percent of RNs nationwide were male.

Growing up in the 1950s …

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My battle against the nurse’s cap