If I hadn’t heard her sob, I might not have looked up. I was so immersed in her story, and so fixated on my own studious note-taking, that I didn’t doubt the steady rhythm of her voice until I heard it break. Huda’s (name changed) eyes were filling with tears, and I quickly handed over the tissue box, feeling that its trifling weight was an apt metaphor for how little …
How the stories of refugees affected this medical student
After three months of using hot compresses to shrink the stye on my daughter’s eyelid, it wasn’t getting any smaller. My daughter is prone to this sort of growth, called a chalazion. This one would have to be removed surgically, like the one she had removed from the same eyelid two years earlier.
But there was one …
He was the perfect person to shop for health care. And he failed miserably.
Most of us do not know the basics of economics, although we should. It impacts every one of us every day that we are alive. Yet, for most of us, once we get beyond the law of supply and demand, our knowledge of the subject starts to vaporize. I can’t explain fiscal or monetary policy. While I regard economics as a science, it seems that experts routinely interpret data differently, …
The cost of drugs confounds this gastroenterologist
After being out of the news for a few weeks, health care reform came back with a bang this week when Senator Bernie Sanders unleashed his Medicare for all, single-payer reform plan, now backed by sixteen Democratic senators. More than anything, to make progress on reform of our dying health care system, the nation needs to get to a place where it can engage in serious conversations about such proposals.
I …
Bernie Sanders and the single-payer dream: Why we must take it seriously
Knee replacements are booming. Between 2005 and 2015, the number of knee replacement procedures in the U.S. doubled, to more than one million. Experts think the figure might rise another sixfold in the next couple of decades because of our aging population.
Since many people receiving knee replacements are elderly, Medicare picks up most of the cost of such procedures. It shouldn’t be surprising, then, that the program is experimenting …
If you cut payments to surgeons, don’t be surprised if they do more procedures
According to Wikipedia, “Productivity describes various measures of the efficiency of production. A productivity measure is expressed as the ratio of output to inputs used in a production process, i.e., output per unit of input. Productivity is a crucial factor in production performance of firms and nations.”
Please tell me how this relates to being a physician or a patient. We do not produce anything. Rather we work with individuals to …
It’s time to ban productivity from medicine
I was recently by the New York Times’ the Upshot to rank eight health care systems they had chosen: Australia, Canada, France, Germany, Singapore, Switzerland, the United Kingdom, and the United States. This forced me to think about a pretty fundamental question: what do we want from a health care system?
What does an ideal health care system look like?
I would argue that most people want a health …
Ranking the world’s health systems: These results may surprise you
Early yesterday morning, a 16-year-old child went missing. Early yesterday morning, a woman, in desperate anguish, put out a Facebook post with pictures of her child and asked for help. By late this morning, through the power of social media, the child was found safe.
Two days ago, a Big Ten university football team played a national military academy’s football team. There was an amazing pre-game military tribute, and the half-time …
We have the same end-goals, but disagree on how to reach them
The debate about the future of health care rages stronger than ever. As someone who grew up and trained in a country with probably the most centrally controlled medical system in the world—the United Kingdom with her NHS—my views have admittedly done a 180 over the last decade. I am no longer as strong a believer in socialized health care as I once was, and actually believe the future for …
Health care reform: America really is different from most other countries
A guest column by the American College of Physicians, exclusive to KevinMD.com.
By the time you read this, Congress will be in session and hopefully not engaged in another watermelon spitting contest on health care (I’d use a urological metaphor, but there may be children in the room). If our Representatives and Senators choose to …
Rising premiums, high deductibles, and gaps in coverage before the ACA
This year, I stood on the curb at the 2017 Halifax Pride Parade and watched high-energy floats pass by. Leading the parade was the indigenous float. The vibrant trans youth float warmed my heart. The prime minister waved and called out “Happy Pride!” to the spectators. It was a stream of enthusiastic faces, song, dance, and brightly colored banners.
I love pride. It’s is a special time for a lot of …
How to improve primary care for trans patients
In a recent Vox interview, Senator Brian Schatz (D-Hawaii) announced his plans to allow individuals without insurance to buy Medicaid coverage. As a family doctor caring for patients on Medicaid in Senator Schatz’s home state, I cannot support such a plan.
Medicare continues to be run by the federal government. In contrast, Medicaid programs are run by states. The trend in recent decades is for …
Here’s how a glucometer turned this doctor against Medicaid for all
Twenty years ago, Congress made a commitment to its children when it created the Children’s Health Insurance Program, recognizing working parents who earned too much to qualify for Medicaid still couldn’t afford health insurance for their kids. For pediatricians who remember, the practice landscape was a great deal different then. So many children were uninsured that pediatric emergency rooms were filled with children who needed routine school physicals and regular …
The next legislative battle for children’s health
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Devastating. That alone cannot fully describe the extent of the destruction of property, the displacement of tens of thousands of residents, the injuries and loss of life in the wake of Hurricanes Harvey and Irma. As Americans, our hearts ache for those affected by the flooding. As a medical student, former international development worker in Afghanistan and EMT in South Africa, I also lay awake thinking about the many infectious …
In this era of increased globalization, infectious diseases show no boundaries
As I approach the end of my medical school training, I want to take a moment to reflect upon the invaluable education that my classmates — novices in medicine but rich in life experiences — have provided.
Nearly all of us identified with the common struggle of medical school: late night study sessions, difficult days, and the general balancing act of focusing on work as well as our own wellness. All …
Advancing physician diversity and representation
A pediatrician husband recently wrote here in KevinMD about the stark differences in assumptions about work-life balance for men and women, in “What does your husband think of you being a surgeon?” Then I came across another article on Medscape by a male cardiologist, whose wife is also a physician, entitled, “The gender gap in cardiology is embarrassing.” Both men’s wives delayed their medical training, …
Patients have more power than they may realize
We humans can’t help but shove as much as possible into one minute, one hour, one day. We’re rewarded for doing it, too. Society says that the more you check off your list, the more productive you are. And by default, then, the more productive you are, the more successful you are. So, we rush. We search for ways to skip steps and still get the same result. We fill …
Gain time by slowing down with your patients
There is a 4,300-strong grassroots movement known as “Save Our Hospital” gaining notoriety in Albert Lea, Minnesota. This story is symptomatic of the fact that hospital consolidation has slowly become a national pastime. With declining revenue under the Affordable Care Act, mergers increased by 70 percent, leaving small communities scrambling for health care access. The latest casualty in the “hospital-consolidation-for-sport” trend is Albert Lea, a small …
The story of how a hospital is being sacrificed for money
I entered the room to see a face that I recognized. As soon as I looked at my chart, I immediately knew this patient. I saved their life last year. I know this because the patient told me so.
The teachers and mentors that I was privileged to learn from and train with 25 years ago emphasized the essential principle of osteopathic medicine — we make physical contact with our patients. …
In Iraq I saved lives. Now, I can’t give an allergy shot.
As Congress returns from its summer recess, the health care debate is sure to heat up … again. And over the past few months, the debate has had a significant impact on public opinion.
A recent report describes how Americans currently view the ACA. According to national polls, over 90 percent of Americans would change the current law. Most Democrats would expand ACA coverage while most Republicans …
Is Medicare for all the future? Only the public can decide that.
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