Orthopedic surgeons, physiatrists, and their patients writing on KevinMD about musculoskeletal care: back pain and the procedures that can weaken a young spine, knee and joint surgery, spinal stenosis treated least invasive first, non-opioid pain management and how it is paid, orthopedic residency and the women entering it, and what a patient in pain needs to be asked. Two maintained records draw on this archive: Opioids: what physicians and pain patients say, in their own words and Surgeons and surgery: what surgeons say, in their own words.

Violent protests in a young African democracy closes a hospital

Physician
July 20, 2021

I had an uneasy weekend.

On the one hand, I was watching the COVID-19 figures around the country and in my region of KwaZulu-Natal. We are waiting for the third wave to hit our hospital. Last week we stopped planned surgeries and reviewed our planning and capacity to deal with the surge.

On the other hand, I had been sunk by the images and reports of violent protests related to the imprisonment …

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Violent protests in a young African democracy closes a hospital

A physician’s personal story with opioids

Physician
April 28, 2021

I once spoke at a leadership forum on opioid abuse. I was asked to speak about the role of hospital systems in addressing this important issue. As I thought about what I would say, I realized there was very little I could add. The crisis is epidemic, and hospitals are ill-prepared to do anything proactive. It is that overwhelming. Leading medical missions, I learned an important lesson that …

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A physician’s personal story with opioids

Learning and refining key clinical skills for residency and beyond: Lessons learned from the Fulbright Program

Physician
April 22, 2021

“Dier Dammen an dier Hären, wëllkomm zu Lëtzebuerg. Déi lokal Auerzeit ass 16:30 Auer.”

Ladies and gentlemen, welcome to Luxembourg. The local time is half past four in the afternoon.

***

The butterflies floating about my stomach throughout the rocky descent intensified as the plane sped down the landing strip, transitioned to a slow crawl, and then skidded to a halt at a jet bridge at the Luxembourg Airport. With a …

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Learning and refining key clinical skills for residency and beyond: Lessons learned from the Fulbright Program

Meet the orthopedic surgeon who stopped taking insurance and does house calls [PODCAST]

Podcast
April 13, 2021
YouTube video

“I can tell you what I don’t want to do. I don’t want to mill through 50 patients a day, mindlessly clicking through EMR checkboxes so an insurance auditor five states away will deem that I’ve done my job and deserve reimbursement. That’s a high volume, high overhead game, and I …

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Meet the orthopedic surgeon who stopped taking insurance and does house calls [PODCAST]

Don’t be the patient that says this

Conditions and Diseases
April 4, 2021

An excerpt from Injured to Elite: A Guide To Empowering Yourself to Transform Your Life After Injury.

Don’t be the patient that says: “Doc, just tell me what to do …” Instead, you should ask for information to empower yourself to make decisions about your healing process. Framing questions around the clinician’s experience is always a good starting point; …

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Don’t be the patient that says this

At-home delivery of physical therapy is changing rehab for the better

Conditions and Diseases
March 27, 2021

As an orthopedic surgeon, I perform about 900 hip and knee replacements each year. In an era of rapid discharge and outpatient surgery, patient education is of paramount importance.  Nonetheless, besides the surgery itself, one of the most common areas of concern for patients is what comes after the procedure. The rehabilitation process after surgery is as important as what happens in the operating room itself, and each patient needs …

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At-home delivery of physical therapy is changing rehab for the better

COVID tragically took a young orthopedic surgeon

Physician
February 17, 2021

Before getting dressed for work this morning, I stood in my kitchen, marveling at the ice crystals, or “tree diamonds,” as my mother calls them, from the window above the sink. As I waited for the coffee to brew, I scrolled through the text messages sent to my phone overnight until I saw my friend’s forwarded news link: “Doctors suspect COVID delayed immune response in young surgeon’s death.” I clicked …

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COVID tragically took a young orthopedic surgeon

An orthopedic surgeon wants to do more

Physician
February 5, 2021

Sometimes I think.

Sometimes I think and nothing happens. That seems to happen a lot during this period of the second wave of COVID-19 that has hit my hospital. Netcare Kingsway Hospital is a community private hospital and has been overwhelmed in caring for patients with COVID-19.

Sometimes I think and something happens. That’s when a story takes shape, and I wonder how I will tie it together to make it work.

Sometimes …

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An orthopedic surgeon wants to do more

How 5-star reviews generated over $225,000 in revenue for my practice

Physician
January 22, 2021

I’ll cut straight to the point: Collecting 5-star Google and Yelp reviews straight out of fellowship generated over $225,000 in new revenue from online patient referrals.  And I have the data to prove it.

I joined my partner as a hand fellowship graduate four years ago. He already had a very busy practice with over 100 new patient visits a month, on average, and my arrival allowed him to cut down …

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How 5-star reviews generated over $225,000 in revenue for my practice

5 questions to ask before you have back surgery

Conditions and Diseases
November 14, 2020

Back pain is one of the most common reasons people see their physician and one of the most common causes of missed days at work. Approximately 60% to 80% of adults experience low back pain during their lives, and for 10% of them, the pain lasts for more than three months. And although nearly 500,000 Americans have surgery for back pain each year, in most cases, …

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5 questions to ask before you have back surgery

You have options when it comes to board certification

Physician
November 9, 2020

It’s good to have options, isn’t it?

So why isn’t there an option when it comes to taking your boards? In other words, can’t residents have a say with which board to become certified with once they’re done with their residency?

Well, there’s good news for you. The answer is yes. You definitely have options. There are other boards for your initial written exams. (And that also includes the oral exams for …

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You have options when it comes to board certification

Orthopedic surgery enters the modern age on a chance observation

Conditions and Diseases
November 8, 2020

For thousands of years, bonesetters and doctors could not accurately diagnosis broken bones or differentiate such injuries from joint dislocations and torn ligaments. That changed with a chance discovery almost exactly 125 years ago. Subsequently, perhaps with equal parts of chagrin and enlightenment, doctors began using the new discovery to discount their previous assumptions and accurately diagnose skeletal diseases.

In his darkened laboratory on November 8, 1895, …

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Orthopedic surgery enters the modern age on a chance observation

Meniscus tear surgery and treatment: What you need to know to decrease your pain

Conditions and Diseases
September 28, 2020

Meniscus injuries of the knee are common. There are lots of treatment options, including meniscus tear surgery or injections. But which one is the best to address your meniscus tear pain? The data surprises almost everyone.

History of meniscus tear treatments

Orthopedic surgeons used to perform a total meniscectomy for patients with meniscus tears. This procedure involved taking out the entire meniscus. If you have a tear that causes you pain, why …

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Meniscus tear surgery and treatment: What you need to know to decrease your pain

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Navigating the river of health

Conditions and Diseases
September 16, 2020

Optimal results are achieved when the patient takes an active role in the wellness plan. This is a phrase published in a brochure describing the details of my work. As a specialist in neuromusculoskeletal medicine and osteopathic manipulative medicine (OMT), patients often present with pain, which is usually multifactorial in nature. Given that the majority of evaluations result in the use of osteopathic manipulative treatment (OMT) to address mechanical dysfunction, there …

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Navigating the river of health

When physicians get sick: We are just as human as the patients we treat

Physician
August 28, 2020

Physicians are natural caregivers. We are in-tune with the needs of our patients, often to the detriment of our own health. It is a rite of passage during medical school to stand in for lengthy eight to ten-hour surgeries, as retractor holders, keeping the surgical field clear for the surgeon. The thrill of being part of surgery makes us forget our own needs; the bleary-eyed fatigue of having woken up …

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When physicians get sick: We are just as human as the patients we treat

6 strategies to help you return to exercise routines safely

Conditions and Diseases
August 28, 2020

If you’ve always been an avid gym-goer, the COVID-19 pandemic may have significantly disrupted your fitness routine as gyms, health clubs and exercise classes were unavailable for months. Getting active again is not only good for your physical health, but it’s also beneficial for mental health and can help you manage the symptoms of depression and anxiety, which a larger than ever number of people report experiencing during the pandemic.

But …

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6 strategies to help you return to exercise routines safely

How a professional lacrosse league created a COVID-free tournament

Physician
August 21, 2020

In 2019, the Premier Lacrosse League (PLL) entered the world’s stage, taking with it more than 100 of the greatest pro lacrosse players in the world from the Major League Lacrosse. The new league launched a tour-based model, offered higher player compensation, player equity, health insurance, and a major media rights deal with NBC Sports Group.

In the months prior to the inaugural game at Gillette Stadium, I was brought on as the …

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How a professional lacrosse league created a COVID-free tournament

Fascia in primary care: When chest pain is not in your chest

Conditions and Diseases
August 11, 2020

“Imagination is more important than knowledge. For knowledge is limited to all we now know and understand, while imagination embraces the entire world, and all there ever will be to know and understand.”
– Albert Einstein

“Mr. Thomas, are you OK? Sir, are you OK?”  It was a full clinic day, and I had just improvised a treatment on him.

I had met this patient, “Mr. Thomas,” only once before.  After meeting me …

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Fascia in primary care: When chest pain is not in your chest

A physician’s convoluted FMLA journey

Physician
July 29, 2020

I have dealt with unstable knees since childhood. In December 2019, I noticed knee swelling, which would improve with rest. This flare-up was not unusual, except that the swelling and pain gradually became a routine fixture in my life. This was still pre-COVID, but winter is busy in the ICU, so I ignored my own health. We went on a trip to the beach in February, and I came back …

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A physician’s convoluted FMLA journey

Pearls and pitfalls for medical students entering their clinical years

Medical Education
July 9, 2020

Transitioning from the classroom to the wards is an uncertain and anxiety-provoking time for many medical students. Schedules are constantly changing, as are expectations and learning objectives. Mentorship and advice from upperclassmen, residents, and attendings was an essential tool in my MS3 toolbox. I would go so far as to say that these pieces of insight are the toolbox. The 2020-2021 academic year will provide its own degree of obstacles …

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Pearls and pitfalls for medical students entering their clinical years

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