Physicians writing on KevinMD about the primary care shortage, the fifteen-minute visit, panel size, what primary care is paid against procedural specialties, continuity, and the administrative load that has grown around the work. Four maintained records draw on this archive: Primary care: what physicians say, in their own words, Direct primary care: what physicians say, in their own words, Prior authorization: what physicians say, in their own words, and Scope of practice: what physicians, nurse practitioners, and PAs say, in their own words.
Just under half of health care workers do not get their annual flu vaccine. Some of these workers contract the flu and unknowingly transfer it to their sick hospitalized patients, and in some cases, because of them passing the flu along, those patients die. We know the most important reason for health care workers to get vaccinated against influenza is that it is the most effective way of preventing influenza …
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Medical workers: Vaccinate yourselves first
It was nearing the end of my day at the mobile health clinic where I work as a nurse practitioner, providing free, comprehensive primary care to uninsured patients in central Florida. Clinic was officially over, and we were no longer taking patients; I was signing notes and finishing up some teaching points with a PA student when a woman walked up and asked me if she could “talk to me …
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The hidden work of primary care
Medical appointments are getting shorter by the year. Sometimes it feels like doctors have no time to spend with their patients.
What’s to blame for these brief clinical interactions? It could be the electronic health record, or EHR. Because of changes in how insurance companies and the government pay for medical care, doctors increasingly need to document their care on the computer, causing many physicians to spend more time with their …
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Surprise! Doctors spend more time with computers than with patients
For the month of September, I embarked on the experience of a lifetime, living and working on the largest Native American reservation in the United States. Sprawled across the four corners region of Utah, Arizona, New Mexico and Colorado, the Navajo Reservation in Chinle, Arizona, encompasses an area as large as the entire state of West Virginia. Its population, however, is only about 300,000, making it extremely rural. To leave …
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An eye-opening rotation at the Indian Health Service
I often see patients for follow-up and learn they are not taking the medications either I or another health care provider prescribed. Sometimes the reason is obvious, and other times the patient is reluctant to give up the information. Patients have the right to take or not take medication that was prescribed. But, sometimes by not doing so, they are putting their health at risk.
As a doctor, I want my …
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4 reasons why patients don’t take their medications
Editor’s note: This article contains a racial slur crucial to the writer’s story.
It took only 57 hours of working as a new attending physician in Charlottesville, Virginia for a patient to call me the N-word.
Fifty-seven hours. In fact, a racial slur found me before I found the shortcut to the hospital cafeteria. So, when torch-bearing White supremacists gathered downtown earlier this year, I saw more confirmation of my conclusion that …
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A patient called me the N-word
When a patient is diagnosed with a chronic disease, like diabetes or hypertension, physicians don’t merely suggest medications to lower blood sugar or blood pressure – they insist that patients take medications to protect their health. However, the recommendation to get an annual influenza (flu) shot to prevent flu is often not as emphatic. Research has shown that patients are much more likely to get a flu shot when it …
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Make a difference by being a vaccine insister
The present state of our nation can be traced back over the past five decades to the concerted efforts of specific entities, their goals based on profit and power, who set specific plans in place to maximize their control of same. Over the past 40 years, two such plans were woven together as they brought us to our present war on physicians and patients.
One plan was created by increasing private …
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To stop the opioid crisis, the war on physicians must end
Doctors, you need to improve the patient experience. Your intentions are there, but patients are starving for more.
Office visits offer definitive evidence that patients need to change. Tests results provide real data to make patients aware of health concerns. This is a clear and obvious starting point.
But after this information is gathered, the framework of change gets cloudy. Doctors go from offering clear and focused details like:
” You have high …
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The surprising way email can make you a better doctor
Three to 17 percent of the world’s population suffers from depression, but trying to explain it to the other 83 percent can be difficult. Normal people have bad days and sad moods, but “normal” means they’re actually able to deal with those bad days, whereas depressed people can’t — not in an adequate manner. Explaining why “Cheer up!” doesn’t work is impossible because they just don’t get it.
I can’t speak …
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5 ways to help your friend with depression
I remember just moving to Atlanta and having breakfast with a new-found friend I had met while working at a hospital as a registered nurse. The food at our chosen eatery was far from great. But I must say, my friend’s enthusiasm for life, specifically living in Atlanta, was fulfilling enough to make me forget the chef’s lackluster culinary skills. She was warm, outgoing, adventurous, somewhat inquisitive — just what …
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Did diet pills kill my co-worker and friend?
When is the right time to have a baby? This question plagues professional women across industries. It takes on more significant importance for women training as physicians. Medical training is long and coincides with a woman’s late 20s, often stretching into her 30s. Waiting to have children until completing training is not always biologically feasible.
Medical schools and residency training programs still lag behind in developing formal parental leave policies. Outside …
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Is there ever a right time for a doctor to have a baby?
Back in the grueling training days of my residency, I was the first-hand victim of theft. Not the kind you see on the big screen, where you’re held up at gunpoint, or the kind where your belongings get ransacked. It was worse, at least in the way that it made me feel. I had my handbag stolen from me, right from its usual resting place on the shelf near my …
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A physician suffers a betrayal of trust
The computerized era has introduced all of us to a genre of errors that never existed during the archaic pen and paper era. The paper medical chart I used during most of my career never “crashed.” Now, when our electronic medical records (EMR) freezes, malfunctions, or simply goes on strike, our office is paralyzed. Although I appear to the patients as a breathing and willing medical practitioner, I might as …
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When EMRs crash: It’s time to push back
Online dating is all the rage these days. Statistics suggest that over a third of couples now meet online. For a lot of older readers of this blog, who met their husband or wife the traditional way and are baffled by this whole new world (and don’t get me wrong, there were probably many ways in which those days were better!), whether you understand the whole online or app dating …
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Look to online dating for the future of telemedicine
Multiple state leaders, including Maryland Gov. Larry Hogan, and even President Trump have declared states of emergency in response to the opioid epidemic. Policymakers claim to be battling this public health crisis on all fronts, but one arena continues to be conspicuously ignored: our prisons and jails.
Roughly half of all incarcerated individuals suffer from addiction. And in the two weeks following their release, former prisoners are 129 times more likely …
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If we are serious about addressing the opioid epidemic, this is what we should do
I was born in Shanghai, China. In September 2000, my parents and I left behind our family and friends, a language and culture dear to our hearts and social and financial stability to immigrate to the United States. I was six at the time. Although I don’t claim to have fully understood the weight of their decision to start a new life, I knew that my parents were making a …
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How being an immigrant shaped the way I treat patients
