I have only been able to make it back to my hometown once a year for many years now, but I recall my father having a very friendly dog many years back, a black Labrador mix named Abby. She was well behaved, would stay in the yard if you let her outside, didn’t cause problems, and was great with children.
Then about ten years ago, another dog was added to the …
Doctors have to become greedy dogs to survive
Since the study of science is the most common route taken to a career in medicine, there’s a tendency among doctors to neglect, if not outright scoff at the arts and humanities. That’s a shame, and not only because an appreciation of history or philosophy might make you a better doctor. I’m in complete agreement with that notion, but as an opinion, it can’t be definitively proven.
Instead, I think it’s …
Take a second look at what a good medical story has to offer
The onset of the new millennium has brought about a shift in not only the technological aspect of our industry, but also the mindset of physicians who are entering the field. Gone are the days of “work 40 years at the same practice, retire and live the good life.” Physicians are finding more creative ways to be doctors including entering non-clinical careers, being entrepreneurs on the side, and moving into …
Life coaching for physicians is an underused physician burnout tool
“I’ve got to use the right tool,” I thought to myself as I attempted to pound a nail into the wall with the bottom of my coffee cup. Kneeling on the exam room table, I was attempting to hang a picture on the wall before the clinic day began. I have all sorts of useful tools in my clinic: scalpels, special scissors and a multitude of precision instruments for surgical …
Science is the right tool to improve health
Imagine a smoking ban in the privacy of your own home? For over 2.3 million residents of public housing, this will be their reality. On November 12, 2015, former Secretary of Housing and Urban Development (HUD), Julian Castro, announced HUD’s policy for “smoke-free” federally funded public housing. The policy requires that residents refrain from “using tobacco products in their units, common areas, and within 25 feet of public housing and …
How a smoking ban is regressive policy
As a physician and businessman, I wish the future looked better for PCPs. But history suggests things will get still worse.
The history of business teaches us disruptive innovation always starts from below. The “untouchable” market leader is threatened by a less expensive version of its own product. The smug incumbent ignores the unprofitable downscale threat. Then the new competitor decides to go upscale, is forced to innovate as a result, and …
Where will disrupted primary care physicians go?
She burst into tears when I asked if she wanted to get pregnant.
Eman, a beautiful young woman from Jordan, sat in my family-practice office with her husband, Ali, and two adorable children about one and two years old. With her scarf and dark clothing covering all but her pale face and enormous sable-brown eyes, Eman looked closer to fourteen than twenty-four, and scarcely old enough to have any children.
“How can …
His power over her was cultural. How could I do the right thing?
We long for the moments in our life that justify our course, that illuminate the banalities of our daily routine, and that instill within us a mission that suddenly harmonizes all that you have done and all that you hope to do.
My first year as a physician-in-training consisted of an insurmountable study load, a constant quarrel with the torturous alliance of fatigue and self-doubt, and the simple reality being a …
A medical student confronts the injustices of our immigration system
As part of trying to figure out where telehealth and video visits fit into the primary care setting, this week I got an amazing tour from the director of our emergency department, during which he showed me the program they’ve developed over the past year.
An incredible system, they take patients from triage who report to the emergency department with nonemergent issues, and move them to a consultation room off to …
What’s the role of telemedicine in primary care?
It has been purported that one of the major take-home messages from the bizarre events of 2016 is that we are now living in a “post-truth” world. Indeed, that very phrase was dubbed the “word of the year” by Oxford Dictionaries, which defines it as “relating to or denoting circumstances in which objective facts are less influential in shaping public opinion than appeals to emotion and personal belief.”
We are also …
Multiple choice tests in our post-truth world
Most health care professionals went into the field because of a calling. For many of us, it is not just a career but a sense of mission. While the system drives hoards to the brink and over the edge of burn-out, a sense of purpose remains. The goals are not the same for all, but it is a good time to re-examine our life goals.
Being a doctor, or any professional …
Doctors serve the people not the system
A guest column by the American College of Physicians, exclusive to KevinMD.com.
When the American College of Physicians (ACP) and the other primary care societies introduced the Patient-Centered Medical Home (PCMH) over 10 years ago, the model was untested. Here’s a look at how the PCMH recognition process has evolved and how my …
PCMH recognition process isn’t easy but it is becoming more relevant and less burdensome
One of the most memorable times from my family medicine training days was the annual residency my intern year. It was the year of the World Cup, and a bonding experience that would later save my life. Being able to be with not only my residency class, but also the faculty in a relaxed and empowering environment brought a sense of safety that allowed me to reach out to one …
Physician coaching and retreats are innovative ways to fight burnout
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Sure, it’s nice to think about cutting back on the work hours and spending more time at home with the kids. Or out on the running trails getting fit and enjoying nature. Or singing in a chorus. But how do you really make that decision? And if you do decide to work part-time, how do you make the most of it?
After struggling to juggle two full-time health care careers with …
Tips for physicians thinking about working part-time
Health behavior was my emphasis in my MPH. Add a faculty development fellowship, time as residency faculty, work in a private practice, and increasing interaction with medical students now as faculty at a medical school; the outcome is not just an emphasis, but a mindset. A mindset of health behavior that is not just for patients, but for physicians, as well.
I must have company in this concept as ten invitations …
How journaling can help physician wellness
When we think of pollution, we think of our planet: stripped forests paved asphalt black, sterile red rivers, brown-gray skies and creeping slums over once virgin land. We imagine massive dumps of civilized waste, the extermination of species and temperatures which bake the earth like a neglected oven. We mourn the global home in which we live, neglected, abused, in ruin. Do we ever think about ourselves?
That is one of …
It’s time we face it: Fossil fuels are killing us
We have two ears and one mouth so we can listen twice as much as we speak,” said Epictetus. It’s clear that the Greek philosopher wasn’t a physician in 21st century America. If you watch doctors — and many researchers do — they speak more than listen.
Studies have shown that doctors interrupt or redirect patients within the …
A positive visit with a patient with chronic pain
In these strange days of unsure future health care policies, shrinking budgets, and significant belt-tightening, as we look for ways to improve access for our patients, we need to reevaluate how we to get them into care, making sure we see them in a timely and efficient manner.
We have always said that in this topsy-turvy time, in the crazy state of health care, what we really need is more primary …
Primary care today is like squeezing blood from a stone
My colleague, Dr. L.T. Kim, was off this week and I covered for him.
On Friday afternoon, I dealt with two of his patients and learned — or relearned — two important lessons.
I saw a man with thoracolumbar back pain. He had fallen off a ladder a few years earlier and suffered from recurring bouts of back pain — sometimes with tingling in both legs. He had been to the emergency …
Knowledge is power. Increasingly, patients are demanding and receiving access to levers in the medical machine that would have been unthinkable a generation ago. The informed consent process, which I support, can overwhelm ordinary patients and families with conflicting and bewildering options.
Television and the airwaves routinely advertise prescription drugs directly to the public. Consider the strategy of direct-to-consumer drug marketing when millions of dollars are spent advertising a drug that …
Should patients order their own lab tests?
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