I have given a number of medical talks over the years — reports on my research, reviews of surgical topics, mentoring speeches, and grand rounds, among others. I prepare for these talks extensively but tend to speak extemporaneously to engage better with my audience. I’m pleased to say that, in general, I have received good feedback. Several times, however, I have been …
When women speak: Is there a gender bias in medicine?
Part of a series.
There is a crisis in the provision of primary care in the United States. If you are a patient, a primary care doctor, an insurer, an employer or a policy maker, this crisis is exceptionally important to you. The crisis means that Americans do not get the level or quality of health care that they deserve and need. This crisis is the major reason that …
Is solving the primary care crisis easier than we think?
I recently attended (and spoke at) the Concierge Medicine Assembly in Atlanta. My role was to give the perspective of a “successful” direct primary care (DPC) practice. This being the second such conference in three weeks, I’ve learned that my panel of 600+ patients and survival for two and a half years puts me in the higher ranks of solo DPC practices. The Atlanta conference was actually a combination conference, catering to …
This is what a successful direct primary care practice looks like
Dr. Google wants you to think he is your best friend. He is there for you day and night, no waiting rooms or office hours needed. He promises answers, and he gives them now. No testing, no lab draws. Dr. Google provides diagnoses after a few clicks on a keyboard and delivers the news in minutes, if not seconds. Dr. Google will …
Dr. Google should be sued for malpractice. Here’s why.
“Patient experience. I’d like you to take over the initiative,” he said. I looked to my left and right.
Sh*t. He’s talking to me.
For a moment, I had an overwhelming sense of insecurity. Give me operations. Give me finance. Give me quality. Give me strategy. But don’t give me patient satisfaction. That’s not me. I’m not light and fluffy. I’m not mushy-gushy. Nor …
How a patient experience doubter became a believer
One of my favorite books of late has been Confessions by St. Augustine. It is a very honest book that talks about the development of the faith of a young man who struggled to accept the faith that he was raised in. Throughout the book, one can sense the inner turmoil he felt at times trying to reconcile his faith with the …
Confessions of a religious doctor
As kids growing up in the Midwestern United States, my friends and I loved baseball. We spent many hours each summer day playing the game, and when we weren’t out on the sandlot, we were reciting the stats of top players, arguing the merits of our favorite teams, and trading baseball cards. Baseball is more than America’s pastime. It is a sport …
Taking a page from medicine to improve the quality of baseball
It was only afterwords that I wondered if I had been condescending. The words had come out so naturally. We were sitting across from each other in the nursing home. It didn’t take a doctor to recognize that his leg was visibly less swollen. I had seen him walking down the hallway with the physical therapist. His face a mix of pain, …
Let patients know when you’re proud of them
Individuality matters to doctors.
In the past, being a doctor brought with it an image. A selfless individual revered by his community and compensated well but fairly. The community had high expectations of him, and he could deliver because there wasn’t much to know. In those days, being a doctor was an entire lifestyle, and it drew extremely talented individuals to fill the …
Embracing individuality will save medicine. Here’s how.
I’m not actually on TV, but there are days I feel like I’ve accidentally stumbled onto the set of a sitcom. When neighbors have never seen your husband in the light of day and friends joke that he is make-believe, then you might be married to a … well, you know the joke.
Being married to a busy physician can leave you playing …
I’m not a single mom. I just play one on TV.
In a field filled with history, data, and very smart people, it can be difficult to do anything with confidence. And yet, this is one of the most desirable traits a doctor can have, that and a light hand when it comes to handing out narcotics. However, I have never been a fan of over-confidence. I feel that if you are going …
Imposter syndrome makes medical training more difficult than it should be
In the late 19th century, Dr. William Halsted, a pioneer of modern surgical techniques, performed ultra-radical mastectomies for women with breast cancer. The procedure, soon named after him, involved the surgeon removing not only the breast itself but also surrounding musculature and the associated lymphatic system.
Halsted believed, and taught generations of medical students, that the more radical the procedure, the higher the …
Why doctors overtreat patients. And how to fix it.
Patients are entitled to receive medical advice 24 hours a day. If you call your doctor at 3 a.m., you will reach a physician who will advise you. Of course, it may not be your own personal physician as this individual cannot be expected to be available 365 days a year until he retires. Physicians partner with colleagues who share on-call responsibility …
You have access to a doctor 24 hours per day. When should you call one?
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How I got 86% off my malpractice insurance. Now, you can too!
Mid-November, and Christmas music is already blaring from speakers camouflaged in silver holiday tinsel. Frank Sinatra’s croons reverberate throughout the barren expanse that is Somerset Mall at 8 a.m. “I’m dreaming of a white Christmas…” It’s raining outside. I begin to laugh and try to explain the apparent irony to my grandmother, but my attempt gets lost in translation. My Chinese is poor. Her English, poorer. …
Where will you find happiness now?
If someone was sitting on a veranda somewhere in the Alpha Centauri system, reading about health care in America of planet Earth, one would most likely conclude that the family of viruses known as the common cold are destroying a health system already crippled by a glut of poorly educated physicians practicing their miserable craft on a slow-moving …
It’s inevitable that physicians will evolve into virtualists
A guest column by the American College of Physicians, exclusive to KevinMD.com.
In the spring of 2009, I represented the American College of Physicians (ACP) at a meeting in Washington of health policy experts discussing payment reform. When I arrived at the cocktail reception the night before the meeting, a …
What, exactly, does a “real doctor” look like?
Jim almost convinced me. The burning in his chest, after all, could have just been gastroesophageal reflux. He assured me that the sensation was nothing new; that he got it from time to time after a large meal and took Tums. I couldn’t, however, ignore that it seemed to worsen with activity. The pain was bothersome enough to drag him into my …
Physician success stories don’t make it to the newspaper
When a doctor makes a mistake, it’s rarely out of ignorance. We usually have the knowledge we need. Instead, most medical mistakes happen because we’re tired, distracted, hurried, or indifferent — or maybe some combination of those things.
Since physicians rarely publicize their personal frazzled-and-frenzied, pooped-out or burned-out quotients, health care consumers shopping for a doctor often consider Board certification as a kind of Good Housekeeping seal of approval. The “board” …
Board certification is no guarantee of excellent patient care
A few months ago, the father of one of my best friends was diagnosed with cancer. He had to have surgery to remove the tumor. His father, being someone I’d known since childhood was like an uncle to me. After the surgery, I sat across from him in an otherwise empty hospital room on a sunny day in beautiful San Diego. It …
Patients just want their doctors to care. But too many don’t.
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