Primary Care

You need to ask these questions to teens starting hormone therapy

Conditions
September 17, 2022

In medical practice today, we have all types of providers in charge of birth control counseling and treatment: medical doctors, nurse practitioners, registered nurses, licensed vocational nurses, and even medical assistants who report to their licensed providers. Having a standardized questionnaire that all providers can easily use and incorporate into their practice would help safeguard against regretful avoidable mistakes. Taking a good history is cheap. Health care costs for strokes …

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The recent closing of Amazon Care shows the magnitude of the challenge in changing health care

Tech
September 13, 2022

Amazon recently announced plans to shut down Amazon Care, an in-home and virtual health care service.

The reasons cited were attributed to a significant overlap of services with the One Medical chain of clinics, which Amazon purchased in July of this year for 3.9 billion, as well as Amazon Care not being a complete enough offering for large enterprise customers for which it was targeting.

This is the third health …

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Physicians did not go to provider school

Physician
September 8, 2022

“If both of you are the same, then one of you is unnecessary.”

That’s one of my brother-in-law’s favorite quotes, and I think it’s applicable to the ongoing debate for physicians to be called “physicians” instead of “providers.”

When you think about what’s been happening in health care, physicians, physician assistants, and nurse practitioners are advertised as equivalent.

How is this equivalence being promoted? By lumping us all into the same category called …

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A personal story about trying new things

Physician
September 5, 2022

You’ve got to understand that I don’t like anything being thrown at my face.

Seriously.

This fear goes back to my childhood in Ontario, Canada, when after school in the winter, the neighborhood kids got together to play hockey. Our back yards abutted on a park which had a big field that, come winter, was iced over by a local parent late at …

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How to make primary care rotations more appealing for students [PODCAST]

Podcast
September 4, 2022
YouTube video

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“It is time that every health profession school specifies their criteria for optimal teaching primary care practices and for the training that would optimize their students’ experience. It is time that we, as primary care physicians, advocate …

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How whole-person care can make us better healers

Physician
September 4, 2022

My patient at a pain clinic on a military base in Virginia carried the deep wounds of war on his face. Not physical scars, but a sallow, slack complexion and a hollow-eyed look of exhaustion and defeat. A veteran of the war in Afghanistan, he had long been suffering from anxiety, depression, and other complications of PTSD, although his presenting complaint was back pain.

The patient, whom I’ll call Sergeant Carlson, …

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How writing a letter on Substack might recharge your life in medicine

Physician
September 4, 2022

“The good life is ever-changing, challenging, devoid of regret, intense, creative, and risky.”
-Friedrich Nietzsche

One year ago, bruised and battered like any physician practicing in this pandemic, I decided to double down on weariness and start writing a medical letter on Substack. I’ve been writing about once a week, with subjects ranging from the newest coronavirus variant of concern, to a reflection on the hidden strengths in frailty, to the pleasure …

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Why this doctor prefers perfectionist physicians

Physician
September 2, 2022

Your plane is about to take off. Like most folks, you are just a little anxious about flying. It is very rare, but you know a lot of bad things can happen to the machine that carries you at 30,000 feet above sea level. Consider this: Would you rather the mechanic who inspects your aircraft be absolutely conscientious to every minute detail, be exquisitely perfectionistic in his examination of the …

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Smaller practices should participate in clinical research. Here’s how they can.

Physician
September 1, 2022

The COVID-19 pandemic and the resulting shutdown accelerated the adoption of decentralized clinical trials (DCTs). The number of trials with virtual and/or decentralized elements exceeded 1,000 in 2021 for the first time, according to GlobalData. That’s a 50 percent increase from 2020. GlobalData expects the number of site-less and/or virtual clinical trials to jump another 28 percent this year, potentially topping 1,400.

This presents a perfect opportunity for smaller and …

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Narrative medicine develops empathy among physicians

Physician
August 31, 2022

A hallmark of modern medicine involves providing compassionate care through an empathetic doctor-patient relationship. This post describes one powerful technique for developing empathy among medical providers: narrative medicine writing.

What is empathy?

A basic definition of empathy involves your ability to understand someone else’s perspective by putting yourself in their (metaphorical) shoes. Empathy can involve cognitive aspects (i.e., understanding why a person is feeling sad or happy) or emotional aspects (i.e., sharing …

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Fill mid-level positions with unmatched medical graduates

Education
August 29, 2022

In a crowded primary care clinic in an inner city, Mr. Smith, with pursed lips, was sitting next to his oxygen tank and waiting patiently for his doctor. He gratefully commented on how much the oxygen tank had helped him with his daily activities. However, his recent Covid-19 infection had exacerbated his symptoms. It had been more than two weeks since he started coughing. He couldn’t wait to see his …

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Immediate, accurate diagnosis is crucial to the future of equitable patient care

Tech
August 29, 2022

As the pandemic-stricken health systems recover from the unprecedented challenges that tested them for preparedness, agility, and health equity, the pandemic undoubtedly also nurtured rapid innovation in telehealth, vaccine manufacturing, and point-of-care diagnostics, which have streamlined and accelerated patients’ access to immediate care at the point of need.

These technological medical advances, especially in the realm of point-of-care diagnostics, are transforming our health system in three especially important ways:

Firstly, point-of-care diagnostics …

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Hope, with a ribbon of uncertainty curling gently around it

Physician
August 27, 2022

A tall, thin, down-glancing man slumped in a chair in the corner of the exam room.

His gray-haired wife sat primly next to him.

They were here with their adult wheelchair-bound daughter.

For the past two decades, the daughter had been under their constant care at home.

A chronic progressive illness had wreaked havoc on this young woman’s body.

Her adult life had been held prisoner by an insidious neurologic disorder.

She was having a problem …

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As we get older and the world changes, it’s not always an easy task to say “where”

Conditions
August 25, 2022

“Where does it hurt?”

As a child, I can remember this ubiquitous question being frequently asked of me. Having grown up on a farm, there was always some trouble for me to get into. A common hazard was my older sister’s 26-inch bicycle, which had no training wheels.

At age 5, if I was to be a “big kid,” I had to master the art of riding the “big” bike on our …

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Improving communication requires tough soft skill development

Conditions
August 25, 2022

If we are going to take on the challenge of improving communication and related behavior, a.k.a. “soft” skills among health care professionals, we should be realistic. As nurses, doctors, and other health care professionals, we are keenly aware of how difficult changing behavior can be. We see it daily in our patients’ efforts regarding healthy choices and lifestyles. For example, it can be hard to lose weight, exercise regularly, or …

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Why you need to care about oral health [PODCAST]

Podcast
August 24, 2022
YouTube video

Subscribe to The Podcast by KevinMD. Catch up on old episodes!

“Guess what? The mouth is attached to the rest of the body. And though dentistry and medicine are typically separated from the very beginning of professional training, they are irrevocably linked for patients and have an impact …

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Patients who are openly skeptical of a physician’s science-backed advice

Physician
August 22, 2022

I’ve just passed the 15-year milestone of practicing family medicine in a small farm town in the Midwest. Knowing my patients and their multi-generational families deeply and enjoying their trust is a major part of my job satisfaction.

Unfortunately, the last two years have put a serious dent in both the trust and the satisfaction.

No one ever takes all the advice their physician gives them, at least in my experience. Until …

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Keep us safe: Stop the violence against health care workers

Physician
August 22, 2022

Violence against health care workers has escalated to unprecedented levels in the last decade. The pandemic seems to have accelerated outbursts against health care providers online, in print, and in person.

A man from Tulsa, Oklahoma, recently angry over back pain, killed his surgeon and other health care workers before ending his own life.

Many health care workers report they are used to working in environments that are …

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