A guest column by the American College of Physicians, exclusive to KevinMD.com.
When talking with patients – particularly those with multiple, complicated medical issues – it often doesn’t take very long to hear about their increasingly suboptimal and sometimes harrowing interactions with our health care system.
Examples include inpatient experiences in which care is provided by …
Most Saturdays, I join a therapy session down the hall from where I do my walk-in clinic. A patient of mine has a weekly session just before the Alcoholics Anonymous meeting at noon in our big conference room.
Last weekend he told my behavioral health colleague that the people in the AA group who have the most solid recovery seemed to be the ones who claimed to carry a lot of …
I recently wrote an article giving 3 reasons why any patient may not have liked their doctor. They included the physician being visibly in a hurry, appearing to brush off concerns, or giving a general sense of not caring. While no doctor deliberately sets out to do any of these things, complaints like these are all too common, unfortunately.
The degree to which the practice of good medicine is …
A recent New York Times piece had the catchy title, “Don’t visit your doctor in the afternoon.” It was prompted by a study published in JAMA Network Open that had the much less catchy title “Association of Primary Care Clinic Appointment Time with Clinician Ordering and Patient Completion of Breast and Colorectal Cancer Screening.” The study found that the frequency of appropriate ordering of …
It was the first time the young woman had come to the health center in a suburb just north of Chicago. When the 26 year old walked into the exam room back in 2008. There was no paper chart or electronic health record (EHR) accompanying her, no background information — nothing to indicate anything but a routine annual gynecological exam.
She and her husband were about to try to have their …
“I have the CPAP machine. I’ve had it for a year, but I don’t have electricity in my house. I stayed with my aunt who has electricity but things didn’t work out,” said the young Navajo man, his massive belly protruding out from underneath the tray table.
The old Navajo man with Parkinson’s disease, unable to walk fast enough to make it to the outhouse in time, had started taking anti-diarrheal …
Work-life balance is hard, and that’s true for so many career options both in and out of the medical field. The topic is something that you consider as you choose a career path. It’s something that you struggle to achieve and maintain as you train for your job, and as I have found out over the past eight months, something that you have to invest energy into after finishing training …
Recently the CEO of a large health care network stated: “Market forces don’t apply to health care.”
Of course, economic and political forces apply to health care. Big Medicine’s most powerful entities (insurers, hospitals, medical schools, pharmaceutical companies, pharmacies, and government agencies) formulate health care policy to enrich themselves at the expense of patients and small, independent medical practices.
As an independent family doctor, my practice’s existence is in jeopardy. Small physician …
Practicing medicine at the frontlines is hard. It’s damn hard. Every minute you need to be alert, ready to respond to a potential life or death situation, and be called to another important problem. The current medical practice environment — with excessive bureaucracy, suboptimal information technology, and extreme time pressure with patients — adds exponentially to the mix, and can make for a very stressful job. Make no mistake, even …
This article is sponsored by Careers by KevinMD.com.
“Sometimes you want to go where everybody knows your name.” So go the famous lyrics from the theme song for “Cheers,” the iconic sitcom of the 1980s. The name thing can get really personal in medicine — and everyone has an opinion — as evidenced by a plaintive blog posting …
I often wonder what it was like before patient-centered care became a mainstream catchphrase. Was there a poor relationship between the patient and physician in the outpatient setting? Were hospitalized patients’ feelings, desires, goals, and therapy options ignored? It amazes me that we were able to care for patients more than ten years ago without using a “patient-centered” approach.
According to NEJM Catalyst, “Patient-and family-centered care encourages the …
As medical professionals, one of the most challenging things to do is to motivate a patient to make changes in their lives. We passionately want the best for our patients, and it is sometimes so difficult for us to be able to connect with and inspire them to take the next step on a path to disease prevention and longevity. The solution? Enter Lebron James and Tom Brady.
It is no …
My elderly patients miss the days when, in an emergency, they could call their family doctor at home, and they’d be cared for. Retired doctors reminisce about the “good old days” when they were in charge of their own schedules and could prescribe whatever drug or test they felt necessary based on years of experience. While there was a strong doctor-patient relationship in those bygone days, it was not necessarily …
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To treat any condition, the doctor needs to know what it is. You would not expect to have your sore ankle treated with penicillin or to have an appendectomy recommended for your sore throat. While this may be self-evident, I know of at least one patient who had a normal appendix removed because the surgeon did not notice the few telltale blisters that were warning the careful observer that the …
Being a primary care physician, I was afraid to start my own practice. There was discouragement from fellow physicians, hospital leaders, business colleagues, and even patients. Many said that the small practice model was not viable. With insurance mandates, mounting bureaucratic pressures from Medicare and Medicaid, increasing regulations by DEA, higher volumes of paperwork, and the health IT requirements, the task of setting up a private practice with primary care …
No one wants to be sick, especially when no one can tell them what is wrong. In the U.S., we live in a culture where we want instant results; we want easy answers for complex problems. However, in medicine, there are often no easy fixes. Adverse medical events happen, despite our best efforts. For example, a young child was recently diagnosed with Type 1 diabetes mellitus. While he and his …
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As more patients and clinicians are searching for holistic approaches to health care, Ayurveda, or the traditional medical system of India, has been gaining popularity in the Western world. Unfortunately, many allopathic physicians still view this system as “quackery” because of its focus on the “intangibles” of health. However, Ayurveda has contributed immensely to the foundations of modern medicine, which many may not know. Sushruta was an Indian scholar and …
“I drank beer with my friends. Almost everyone did.”
Alcohol has become constitutional to American culture: “grabbing a drink” after work, happy hour, cheers before meals, on New Year’s, or just because. Our society’s normalization of drinking creates a slippery slope toward excessive alcohol use. Unhealthy alcohol use is rampant: one in six Americans drinks excessively four times a month, according to the Centers for Disease Control (CDC). Almost thirty percent …
A guest column by the American College of Physicians, exclusive to KevinMD.com.
Much has been discussed in recent years around the concept of “practicing at the top of your license.” But what does this really mean?
The most common definition is that each medical professional’s routine activities should utilize the full extent of their education, training, …
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Perhaps the most important aspect of a physician’s role is our diagnostic capabilities. Truly, if we cannot identify and diagnose a patient’s pathology with reasonable accuracy, we cannot effectively treat them and may even cause greater harm.
Let’s look back. The year is 1816, and you are a physician evaluating a patient with shortness of breath. The common practice of the time was direct auscultation by placement of the practitioner’s ear …
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