A guest column by the American College of Physicians, exclusive to KevinMD.com.
I distinctly recall during residency a much older and well-respected clinical teacher periodically opining that what was needed in a particular patient case was “a dose of the tincture of time.”
For those less familiar with more historic terminology, a tincture is an alcoholic …
The health care experience is so much more than a buzzword to be talked about in administrative circles. Some physicians I encounter (a minority, but still enough) really scoff when they hear this term. Responses I’ve heard from doctors include: “Hospitals are not hotels!” or “If that means giving our patients as much Dilaudid as they want, then count me out!”
Aside from these sweeping statements being entirely silly, they are …
Many patients who end up in Suboxone treatment have chronic pain. They were originally prescribed other opiates and ended up addicted to them.
Skeptics argue that is just substituting one opiate for another. But that isn’t quite accurate. More on that in a bit.
In my seven years of prescribing Suboxone for opiate addiction, I have often observed how potent a pain reliever this medication is, even in fairly low doses. More …
We know the statistics. More than 50 percent of physicians are experiencing burnout at the hands of EMRs, a nonexistent work-life balance and regulatory constraints to name a few. This is causing physicians to leave clinical medicine and find other work. Some are opting for nonclinical administrative roles, and others are leaving altogether for careers outside of medicine. This is adding to the shortage of physicians that we were already …
This article is sponsored by Careers by KevinMD.com.
When George W. “Billy” Campbell, MD, walks down the street, he never knows who — or what — he’s going to encounter. Anything can happen when you’re the doctor at Foothills Family Medicine of Westminster, South Carolina, a small town with a population of only 2,500.
“I’ve had someone pull …
For longer than anyone could remember, he was the rural community’s pharmacist. A skilled compounder of prescriptions, he was conversant in chocolates, greeting cards, and how to obviate a trip to the doctor’s office by using an over-the-counter remedy.
A devoted family man, he was involved in many civic and church activities. Most have forgotten all the roles he once played in the community, but no one will ever forget that …
Back when cholesterol target numbers ruled unopposed (before 2013), we all checked fasting lipids every three months. Before 2012, we also checked liver function quarterly in hapless riders on the cholesterol pill merry-go-round. That year the FDA announced there had not been enough reports of statin-induced liver problems to recommend routine monitoring.
I have many colleagues who still do this, and who also routinely monitor routine labs quarterly …
Figuring out what’s actually true is far harder than most people realize. Our brains are both hypothesis-generating machines and incredibly credulous. As a result, most of the things we believe to be true turn out to be false. We don’t just mistakenly believe that vaccines cause autism, that the flu shot can give us the flu, and that astrology can predict our future. We also mistakenly believe that the salad …
A guest column by the American College of Physicians, exclusive to KevinMD.com.
Those of us who provide clinical care inevitably have patients who simply don’t do what we tell them. And this isn’t limited to only primary care but is encountered in all specialties and by subspecialists and consultants alike.
Not only can this be frustrating …
We’ve all heard about the importance of greater stakeholder collaboration in health care. It’s the premise of current movements aimed at improving the outlook on some of the most costly, chronic conditions.
Like most physicians today, I maintain a tight work schedule to keep bottom-line margins in the black. On a daily basis, I see between 25 and 30 patients while also serving as the medical director of employee health for …
It’s a common scenario: a patient shows up to my office lugging a bagful of over-the-counter supplements, defiantly informing me that they “don’t believe in prescription drugs.” In the very next breath, they present a lab slip with a list of bloodwork that their alternative medicine doctor wants me to order to help diagnose their myriad symptoms.
I’ll admit, my initial natural reaction in this situation was a feeling of annoyance …
“There will always be suffering. It flows through life like water …”
Those famous lyrics sung by Nick Cave in his Lime-Tree Arbour ring true for many of us. They take on an entirely different layer of meaning for physicians.
Even the very journey of becoming a physician is marked by suffering. While many of our classmates frequented football games, nightclubs, and social events, most of us were studying day and night …
Sometimes things go just the way you want them to, and sometimes they don’t.
Compare and contrast the case of two different patients, and how things went trying to get them the care they needed.
The first patient, let’s call him Mr. Smith, called up one day last week with a brand-new symptom, which after a phone call was ultimately determined to be disturbing enough that he was offered a same-day appointment.
After …
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The medicine I practiced between 1974 to 1992 is gone. Evidence is the coin of the realm in the courts of modern medicine. The rule “first, do no harm” demands a corollary — be paranoid.
We receive extensive training and licensure to “touch” patients. Any person who is not a physician who cuts into another person commits a very serious crime. The same is true for merely talking with a person, …
An excerpt from Let Go of Emotional Overeating and Love Your Food: A Five-Point Plan for Success. Copyright © 2018 by Arlene B. Englander. Published by Rowman & Littlefield. All rights reserved.
Anyone who has ever tried to lose weight or keep weight off realizes that evening can be …
We should consider a new position in our primary care teams — that of the scrum master. “Scrum” is a rugby term that comes from agile, a work methodology for software development that now is being applied to industry and health care.
In rugby, a scrum is a huddle where the teams come together with interlocked arms to regroup and start play again. In agile, scrum masters facilitate team huddles and …
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It’s hard for me to believe that a few years ago, I completely turned my back on an acting career I had spent almost two decades building and instead decided to forge into an unknown world of medicine. Even now, with nearly seven years of experience in the medical field and currently in my fourth year of medical school, I sometimes feel lost for an identity.
At the time of my …
The other day I felt like a used car salesman.
I was carefully phrasing my words, picking out just the right ones — the kind that really pack a punch — and delivering them at the right moment, with the perfect momentum. I was trying to make a sale.
Now, my cadence happened to be spot on, as I approached the finish line: the part where I get to package it all up. …
I saw two patients with a chief complaint of bubbles in their urine this month.
One middle-aged woman had eaten some wild mushrooms she was pretty sure she had identified correctly, but once her urine turned bubbly a few days later, she came in to make sure her kidneys were OK.
Even though she was feeling quite well, they were not, and she ended up going straight to Cityside hospital for IV …
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I spent my first two years of medical school collecting stories. I journaled about my thoughts in the anatomy lab. I wrote about what it was like to learn how to interview and examine patients, about the immense honor and privilege I felt just being able to don a white coat with a stethoscope around my neck. I wrote about the patients that touched my heart – the patient with …
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