Primary Care

A medical student’s guide to taking a social history

Physician

August 11, 2021

Dear medical student:

I was in your shoes twenty years ago. At that time, I thought that becoming a doctor was all about gaining medical knowledge. When I started my clinical rotations, I was convinced that the “history of present illness” is the most important aspect of patient evaluation. As a resident, I felt that navigating through the differential diagnosis and treatment options is all that medicine is about. Now, being …

Primary care: I love the variety and the intimacy of the problems that are placed before me

Melissa Schiffman, MD

Physician

August 4, 2021

An excerpt from Becoming Doctors 25 Years Later: Twenty five physicians sharing the journey from medical student to retirement.

If I get out of bed now, I can squeeze in that ten-minute morning yoga routine on YouTube. But it feels so nice lying here, sunlight streaming in, sips of coffee warming my body and boosting my heart rate up a notch. If …

Don’t let anyone tell you to stay in your lane

Diana Londoño, MD

Physician

August 3, 2021

Do you ever wonder why some issues are global or universal? It does not matter if you are a surgeon, a mega soccer star or a world-class runner—we all have things in common. Whether you are at the top of your game or just climbing your way, we must always fight for equality, for basic rights, for humanity?

While driving home, I heard an NPR interview with Megan Rapinoe, the U.S. …

Can doctors have personalities?

Erika Visser Aragona, DO

Physician

August 3, 2021

Can doctors have personalities? I get this question a lot, or, rather, I get told by patients as a running joke that physicians typically lack the fun gene. Understandably, we have dedicated our youth to the medical profession and have missed out on most of our twenties and thirties by completing rigorous training and building our new careers to where we do lose a crucial time in early adulthood development. …

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Can doctors have personalities?

The future of general internal medicine is bright

Betty Rabinowitz, MD

Physician

August 2, 2021

A 2020 President’s Message by Dr. Douglas DeLong struck a reassuring, optimistic note regarding the future of general internal medicine, a primary care specialty that has struggled in the last decade with decreasing numbers of residents choosing to join its ranks. Data shows that since 2011, the percentage of U.S.-trained physicians who have matched into primary care positions has been on the decline.

Many factors …

Burnout and bias? Or medical gaslighting?

Kara Wada, MD

Physician

July 29, 2021

Five years into my practice as an academic allergist/immunologist, my perceptions continue to evolve. Though once primarily informed by my mentors’ wisdom, I continue incorporating my experiences as both physician and autoimmune patient to guide my practice. Though we all know medicine isn’t like it used to be, nostalgia is bittersweet. In its wake, the real question remains: how are we going to respond to ongoing changes and fight for …

3 mistakes physicians make that triple charting time

Gail Gazelle, MD

Physician

July 19, 2021

Let’s face it, what’s getting most physicians down is not their patients. No, ask any group of physicians what the hardest part of the job is, and you’ll like get a pretty consistent response: It’s the EMR! With studies showing that we spend, on average, two hours on “paperwork” for every hour in the room with a patient, there’s no question that it is a massive time suck for most. …

The burden of the documentation and administrative tasks on physicians needs to be lightened significantly

Rosemary Eseh-Logue, MD

Physician

July 19, 2021

It takes a special person to care for people during their most vulnerable states, to keep intimate details about people while remaining compassionate even toward the seemingly vilest of persons. The white color of a physicians’ coat can be a metaphor for the purity expected of physicians. A physician’s signature or words carry weight. With such power comes the responsibility to be trustworthy.

Documentation is an important part of patient care. …

A holistic approach to health and wellness requires openness and vulnerability

Tomi Mitchell, MD

Physician

July 15, 2021

The health care crisis is a difficult one to face. Health care budgets have skyrocketed, and rates of chronic illnesses have increased much faster than before. As physician leaders, what if we each took personal responsibility for the crisis? Perhaps it all boils down to how many people trained in health care know what is necessary for living healthy lifestyles. Yet, that knowledge often doesn’t materialize in excellent health outcomes. …

A resignation letter to my patients: How do I leave you well?

Anonymous

Conditions

July 14, 2021

Before I walk into clinic, I already know their response if I submitted my resignation letter today.

I hear it monthly from multiple patients who have no reason to believe I’m leaving: “You aren’t going to leave too, are you?” “It took us years to get here after the last doctor left.” “Please promise me if you move on, you will let me know where you go.”

They have baseline trauma from …

Stop blaming others. You need to own your actions.

Diana Londoño, MD

Physician

July 13, 2021

Own it.

People sometimes say, “Own it.” Own your mistake. We use it less frequently to say own reactions or actions instead of blaming others and external forces for our actions. Life coaches call it being in a state of “emotional childhood.” It means that instead of saying you are responsible for your thoughts, feelings, and actions, you blame others for these.

“The situation is bad.”

“I am angry because it is not …

The unfair blame on primary care physicians

Sheetal Khedkar Rao, MD

Physician

July 12, 2021

When plastic surgeon Dr. Robert Pearl published his Los Angeles Times op-ed, “How Doctor Culture Sinks U.S. Healthcare,” a polemic essay critical of primary care physicians like me, he set off a firestorm. While he made some valid points, Dr. Pearl also blamed many of the preventative health failures in the U.S. squarely on the shoulders of primary care physicians without acknowledging that our health care …

Why do patients hate going to the doctor?

Maheswari Raja, MD

Physician

June 30, 2021

“No offense to you, Doc, but I hate coming to the doctor.”

I hear these words at least once a week when I walk into a patient’s room.

In 15 years of practice, that means about a thousand times.

And that does not include my training years.

There will be variations of the theme, of course:

“I really don’t like coming to the doctor.”

I get anxious in the doctor’s office. That is why my blood …

Why I became a doctor: reflections on a calling

Gerald P. Corcoran, MD

Physician

June 24, 2021

The landscape of medical practice has changed dramatically over the many decades I have been in practice. Most of these changes are intensely discouraging and depressing and are negatively affecting the physicians of today. The government, hospitals, networks, even our own professional organizations are working to establish and enforce new regulations — new hoops for doctors to jump through, mainly in the furtherance of their profit and their power over …

Language is a barrier for many patients. Let’s change that.

Laura V. Robles-Torres

Conditions

June 15, 2021

My role as a care coordinator for a local mobile health clinic — the mobile outreach clinic (MOC) — comes with responsibilities seldomly awarded to an undergraduate, 20-year old, volunteer student. MOC is unique in that it not only provides free, low-barrier, patient-centered primary care, but it also assigns patients to volunteer care coordinators. Care coordinators have a daunting task: to identify our assigned patients’ socioeconomic barriers to health and …

Are you a healer or a widget?

Steve Adelman, MD

Physician

June 9, 2021

In the “Show-Me State” of Missouri, physicians receive their licenses from the Board of Registration for the Healing Arts. Seriously! This quaint term harkens back to a time when newly minted doctors had a relatively easy time realizing their desire to meld compassion, knowledge, and skill in order to relieve human suffering.

Armed with credentials suggesting that we have the right stuff to avoid doing harm, many of us are drawn …

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Are you a healer or a widget?

365 shows later: The Podcast by KevinMD’s most popular episodes

The Podcast by KevinMD

Podcast

June 1, 2021

It’s been such an inspiring journey for The Podcast by KevinMD! I started the show one year ago, on June 1, 2020. I didn’t know what to expect, who would want to be on the show, or who would listen. Heck, I didn’t know the first thing in starting a podcast.

I did know one thing: Thousands intersect with our health care …

The mission of medicine: not just a job

Pepi Granat, MD

Physician

May 31, 2021

The mission of medicine is to heal the sick. When cure is elusive, it is to relieve distress, and always to comfort. All of us who became physicians had our reasons, but we had to have a genuine interest and ability in science, and an appreciation of people as individuals living in families and societies. We had to be willing to work hard to learn and to keep up with …

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The mission of medicine: not just a job

Doctors’ dirty little secrets

Tomi Mitchell, MD

Physician

May 27, 2021

Doctors have a few dirty little secrets. We have the highest rates of suicide amongst all professions and are in desperate need of mental health reform.

For those who don’t know what it’s like to work in this area, it can be difficult to understand the pressures that doctors face daily.

Doctors live their lives balancing an intense workload with long hours, often without any time for themselves or their families. Many …

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Doctors’ dirty little secrets

I was a doctor. Could I also be a nurse?

Jennifer Lycette, MD

Physician

May 26, 2021

One of my clinic patients recently asked me to administer his intramuscular medication injection. I appreciated the vote of confidence but had to tell him he was mistaken in thinking that my skill would surpass that of our nurses’.

“Trust me,” I told him. “You’re in better hands with them.”

It reminded me of the time, some years back, when I inadvertently found myself “impersonating” a nurse for a school field trip. …