Psychiatry

Do microaggressions persist after practice?

Physician
July 29, 2022

Microaggressions are common, subtle, offending behaviors and attitudes that stem from implicit (unconscious) bias. Individuals targeted by microaggressions are different than us — different in their look, skin tone, gender, sexual preference, socioeconomic status, educational level and age.

Implicit bias refers to unconscious stereotypes, assumptions, and beliefs held about an individual’s group identity. They affect our understanding, actions, and decisions and increase Read more…

Perfectionism is a myth: Are you ready to hear the truths about perfectionism?

Physician
July 25, 2022

Are you a perfectionist?

Did you know that perfectionists are actually some of the biggest procrastinators? Yes, really.

In theory, perfectionism sounds like a good thing. Who doesn’t want to do and be their best? It can even seem like a harmless way to motivate yourself.

But the reality is, nothing is perfect.

What does “perfect” even mean? What does it look like? Who has the instruction manual?

It’s different for everyone. What’s “perfect” in …

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A child psychiatrist on Sarah Silverman’s The Bedwetter

Physician
July 21, 2022

As a child psychiatrist, it was such a pleasure to see a play about a child who suffers psychologically and finds a way to heal that does not require an epic quest, a magical ability,  becoming a princess, or even fixing the problem itself.

Sarah Silverman’s delightfully witty, dirty, and wordy musical, The Bedwetter, which ends its run today, features a spunky and irreverent 10-year-old girl with typical tween issues. A …

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The claims data dilemma: 4 things to consider

Policy
July 20, 2022

I recently met with leaders of provider organizations representing a range of specialties and geographies. One of the themes that came through loud and clear was their ongoing struggle to obtain claims data from their payers. As providers continue their efforts to navigate alternative payment models (APM), their need for global claims data becomes a more pressing issue.

Why claims data is important to providers

Many providers are still in a position …

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A bullied medical assistant’s tragic story [PODCAST]

Podcast
July 19, 2022
YouTube video

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“Today, I’d like to tell you the story of one who was exemplary. He was never late to work. He never came in and insisted on finishing his breakfast at his desk before rooming our first patient. He was so personable that they …

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It’s time to invest in trauma-informed ACEs interventions

Policy
July 19, 2022

Last year, I witnessed the extreme consequences of untreated childhood trauma as a medical trainee rotating through multiple safety-net hospitals in Los Angeles County.

I helped care for children who arrived in our emergency departments after multiple suicide attempts due to trouble in the home. Some children confided in me about their parents’ struggle with untreated substance use or mental illness and how witnessing these conditions deeply affected them.

Other children were …

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The new 988 hotline has the potential to transform mental health care, but challenges loom

Conditions
July 13, 2022

The federal 988 hotline represents a promising new approach to alleviating the nation’s growing mental health crisis, but several key challenges loom that could derail this well-intentioned initiative.

One significant information technology challenge the hotline will face involves how to uniformly store and interpret mental health data (more on that later) but the most immediate roadblock is a lack of awareness.

Though the hotline is scheduled to debut in July, the program, …

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Protect the rights of licensed health care workers to take buprenorphine

Meds
July 13, 2022

Early in my addiction medicine fellowship, I met a patient for the second time while shadowing another physician in their practice. The patient was a former nurse with opioid use disorder on maintenance therapy with buprenorphine (commonly called Suboxone, the original brand name of a formulation combined with naloxone), a partial opioid agonist that is FDA-approved for the treatment of opioid use disorder and can be conveniently prescribed in the …

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When is enough … “enough” in your career?

Physician
July 10, 2022

We spend so much of our lives chasing a sense of doing “enough” and being “enough.”

Though I anticipate it’s been years in the making, I feel like I woke up one day and just had enough. This time, it wasn’t in a hopeless way. It was more of an awakening and permission to stop running on the treadmill to nowhere.

At first, I felt a wave of grief as I let …

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What doctors need to know about physician health programs [PODCAST]

Podcast
July 1, 2022
YouTube video

Subscribe to The Podcast by KevinMD.

“Change is overdue. Physicians who need help for mental health issues or substance use disorders need to get it in a manner that is free of financial and other conflicts of interest. They need to be able to go to …

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How to fix the psychiatrist shortage in the U.S.

Physician
June 27, 2022

Mental health disorders are by far the largest cause of disability in the world. More money is spent on mental health than either diabetes or cardiovascular disease. About 45 million people in the U.S. have a mental illness. Almost every American will, at some point or another, face a mental health challenge. It may be related to depression, anxiety, suicidal thoughts, substance abuse or maybe something more circumstantial like grief …

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Boards should protect the public, not destroy doctors

Physician
June 26, 2022

Every primary care doctor knows what we are up against. The obstacles are many: payers, licensing boards, MOC, CME requirements, coding for billing, access issues, and the changing clinical field.

Sometimes these cause real harm.

Fifty miles north of where I-95 ends in Maine, winters there are long. My friend Dr. J did locums and spent a winter there. He tries new things wherever he goes, like spearfishing on Maui. So he …

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Why is there a shortage of mental health professionals?

Conditions
June 26, 2022

There are many topics on which I cannot claim to be an expert. I cannot solve the issue of gun violence, I don’t know what will “fix” the current societal crises, and I have no idea what will happen in the future regarding climate change.

There is one topic that seems to be coming up with more frequency and regularity, and I am qualified to speak on that. The shortage of …

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Game over for behavioral health

Conditions
June 24, 2022

He was a tall, healthy psychiatric technician, experienced in his line of work. He was a CNA but wanted more. He wanted to help heal the troubled, forgotten, and neglected — behavioral health was his niche.

He would lead the way with therapy sessions in this group every day. This was Intensive management: the intermittent home for the paranoid schizophrenics, bipolar, and MDD.

They came in all shapes and sizes — wealthy, …

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A physician’s struggle with postpartum depression

Physician
June 24, 2022

It’s been five days since I’ve been able to sleep. My two-month-old daughter coos softly in her bassinet. My husband sleeps soundly next to me. But I lay awake, hijacked by thoughts that I am a bad mother, wife, and doctor. This unwanted torment consumed me. All I wanted was to remain still and make this stop.

I lay awake; time stands still.

I am swept by flash currents beyond my control.

I …

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Who do we become when we love work more than we love ourselves?

Physician
June 22, 2022

On June 4, 2022, CNN.com published an Opinion piece written by Carolyn Chen: “Why ‘do what you love’ is the worst graduation advice.” As a mother of a recent college graduate, with two others close behind, I read it to garner insights into which encouraging words to use with my own babies entering the adult workforce. The target audience is college graduates, narrowing the relevance to those privileged to …

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Fresh prescriptions: Looking for the twinkling lights

Physician
June 15, 2022

I always got my contacts from Costco, and it constantly felt like a chore. Like any child made to go on errands with their parents, Costco was my eye-rolling-moan-inducing trip.

I realized my eyes were inadequate in third grade while reciting the Hail Mary. I was a little distracted as my blue and green plaid skirt was all twisted and the scratchy green sweater vest a little too tight. Despite years …

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