Dear NP student who rotated through here back over the winter: You probably don’t remember seeing this particular woman. I sent you in to do a well-woman exam on her; everything was completely normal. There was nothing particularly memorable about her, either clinically or personally. Just another nice lady coming through the office; just another physical. You asked her a question, though: “How are things in the bedroom?” She was too shocked ...

Read more...

If you want to succeed in academic cardiology, get a federal grant for research. Better yet: get a few well-paid industry grants, too. These days lower-paid academic cardiologists are finding it tougher to find protected time for research and speaking because grants are harder to come by and money from their academic center is getting tight.   For instance, the National Heart, Lung and Blood Institute (NHLBI) of the NIH no longer accepts ...

Read more...

In early 1996, I sat down at my computer looking for help. My third child, 2 months old, had just been diagnosed with a severe brain malformation called lissencephaly. He won’t be normal, the doctors said grimly. His life will be shorter, we were told. He will have seizures and other problems, they said, but it’s hard for us to say what or how bad those problems will be. We were ...

Read more...

My mother is my role model and my inspiration for what I do every day. She was diagnosed with breast cancer when she was in her forties, and fought it courageously for seven years until she passed away in 2010. There are so many stories I can tell about my mother and her battle with cancer. Let me start with just one. Whenever she’d go to her oncologist, she would go ...

Read more...

Facing advanced cancer, who among us wouldn’t look to our oncologist for expert advice on whether another round of chemotherapy makes sense?  But do you know what your oncologist cares about, and can you be sure her recommendations map onto your own treatment preferences? A recent study lead by Michael Kozminski (I was senior author) shows that American oncologists downplay the value of treatments that improve quality of life, ...

Read more...

Burnout is a constant threat for physicians. Research consistently shows an average of 1 in 3 doctors suffering from symptomatic burnout on any given office day. In my work with over stressed and burned out doctors, I have found that most of us work way too hard being the superhero to our staff, patients and families -- and don’t have any fun at all. It doesn’t have to be ...

Read more...

Here’s a little story from the early days of my first job as a chairman of surgery. Shortly after I assumed the role of surgical chairman in a community teaching hospital at the ripe old age of 40 and having absolutely no administrative experience, I visited a mentor of mine whom I had known since I was a medical student. He had been serving in a similar role at a larger ...

Read more...

A recent article, "Burned Out Nurses Linked to More Infections," addresses an important issue that is often overlooked and ignored. Let’s be brutally honest, without an appropriate nursing workforce, our entire healthcare system would collapse.  As our healthcare system continues to shift to a business and profit model, both nurse and physician burnout will only increase. Decisions to “cut corners” by not providing adequate nursing staff are made on a daily ...

Read more...

A recent case from Dayton, OH highlights the tangled mess of emergency department specialty coverage, federal law, and out-of-network insurance benefits.  When these interact, patients, doctors, insurers and hospitals can be left frustrated and perplexed. Here’s a brief summary. A 6-year old boy suffered a fingertip injury and the emergency staff called the covering plastic surgeon, who repaired the injury.  The surgeon, who does not participate with insurance, submitted a bill ...

Read more...

AMA works to reduce administrative burden for physiciansA guest column by the American Medical Association, exclusive to KevinMD.com. Since the American Medical Association launched our National Health Insurer Report Card in 2008, there has been noticeable progress by health insurers in response to the AMA's call to improve the accuracy, efficiency and transparency of their claims processing. The AMA has been working constructively with insurers, and as a result ...

Read more...