Not old enough to remember any sort of “glory day” in medicine, I still enjoy hearing from older colleagues who recount days when they were respected, paid fairly, and able to practice medicine autonomously at the highest and most uncompromising level. What was that like, I wonder?
For five years, I’ve been a busy practicing anesthesiologist. And for five years, I’ve listened carefully to and cataloged the gripes and woes of ...
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After six weeks in the accelerated bachelor of science in nursing program at the University of Rochester, I was already on clinical rotations in the hospital. I was learning clinical functions that my second-year medical school friends had no idea how to perform: catheterizations, wound dressing changes, how to calculate and administer medications. There’s just not enough time in the first two years.
On the other hand, in the nursing program, ...
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Psychotic and manic depressive disorders can not only disrupt the life of the person suffering with one of these illnesses, but the lives of family and friends as well.
You should seek professional advice if you suspect that you, a friend or a relative or even a spouse may be experiencing a psychotic or bipolar disorder. It's important not to attempt a diagnosis yourself. There are many external factors that can ...
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What is the measure of successful technology adoption? Is it never having to hunt for a missing chart? Is it a reduction in specific operating cost line items? Is it about access to clinical information when you need it and where you need it?
Technology implementation has a significant effect on profitability. The Medical Group Management Association Cost Survey Report beginning with 2010 data shows that total medical revenue after operating ...
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I recently took part in a "civil discourse," an unusual occurrence in this era of media pundit-orchestrated shouting matches.
Unlike a debate with winners and losers, a civil discourse begins with the premise that, when there are different points of view on a topic, it is better to understand those with whom we disagree than to turn off the sound.
By listening and asking probing questions, we come to understand how such ...
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Medical and surgical errors are very common in the hospital setting. They increase malpractice lawsuits, the cost of medical care, patients’ hospital stays, and morbidity and mortality. As an infectious diseases specialist for over forty years, I was not aware how common these errors are until I became a patient myself after being diagnosed with hypopharyngeal carcinoma. My initial cancer was successfully removed, but a local recurrence occurred twenty months ...
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I have witnessed a lot of obesity bias in my career, and I have railed against it on more than one occasion. But it's not the focus of my career, as it is for some of my colleagues. I have long thought those colleagues who do devote themselves to the topic may tend to overlook a very fundamental question, namely: Why would obesity bias ...
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Choosing a new doctor is never easy. You need to know about convenience factors, such as office location, available appointment times, and accepted insurance plans. You will probably also consider background information, such as education, board certifications, and licenses. But the most important question you likely have involves results: Is this doctor any good?
Unfortunately, there just isn’t a single, perfect way to measure the quality of individual doctors. ...
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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 45-year-old man is admitted to the hospital for a 2-day history of fever and abdominal pain. His medical history is notable for cirrhosis due to chronic hepatitis C, esophageal varices, ascites, and minimal hepatic encephalopathy. His medications are furosemide, spironolactone, nadolol, lactulose, zinc, vitamin A, and vitamin D.
On physical examination, temperature is 36.5 ...
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For the past fifteen years, I have had an incurable form of leukemia.
Such diseases used to be called terminal illnesses, but we don't hear that term as much anymore. With all the new drugs and treatments available, doctors have become more reluctant to refer to diseases they can't cure yet as "terminal."
In the years just after my diagnosis, when friends and family would ask what could be done for it, ...
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I am a physician, an anesthesiologist. I care for the sickest of the sick every day – struggling NICU babies born only hours earlier, victims of major traumatic accidents, and critically ill patients with life threatening illness. In this job, I must both connect with the patient, but also maintain a distance from them at the same time. Dealing with life threatening ...
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Don't get me wrong, it's huge to see patient safety evolving to be a front-burner issue. After beating the drum for years, the National Patient Safety Foundation and other groups are seeing progress, with meaningful use, electronic health records, pay for performance, and the patient-centered medical home.
Medicare innovation grants and the Partnership for Patients are chipping away at medical harm and 30 day readmissions. Empowered patients are test-driving their choices ...
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If you’ve read my reviews of the new medical TV show Monday Mornings, you’ll know I’ve been critical of many things about it. I was particularly disappointed with the way the show handled one of its central themes: the morbidity and mortality (M&M) conference.
I thought it might be useful to tell you how most real M&M conferences are run. M&M conferences generally take place at hospitals with residency training ...
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Could a greater miracle take place than for us to look through each other’s eyes for an instant?
-Henry David Thoreau
It is almost 7:00am I carry my briefcase and lunch bag from the car to my office. I nod to some of the night shift employees heading home. Another day has begun.
I type my password and check the computer, reminding myself of the twenty patients I am scheduled to see today ...
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In many of our local supermarkets, there is a section of organic produce in addition to produce that is traditionally farmed. For those of us selecting and preparing food for our families, we often wonder what items, if any, we should purchase with the organic label.
When I shop, I typically choose traditionally farmed foods for my family’s meals. There are certain items ...
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A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.
Recently, discussion about health care has reached a fever pitch, between changes in policy, adjustments to scope of practice and a multitude of other medical issues. As health care providers, it is our duty to provide the highest level of medical care to all patients to ...
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In addition to the possible legal pitfalls of advertising on Groupon-type websites, there are also ethical and practice management concerns to be weighed by healthcare practitioners before agreeing to such arrangements. Even with the recent announcement that companies such as Groupon and LivingSocial may be offering contracts to healthcare providers that take into consideration the prohibition against fee splitting, practitioners should nonetheless proceed with caution.
The concerns about social coupons in the healthcare context extend ...
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One of the more contentious topics on my site is the scope of practice for non-physician providers, such as nurse practitioners. This echos the debate on the national stage where leaders of physician organizations, who want to protect their scope of practice, conflict with those of nurse practitioners’, who want to perform the tasks that physicians traditionally have.
Simply Google “nurse practitioner” on this site, for instance, and you’ll see ...
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When I recently read the phrase, “I’m embarrassed to be sick,” it made my stomach clench and my breath catch. That's exactly what I've been feeling: this vague sense of social unease even with close friends, a reluctance to be seen or even talk to people--especially those that knew me before I became chronically ill.
At the age of 55, after a lifetime of seemingly ...
Recently, an article by Kate Baicker and colleagues came out in the New England Journal of Medicine. Almost immediately, the article received widespread attention in the media where headlines claimed that giving people Medicaid coverage doesn’t improve their health. This is not exactly what the article said, but most journalists aren’t scientists, so we should cut them a bit of ...
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"A comprehensive and extremely useful roadmap for doctors."
-Eric Topol, MD, author of The Creative Destruction of Medicine
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