ama_logoThe medical profession must play a lead role in reversing the opioid epidemic that, far too often, has started from a prescription pad. For the past 20 years, public policies -- well-intended but now known to be flawed -- compelled doctors to treat pain more aggressively for the comfort of our patients. But today’s crisis plainly tells us we must be ...

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As a fourth year student in her last few weeks of medical school, I recently found myself in an interesting new course: negotiation skills for graduating medical students. As part of a push from accrediting organizations like the LCME, the final weeks of our medical education are being devoted to lesser-taught subjects in medicine: licensure processes, malpractice, wellness and resiliency training, and contract negotiations. At the start of the lecture, a ...

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acp new logoA guest column by the American College of Physicians, exclusive to KevinMD.com. When I accepted the invitation to write this monthly column for the American College of Physicians (ACP), I assumed it would be a one-year assignment. Even so, I wondered if I could come up with a different topic each month. Now, over 40 columns and ...

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I would like to discuss how I achieved financial independence at age 39, and how it allows me the freedom to practice medicine in a way that keeps me happy. Financial independence is defined as having enough money saved and invested in a way that would allow you to quit gainful employment and continue your present standard of living. The math, based on a 4 percent withdrawal rate, requires you to have ...

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We are all familiar with the statistics. Chronic conditions like obesity, hypertension, and diabetes are present in our population at unacceptably high and costly levels. More than 78 million American adults are obese, and more than 1 in 20 is extremely obese. About 70 million U.S. adults have hypertension with only 52 percent having the condition under control. Just over 29 million Americans have diabetes and an additional 86 million ...

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These seem unrelated, but give me a chance. I was eating outside at a restaurant with my 5 month old, Max, and a car with a modified muffler hit the gas right in front of us. In Australia, you'd call the driver a "hoon." The noise terrified my boy, and I felt something I'm not used to: protective rage. When Max stopped crying my mind went to struggling families, kids, ...

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It was 2 a.m. on a typically hectic Friday overnight shift in the emergency department. A young woman, Kelly, checked into triage, accompanied by her older boyfriend Jim, who explained that Kelly had abdominal pain and some vaginal bleeding. Jim wanted her checked out and maybe some pain medicine to help her rest at home. Kelly had no identification. She appeared younger than her stated age of 18. I also noticed track marks ...

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Waqas Khan is the brainchild behind Healthcare Not Fair.  Click his video above to see why we are driving doctors to suicide then join the lively discussion on Facebook.

There’s a window in the driveway to the dental school that always catches my attention.  Usually, the old, horizontal blinds are hanging at a lopsided, half-open-half-closed stance.  Occasionally, though, they are open all the way, and you can see inside. For the first few months of my dental school education, I felt like that was my only window into dentistry: through the obstructed, double-paned division between me and the dental school ...

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"If it walks like a duck and quacks like a duck, it is probably a duck. " At 62 years old, Roberta had been healthy. She walked three miles a day, stayed up late and enjoyed events with her three grandchildren. She had no history of significant surgery, and took only a single pill for blood pressure. The only health tragedy in her life was the death of her last child, an ...

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A reader writes: “Grunting baby syndrome. Is this really a thing? My 6-week-old son grunts, strains, and writhes from approximately 3 to 6 a.m. every night. Most of the time he sleeps through it. My GP suspects reflux but ranitidine has not helped. Also, he’s very happy/calm all day rarely fusses or cries. My Google searching came across grunting baby syndrome. Is that a real thing? When do babies grow out of ...

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Readers know that I believe that servant leadership should inform leadership and management decisions.  We who have the privilege of having leadership positions at medical schools, therefore, have as a primary responsibility to our students. Being a medical student, while a reward and a privilege, is nonetheless a stressful experience.  The first two years at most U.S. medical schools have the students grinding through the basic sciences related to medicine.  The volume ...

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You ask questions.  I answer them on Facebook Live.  Click on the videos above for a replay. I had some technical issues on this one, where the Facebook app kicked me out twice.  Hence, the two videos.  Sorry about that. Send your questions @KevinMD on Twitter with the hashtag #AskKevinMD.

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 52-year-old man is evaluated during a follow-up visit for a 2-year history of progressively symptomatic rheumatoid arthritis. He reports increased difficulty with his job due to persistent pain and swelling in the first proximal interphalangeal joints, second and third metacarpophalangeal joints, and bilateral wrists. He also has increased difficulty climbing ...

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How would you react if you sent your sputtering car to the auto mechanic, and they stopped trying to diagnose the problem after 15 minutes? You would probably revolt if they told you that your time was up and gave back the keys. Yet in medicine, it's common for practices to schedule patient visits in 15-minute increments -- often for established patients with less complex needs. Physicians face pressure to mind ...

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There are over 400 pediatric intensive care units (PICUs) in the USA, as most recently estimated by the Society of Critical Care Medicine. These units vary widely in size, from 4 or 5 beds to fifty or more. The smaller units are generally found in community hospitals; the larger ones are usually in academic medical centers, often in designated children’s hospitals, of which there are 220. Given this size range, it ...

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For almost ten years now, family physicians have been the most recruited specialty in the medical profession, and that is not likely to change anytime soon. We face a huge shortage of primary care physicians that is only going to get worse because we aren’t training family doctors as fast as they are retiring. Business training isn’t in the curriculum What this means for me and my fellow family medicine residents is ...

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We stand outside in the heat. We swat at the occasional persistent mosquito. We try to ignore the sweat beading down our foreheads and the backs of our necks. We retreat to the deepest recesses of shade we can find. We wish for a hint of a wisp of a smidgen of a breeze. We hold court on life and love. We laugh and tease and are determined to have ...

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A woman in her mid-thirties with a terrible limp and a past surgical history in the dozens became my patient two years ago. Her prosthetic left leg served her well, but her right leg was moving awkwardly because of advanced hip arthritis and a formerly shattered ankle. She was on long-acting morphine and short acting oxycodone. Her Social Security disability insurance didn’t cover the long-acting form of oxycodone. She told me several ...

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As physicians, we are charged with extending empathy to our patients. In addition to a professional responsibility, empathy is also a mechanism for improving patient care and professional satisfaction. It has been associated with better patient satisfaction, clinical outcomes, fewer medical errors and lawsuits, as well as provider happiness. However, while physicians can be expected to pursue the ideal of empathy towards individual patients, that of empathizing with populations is ...

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