You ask questions.  I answer them on Facebook Live.  Click on the video above for a replay. Send your questions @KevinMD on Twitter with the hashtag #AskKevinMD. Join my Facebook page get notified about future live chats.

I’m a physician, part of the enormous all-consuming machine called modern health care.  This machine is driven by value-based best practice and end results. Literal life and death decisions are required daily, so naturally I become impatient when my son can’t decide between chocolate and vanilla or which movie to watch. My cultivated Achilles' heel of impatience has a tendency to interfere with daily interactions or decisions because of the dreaded ...

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If the act of organ donation is among humanity’s greatest gifts, what can be said of living donors who undergo surgery to extend and improve the life of another? It’s truly a courageous and inspiring sacrifice. I was honored recently to be able to perform my first living-donor liver transplant. Jason Clark, 28, donated about 60 percent of his liver to his father, Lynn, 57, who had been sick for many ...

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Two weeks before my oldest cousin’s twenty-third birthday, he shot and killed himself. It scarred our family. The kind of jagged, gnarled scar, like a poorly-filled pothole, that -- even though it’s been nearly twenty years -- you still run your fingers across from time to time and feel the sting of a fresh wound. We weren’t all that close, but as a 14 year old, sorting through my own perceptions ...

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I've held many hands, been generous with my hugs, and tried to treat every patient as though they were my mother. I lost my mother to leukemia almost one decade ago. I know what it's like to feel defeated by the health care system, by health care providers, by medications, and by the human body's response to all of the above. A patient will never forget a health care provider that ...

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Talking to health care professionals about the importance of loving your patients and colleagues -- as I often do -- might raise eyebrows. How can we be expected to love our patients during a 15-minute clinic visit? How can love form among hospital teams coming together for a surgical procedure but then moving on to other work? Perhaps most importantly, how will this love make any difference in our patients' lives ...

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I recently had an enormous kidney stone. Well OK, it seemed enormous to me. But in terms of kidney stones, it was reasonably large; 9 mm, in fact. Large enough that I had to have lithotripsy (the use of sound waves to break up the stone) performed by my friend and most excellent urologist, Dr. Robert McAlpine in Seneca, SC. As uncomfortable as the whole experience was (and it wasn’t my ...

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Nothing brings out the mama lioness in me more than seeing one of my cubs not being treated as well as I think it should be. Recently I had the unusual experience of accompanying my oldest daughter into an unfamiliar hospital for a minor surgical procedure. Now, this daughter isn’t exactly a cub; she’s a full-fledged adult, with a master’s degree in health care administration, a husband, and two small boys of ...

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This is the first letter I’ve ever written to a political figure, and I pray that someone on your staff will bring this letter to your attention. I have been a physician for close to 30 years. I am a second-generation pediatrician struggling to keep an independent solo practice alive. Not one politician has addressed what I feel is the major threat to health care: the physician-patient relationship. Without this, ...

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Just three weeks earlier, she had noticed something strange about one of her breasts. An irregular shape. Her daughter brought her to the doctor, and soon the patient, I’ll call her Amanda, was diagnosed with breast cancer, stage “to be determined.” In fact, she was now in an oncologist’s office, learning what tests she would receive to determine the extent of her tumor. And sitting between her and the doctor ...

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Ran into a radiology colleague today.  He will retire soon, and was happy to discuss the stress on radiology.  I have observed more interpretation errors (or at least I think I have) over the past five years.  We now strongly stress that the learners review all films and question radiology reads. My friend opined that volume expectations have become unsustainable.  We order too many imaging studies.  When you ask physicians to ramp ...

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Dear future self, Remember that day on surgery you stepped into the OR for the first time? How you had no idea you were supposed to pull your own gloves for the scrub nurse from the supplies cabinet, or that you needed to stand an arm’s length away from the equipment table to avoid breaking sterility? Remember how scared you felt? How clumsy you were when you scrubbed in, in a ...

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Like an anthem, a holy grail, the word appears in every journal, every proposal, and every health strategic plan. “Quality.” We say, read and hear it so often we are developing quality fatigue. Like iterative hackneyed phrases such as “out-of-the-box”, “deep-dive” and perhaps even “personalized medicine,” quality has begun to feel like water torture and risks being deprived of flavor or meaning.  However, do not so fooled or bludgeoned that you lose ...

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You ask questions.  I answer them on Facebook Live.  Click on the video above for a replay. Send your questions @KevinMD on Twitter with the hashtag #AskKevinMD. Join my Facebook page get notified about future live chats.

I was talking with a few friends not long ago.  Our conversation somehow got to the issue of authority, and what exactly respect for authority looks like.  One of them, trying to make a point, turned to me and asked: "So you surely deal with people who don't listen to what you have to say.  What do you do when your patients don't take the medications you prescribe?" I think he ...

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My longtime patient Brenda let the top of her exam gown drop to her waist, stepped down off the exam table and turned to look at herself in the mirror. As I watched, she cupped her seventy-eight-year-old breasts in her palms and unceremoniously hoisted them up to where they'd probably resided when she was in her twenties. "I'm thinking about having my boobs done," she said. "My girlfriend had hers done, ...

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My most important patient requires my constant diligence. For this reason, I am seldom far away from him. Only a few minutes inattention and there will be problems. I cannot forget my patient; I am trained to attend to him constantly. I am a professional, and my patient is, ultimately, my customer and the customer’s service is paramount, I am told. I am reminded by policies and procedures as well, ...

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When he turned 45, Mitch Alsup bought a red Corvette. Mitch is a quick-talking guy with dirty blonde hair and a short, trim physique. He has a ready smile and is willing to share his story. “As a kid, I use to go down to the Chevrolet dealership and sit in a Corvette,” he recalls. “I wanted one when I turned 18, but I came from a poor family. I had to ...

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Guilt was not a huge part of my vocabulary until I became a mom.  I never felt much guilt about how I spent my time.  Didn’t feel guilty about sleeping in, or working out, or having a girls’ night out.  And so on and so forth. And then I became a mom.  You know, that moment when you get shoved into the most beautiful world; a place more beautiful than you could ...

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In a recent post, I wrote about the iCOMPARE research study that is comparing the effects of increasing medical residents’ consecutive duty hours with observing the currently prescribed limits on their shifts. According to the study protocol, the primary hypothesis of the research addresses the safety of patients: that mortality under ...

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