Marijuana use today is not limited to the poor, the marginalized among us; nor is it kept in the inner city, as it pretty much was when I was a kid.  Now it is widespread, even legal in some states.  One might even make the argument it has become a substantial part of the life of the elite, the affluent of America.  And when we think of elite and powerful ...

Read more...

"Do you have a family history of sudden death?" In medical school, I learned to ask my patients this standard prompt during sports physicals, in search of possible hypertrophic cardiomyopathy. Their answers often surprised me. Many of my patients do have relatives who suffered a "sudden, unexplained death," often the result of a murder or suicide. Which feels, in a way, utterly unexplainable. The impact of violence, including deliberate self-harm, is overwhelming: According ...

Read more...

How do you motivate and inspire?  How do you create an environment where people are eager or excited about their daily work? This question has created a multi-million dollar industry of motivational speakers, consultants, and higher education learning curriculum.  I have to admit that I’ve been an avid pupil of the movement, focusing on others when the answer is literally staring me in the face each morning while brushing my teeth.  ...

Read more...

Every now and then, more often when on call, I experience what I think it was like to be a physician when I was a boy. I remember the era of the house call. I remember the physician as a part of the community. You saw him around town, school, and at church. You knew his wife and went to school with his kids. I remember that. And I remember the ...

Read more...

I was recently invited to visit an academic anesthesiology department to speak to the residents about becoming a leader.  In addition to recognizing the honor and privilege of addressing this important topic with the next generation of physician anesthesiologists, I had two other initial thoughts:  1) I must be getting old; and, 2) This isn’t going to be easy. I came up with the following list of lessons that I’ve learned ...

Read more...

Part of a series. We tend to think of the primary care physician (PCP) as the one who does the simple stuff, a doctor who is a mile wide and an inch deep in knowledge and experience. That is a false impression. By education and experience, the PCP is actually a chronic disease specialist. That is, provided the PCP has the time to care for his or her patients with ...

Read more...

Dr. Robert Centor has an important post about hubris. It’s not a long post, if you want to click through and quickly read it. It’s about the danger of overweening pride and overconfidence that can come from blindly believing the praise that is often heaped upon us by those in our care. Essentially Dr. Bob is saying that we must avoid believing all the wonderful things our patients ...

Read more...

I have never been the director of any professional group. I have, however, been directed. As such, I have a few tips for those who are directors and administrators. I give you my physician satisfaction system. It is arranged in no particular order. In every physician break room or lounge, there should be a wall for photos of girlfriends, boyfriends, children, spouses, parents, dogs, cats, horses, boats, new shotguns or whatever ...

Read more...

The daughter of the patient walked out of the room livid.  She was convinced that the nurse had no business taking care of patients.  She seethed as she recounted all the supposed injuries and mistakes that had occurred.  I took a deep breath and paused for a moment, trying to collect my thoughts. The daughter didn't know that I had watched this same nurse successfully perform CPR on a man the ...

Read more...

acp new logoA guest column by the American College of Physicians, exclusive to KevinMD.com. In December, I concluded a 13-year term on the board of directors of the Rhode Island Quality Institute (RIQI). RIQI was formed in 2001 to “to significantly improve the quality, safety, and value of health care in Rhode Island.” For much of its ...

Read more...

Most Popular