Sometimes before I go on a run, I take the laces of my jogging shoes and tie them together in a knot.  I wear the pair around my neck with each shoe falling to opposite sides.  The heels clunk against my chest as I make my last minute rounds.  It's as if running is my job and the shoes are the instrument I use to perform that job.  Eventually, I ...

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The American Board of Internal Medicine has been under fire for the excessive testing requirements of physicians and they recently have been seeking clarity for the maintenance of certification process.  In my opinion, the answer is to eliminate the examination completely and create a better, ongoing assessment using CME chosen by the physician that meets their needs, especially in a time where medical knowledge changes so rapidly. Doctors are essentially tested ...

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Recently during rounds on a busy inpatient teaching service at a county hospital, I led a group of medical students into a patient’s room. I asked the same question I have asked well over 10,000 times: "What do you see?" Observation is a powerful tool at the bedside, and offers us an opportunity to learn from one another. My student replied, "I see a white man sleeping in no acute distress." I repeated ...

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Contributors on this site regularly recommend improved doctor-patient communication. Indeed, that's one reason I'm a devoted reader. But we need to articulate exactly what “communication” is. When I ask colleagues about that word, they usually define it as what they say to patients. I can't argue with that. Yes, we need to express ourselves clearly and simply. But communication includes much more. The occasional complaints I hear from patients about their care ...

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american society of anesthesiologistsA guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. “I said, ‘Somebody should do something about that.’  Then I realized I am somebody.” - Lily Tomlin Each day, family, work and extracurricular activities all compete for our attention. They are positive aspects of our lives but can be overwhelming at times.  When legislative or regulatory ...

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A response to "You signed up to be a doctor, not a martyr." Dear next patient, I appreciate your letter and your advice. I would sincerely like to follow all your advice concerning exercise, eating right, and spending more time with family. I try to make every effort to do so. Unfortunately, I am in the middle of transitioning for the third time to a new EMR system and managing quality ...

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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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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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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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