In 2012, tension over online doctor reviews ran high. As the New York Times reported, physicians were turning to third-party reputation management firms who used legal threats to silence critical patients on the web. Information freedom non-profits and tech media outlets responded with investigations and an FTC complaint. As a former practitioner, I sympathize with some doctors’ apprehension about online reviews; the desire to protect oneself from unfair or ...

Read more...

A response to The creative destruction of the American family physician. Dr. Brooks' column shines a bright light on the misconception that some subspecialists have about the core of primary medical care and family medicine. As a former nurse practitioner and current family physician, I'd like to point out the flaws of his argument. At a time when the health care community is working to end the fragmentation, duplication and gross ...

Read more...

Once upon a time a doctor first attended 3 or 4 years of college, then finished 3 or 4 years of medical school, trudged through 1 to 8 years of residency training to hang out “a shingle,” and finally begin to practice medicine, usually in solo practice.  Those days are long gone.  Time has expanded—schooling and training are longer. Breaks are taken between and during this once but no longer traditional ...

Read more...

Don’t be surprised if patients start asking more questions than usual about awareness under anesthesia.  We can all thank a recent article in The Atlantic magazine, with a large-print headline on the cover:  “Awake Under the Knife”.  Written by a UCSF medical student in preclinical training, the article not only assures everyone that awareness can happen, but takes pains to point out that anesthesiologists can’t always prevent it. The ...

Read more...

How we spend our days is, of course, how we spend our lives. -Annie Dillard I wish I could add up all of the moments I spend waiting for things to happen. I wait for computers to boot up. I wait for computer screens to load. I wait for programs to ask for and accept my user name and password for the umpteenth time so I can view a CT scan and then re-enter a different ...

Read more...

Here are the sad the financial facts. You have heard them before:

  • Women physicians earn $0.62 on the dollar as compared to men (US Census Bureau, 2010).
  • Women physicians start out their careers with a $17,000 pay gap, after all other factors are accounted for (LoSasso, Health Affairs 2011).
  • Mid-career women physician researchers are paid $12,000 than their male counterparts (Jagsi, JAMA 2012).
Anyone who discounts that fact that we women physicians are discounted ...

Read more...

Medical journals aren't what they used to be. Just ten short years ago, medical journals were places to report scientific study, interesting cases or clinical updates and reviews. They were, for the most part, about science and discovery. Now, there is a dramatic shift of scientific content in our journals to politics and policy. No where is this more evident than the much-heralded and widely read New England Journal of ...

Read more...

Some physicians will make over 7 times what the average college dropout will earn over a lifetime. Even within medicine there are significant differences in lifetime earnings between primary care, surgery, and specialty care. With the recent Powerball lottery jackpot at a record high, there was a lot of daydreaming going on recently for many Americans, maybe even some doctors: What would you do if you actually won it all? ...

Read more...

Why physician led pain care is important for patients A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. All of us know the unpleasant feeling of pain. Often we know what caused it: a burn, a sprain or a surgical procedure. Most pain stops when the cause is removed and healing takes place. That is acute pain. When pain arises and persists for three months or more without ...

Read more...

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 65-year-old man is evaluated for a 1-month history of headaches and blurred vision, early satiety, and itching that occurs after showering. He has a 90-pack-year smoking history. He has no history of cardiopulmonary or sleep disorders, no other medical problems, and he takes no medications. On physical examination, temperature is normal, blood pressure is ...

Read more...