At a quality and patient safety meeting recently, one of the departments was presenting their annual report on all they have done, reviewing progress that has been made around several quality and patient safety initiatives. One of their project centered on efforts to decrease an incredibly high no-show rate. Coupled with their desire to avoid overbooking appointments, the problem has compromised patient access, both for their own established patients and for new ...

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Well, they are calling it the golden age of rectums! The trends are simple and straightforward. First, Baby Boomers and beyond are aging and staying alive longer. The gut, a hidden culprit behind many ailments, requires continuous maintenance. Colonoscopies, EGDs and ERCPs. These require services of gastroenterologists (GIs) who are always in short supply (14,000 in the U.S.).4 Second, gastroenterology practices are fragmented like hotels were before the Hilton. Regulatory, technological and ...

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The stethoscope. Nothings says “I’m a doctor” more than the stethoscope in a pocket or draped around the neck. Forty-five years ago when I got my first one, a gift from my physician-father, the former was more common. Then we were more likely to wear coats — white coats or suit coats — and pockets were available. I had suit coats in which the lining was worn out from the ...

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I am writing this from the perspective of a woman physician in academic medicine. I am a mid-career cardiac anesthesiologist who works in several national organizations and serve on various committees and boards. I have learned a lot from serving in national medical societies, made great friends this way, and been able to feel a sense of accomplishment in being a part of change within my specialty. That is why I ...

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We all know that there’s a remarkable shortage of physicians in America and that it’s growing worse.  This is especially true in primary care but it’s present across all specialties.  This shortage alone is a significant stress on practicing physicians.  But when it is coupled with corporatization, the increasing complexity of medical care, unrelenting electronic charting requirements and the explosion of administrative tasks, physicians barely keep up each day. This is one of the ...

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I didn’t know that he and I were on the same train. At the Othello stop, I got out of the last car and walked towards the front of the train. The morning chill seeped through my coat and I slid my hands into my pockets. “Dr. Yang!” The doors of the train were still open, and there he was: A baggy black hoodie was pulled up over his head, but it ...

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Back when cholesterol target numbers ruled unopposed (before 2013), we all checked fasting lipids every three months. Before 2012, we also checked liver function quarterly in hapless riders on the cholesterol pill merry-go-round. That year the FDA announced there had not been enough reports of statin-induced liver problems to recommend routine monitoring. I have many colleagues who still do this, and who also routinely monitor routine labs quarterly ...

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Shock. Horror. Did you just read the title correctly, or are you seeing things? Well, after you recover from the shock of reading a line you probably never thought you could possibly see in writing -- let me tell you this: Physicians and politicians are probably as opposite as you can imagine in terms of their daily work life, guiding principles, and yes, level of respect shown to them by ...

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Physician well-being is a major focus of many physician organizations and is frequently highlighted in popular media.  Some have described the root of the problem as a disconnect between expectation and reality.  This is a helpful framework for situations that result in disappointment.  I recently rented a house on Airbnb. Eagerly anticipating our vacation, I was dismayed to find upon arrival that the house lacked electricity and water.  Camping in ...

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Compassion. Empathy. These are some of the words commonly thrown around in medical school and residency training. If you ask most medical students why they chose medicine, they will respond with something like this: “ I love to help people,” or “I want to save a life.” I remembered when I entered medical school, one of my professors said, “In order to be good a doctor, you must be compassionate and ...

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