How can you work for 24 hours in a row? My friends outside of medicine ask me that often. What is it like? I wondered the same thing the night before my first 24-hour shift or “24.” I lay awake worrying, ironically, that I should have gone to bed earlier to rest up for the ordeal. When I get to work, full of nervous energy, I am relieved to find out ...

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A commentary in the New England Journal of Medicine titled "Beyond Evidence-Based Medicine" received much well-deserved criticism for not only mischaracterizing EBM, but advocating for a novel approach, "interpersonal medicine," that was explicitly codified in the recognition of the U.S. specialty of family practice nearly 50 years ago. Here's what the authors wrote about this practice of medicine that is, apparently, new to them but well-known to the ...

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I have had a complex relationship with music. As a child, I had several instances of feedback that I was “bad at music.” When my class would sing at assemblies, I would get side glances and subtle and not so subtle clues that I should be at the edges and sing quietly. I played the viola from second to ninth grade. I had fun in orchestra class. For the rehearsals, I ...

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I sat knee-to-knee with a nurse practitioner at a school-based clinic in rural Ohio. Choking back tears, she described a patient she couldn’t get out of her head: a middle-school girl, accompanied by her mother and a social worker. Just days prior, the girl was dropped off at her father’s home for the weekend. Before the promised Friday night football game, she discovered him unconscious on the bathroom floor. Within ...

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There is no doubt about it, I am my mother’s son.   What would you expect? My father died when I was eight years old.  During my formative years, I was brought up solely by my mother.  I believe this is a unique lens in which to see both life and financial independence.  As the years pass, I feel lucky.  The importance of female role models cannot be ...

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Long ago, and far away, I encountered a patient that changed the way I practice. I was with a medical student while examining a middle-aged woman who presented with a dramatic eruption that was probably DRESS syndrome (DRESS syndrome was not yet described). I prescribed prednisone and asked her to come in a few days later so I could assess her progress. She returned – I did not recognize her ...

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I am a pediatric hospitalist in middle America. I believe in you, and I hope that you believe in me. Many of my patients’ parents do not believe in me, you see, and it makes it hard for me to do my job and to take care of these children in the way that I have been trained and believe to be in their best interest. A toddler has just died ...

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acp new logoA guest column by the American College of Physicians, exclusive to KevinMD.com. When reading (or writing) blog posts, it’s easy to be left with a mostly negative and often depressing view of the current state of medicine.  This is completely understandable as people usually write on topics and issues about which they feel strongly, and ...

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Recently, news broke about a disturbing act of medical battery carried out by doctors at St. Joe’s Medical Center in Syracuse, New York. The case began when police officers conducted a pretext stop and elected to harass their victim about a small amount of marijuana.

As the situation escalated, the cops took the man to St. Joe’s Medical Center for him to be searched for ...

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Net promoter scoring (NPS) measures customer experience and predicts business growth. Recently it is becoming more common for health networks to adopt NPS. The word "customer" should be a red flag. In medicine, we do not have customers; we have patients. It is common practice for a patient to receive a text message after they leave an office asking them to rate their experience. It generally looks something like ...

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