Sixteen months into retirement, the absence of any externally imposed schedule still leaves me partly edgy. Medicare, COBRA, and cell phone bills come due at expected dates. The check goes out the next day, but it could wait another day or a week. Shabbos commences and concludes as the cycles of nature require. If I miss a meeting or an Osher Lifelong Learning Institute class, there are no demerits. In ...

Read more...

I enjoy a fairly small private practice and a manageable telepsychiatry side job with good support staff. But even the small scale of my outpatient clinical practice doesn’t fully insulate me from the pain of unnecessary practices that I wish would become obsolete. 1. Preauthorization. The dance of preauthorization starts with the naivety on my part that I decide what medication my patient should be on. I spend precious time crafting ...

Read more...

We are going to need new types of physician leaders to get the change in health care clinicians want. When I observe current physician leaders, I notice the bulk often fall into two distinct groups. On one side, there are the out-of-touch and on the other the overwhelmed. Both types have positive and negative attributes. In my opinion, the successful health care leader of the future will draw from what works ...

Read more...

When I was accepted to medical school, I debated — hard — whether or not to attend. Out of the physicians I shadowed and interviewed, 19 out of 20 advised me not to become a physician. Their dissatisfaction was rampant. Over and over, I was told, “Don’t be a doctor. Medicine’s not what it used to be.” They spoke of concerns ranging from unreasonable work expectations to inhumane conditions. They described insurmountable pressure, decreasing ...

Read more...

A recent article was published in the Atlantic about Americans being the worst patients. Americans are part of a broken and dysfunctional health care system with exorbitant costs, a maelstrom of bureaucratic red tape, and insurance coverage that barely covers what most people need. But are they contributing to this system by being such bad patients? The article in the Atlantic seems to imply that this is the case. The ...

Read more...

As we approach Christmas, you only need to go to the nearest mall to witness the frenzied activity in preparation. People scurry around trying to find the perfect gifts for their loved ones and co-workers at the lowest prices. While gift-giving indeed is an act of love, many postulate that we have become lost in commercialism and materialism. If we look deeper, there is another Christmas happening as well: the spread ...

Read more...

Mindfulness and meditation.  Meditation and mindfulness.  Allow me to elaborate. I went to medical school in the 1980s.  Nobody talked about complementary and alternative approaches to healthcare or mind-body medicine.  It wasn’t because we students thought it was weird; it wasn’t even on our collective radar screen.  It was, however, out there even then.  Andrew Weil was busy in his movement toward integrative medicine, and Jon Kabat-Zinn was pioneering his Mindfulness-Based ...

Read more...

“It should be in my chart.” I’m sure we have all heard this statement uttered with a subtle (or not so subtle) edge of frustration from our patients after asking a question such as “what medications do you take?”  I find clinicians despise this comment because it is interpreted as (a) the patient is not making an attempt to recall his or her medical history, or (b) that the patient doesn’t ...

Read more...

Like all doctors, I’m a lousy patient. My doctor is a lovely man, but going to see him? That’s right there with weighing myself, getting a flu shot and doing my taxes, and behind celebrating Thanksgiving with the in-laws and getting a root canal. And I’m not the only one. If I had a dollar for every patient who told me they hate doctors (no offense), I’d be long retired. If you’re ...

Read more...

Working as an emergency physician at a level 1 trauma center and as an Army reserve officer, you learn to expect the unexpected – but working as the ER doctor taking care of patients impacted by the most deadly and destructive wildfire in California history last year changed me. As I walked into work last year to start my clinical shift as the attending emergency physician, our hospital began receiving multiple ...

Read more...

Most Popular

Join 150,000+ subscribers

Get the best of KevinMD in your inbox

Sign me up! It's free. 
close-link
✓ Join 150,000+ subscribers 
✓ Get KevinMD's 5 most popular stories
Subscribe. It's free.