Just the other day I was called to see a patient coming up to the Intensive Care Unit with a diagnosis of pneumonia. Upon my arrival the patient is "hanging in there" with the blood pressure in the 60’ and 70’s systolic. This is a no-brainer situation - the patient is in sepsis and septic shock. Early intravenous antibiotics and aggressive resuscitation is what this gentleman needs right now. Per the ER ...

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I recently finished another 5-week clinical rotation.  This one was primary care (outpatient internal medicine +/- family medicine). First a few words about primary care as a field:  I found it to be both awesome and boring. It was awesome because I was the "doctor."  I had essentially full responsibility for my each patient.  From calling him in from the ...

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by Zakari Tata, MD Many articles have been written on physician suicides. Yet nothing practical has been implemented. The problem is probably much larger than reported, as families will try to avoid publicity where possible. In medicine, just as in the rest of society, people diagnosed with depression are wrongly labeled as weak, and discrimination, especially the subtle passive ...

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Is anyone else tired of hearing about how important empathy is in the physician-patient relationship?  Every other day it seems a new study is talking about the therapeutic value of empathy.  Enough already! It’s not that I don’t believe that empathy is important, I do.  I also believe the data that links physician empathy with improved patient outcomes, ...

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Should physicians strive to keep hospital beds full or empty? Obviously, in an economically optimal situation, just like in the hotel business, the hospital beds that are "needed" and available should be kept pretty close to full, in order to cover fixed costs and balance the hospital budget. A recent discussion board on another physician website has called attention to an alleged practice of both emergency physicians and hospital administrators being paid ...

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When I go to the doctor for my yearly physical (OK, not quite yearly, but…) he puts me through the ringer.  He asks me dozens of questions, follows up with more questions, and does a (thorough!) physical exam.  Then he takes some blood, and sometimes runs some other tests.  The big question is "why"?  What are ...

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What should we expect of a physician leader today? I believe it should be something much different than what leaders do now. Today, a hospital physician CEO might be expected to develop new or improved clinical programs, in part by recruiting the best and the brightest, by building new wings, and by purchasing new technologies. The measure of success would be improved finances as a result of added ...

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Working as a psychiatrist is very rewarding. It’s stressful in a unique way, and some people may look at me strangely for having an unusual job. But overall I really enjoy it. Here are some of the aspects of psychiatry that I really appreciate. 1. Being trusted. Psychiatrists meet people when they are at their most vulnerable points, and we are entrusted with extremely ...

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A guest column by the American Medical Association, exclusive to KevinMD.com. The Centers for Medicare and Medicaid Services (CMS) has pushed back the April 1 deadline for states to implement their Medicaid recovery audit contractor (RAC) programs until an unspecified time later this year. The implementation delay was welcomed by the American Medical Association (AMA) and other national physician organizations who have vocally urged CMS to improve its proposed Medicaid RAC ...

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By now, most healthcare professionals -- and many well-read consumers -- are aware of the disturbingly high rate of surgical site infections (SSIs) in our nation's hospitals. Each year, approximately 500,000 surgical patients develop SSIs. In some types of operations, such as colorectal surgery, the rate is close to 10%. Many hospitals submit information about SSIs in their institutions through the ...

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