The recent prominence of the #MeToo movement has shined a light at many places in our society where insidious or even obvious sexism against women has long gone unremarked. Even when noticed it’s just shrugged off as the way things are. In honor of this, #MeToo was named Person of the Year for 2017 by Time Magazine. Medicine is no exception to this pervasive problem. A very interesting recent essay in the New ...

Read more...

The recent suicides of an NYU resident and a medical student highlight the growing mental health problem among physicians and physicians-in-training in this country.  This crisis is certainly not exclusive to physicians, as evidenced by the suicides of designer Kate Spade and television personality Anthony Bourdain.  However, suicide among physicians is of particular concern.  A literature review of physician suicide in Medline and PubMed yielded alarming results ...

Read more...

Dear CVS, Please change your hold music. Please. Do the right thing. It’ll take you, or someone who works for you, or even a barely pubescent adolescent who nevertheless knows how to program music on his iPhone with more aplomb than anyone born before 1975, only about 48 seconds. And 48 seconds is substantially less than the amount of time I have listened to your never-changing hold music. I have researched the source of this ...

Read more...

The following are intended to inspire to medical students and residents to learn more about organized medicine. Whether it be at the national, state, county, or specialty level, there are numerous societies with opportunities for contribution. 1. To pull back the curtain. Many physicians are innately curious and like to “see how the sausage is made,” so to speak. There is a great deal of policy behind the scenes of our ...

Read more...

Generally speaking, patients and physicians are working towards good health. While many patient expectations can be unreasonable, others are practical; this article amalgamates them. Can you identify the absurd demands? But multiply half of the listed expectations by hundreds or thousands of patients, and we begin to understand why there is such a high rate of physician burnout. Bilateral empathy lowers expectations. Bedside manner. Don’t accept a walk-in patient and leave us waiting ...

Read more...

“There’s an app for that.” The phrase became so popular with the advent of smartphones that Apple even trademarked it. There are currently 3.8 million apps available on Android devices and over 2 million available to Apple iPhone users. Does that mean that we’ve reached a limit on new and useful apps that can be created? Absolutely not. Especially in the medical world, it seems as if there’s so much room to ...

Read more...

When we think of bullying, we’re usually worrying about our school-age kids or remembering bad experiences from high school. We learn quickly in the health care field that bullies don’t change once they enter the clinical world. Health care, with its incredible differential in knowledge, authority and pay creates large power differentials and easily generates subordinate/superior relationship dynamics. Bullying occurs within professions between trainees and trainers and faculty, and across clinical areas ...

Read more...

Before managed care became the dominant force that it is, patients and doctors had the opportunity to get to know each other well. Doctors treated multiple generations within families. This helped establish a strong bond among patients and their doctors. While it might have intended to mean preventing expensive care, managed care began to mean organized care. Run by institutions such as health maintenance organizations. Insurances began to decide which doctors you ...

Read more...

We live in incredible times. A time when a millennial with a YouTube account clears six-figures a year (sometimes, seven figures!) with just a computer and a webcam. A time when a small-town girl with a love of fashion and an Instagram account can go from Nowheresville, America to front row at New York Fashion Week. A time when the shy girl in the back of the classroom amasses a following of hundreds ...

Read more...

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 30-year-old woman is evaluated during a follow-up visit for systemic lupus erythematosus. She was diagnosed 3 months ago after presenting with pericarditis and arthritis. She was initially treated with prednisone, 40 mg/d, with improvement of her presenting symptoms. The prednisone has been tapered over 3 months to her current dose ...

Read more...

Altruism is killing us. Take a second to let that sink in. Truly think about it. Resist your conditioning to refute this claim and try to apply it to your life. Still having trouble? Let me try to explain. In order to understand the truly destructive force of altruism on medicine, one must first define altruism. This can be difficult to do in the United States as any “good” or “charitable” ...

Read more...

It's a Sunday evening in a local South Texas emergency room with the expected ER traffic for a weekend evening. Lots of simple traumas: ankle sprains, abrasions, lacerations, falls, common URI symptoms, and fevers. The EMS radios in with a call of a five-year-old male who has altered mental status. The patient is brought in around five minutes later and placed in an open emergency room. The patient is accompanied by ...

Read more...

Why does she work? It’s a question that she must answer, for it begs itself every time she picks him up from daycare. She always finds him happy there. And yet that — selfishly? — is part of what tears at her. Shouldn’t she be the one making him happy at 11 months? It's more important to her than any other role that she plays – she wants to be everything that ...

Read more...

I am frequently asked what I do at social gatherings. My response, naturally, is that I am a physician. The individual then asks what your specialty is and I respond that I am a board-certified family physician. Then, I hear, “Oh, you are a GP.” Really! After all these 35 years, I am perceived as just a GP. "Just" is the key word at social gatherings — implied or stated. Well, ...

Read more...

The initial doubts first surfaced mid-way through our flight bound for Montego Bay, Jamaica. In fact, we were not entirely sure that this trip was such a good idea after all. Our eldest son, 13 and in eighth grade, was already complaining about how much school he was missing and how much homework he had been assigned. Our daughter, a sixth-grader prone to procrastination, had her nose buried deep within ...

Read more...

Often a stay at home mom, like we have in our house, is not thought of as a contributor to wealth. Too often, only the person who “really” works and brings home an income is considered to be generating wealth. This is a case of incorrect thinking. The non-working spouse is a very big factor in attaining wealth. In the book, The Millionaire Next Door, the spouse is considered one ...

Read more...

Surviving suicide loss is difficult. And in some sense, the resulting grief is open-ended. I am a mother and doctor whose two sons died by suicide associated with psychotic bipolar disorder. My ever-present sensitivity to the fierce loss of death by suicide is again touched when I hear of death by suicide. The suicides of Anthony Bourdain and Kate Spade triggered in me a renewed feeling of grief. Like so ...

Read more...

It is a little after 9 a.m. I am about to start the second of a long list of endoscopy cases when my phone rings. I glance briefly at the caller ID to confirm it isn’t my office or the hospital calling about another patient, and am quickly overcome with dread as I see the screen reads, “daycare.” Intuitively, I know why they are calling. My four-month-old must have a fever. ...

Read more...

Summer is upon us, and with it comes the end of the academic year, graduations and the arrival of the newest crop of interns. Soon these fresh-faced physicians will enter into one of the most remarkable educational experiences of their medical careers: residency. Many of these soon-to-be-interns are looking to attendings now for advice on how to excel during (or survive through) the arduous first year of training. Suggestions like ...

Read more...

In the context of human evolution, a vestigial organ is defined as one that has lost all or most of its original function through evolution. Charles Darwin provided a list of vestigial human organs in "The Descent of Man," including the muscles of the ear, wisdom teeth, the appendix, the coccyx, body hair and the semilunar fold in the corner of the eye. If you had told me 19 years ...

Read more...

1483 Pages

Most Popular

Join 141,000+ subscribers

Get the best of KevinMD in your inbox

Sign me up! It's free. 
close-link
✓ Join 141,000+ subscribers 
✓ Get KevinMD's 5 most popular stories
Subscribe. It's free.
close-image