KevinMD.com

My friends ask me how I’m doing.  The short answer is always, "We’re OK."  But the real answer is much longer. I feel a lot of anxiety these days.  It’s always there, sometimes with more intensity than others.  But a constant, ever-present, lurking beneath our routine. Like everyone else, sheltering in place is a component of it.  There are the combined aspects of keeping my four children entertained, keeping them from fighting, ...

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On Doctors' Day, my hospital celebrated our work by giving us each a pair of cheap headphones, and also announced the death of an attending. Though the personal risk to each of us was highlighted by the recent death, the administration did not give hazard pay, or PPE comparable to other countries', or even a guaranteed supply of isolation gowns. Just headphones a different color than the ones they gave ...

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On the front lines, America's emergency departments (ED) are currently in at the center of a crisis treating patients with COVID-19.  Emergency physicians and other clinicians are placing themselves and their families at risk. Yet, there is also another important crisis facing hospital-based EDs: surprise billing legislation. Certain forms of surprise billing legislation have the potential have a substantial and negative impact on how America’s EDs are supported, and our ...

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Testing for novel coronavirus is still a serious issue in the U.S. due to a lack of lab capacity, test reagents, nasal swabs, and even personal protective equipment for health care workers. Due to these shortages, the CDC is recommending that COVID-19 testing should not be performed on patients without symptoms and instead be prioritized for: 1. hospitalized patients and symptomatic health care workers, 2. patients ...

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In times of disaster, marginalized groups often become even further marginalized. Both those of lower socioeconomic status and those with disabilities often are left out of emergency planning, as is evidenced by the current COVID-19 pandemic. From access to testing to ability to acquire needed goods and services to triage policies being adopted from community to community, those with lower SES or ...

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During the influenza epidemic of 1918-1920, my great-grandfather, Ralph Norton Mitchell, was in the military. He helped stack the corpses of those who had died from the infection. I shudder to think about what type of personal protective equipment he used. However, his survival reminds me of a feature of all epidemics--some individuals have or develop immunity, and those who have immunity can “do the work.”

Currently, we are ...

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About a decade ago, I had my first doctor-client. And part of what they wanted to discuss was budgeting in order to save more. They just got new jobs and wanted some general planning for the sake of making good decisions. Software for budgeting and spending history didn't exist the way it does now. I wanted to provide the best help I could on this topic, and I knew about budgeting, ...

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This is a frightening time. The coronavirus is called “novel” because it is new, and what is new is often terrifying. We don’t know enough about our new microscopic enemy. Scientists, clinicians, and policymakers are all working tirelessly with limited data and learning along the way. Consider that many diseases that we regularly face have been observed, reported, studied, and treated for decades; some for centuries (although with less success than now). Novel coronavirus ...

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COVID has taught me many things in and outside of medicine.  Most importantly, it has taught me that the medical field is a family.  There is nothing that drives a family together like a crisis.  For those of us on the front lines, I’m raising a pint of the finest for you!  That “front line” not only includes the doctors, nurses, and staff caring for patients sick with COVID.  It ...

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“You are a hero! “ “Thank you for all you are doing!” It is overwhelming and tremendous; it is touching and heartwarming; it is genuine and sincere.  The outpouring of support and love for health care workers and first responders has been a bright light in the dark days of the coronavirus.  But I have been forced to wonder: What has really changed?  OK, before you get outraged by that statement, hear ...

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I am writing this a bit selfishly as part of personal catharsis, and it has been helpful serving that purpose and helping me better understand what I am experiencing. If, however, some of it strikes a meaningful chord or you have some critique or suggestions, then, of course, I am delighted to hear from you.

While we all are under stress, I have been feeling angst I ...

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Last week’s death of the first nurse to die from COVID-19 in New York City infuriated health care colleagues who blamed his death on lack of protective gear. Across the U.S., health care workers are scrambling to design makeshift personal protective equipment, also known as PPE. Nurses are resorting to wearing Hefty trash bags because they have run out of gowns. ...

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About a year ago, I wrote about how physicians are being devalued. More recently, I posted on my Facebook page how, in the current time of need, physicians are suddenly being valued more. I noted how in the midst of the COVID-19 pandemic, the powers that be are turning to the same physicians to lead us out of the crisis. I alluded to compromises being contemplated ...

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Faced with the prospect of not being able to provide all COVID-19 patients with the life support that they may need, physicians and nurses are working in conditions that have been described as “hell.”

How are providers to cope with the trauma they are experiencing in New York and Italy, and presumably other nations as well? How are they to cope with the moral implications of the ...

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I am not a germaphobe. I have never wiped a grocery cart handle before now. I don’t wear a mask during flu season in my office. I love for my kids to play in the dirt, and I welcome the daily exposures they have in our house, school, and life. I have the utmost respect for the immune system and the amazing job it does every single day, battling more ...

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Coronavirus, COVID-19, social distancing, quarantine, flatten the curve, wash your hands, do not touch your face: These are not terms that I am reading out of any of my of medical school books, these are terms that have become a reality for every household in the world, irrespective of nationality, socioeconomic status, gender, creed, etc. I write this article not as a physician, but as a person full of fear and ...

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It is a dark time to be a physician.  Yes, because of the global pandemic- watching our colleagues in other countries die, staring down the barrel of not enough ventilators, reading the New England Journal of Medicine’s paper on how to choose who gets care and who we allow to die. But we are trained for this.  We are up to the task, to take care of the ill.  What is ...

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It is well known that physicians are more likely to screen positive for depression and have higher rates of suicide than their counterparts in the general population. But how is this fact exacerbated by the global pandemic of fear, anxiety, and mounting death tolls known as COVID-19? For starters, health care workers are at the front lines of the emerging disaster, having to ...

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I recently received a postcard in the mail titled “President Trump’s Coronavirus Guidelines for America.” The first of these recommendations is to follow the directions of my state and local authorities. In my community, notable restrictions on commerce have been handed down by my governor, my mayor, and a county judge. This has had a crippling effect on our local economy as we brace for the storm to get worse. For ...

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