Physician burnout is increasing at an alarming rate. According to a January 2017 AMA Wire report, physician burnout rate has increased from 2013 to 2017 across every specialty in medicine. Greater than 50 percent of primary care providers are burned out. Therefore, every patient at the entry point of medical care is, more likely than not, going to be treated by a burned out physician. The question is why are ...

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Growing up with a father who is a physician made for a natural draw to medicine. However, as young people are prone to do, I did my best to rebel. Early into my undergraduate career I proudly announced to my father that I had decided to go to law school. And perhaps to dig the needle a little deeper, I told him I planned on going into medical malpractice, on ...

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For the over 6,500 candidates who applied to Canadian medical schools this cycle, the term “admissions” has taken on a whole new meaning. For some, the word has become a kind of divine judgment -- a determinative force defining the individual’s value or worth. For others, a long road of struggle has led them to acceptance of the next step in their career. To most, however, the word has morphed ...

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The power of social media is clearly evident in cases such as the Russian influence on our election and Mark Zuckerberg‘s realization of the need for transparency on his powerful platform of Facebook. However, maybe not so evident, is the transformative power of social media on health care trends and misinformation. A popular new term for the misinformation regarding medical topics has arisen: pseudoscience. It has run rampant on sites such ...

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Physician burnout is the depression of the medical world. We are aware of its presence and the detriment it can cause, but yet, we don’t really like to talk about it. The problem is, just like depression, if we don’t talk about it or seek to address it, it persists and leads to a number of unwanted outcomes including decreased productivity, decreased patient satisfaction, and increase in medical errors. And ...

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An excerpt from Are We There Yet?: The Road to Universal Health Care. Getting your business matters. Much of what’s happening now in health care and retail markets concerns pleasing you, health care consumers and patients, and getting your business. The internet matters. You’re almost all wired now. The internet is ...

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There are a lot of what-ifs in life. If only I had made that putt on 14, I could have shot my best score ever. If only I had taken a different job or performed better at the interview, I would be so much happier at my job. For decisions large and small, there are ample opportunities to second-guess yourself. I’m sure you have your own what-ifs when it comes to investing. If only I ...

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Recently there was an article in the Washington Post titled, "Uber and Lyft think they can solve one of medicine’s biggest problems," in which these two companies are angling to provide better, safer more reliable transportation for patients. While I applaud this mission, given the depth and reach of both companies, I think they may be underselling their abilities to improve health care delivery and reduce cost. Recently, one of my ...

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The words were like bitter candies that I had been sucking on, hoping to come to a sweet center. I had walked the hallways of the hospital holding them in the silky pocket of my cheek for weeks. Finally, afraid I would choke, I spit them out into the middle of the dinner table. “I think I’m depressed.” I stared down at the tablecloth, moisture collecting on the base of my water ...

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My name is Lucy. I have stage IV liver cancer. I wanted everything done — even though the doctors told me this disease is terminal. My family, my church and my friends were praying for “the cure.” Though I believed in God and the hereafter, I wasn’t ready to go. 74-years-old with beautiful children, grandchildren, and a great-granddaughter. I woke up confused. In the background — wherever I was — I could hear ...

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Once every couple of years I have medical students from the local medical school over for dinner. At some point, the conversation usually turns to finance, and I commiserate with them about their loan burdens. I typically toss them a few pearls of wisdom, wish them good luck, and we move on to something else. They always think it’s funny when I say, “If you can’t live on $200K, you ...

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Recently, I was asked to give a talk on resilience and its role in reducing physician burnout.  I was excited by the opportunity, but asked if I could focus more on cultural change and institutional solutions for burnout.  When they said no, I declined.  Why? Well, it’s not that I don’t see the value in resilience.  A lot of physicians that I really respect write and speak about resilience.  I think ...

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In 1994, Penguin Books published what would become a national bestseller titled, Listening to Prozac written by Dr. Peter Kramer, a Clinical Professor of Psychiatry at Brown University at the time. Throughout the book, he debates the ethics of "cosmetic pharmacology" a term associated with the transformation of personality traits through medication. Kramer describes several patients as becoming “better than well” on Prozac -- more socially adept, less inhibited, and ...

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As we continue to attempt to restructure how health care is measured, reimbursed and organized, we must hold true to the idea that health care is simply not a service commodity. "A commodity is any good or service ("products" or "activities") produced by human labor and offered as a product for general sale on the market." Our health care delivery model continues to evolve as we move away from the fee-for-service (FFS) model ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 35-year-old woman is evaluated for intermittent fever, sweats, fatigue, and dull midchest pain of 2 weeks' duration. Medical history is significant for liver transplantation 6 months ago for primary biliary cirrhosis; she was seronegative for cytomegalovirus and Epstein-Barr virus, and her donor was positive for both. Results of ...

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The interviewees in my book talked about declining quality of health care. Do people even know or remember what it is like to get quality health care? Doctor visits are often too short to be adequately through. Psychotherapy is too often too brief,  with a focus on "quick fix." Psychotherapy isn't just about talking. It involves careful, thorough study and application of knowledge to the issues that patients bring with them. ...

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Last fall, my nine-year-old daughter asked me to buy some extra lunch items at the grocery store because she and a friend of hers were going to take turns bringing in food for a classmate who couldn’t afford to purchase lunch at school. I was reminded of this conversation last week, when the school committee in my city voted to no longer deny middle- and high-school students lunch if they ...

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Change and health care are closely interconnected. Health care organizations are continually faced with the need to adapt to change, whether it be advances in medical care or technology, growing demand for care delivery, a patient population that is increasingly active and involved in their own health and well-being, or evolving reimbursement and cost models. By recognizing that change is inevitable in the health care sphere, organizations can focus on ...

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The two-page letter of complaint was typed on crested letterhead. The words "utter disappointment" jumped off the page, bold-faced and caps-locked. "The doctors left me to bleed," she wrote, banging on the exclamation key as if she was firing lasers in a game of Space Invaders. "I was hemorrhaging, and they did nothing except pop in and tell me it would stop." The tirade was directed toward me and the ...

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A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. I love to see the pure joy that floods over mothers as they hear their new baby’s first cry!  The ability to help make childbirth safer for mothers and babies led me to a career in obstetric anesthesiology -- in the high-risk, high-reward ...

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