If you asked me five years ago what my career goals were, I may have said something about getting more grant funding and writing more manuscripts so I could eventually become an independently funded physician-scientist. But honestly, at that time, I had no concept of the nitty-gritty details and emotional support that it would take to accomplish those goals. My primary research mentor was a notable figure in our field ...

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Of the nation’s 3.5 trillion in annual health care spending, 90 percent is for people with chronic and mental health conditions. How long can this continue? Can health care institutes afford not to engage in the 2020 wave of preventative care health care disruption? For those riding the disruption wave, the answer is simple. CMS alone is providing more than 80 billion in ...

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A spirited discussion erupted over The Joint Commission’s role in prohibiting food in patient care areas: "Taking food and drink away from doctors and nurses is just cruel." The rumor that The Joint Commission is the enforcer of food and drink policies meant to starve clinicians has been around since I was working as a nurse in direct patient care capacities in the ‘80s and ‘90s. I’ve devoted plenty of time to clarifying my ...

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I admitted an elderly woman to the hospital recently.  The previous week, she had presented to the emergency department (ED) with chest pain and shortness of breath.  For some unknown reason, a urinalysis was obtained and was found to be abnormal.  The patient left the hospital with a prescription for cephalexin, in addition to unexplained chest pain and shortness of breath.  The patient presented to the hospital this time with, ...

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I read the recent article on KevinMD: “I’m sorry: Why I lost my love for medicine” with great sadness. My heart goes out to the author; many of their concerns echoed deeply within me. I am sorry that we, as physicians, haven’t effectively succeeded in solving the myriad of problems facing health care today. And the author is right: Health care as a system, in the ...

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"What do you want to be when you grow up?" It's a question I frequently hear from physicians on my clinical rotations. Phrased somewhat tongue-in-cheek, the wording allows me to answer either in jest or in earnest. "An astronaut," I sometimes say, hoping for laughs and no follow-up. Other times, I try out different responses like Halloween costumes: a critical care specialist, an emergency physician, a surgeon. If I want the questioner's ...

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"I should explain to you, Socrates, that our friend Cratylus has been arguing about names; he says they are natural and not conventional; […] that there is a truth or correctness in them." - Plato I once heard that the sound of one’s name is the most beautiful thing in the universe, which is probably an overstatement. But one’s name is one of the first words one hears from birth, as parents ...

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Empathizing with others' suffering is one of the most human expressions in life. For empathy to nurture, like any other emotion, it needs time and space, and in none other professions, this maxim is codified as profoundly as in medicine. Even in the times of pre-modern medicine, humans had the temptations to heal fellow humans' suffering from ailments about which they knew little and had no therapeutics to offer. Nevertheless, ...

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Medicine is for the birds, or it should be.  Hear me out.

A day before I wrote this, I was on the trail in northwest Ohio, binoculars in hand, trying to tell one warbler from another.  This was the final weekend of the biggest week of birding in Magee Marsh on the shore of Lake Erie.  Birders converged here from neighboring states and even from foreign countries ...

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Recently, a fellow physician mom ended her life. While outwardly, a very vibrant, lively, and happy woman, she fought her own internal demons for some time. From what we know, she struggled with depression but was still committed to being a good mom, physician, and wife. Sadly, a few days before her birthday, she could no longer bear her sadness and decided to end her agony. I know many physicians’ ...

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Would a Hippocratic Oath for health care executives make a difference? Probably not. Nonetheless, there is ample evidence that the organizational cultures of too many hospitals are not conducive to physician well-being. In a provocative blog posted on May 2, 2019, emergency medicine physician Mark Borden indicated a Hippocratic Oath was urgently needed for administrators. Dr. Borden wrote: "Physician employment was, and is, obviously an intrinsically flawed structure ...

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What seems like a tidal wave of pages washes over you. Drowning in a torrential sea of order clarification, bowel regimens, and vital sign deviations — you struggle to stay afloat. Medical school did not prepare you for this. Patients and nurses are calling you, “doctor,” you wish to return to that minimal responsibility role as a medical student. Welcome to your first on-call weekend. These first few days, weeks, and months ...

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I knew things weren't right when a nurse called me on my cell phone just a few minutes after she sent me to pump milk in a private room and said that the medical team wants to meet with my husband and me immediately in a conference room. My suspicions were confirmed when we walked into a conference room and saw a long table full of doctors who all stood ...

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Burnout is a big and burgeoning problem in the United States. According to a recent Mayo Clinic report, it affects 28% of the general working population. Among physicians, however, the rate is markedly higher, ranging from 44% to 54% in most studies.

More concerning are the consequences: Doctors who report burnout symptoms are twice as likely to ...

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"Let me order some labs, and then we'll discuss where we go from there once I have the results." I walk out of the patient's room and right into one of my nurses. "Zoe, can we start that lady on pressors like we talked about? Her blood pressure is still low after the fluids. I need you to put the order in so the pharmacy can send it up." I smile my ...

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Sometimes what makes truly great catchphrases, mission statements, and movie titles so powerful is that they are true, always necessary, and sometimes sufficient.  I was reminded of this a few months back when a patient called into our telephonic urgent care triage line worried about a drug overdose.  I was in my office typing or talking away, as I am prone to do, when the registered nurse who took the ...

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A person rolls into an outpatient clinic. A pleasant bleach smell emanates from freshly scrubbed chairs. Happy chatter about people's lives, and this week's health issues are dimmed by the local radio station playing in the background. The person who just rolled in for the first time has a confoundingly complicating diagnosis. It's not the first sized holes in their body under their urine-soaked shorts they initially refuse to take off. ...

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The first time a woman went into the final stage of labor, I watched from a corner of the room. As a third-year medical student, I was on my six-week clinical rotation in obstetrics and gynecology, and it was day one of the two-week portion on the labor and delivery floor. As a loudspeaker announcement projected over the woman's screams, and nurses and doctors rushed in response, I instinctively clasped ...

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I have been fortunate in that I have not had to hospitalize any patients in the past four weeks.  This means I have an extra 60 minutes or more to prepare for the workday in my office. The streak ended this weekend when my associate, taking his rotation of being on call, hospitalized one of my patients with pneumonia. In many cases, pneumonia is treated as an outpatient. You receive an ...

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Thank you all for making 2019 another great year on the KevinMD platform. With over 25 million page views, and 500,000 followers across Facebook, Twitter, and LinkedIn, KevinMD continues to be your leading health care voice. KevinMD was named to Medscape's 20 Top Physician Social Media Influencers, PR Week and MM&M's Health Influencer 50 2019, and FierceHealthcare's Social media ...

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