My anger rises when I see the TV "nurse" with her short white dress and her breasts spilling over her pronounced cleavage and her submissive voice speaking to this muscular male MD. Her quick giggle and pretentious demeanor is a stereotype portrayed across the land. And the reality of what we really do goes unnoticed. We have people shouting: "Bring me a coke!" "A blanket, hurry up!" "The food is too cold ... the food ...

Read more...

The use of health care information technology has increased exponentially over the last five years, and as a frontline physician, I have seen this change at close quarters. In most of the hospitals I’ve worked in up and down the East Coast, it’s been interesting to observe this transformation. The process has usually started with nurses and then moved on to encompass doctors. It’s overall a good thing, as I 
Read more...

A little background before I set off:  I study in a medical school in India whose attached public hospital is as busy as it can get. It serves its people absolutely free of cost and is often a refuge for the poor of the society. We often run out of resources, and patients outnumbering the beds is a common sight. And yet, like everything else, life and medicine must go ...

Read more...

How do you react when presented with your quality data? In my experience, physicians generally respond by:

  1. Ignoring the metrics
  2. Arguing about why the metrics are wrong
  3. Saying the metrics are stupid
A lot of doctors refuse to participate in the process of developing, reviewing and refining quality metrics. Although this has the definite advantage of feeling like you’re sticking it to “the man,” it feeds an unhelpful cycle that eventually hurts ...

Read more...

I was recently working in clinic on a Friday afternoon. I was on my last patient of the day, and it had been a particularly long clinic. I had big plans for the weekend and should have already finished. The gentleman entered the room, sat down, and we began the consultation. Because I was so behind, I went through everything a little quicker than I usually would, but still covering ...

Read more...

As voters fume about the high cost of health care, politicians have been targeting two well-deserved villains: pharmaceutical companies, whose prices have risen more than inflation, and insurers, who pay their executives millions in salaries while raising premiums and deductibles. Although the Democratic presidential candidates have devoted copious airtime to debating health care, many of the country’s leading health policy experts have wondered why they have given a total pass ...

Read more...

What if each new feature of your medical record came with a description of how it would improve patient value, not just how to use it? Could a simple checklist help to achieve Annals' vision of putting patients first by helping to ensure that health care innovators release only those features that help us improve patient value? Could a simple checklist help organizations reduce ...

Read more...

Growing up, any opportunity to eat out was truly a luxury. We just didn't have the money for it. Occasionally on birthdays or a special trip, we would be treated with a big fish sandwich from Burger King, or my personal favorite, a $20 party tray of shrimp fried rice from the local Hong Kong Express takeout spot. As trivial as these fast food places were, they were special because of how ...

Read more...

As media coverage of the 50th anniversary of Woodstock shifted into high gear earlier this month, two articles in the "Arts and Medicine" section of JAMA called attention to another anniversary that transported me back in time. It has been 40 years since the publication of The House of God -- an unabashedly irreverent (some would say "borderline pathological") fictionalized account of author Stephen Bergman's ...

Read more...

Personal journal entry, September 11, 2017: Sometimes we wear womanhood like a yoke — burdensome on our shoulders, as we carry the torch for younger women coming behind. Sometimes, we swing womanhood as a sword, slicing, and jousting for survival in a world that started without us, and in some cases, would be more than happy to continue that way. Sometimes, womanhood surrounds us thick as a fog, wrapping us in ...

Read more...

We all expect hospitals to be open and operating when we need them, but extreme weather events like hurricanes are a strain on resources and pose significant challenges for hospitals. Closing a hospital is an extreme action, but several hospitals in Florida, Georgia and South Carolina did just that before the arrival of Hurricane Irma in 2017. With more than 300 hospitals and a higher share of older adults than ...

Read more...

The attending physician looked concerned. My fellow medical student’s face was wet with tears. I knew the next words out of the attending’s mouth would be “Are you OK?” and indeed they were. I have encountered this phrase many times, almost exclusively in psychologically traumatic situations.  It’s a reflex response to an uncomfortable social situation, the “right” thing to say to a student in distress. As medical students, we learn and practice the ...

Read more...

When I walked into my first shift on labor and delivery as a brand new OB/GYN intern, complete with a freshly starched white coat, I was 33 weeks pregnant. As I listened to my chief resident effortlessly sign out the labor board, I was terrified. As the words pre-eclampsia, chorioamnionitis, and postpartum hemorrhage swirled around the room, I couldn’t get my heart rate under control. “They already hate ...

Read more...

I yelled for the nurse as I wrapped my arms around Mr. John. He was suffering from a violent acute dystonic reaction from a dose of Haldol the night before. Severe muscle spasms overtook his entire body. I saw the whites of his eyes as his gaze shot to the ceiling. He had lost all control over his body — legs, torso, arms, neck, face, eyes. "I can't breathe, I can't ...

Read more...

I was an intern, doing a rotation in the coronary care unit (CCU) of a large urban hospital. It was very challenging: The patients had complex medical issues, and my fellow residents and I were given lots of responsibility for their care. Still, I felt I was finally getting the hang of residency. One of the first patients I saw was Mrs. Smith, a middle-aged woman who had come to the ...

Read more...

The money was so good in the beginning, and it seemed it might gush forever, right through tiny country hospitals in Missouri, Oklahoma, Tennessee and into the coffers of companies controlled by Jorge A. Perez, his family, and business partners. It was his “secret sauce,” the rotund Miami entrepreneur would smilingly tell people in their no-stoplight towns. The money-making ventures he proposed sounded complicated, sure, but he said they would bring ...

Read more...

For more than 30 minutes, Robert Findley lay unconscious in the back of an ambulance next to Mercy Hospital Fort Scott on a frigid February morning with paramedics hand-pumping oxygen into his lungs. A helipad sat just across the icy parking lot from the hospital’s emergency department, which had recently shuttered its doors, like hundreds of rural hospitals nationwide. Suspecting an intracerebral hemorrhage and knowing the ER was no longer ...

Read more...

Toward the end of my clinical rotations, I met Salma, a 34-year-old woman who came from Egypt with her family to the U.S. two years ago. Wearing a latte-colored hijab, she was here at the hospital to care for her father, who had a case of congestive heart failure exacerbation with pleural effusions. When deoxygenated blood comes to the right side of the heart, it gets pumped to the lungs to ...

Read more...

Imagine yourself spending two years of your life indoors with books. Sometimes the only person you speak to for a few days is yourself, as you memorize intricate details of bugs and drugs that you never imagined yourself knowing. And then after these two years, you're completely isolated from the world for about two months or so, studying for the exam that they tell you determines the rest of your ...

Read more...

A debate highlighting gender discrimination in medicine currently rages within the pediatric hospitalist medicine community. The debate centers on the board certification process for "grandfathering" for the new pediatric hospitalist subspecialty which effectively excludes women on the basis of motherhood. For those not familiar with "grandfathering in," this is the process by which a new subspecialty may grant board certification to physicians who have been practicing in the specialty. The alternative option ...

Read more...

Most Popular

Join 150,000+ subscribers

Get the best of KevinMD in your inbox

Sign me up! It's free. 
close-link
✓ Join 150,000+ subscribers 
✓ Get KevinMD's 5 most popular stories
Subscribe. It's free.