I am overwhelmed right now. I know I am not alone. I hear it in the voices of my friends, family, colleagues, patients. We are all feeling it. I am overwhelmed by this virus. There is so much to learn, so much to teach. Every day the information changes. Who is credible? Who is just shouting the loudest? It can be hard to ...

Read more...

"Each patient I have seen over these four decades has made me a better doctor. Books do not impact long term memory the way a real patient can. I once heard the chair of medicine at a teaching hospital say that the worst thing about being on call every other night as an intern is missing half the patients. I now ...

Read more...

"The COVID-19 pandemic has upended health care, with telemedicine emerging as a strategy to reduce risk exposures for patients and clinicians. Video visits, in particular, can be effective for many types of clinical care and offer convenience and savings for patients. As care shifts to this virtual modality, however, there is a risk of jeopardizing the meaningful human interaction that is ...

Read more...

In so far as our current public health emergency is concerned, telehealth has obvious, indisputable benefits.  The redirection of patient flow has enabled the conservation of personal protective gear, decreased nosocomial transmission of the coronavirus, and, therefore, saved lives, especially those who are immunocompromised, who are far more likely to contract COVID-19 as well as experience worse outcomes. As most of us fully appreciate, telehealth is not, however, a mere ...

Read more...

Standing in the hallway, I look attentively to the computer screen while the attending skims the records. “This is a longstanding patient of mine.  I’m just going to have you listen while we do a visit with our psychologist,” he says. With the paucity of chairs, I stand. I wondered if it would add an unnecessary sense of urgency to the seemingly comforting timelessness to my attending and psychologist’s voices, ...

Read more...

On the morning of George Floyd’s funeral less than ten miles from our medical center in Houston, I was avoiding the word “Black.” Despite wholehearted pride in the strong Black presence in our community health center’s physicians, staff, and patients, I felt a loss of words that Tuesday morning. There was simply too much pain, grief, and rage in our community.

I was thankful ...

Read more...

Primary care is on life support. COVID-19’s toll on American health care extends beyond the hospitals and medical workers besieged by infection. An equally insidious but less-visible crisis is engulfing primary care, the long-neglected foundation of our health care system. Given the role of America’s largest corporations in providing health care benefits, the C-suite should be on high alert.

As growing numbers of patients postpone appointments over concerns about ...

Read more...

"Being present is a wonderful thing. It relieves stress caused by focusing on failures of the past and worries of the future. Both realms are unreachable, largely unchangeable. But at the same time, they both entice and tease our minds such that we often find ourselves everywhere, but at the moment as we focus on changing what has already passed or ...

Read more...

He did a double-take as we passed on our small town sidewalk the other day. “Hey Doc, I didn’t recognize you dressed like that, without your …”, he gestured to where my tie or stethoscope would have been. I was wearing a cafe-au-lait colored T-shirt and faded Levis. “Did you hear about the appointment with the cardiologist yet,” I asked. “It’s in two weeks,” he answered. “Tell me, Doc, how serious is this ...

Read more...

"Recently, I realized that something needed to change in my family life. With three busy daughters at three different schools who participate in multiple activities along with my full-time job as an anesthesiologist, my life depended on accurate and concise communication. However, this was the third time in a week that a ball had been dropped between my husband and me. This ...

Read more...

"All too often, physicians and other health care providers have tried to do the right things for our patients to ultimately have had our hand slapped. So pause for a second, get the questions answered, know what future implications are for today’s actions. Make the right choice for your patient, and for yourself, especially if it means amending your contract before you ...

Read more...

Have you ever found yourself with a patient not knowing what to say or do? Maybe you just told them they had cancer or that the last treatment option had failed or a loved one had died. I have, many times, and I always felt helpless, inept, and alone while doubting my abilities as a physician. Medical school had not prepared me for this. I learned firsthand, one difficult, and ...

Read more...

I knew it was the end of the world. I was about ten years old and returning home just as it was becoming dark. The sky began to be shot full of incredible colors coming from one direction. They became larger and brighter. Having been raised in a strict Catholic household, I had been well prepared for the end of the world – it was here! I raced home at ...

Read more...

"Sitting in front of my laptop with both of us on the screen, I can maintain decent eye contact even if I look something up or type something into the medical record. The patient sees me as paying more attention than when I couldn’t effectively both maintain eye contact and look at the screen while talking to him or her (because ...

Read more...

Slow. Sluggish. Feet dragging. Legs heavy. The run was not the effortless morning wake-up I had envisioned when I sat on front steps tying the shoes. The gazelle I had envisioned, gently bouncing over the trails, had turned into more of a hippo waddling along. Then, around 15 minutes into the run, I remembered a friend’s wisdom. “Don’t fight the current. Find it and flow with it.” So, flow with it became my ...

Read more...

This article is sponsored by Medici. Telemedicine has increased exponentially since the rise of COVID-19. It reduces COVID-19 exposure risk for both patients and providers. In many ways, telehealth has become an essential service for physicians and other health service workers. Still, with the rapid rise of the pandemic, many providers have difficulty navigating the billing side of ...

Read more...

Opiates relieve pain and can transport people to their apparent happy place. So does marijuana.  Lyrica, the seizure-turned-pain medication, caused enough of a buzz in early study participants that it became a controlled substance. The anesthetic ketamine is now used for treatment-resistant depression. Years ago, we had to be very specific about the location and classification of our patients' pain. When pain then became a self-reported vital sign and chronic opioid ...

Read more...

Spring 2020 has brought a disproportionate amount of grief for many of us. The losses include mortal ones, such as the death of a loved one, a colleague, or a patient. We’ve lost productivity, opportunities, and income. We’ve also lost freedoms, from the personal liberty to go where we please to our ability to spend time alone (due to quarantine in close quarters with family members). And as an anesthesiologist, ...

Read more...

I am a physician that was placed in a unique position.  I was hired as a private contractor to work for three months in a remote medical setting on Wake Island. Wake Island is a remote island approximately 2000 miles west of Hawaii, with a population of 150+ people. Wake Island is unique in that it is a mid-Pacific refueling stop for military aircraft. ...

Read more...

Much has been written about the response of the governmental agencies in the foreseeability of COVID-19 spread and management in the United States. Travel restriction from mainland China seemed to be a very timely intervention. However, instead of considering it as an initial step in a prolonged exercise of vigilance in preventing the disease from getting a foothold on the continent, it was considered the only one. Now it is ...

Read more...

320 Pages

Most Popular

✓ Join 150,000+ subscribers
✓ Get KevinMD's most popular stories