The pediatrician kept on telling me that everything was fine. What could possibly be wrong? His motor skills were right on time, if not a little early.  He even had emerging problem-solving skills. He did things like push a chair up to a shelf to climb up and get what he wanted.  Three decades later, he still does clever things that make me question why he is so impaired. Unfortunately, there ...

Read more...

A physician health program, PHP, is a state agency that is responsible for advocating, treatment referral and physician monitoring, residents and medical students who have substance abuse disorders, psychiatric disorders and/ or boundary issues. There are two ways of becoming a part of these programs, self-referral or be reported. Currently, 47 states have a PHP, and the issue is that there is no set guideline and several variables in the ...

Read more...

An excerpt from Mind Bubbles: Exploring mindfulness with kids. I am not a pediatrician.  My training as an OB/GYN taught me to care for mothers-to-be and bring their babies safely into the world—and then hand them over to the waiting pediatrician.  I am also a mom and mindfulness teacher, however, ...

Read more...

National attitudes have greatly shifted over the last 25 years towards the idea that mental and emotional well-being are vital to a person’s overall health. Today, nearly six in ten Americans have sought or want to seek mental health care for themselves or someone they love. While stigma and costs persist as primary barriers to progress for solving the mental health crisis, the key issue—as we have ...

Read more...

I recently returned from my second extended stay in New Zealand with my family. The entire experience was wonderful, but perhaps our most memorable day began with our three teenage sons waking up early to surf in the South Pacific Ocean. Once we had our fill of tropical paradise, we jumped in the car and drove a few hours to the local ski resort, where we found 10 feet of ...

Read more...

Jacob is just past 30 by a year or two. He is, as I like to describe him, a little boy trapped inside a man's body and very much mentally ill. He started off with fetal alcohol syndrome, which means his mother drank heavily when she was pregnant. I am not sure I believe that diagnosis is correct, by the way. Fetal alcohol syndrome is a much more complicated condition ...

Read more...

While researching for my next book, I noticed a peculiar trend: Most news reports about suicide linked victims to mental illness. It is nearly always depression, multiple personality disorder, or more depression. While it is true that personal mental illness and a family history of mental illness are often bonafide risk factors for suicide, they — collectively as mental health issues — are only one of many underlying causes of suicide ...

Read more...

I enjoy a fairly small private practice and a manageable telepsychiatry side job with good support staff. But even the small scale of my outpatient clinical practice doesn’t fully insulate me from the pain of unnecessary practices that I wish would become obsolete. 1. Preauthorization. The dance of preauthorization starts with the naivety on my part that I decide what medication my patient should be on. I spend precious time crafting ...

Read more...

Janelle had overdosed 32 times. Fentanyl coursed through her veins as she was given naloxone (Narcan) for the 32nd time in the ER, from the police, from a bystander. She could never get off of fentanyl. It had made her feel warm and numbed her from the trauma and horrors she had grown accustomed to. When she would wake up in the hospital, sore and discombobulated, she would beg for help. She ...

Read more...

What is the unspoken fatal epidemic of our time? And the greatest predictor of overall health, happiness, job satisfaction, and resiliency? Loneliness. As a clinical cardiologist, I am committed to the health and well-being of my patients. As a recovering burned-out physician who suffered in silence for years while hiding this so well from others, I am committed to finding solutions to help my partners suffering so often in silence. As a husband, ...

Read more...

After third-year medicine, I was required to withdraw for handing in an assignment late. It was a paragraph of self-reflection; I couldn't believe I was being kicked out for something so seemingly inconsequential. My dealings with the faculty became increasingly hostile and negative. I realized that my fellow students had to band together. Otherwise, there will be no change. I have to say that at my medical school, they have been ...

Read more...

With the epidemic in health care of overwork, stress, and burnout, psychological safety is a crucial factor in achieving the highest levels of quality of care and quality of work environment. While simple in concept, psychological safety is also quite fragile and needs careful attention on a day-to-day and conversation-to-conversation basis to assure it. Psychological safety means that people feel safe to speak up about concerns, new ideas, negative feelings, and ...

Read more...

As an academic psychiatrist who treats people with anxiety and trauma, I often hear questions about a specific class of medications called benzodiazepines. I also often receive referrals for patients who are on these medications and reluctant to discontinue them. There has been increasing attention into long-term risks of benzodiazepines, including potential for addiction, overdose, and cognitive impairment. The overdose death rate among patients receiving ...

Read more...

Along with a steeper financial burden and an increasingly competitive academic environment, this year’s incoming freshman university class will likely be confronted with the pressure to take a little pill that some popular culture references say will make you "awesome at everything." Or they may eschew the temptation and rely on the standard practice of study, sleep, repeat. Welcome to #GenerationAdderall, the ...

Read more...

I will always be a vascular surgeon. But let’s be clear; I no longer practice vascular surgery. Despite a busy practice, happy patients, local awards, and the respect of my peers, I quit. I gave it all up. All of the education, all of the endless training, all of the time, hard work, and, yes, all of the salary — I turned my back on it. Why? I am a recovering patient with constant ...

Read more...

When Will tried his first vape during his sophomore year, he didn’t know what to expect. It was just something he had vaguely heard about at his high school. “I just sort of remember using it a bunch of times, like in a row,” he said. “And there’s this huge buzz-sensation-like head rush. And I just … didn’t really stop.” Will kept vaping nicotine addictively for the next year and a half. ...

Read more...

Spoiler alert: Plot points of the movie "Joker" are revealed. "Joker" opened to a mix of rave reviews and criticism on October 2, 2019, amid fears of mass-shootings at theaters in the U.S. This left law enforcement agencies scrambling to beef up security at movie theaters to prevent any untoward incidents. Quite ironically, October  2, is also the 150th birthday of Mahatma Gandhi — the crusader and champion of non-violence. Warner Brothers even ...

Read more...

“When you start seeing your worth, you will find it harder to stay around people who don’t.” - Unknown After graduating from my residency a few years ago, I accepted a job within my organization as a staff psychiatrist and a medical director. The idea of familiarity was a big driver in my ambivalence towards pursuing alternate opportunities, even when they came knocking on my door. As the job started and progressed through ...

Read more...

In previous posts, we have reviewed the use of selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), as well as the off-label prescribing of gabapentinoids, for treating anxiety disorders. Anxiety is such a ubiquitous problem that it is not surprising that many other compounds have been used off-label as well.  In this posting, we will review some of the common ones: propranolol, mirtazapine, and quetiapine.  ...

Read more...

Fashion Is Moving Too Fast, and It’s Killing Creativity," by Veronique Hyland, talks about burnout in the fashion industry. As a former Fashion Designer turn physician, my curiosity was piqued. If you substituted the word "medicine" for "fashion," the title would be just as relevant to the medical industry, as it is to the fashion industry. Yes, medicine is moving too fast, and it’s killing creativity and our doctors. Burnout in the fashion industry stems from the need to ...

Read more...

41 Pages

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.