In February 2017, I saw my last patient and left clinical medicine. Most people would say I retired. I have chosen to say I have repurposed. I no longer see patients, but I still work. I am writing the Doctors Guide series of books, keeping up a blog and working with physicians who need help with a financial makeover, usually to eliminate their debt, set themselves up for retirement or ...

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In early April 2017, a cover of The New Yorker depicting four medical providers sparked a movement within surgery. Women surgeons claimed this illustration as a rallying cry; recreating it proudly with colleagues in the operating room and sharing their images on social media tagged with #NYerORCoverChallenge and #ILookLikeaSurgeon. We were in our fourth year of general surgery residency when we became the ...

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It is well known that smoking cigarettes negatively impacts health and leads to an increased risk of stroke, heart disease, lung cancer and death. No one debates this anymore. But it wasn’t always this way, and it didn’t come easily. In the 1940s, almost half of the population in the United States smoked, and the tobacco industry was subsequently incredibly powerful and politically active. It spent millions of ...

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“Don’t get tired! Don’t f*cking move! Don’t you f*cking move, or I’ll f*cking die!” That’s an excerpt from an OR in St. Louis on March 12th. This is just one of the outbursts that was reported from a single, multi-hour surgery — an attending’s toxic mandate to her resident, who was poised in a precarious situation under the drapes. The rest of the OR staff caught plenty of its own abusive ...

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She pushes her cleaning cart into the bright room. “Looks like the usual mess,” she mumbles to herself, pushing a loose piece of hair back into her blue cap. Methodically, she cleans the room beginning with the operating table, stripping off the bloody sheets. Then cleaning the floor of blood-stained shoe prints, amniotic fluid and bits of paper, needle caps and such, that managed to escape hands and land on ...

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Eye surgery is a delicate business. It involves operating within an orb the size of a large marble to remove a cataract or repair a retinal detachment. Not only is superb eye-hand coordination a must, but also an awareness of the myriad other medical issues in the elderly population most in need of eye surgery. Traditionally, patients undergoing cataract surgery had a preoperative medical evaluation, including blood work, chest X-ray, and EKG, ...

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I’m coming off a string of talks about physician finances and physician empowerment, and despite knowing that physicians are stereotypically financially naive, every once in a while I’ll hear a question that really makes me pause and drives home the need for a better financial education.  The latest came up when I was discussing negotiation techniques, and somebody interrupted me to ask, “When you’re earning a six figure ...

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When we look back on the last century, the pace and number of advances in our ability to treat disease and injury is truly astonishing. The exponential growth of technology has contributed to this greatly, as we see new advances often come in the form of new technologies. Amazing innovations in the fields of endoscopy, catheterization, robotics, imaging, navigation, 3D printing and more allow us to do things that were ...

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“4 ounces water every mile, half an electrolyte ‘gu’ pack over 2.5 miles, ¼ energy bar every 6 miles” -- a.k.a. how did you manage training for a marathon while in medical school?  The simple truth: I decided to run a marathon, so I did. Longer story: months of rigorous training, more moments of doubt than I care to recall, and insights already positively impacting my medical training. Training for and ...

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I leaned back against the wall, breathed into my palms and brushed beads of sweat from my forehead. I wondered if I wasn’t crying because I lacked the emotional capacity, was too exhausted to expend the energy or maybe simple dehydration. Sounds from the preceding hours played on repeat: congratulations on a clean dissection, a panicking anesthesiologist unable to ventilate, the sad songs of bradycardia and hypoxia playing on the ...

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