How does a working mom and physician keep practicing medicine when her husband’s career brings her halfway around the globe? For me, it was an adventure. While it can be challenging, I encourage other physicians to experience the world with their families while still practicing medicine.
As a 14 year family practitioner from Ohio, I suddenly found myself in Qatar with two young children because of my husband’s job. Qatar is …
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.
Comparisons between the airline industry and anesthesia care are common. One of the most commonly heard analogies is that the takeoff and landing of a jetliner are similar to induction and emergence during a general anesthetic. But there are other equally important analogies between the two …
His nurse paged me at 9pm: Mr. L wants to leave against medical advice (AMA). As the covering doctor, I dreaded the impending standoff even more than usual.
I emerged from the elevator minutes later to find that the gaunt octogenarian had advanced from his isolation room, passed the nurse’s station and the unit doors, and arrived at the elevator bay to greet me. Security guards hovered at a cautious distance …
There is a disconcerting myth about single mothers that has been circulating in our society for some time. It was popularized in the Reagan Era as a denunciation of US social welfare policy and resulted in a pointed caricature of a woman on welfare, forever to be known as the “welfare queen” or the entitled single mother.
The narrative of such a woman goes something like this: Not only is she …
As I explained his options, my patient’s initial shock turned to disbelief. I told the 84-year-old man that Medicare would pay for treatment of his urinary tract infection if he received infusion therapy at a nursing home, but it would not be covered if he opted to receive the therapy at his own home.
We calculated that the four weeks of therapy at a skilled nursing facility would cost Medicare about …
I have just turned on my computer. It is midnight. I should be trying to sleep right now.
My 5-year-old is sick and I am on call for the next few nights. Fortunately, my daughter should get better in a day or two. She needs Tylenol for her fever, mama’s love and time to kick this virus. But as I sat in bed holding her and waiting for her fever to break, …
The term “open access” in the context of primary care means that patients are able to get an appointment whenever they wish.
The ultimate in open access is 24/7 availability. No, I don’t offer this, although I come pretty close. I’m available by cell phone virtually 24/7 and I’m also almost always willing to come in and see someone if they really need to be seen. This seldom happens. Most of …
I was 8-years-old in June 1963 when the Readers’ Digest arrived in the mail inside its little brown paper wrapper. As usual, I sat down in my favorite overstuffed chair with my skinny legs dangling over the side arm and started at the beginning, reading the jokes, the short articles and stories on harrowing adventures and rescues, pets that had been …
I came across a really good post on the Daily Beast written by a pediatrician in New England, griping (appropriately) about parents who were unwilling to trust his judgment about vaccinating their children.
Why have so many patients lost trust in their doctors?
You might challenge the assumption that patients used to trust their doctors more, and that would be a fair question. I haven’t …
This morning I went for my annual mammogram. It’s not something I generally look forward to. In fact, I mildly dread it.
In my personal experience, mammograms have ranged from quite uncomfortable to downright painful. And then there’s the general unpleasantness of standing topless in a cold room. The first time I had this screening imaging study done, the plate pressed so hard into my sternum that I was almost in …
Hospitals are commonly thought of as the safest place to be for sick people.
Patients have around-the-clock access to skilled care teams. Their vital signs are continuously monitored. A physician stops by every morning to check on them.
While it all sounds safe, a hospital can be a very dangerous place to be. Here are four frightening risks hospitals pose, along with their causes and some easy-to-implement solutions that could save hundreds …
Ever felt misjudged by a doctor? Or treated unfairly by a clinic or hospital? You may be a victim of patient profiling.
Patient profiling is the practice of regarding particular patients as more likely to have certain behaviors or illnesses based on their appearance, race, gender, financial status, or other observable characteristics. Profiling disproportionately impacts patients with chronic pain, mental illness, the …
“What’s a high-risk patient?” asked our newly hired care coordinator.
Interesting question, and, as you would expect, one without an easy answer.
One of our patient-centered medical home certifying agencies was performing an audit for recertification, and requested information on our high-risk patient registry, including how patients were identified and assigned to the registry.
When you ask doctors or any other providers, we all know one when we see …
Where I come from, when most people refer to the Good Book, they are referring to the Bible. This is not true for my father, because to him, the Good Books are something else entirely.
He describes a scene early in his career as a plastic surgeon, when he had taken his doting mother to see his new office. Coincidentally, a lovely thank you note had just arrived from one of …
I have noticed over the years that physicians who write about medicine, particularly for the general public, are limited to very specific discussions. For instance, it is perfectly acceptable to write about the plight of the poor and uninsured. It is always reasonable to advocate for a single payer system. It is perfectly acceptable to discuss how one downsized in order to make less and “give back” more. And it …
Should joint replacement manufactures provide a warranty for their products? It seems pretty logical since most consumer products come with some sort of warranty these days. Basic warranties are almost universally provided and the market for extended warranties is increasingly popular.
Take for instance my recent upgrade to the new iPhone 5s. At the time of purchase, the AT&T store suggested their extended …
In 2007, I wrote a post called “Why Shrinks Don’t Take Insurance.” The post is a bit dated, the CPT codes have changed since then, and the reasons to not take insurance have increased. Many other doctors don’t take insurance now, though psychiatry remains the number one specialty where doctors don’t participate in health insurance plans. This is an updated version of that same post.
Many psychiatrists in private practice don’t …
Case 1: You have a 94-year-old woman with multiple medical problems in hospice who develops a fever (subjectively hot to the touch), shortness of breath, and a cough producing yellow sputum. Her daughter asks if she can be treated with antibiotics “to make her feel better.” The patient is not well enough to make decisions, but in earlier conversations had stated a goal of remaining comfortable at home, while also …
I trained in internal medicine and cardiology at the tail end of the era of lifetime board certification by the American Board of Internal Medicine. In fact, my timing was perfect — I was “boarded” in medicine in 1987, and in cardiovascular disease in 1989, which (I am pretty sure) were, respectively, the last years that the ABIM offered certificates without an expiration date in those disciplines.
Late last year, I …
A recent research article in the Journal of General Internal Medicine, and the gap between its findings and the real world, helps point up the usefulness and limitations of research. The article, by Susan H. McDaniel, PhD, and coauthors, set out to determine how often doctors speak about their colleagues in supportive or critical ways.
Their method is one widely used in the field: simulated patients, actors, were prepared with lifelike …
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