Primary Care

Questioning medical traditions for the sake of patient care

Physician
January 20, 2023

The United States consumes forty-six million turkeys every Thanksgiving. Have you ever wondered why? When traditions take hold in society, we start to forget why they existed in the first place. For example, the tradition of eating turkey on Thanksgiving started with a writer named Sarah Josepha Hale, who published scenic depictions of American life in New England. She subsequently campaigned for everyone to adopt her depiction of a cooked …

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Direct primary care: more access, more savings, more care

Physician
January 19, 2023

Your doctor will see you now. Really, now. Come on in! Forget about waiting for two months for an appointment, hours on hold, or a six-hour wait at an urgent care clinic. Your doctor can see you now; shoot them a text.

More and more primary care clinics are providing a more personal, accessible, convenient, and affordable health care option called direct primary care (DPC). This model focuses on patients rather …

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Doctors struggle with unrealistic expectations and lack of self-care, leading to a lack of mercy towards colleagues

Physician
January 19, 2023

“Mercy and consideration for the other man, but none for yourself, upon whom you have to keep an incessant watch.”
– Sir William Osler, MD.

Ironic, isn’t it? The physician is expected to go above and beyond, superhuman even, held to an unrealistic standard above most others, and yet, is their own worst critic. (Or was until social media, but that is another writing for another day.)

We continuously hold ourselves to that …

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The decline of whole-person treatment in modern medicine

Physician
January 19, 2023

Recently, a nurse practitioner responded to one of my op-eds in which I discussed the doctor-patient relationship. The nurse said:

I feel so frustrated at times, by the time constraints forced on us by using a business model of practice. In the 30-plus years I’ve been a nurse, we have moved from patient-centered care (which is the current inaccurate buzzword for the type of care we provide) to …

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Lean on me: the power of human connection and the support of a caring doctor

Conditions
January 16, 2023

Sometimes in our lives, we all have pain, and we all have sorrow.

But if we are wise, we know that there’s always a tomorrow.

Lean on me when you’re not strong, and I’ll be your friend; I’ll help you carry on,

for it won’t be long ’till I’m going to need somebody to lean on.

Some might recall these lyrics from the song Lean on Me, written in 1972 by American singer-songwriter Bill …

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Emotional seasons: 3 vignettes of love, loss, and connection

Physician
January 14, 2023

At the end of a year and the beginning of another, emotions tend to run high.

Whether it be the loss of a loved one or the tangled web of interactions with relatives, an unexpected illness or travel plan glitches, wonderful moments to cherish, or joyful connections – all are wrapped up like presents topped with emotional bows.

The opening and unraveling part often takes courage and creativity.

This is a series of …

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Don’t lose yourself: a warning from a divorced physician

Physician
January 13, 2023

I was going through drawers, finishing unpacking as best I could, when I stumbled upon one of those moments that feels like a puzzle piece sliding into place. I recently divorced, moved across the country, took a leave of absence from work, and changed my job. It’s been tumultuous, but grounding. I’m back in my home state, near good friends and family, and in therapy. I’m sleeping 8 hours a …

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Physician speaks out about being threatened by a patient and betrayed by an organization

Physician
January 13, 2023

I’ve been practicing internal medicine for over a decade now. I was drawn to this field because of my admiration for Dr. William Osler and the superb physicians I have met who embody his qualities. As an internal medicine physician, I am expected to be a critical thinker and a “doctor’s doctor,” specializing in complexity and solving problems with multiple layers, like peeling an onion. However, I never imagined that …

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Is success really just about wealth and achievements?

Physician
January 11, 2023

Success is a word that is used frequently across the globe. Almost everyone wishes to experience a great amount of success all the time. We are constantly bombarded with images of success through the internet, mainstream media, and social media. These images often depict high net worth, lavish possessions, luxurious lifestyles, impressive titles or achievements, exotic travel, and more. However, data shows that this appearance of perceived success is not …

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The intertwined roles of parenting and medicine: How personal experience can enhance patient care

Physician
January 10, 2023

As a pediatric subspecialist in the division of developmental medicine at our hospital and a mother of two school-aged children, I constantly strive to find new approaches to both parenting and my medical practice. Some of these strategies work well, while others do not. Despite my attempts to believe that my roles as a pediatrician and a parent do not influence each other, the truth is that they are deeply …

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Returning the joy of medicine to our primary care physicians 

Physician
January 10, 2023

Nearly 50 years have passed since the first published mention of physician burnout. Clinical psychologist Herbert Freudenberger described the “excessive demands on energy, strength or resources” and wrote of how it resulted in “fatigue, frustration, cynicism.” And though initiatives, programs, and solutions to address burnout have grown, the concerns first cited in 1974 have grown as well—now reaching the undeniable crisis.

In a recent survey, 61 percent of physicians reported …

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How you can thrive despite the looming physician shortage

Physician
January 7, 2023

A perfect storm is brewing in the U.S. health care system, and we must prepare to counter the rushing waves. America is facing a potentially catastrophic physician shortfall. All indicators point toward unprecedented times ahead. If I were an attorney, I would state my case something like this.

Exhibit A

According to the Association of American Medical Colleges (AAMC), the United States is facing a projected shortage of between 37,800 and 124,000 …

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Understanding patients’ religious and spiritual beliefs promotes healing

Physician
January 6, 2023

Religious and spiritual experiences have shaped my worldview since I was a teenager. At age 13, I celebrated my bar mitzvah. Later that year, I underwent an appendectomy. A priest asked my mother if he could pray for me prior to the operation. My mother did not hesitate to accept the priest’s blessing. I learned at an early age that prayers for one’s well-being should be welcomed regardless of …

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How to deal with challenging patients

Physician
January 6, 2023

Dealing with challenging patients can be difficult and stressful for doctors and health care professionals.

It can be helpful to remember that they can be difficult for a variety of reasons, such as pain, fear, confusion, or unmet expectations that were expressed or not — reasonable or not. To effectively handle challenging patients, a few key points must be kept in mind.

Remain calm and professional. This will help keep the situation …

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Treating rare, multi-system illnesses [PODCAST]

Podcast
January 4, 2023
YouTube video

Subscribe to The Podcast by KevinMD. Catch up on old episodes!

“If patients had an accurate diagnosis and their physicians knew the root of their illness and could treat it effectively, then the medical care costs would go down. The effect on patients of being diagnosed years earlier …

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Doctors trained abroad will save rural health care

Policy
December 31, 2022

Health care is growing hard to come by in rural America.

Three-quarters of rural counties suffer from doctor shortages. More than 200 rural hospitals are at risk of closing due to financial hardship within the next two to three years, according to a study published this spring. And while 20% of the U.S. population lives in a rural region, just 10% of physicians practice in these communities.

Fortunately, there’s a group of …

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The transformation of doctors into “Dr. Widgets”

Physician
December 29, 2022

It has finally happened, I have transitioned to viewing myself as a widget, a depersonalized interface between the EMR and the patient. I am the unnamed device that collects the patient data and subsequently transcribes it into prose for billing purposes and maybe the occasional colleague review. There is a bit of curious comfort in identifying myself as a mere cog. I’m imagining I will now fly below the radar, …

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Ode to the paper chart

Physician
December 29, 2022

Oh how I miss the feel of your thick spine, so wide I could barely grasp you with my oddly small hands. Wrist cocked, an awkward drag ensued from rack to desk, your heft landing with a thump under fluorescent lights on the laminate desk. I scooted into the low chair and dove in with aplomb. I was ready.

I started just beneath your mauve plastic cover. There, just under the …

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Myths and misconceptions about virtual primary health care

Tech
December 27, 2022

Virtual primary care, unlike virtual urgent care, involves doctors who take the time to get to know their patients, creating (and nurturing) trusted doctor-patient relationships. Virtual primary care requires that doctors be consistently available for providing ongoing care to their patients.

Can doctors who meet their patients via video form an effective doctor-patient relationship, and does that relationship lead to appropriate and needed primary care?

The answer is a resounding “yes” on …

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The solution to America’s primary care shortage is direct primary care 

Physician
December 24, 2022

Primary care in the United States is on the brink of collapse. Primary care providers suffer existential burnout, are the lowest compensated among all medical specialties, and there is a crisis-level shortage of primary care physicians, especially in health professional shortage areas. Despite strong evidence linking primary care (unlike any other medical specialty) to a better quality of life, longer life expectancy, better patient experience, and lower total …

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