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Improving physician satisfaction by eliminating unnecessary practice burdens
A guest column by the American College of Physicians, exclusive to KevinMD.com. In April, the American College of Physicians (ACP) released a position paper titled Putting Patients First by Reducing Administrative Tasks in Health Care, published in the Annals of Internal Medicine. The paper, part of ACP’s Patients Before Paperwork initiative, is a thoughtful look at the many administrative tasks that physicians face every day. It presents a framework for evaluating these tasks and calls on health plans, regulators, vendors, and others to consider this framework when they impose new requirements on physicians. This po...
Source: Kevin, M.D. - Medical Weblog - August 23, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/yul-ejnes" rel="tag" > Yul Ejnes, MD < /a > Tags: Policy Practice Management Primary Care Public Health & Source Type: blogs

Is the end of disparities in medicine near?
The patient looked at me and said that he did not remember the name of the specialist, only that she was a “woman doctor.” As this was completely unhelpful, I pondered the fact that a doctor who was male is never referred to as a “man doctor.” Why is it that woman physicians need the added label, as if the norm is a doctor who is supposed to be a male? While I have nothing against my male colleagues, I think I deserve to be equal to them, especially as we are now in the 21st century. When I have approached this subject in the past, many told me that I am simply wrong, mostly by men in the audie...
Source: Kevin, M.D. - Medical Weblog - August 23, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/linda-girgis" rel="tag" > Linda Girgis, MD < /a > Tags: Physician Medical school Practice Management Primary Care Source Type: blogs

The vision forward for health care should be bipartisan
Last November, we wrote an op-ed for STAT, as medical students, lamenting how politicized our future profession has become in recent years. In the aftermath of a divisive election that we argued may well have been a “referendum on the Affordable Care Act,” we implored policymakers and other stakeholders to take politics out of health care before attempting to reform it. We believe that partisanship has infected health policy in devastating ways, weakening the level of scrutiny, paralyzing the rigor of debate, and ultimately preventing much-needed progress on issues of cost, access, and quality in American healt...
Source: Kevin, M.D. - Medical Weblog - August 23, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/suhas-gondi-and-vishal-khetpal" rel="tag" > Suhas Gondi and Vishal Khetpal < /a > Tags: Policy Medical school Public Health & Washington Watch Source Type: blogs

10 things that weren ’t advertised to me before I started medical school
Last month, thousands of medical students donned their white coats as they took their first steps into hospitals nationwide to begin clinical rotations. This marks an important transition from the classroom into an actual inpatient setting to demonstrate the knowledge they’ve accumulated over the past two years. For most students, this means pretending to hear and correctly identify heart and breath sounds while agreeing with whatever the attending says. During my brief time on the floors, I’ve not only learned a great deal of medically relevant information, but also things that weren’t advertised to me w...
Source: Kevin, M.D. - Medical Weblog - August 23, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/brandon-jacobi" rel="tag" > Brandon Jacobi < /a > Tags: Education Hospital-Based Medicine Medical school Primary Care Source Type: blogs

Traditional private practice needs to change
Owning a business is not some pie in the sky deal where you take a phone call when you make the turn at the country club every day. The public at large, however, thinks that is exactly what business owners do. Owners are the people that collect money while others work right? They are rich people that just happened to be rich, so they bought a business for other people to make them more money. How spoiled! In reality, business ownership is one of the toughest jobs there is. You are ultimately responsible for not only the financial well-being of your family but all of the employees that work for you. Your decisions shape the...
Source: Kevin, M.D. - Medical Weblog - August 22, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/thebossmd" rel="tag" > TheBossMD < /a > Tags: Physician Practice Management Primary Care Source Type: blogs

It ’s important for medical students to have mentors. Here’s why.
Dr. Leon Pedell on the importance of mentors. Courtesy of Before the Floors. Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - August 22, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/admin" rel="tag" > Admin < /a > Tags: Video Medical school Source Type: blogs

This doctor sings to her patients. And the results are beautiful.
I am an interventional pain physician. I spend most of my days doing spine injections with a fair amount of kyphoplasties and spinal cord stimulators thrown in as well. It seems to me that these are minor procedures that shouldn’t evoke anxiety in patients, but they do. Patients get nervous. They get anxious. I am also a singer. I had the privilege of being classically trained through my college years. Like so many other passions, singing was put on the back burner in my pursuit of medicine. Music is a blessing that I hold dear to my heart, and it has pained me to not have an outlet for this gift. When I got out of f...
Source: Kevin, M.D. - Medical Weblog - August 22, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/jessica-jameson" rel="tag" > Jessica Jameson, MD < /a > Tags: Physician Pain Management Practice Management Primary Care Source Type: blogs

A medical student confronts life outside the hospital
There is a feeling that you get when you’re out at a dinner party standing and smiling at strangers as they walk by you — a temptation to rest on the “wow” factor of your medical training. Partly because peacocking is inherent to social events such as these, but partly because you fear that you’re inherently boring to people outside your field. The surest way, you think, is to announce that you’re in medicine and bask in the raised eye-brows and approving nods that previously alluded you in smaller talk. “Oh, what kind?” The inevitable next question, and soon you own the conv...
Source: Kevin, M.D. - Medical Weblog - August 22, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/shirley-nah" rel="tag" > Shirley K. Nah < /a > Tags: Education Hospital-Based Medicine Medical school Source Type: blogs

Why a pediatrician does what he does: Lessons from Caleb
A tired but beaming mom greeted me as I entered the room. In her lap was a content appearing, slightly chubby, cherubic faced baby. “This is Caleb … isn’t he beautiful” mom gushed. “He is named after his dad …” but then added in a softer voice, “but I’m not sure how much he plans to be involved.” Mom’s smile waned for a moment but quickly came back. “Looking forward to coming here often,” she said as she gave me a tight bear hug that literally took my breath away. Mom ended up being prophetic on both accounts. Dad Caleb indeed ended up falling ...
Source: Kevin, M.D. - Medical Weblog - August 22, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/alexander-rakowsky" rel="tag" > Alexander Rakowsky, MD < /a > Tags: Physician Pediatrics Pulmonology Source Type: blogs

Our noble profession is being destroyed by legislators and administrators
I had a great day in the office today. Not that I came up with any brilliant diagnosis nor cured anyone. I was able to just be a physician. No time wasted on the phone with insurance companies. No prior authorizations to do. It was a reminder of how much I love my job. I love my actual job — the one I trained for — being a physician. Listening to patients — I do find it a privilege to be part of their lives — to hear their stories as I start to work the puzzle of the possible diagnosis in my head and create the plan. Examining, looking for cues, asking more questions. Labs ordered, medications tried...
Source: Kevin, M.D. - Medical Weblog - August 22, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/cathleen-london" rel="tag" > Cathleen London, MD < /a > Tags: Physician Practice Management Primary Care Source Type: blogs

Compare your own practice patterns to the national average. Here ’s how.
In an era of increasing transparency in medicine, the Centers for Medicare & Medicaid Services (CMS) has been publishing data annually on payments to individual physicians since 2014. The database, officially called the Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File, has been a window (albeit a cracked and opaque window) into the practice patterns and reimbursement of individual physicians. It includes most payments for services covered under Medicare. For each physician and billing code, the database provides the number of services provided and the total amount of money re...
Source: Kevin, M.D. - Medical Weblog - August 21, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/wall-street-physician" rel="tag" > Wall Street Physician, MD < /a > Tags: Policy Medicare Primary Care Public Health & Source Type: blogs

This frontier of medicine and surgery has been largely ignored for many years
Medical and surgical research is breaking boundaries at an astounding pace. From genetic modification and stem cell therapy to robotic and 3-D printing technology, scientific advancement is finding novel, unique and unprecedented solutions to complex, challenging diseases. Indeed, such is the rate of change that I am certain the last eight years of my surgical training in the UK will likely be rendered obsolete within the next twenty years of amazing, exciting, ground breaking advancements. However, despite these ongoing achievements, I fear we as a scientific community have a much greater challenge ahead of us: a frontier...
Source: Kevin, M.D. - Medical Weblog - August 21, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/saqib-noor" rel="tag" > Dr. Saqib Noor < /a > Tags: Physician Emergency Medicine Public Health & Policy Surgery Source Type: blogs

A letter from a parent to her child ’s pediatrician
I am a child psychiatrist who is also a patient, a mother of patients and the wife of a patient. I have lived all sides of health care and appreciate the complexity that is our American health care system. After a recent move to a different part of town, we decided to find a new pediatrician for our daughters. I knew that we had several good options near our home. When we eventually chose a pediatric clinic whose doctors I knew personally and had even shared a few patients with, I was confident that either of the physicians would be a good fit for our family. However, I was not prepared for how I would feel at the end of o...
Source: Kevin, M.D. - Medical Weblog - August 21, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/tracy-asamoah" rel="tag" > Tracy Asamoah, MD < /a > Tags: Physician Pediatrics Primary Care Public Health & Policy Source Type: blogs

Why the anti-vaxxer label makes this medical student uncomfortable
I’ve had some of the most wonderful experiences of my entire medical training working with kids and their families. And this, to me, is not surprising. After all, I envisioned myself as a pediatrician long before I ever entered medical school. However, I remember that more frequent news of declining vaccination rates at one point temporarily gave me pause: What would it be like to take on the tremendous responsibility of convincing a parent to protect their child against some of the world’s most dangerous diseases? I knew that with time I would be up for the challenge, but early on in my training, it definitely...
Source: Kevin, M.D. - Medical Weblog - August 21, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/subha-mohan" rel="tag" > Subha Mohan < /a > Tags: Education Allergies & Immunology Medical school Pediatrics Primary Care Source Type: blogs

Food allergies are frightening, not funny
Last night, my son was reading a book that was required summer reading for 6th grade. This book was published over 30 years ago. When he got to a sentence that used the word “retard,” he stopped and innocently asked, “Mom, what does that word mean?” At first, I was shocked that he did not know the meaning, but as I thought about it more, I realized this term was no longer an acceptable descriptor in society. He simply had never heard someone use the term. When I grew up, I vividly remember people would joke and use the phrase. This was considered the normal slang, and common in everyday conversation...
Source: Kevin, M.D. - Medical Weblog - August 21, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/lianne-mandelbaum" rel="tag" > Lianne Mandelbaum < /a > Tags: Patient Allergies & Immunology Mainstream media Pediatrics Primary Care Source Type: blogs

A ukulele helped this physician get through intern year. Here ’s how.
At the beginning of this year, I bought a ukulele. I started intern year at a sprint, like anyone does, arms full of hope which was quickly extinguished, lost in an atmosphere so devoid of hope that all of it flew out of my arms to settle into places so far in between it might as well have been floating in the vacuum of space. The cloak of physicianship burdens upon you suddenly not just the obvious — the responsibility for human lives — but also darker, sinister things that are similarly heavy: a power over people nobody shows you how to soften, a tradition of institutional oppression that’s now official...
Source: Kevin, M.D. - Medical Weblog - August 21, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/monica-samelson" rel="tag" > Monica Samelson, MD < /a > Tags: Physician Hospital-Based Medicine Psychiatry Residency Source Type: blogs

Online physician reviews: Patients are the ones who will suffer
The rise of the Internet has changed many things in the world of the customer.  Now, in the age of the online consumer, a person can search for not only the exact item or service he or she wants, but read hundreds of reviews on that particular item or service.  Thanks to Yelp and a host of other online rating sites, a person can find a reputable painter or contractor or babysitter with the click of a button. While the ability to rank and review online professionals has empowered consumers and been mostly positive, this is not the case for all professions.  Specifically, it is detrimental to physicians. ...
Source: Kevin, M.D. - Medical Weblog - August 20, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/kaci-durbin" rel="tag" > Kaci Durbin, MD < /a > Tags: Physician Hospital-Based Medicine Infectious Disease Primary Care Source Type: blogs

Minnesota and measles: Andrew Wakefield targets refugees
I had the pleasure of traveling to Rochester, Minnesota for a wedding this summer.  Minnesota is home to more people from Somalia than any other state. My home of Columbus, Ohio is also a hub for people from Somalia.  As a pediatric resident, I take care of Somali-American children and work with Somali American healthcare providers every day. It was surreal, then, to set foot in a state recovering from a measles outbreak with more cases than the entire country saw last year.  I was only ninety minutes away from Minneapolis, the center of the outbreak.  Former physician and academic fraud Andrew Wakefiel...
Source: Kevin, M.D. - Medical Weblog - August 20, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/sean-gallagher" rel="tag" > Sean Gallagher, MD < /a > Tags: Physician Neurology Pediatrics Public Health & Policy Source Type: blogs

Planning for the end of life: What baby Charlie can teach us
Charlie Gard was a one-year-old boy who had a rare genetic disease leaving him blind, comatose, and unable to breathe on his own. This metabolic disorder can be fatal and has no known cure. Charlie’s parents wanted him treated with experimental drugs in the hope that a miracle would happen. As reported in the press, the British medical and legal community considered this care futile and blocked it. This sad story created a flurry of public discussion about ethics, end of life care, and patient and parent autonomy. Experts debated the wisdom of the parents’ decision. The discussion centered on whether ...
Source: Kevin, M.D. - Medical Weblog - August 20, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/mark-kelley" rel="tag" > Mark Kelley, MD < /a > Tags: Physician Critical Care Neurology Palliative Care Pediatrics Source Type: blogs

Stop the abuse of hierarchy with these 5 tips
When I was a medical student, trying to forge my path on the clinical wards as a third year, there was a lot to turn me off the idea of a career in medicine entirely — sleep deprivation, early mornings, late nights, standing for hours on rounds, subsisting on diets of hospital graham crackers and off-brand peanut butter. However, what frosted me the most was constantly playing 6 degrees of separation from the attending. As a student, you reported to the intern who reported to the junior resident who reported to the senior resident who reported to the fellow who then discussed with the attending. After all that work, ...
Source: Kevin, M.D. - Medical Weblog - August 20, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/amy-ho" rel="tag" > Amy Ho, MD < /a > Tags: Physician Emergency Medicine Neurology Surgery Source Type: blogs

We look at the same picture but see different things
As you look at the above image, please let me ask you a simple question: “What do you see?” Do you see a sick man lying on a bed with a friendly looking doctor standing by his bedside? Do you see only men in the picture and wonder, “Why not women?” Do you see a clinical setting of an engaging sketch of a doctor and a patient having an interaction? Do you see a funny appearing cartoon illustration? Do you only see white characters in the picture and wonder, “Why not another race?” Do you see an old man and a young doctor and wonder, “Why a young doctor and not an older doctor?&rdquo...
Source: Kevin, M.D. - Medical Weblog - August 19, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/nonye-aghanya" rel="tag" > Nonye Aghanya, FNP-C < /a > Tags: Physician Hospital-Based Medicine Primary Care Source Type: blogs

Physicians put up walls. But they feel everything.
We sat in the office of the intensive care unit under fluorescent lights, both staring at computer screens covered in vital signs and labs. It was the summer of my second year of residency, and I spent it entirely in the intensive care unit. There were two of us on call at night. Half the nights we would spend shooting the shit about life, and the other half we spent running around trying to pretend like we knew what we were doing. One year as a doctor, and we were the front lines in the ICU with the sickest patients in the hospital. The learning curve is steep, to say the least. I could feel the pressure of that every day...
Source: Kevin, M.D. - Medical Weblog - August 19, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/caitlin-smith" rel="tag" > Caitlin Smith, MD < /a > Tags: Physician Cardiology Critical Care Emergency Medicine Surgery Source Type: blogs

Do doctors need an emergency fund?
There is a lot of talk on the web about having an emergency fund. Typically this is three to six months of expenses. Some would argue to keep three to six times bare bones expenses, and others would argue to keep three to six times the average amount you spend on expenses. Having an emergency fund makes sense to cover life’s unexpected occurrences. What could these be? Well, the biggest would be losing a job. Lower on the list would be for major expenses like car or home repair. After that, medical expenses are the other most likely unexpected expense. These things may run between $500 and $5,000 (a broken furnace ca...
Source: Kevin, M.D. - Medical Weblog - August 19, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/dads-dollars-debts" rel="tag" > Dads Dollars Debts, MD < /a > Tags: Physician Practice Management Primary Care Source Type: blogs

MKSAP: 36-year-old man with history of fatigue
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 36-year-old man is evaluated for a 1-year history of fatigue, intermittent headaches, sore throat, and joint and muscle pain. He reports no difficulties falling asleep and gets 10 hours of uninterrupted but nonrestorative sleep each night. He has seen several physicians over the past year. Evaluation has included a complete blood count with differential, thyroid-stimulating hormone level, and plasma glucose level that were normal at the time of initial presentation and again 2 months ago. HIV testing p...
Source: Kevin, M.D. - Medical Weblog - August 19, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions Endocrinology Infectious Disease Pain Management Primary Care Rheumatology Source Type: blogs

Can health care executives help with physician burnout?
The National Academy of Medicine has launched an Action Collaborative on Clinician Well-Being and Resilience, but there is one missing stakeholder. On July 14th, NAM hosted its first public meeting on establishing clinician well-being as a national priority. The inaugural sponsors include nearly many medical specialty societies, the major insurance companies, the American Associations for hospitals, nurses, physicians and medical colleges, Johns Hopkins, Mass General and my employer — IBM Watson Health. It is great to see the growing recognition of clinician burnout as a problem and the growing collaboration between ...
Source: Kevin, M.D. - Medical Weblog - August 18, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/paul-dechant" rel="tag" > Paul DeChant, MD, MBA < /a > Tags: Physician Hospital-Based Medicine Primary Care Psychiatry Source Type: blogs

A physician doesn ’t hide his depression
A colleague said earlier this week, as he bravely disclosed his journey with anxiety and depression that he had “become excellent at hiding [his] depression, especially as an extrovert.” My colleague brings others along into a wake of happiness he trails but is also able to sit knee-to-knee with the parents of dying patients and empathize in their suffering — to truly let a small part of their pain sit and brew in his heart, to be laid on his shoulders. Depression and a full understanding of one’s own emotions lend themselves to empathy. I have suffered depression for over a decade. My depression ha...
Source: Kevin, M.D. - Medical Weblog - August 18, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/peter-h-baenziger" rel="tag" > Peter H. Baenziger, MD < /a > Tags: Physician Psychiatry Source Type: blogs

Do we really have a choice in health care?
As every physician practicing today knows, health care is in a constant state of flux. The latest news from Washington creates even more uncertainty. What we do know is that, for the foreseeable future, there will be an emphasis on team care, coordination, technology and, of course, meeting the requirements of the ever-expanding alphabet soup of acronyms, from MACRA to MIPS and beyond. As I think about all the changes of the past decade, it’s quite remarkable to see where we are, and how far we’ve come. In the 1990s, most physicians were still in independent or small group practices. Today for the first time, t...
Source: Kevin, M.D. - Medical Weblog - August 18, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/cary-fitchmun" rel="tag" > Cary Fitchmun, MD < /a > Tags: Policy Primary Care Public Health & Source Type: blogs

Let ’s change the mediocre status quo of health care
On a daily basis, I am introduced to new people from all walks of life. Some sit on the board of directors, some are CEOs, some are presidents, some are middle managers and other administrators, some are investors, others are entrepreneurs, and some are physicians, nurses, case managers and even patients. I listen to people talk about the big challenges in health care. It costs too much, we have a shortage of trained professionals, and our communities live an unhealthy lifestyle. I learn about strategies to take costs out of the system, to be more efficient, to increase productivity, to improve utilization, increase ROI, i...
Source: Kevin, M.D. - Medical Weblog - August 18, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/andy-delao" rel="tag" > Andy DeLao < /a > Tags: Patient Hospital-Based Medicine Oncology/Hematology Public Health & Policy Source Type: blogs

Literacy is a health care problem no one talks about
Just as summer is in full swing, the back-to-school advertisements are running. This time of year can be exciting for many — the first day of elementary school, high school or college. For the rest of us, we try to be lifelong learners: learning from our successes and failures, learning from others and if we are lucky learning by reading. Reading is a skill learned in the early school years. Children spend the first few years of their education learning how to read. After that period ends, in the third or fourth grade, children read to learn. Unfortunately, many of our nation’s school districts have poor readin...
Source: Kevin, M.D. - Medical Weblog - August 18, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/jarret-patton" rel="tag" > Jarret Patton, MD < /a > Tags: Physician Patients Pediatrics Primary Care Source Type: blogs

Doctors: Don ’t emotionally detach
“He is the best physician who is the most ingenious inspirer of hope.” – Samuel Taylor Coleridge I was a third-year medical student on a Sunday morning when the reality of what I had chosen as my life career truly hit me in the gut. At that moment, I realized how intimate the practice of medicine was and that I would have to bring not only my brain and skills to work every day but my heart. I was on my internal medicine rotation on hospital wards, and I was pre-rounding, seeing each patient on my list and gathering their vitals and current medicines. I would examine them at 6:00 a.m., before joining the t...
Source: Kevin, M.D. - Medical Weblog - August 18, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/sasha-k-shillcutt" rel="tag" > Sasha K. Shillcutt, MD < /a > Tags: Physician Cardiology Hospital-Based Medicine Oncology/Hematology Primary Care Source Type: blogs

7 ways to combat compassion fatigue
This is the patient’s eight admission over the course of two weeks. The patient is a heroin abuser and has bacteremia and endocarditis. Their heart valve is failing and they are in and out of congestive heart failure. Every day, dozens of medical professionals converge on the patient to give treatment and advice. And every day after hearing that advice, the patient leaves the hospital against medical advice and goes to use IV drugs. They wind up back in the hospital out of fear or panic, or they are brought back in after overdosing by the police. The cycle continues. In this common daily scenario, it is very easy as ...
Source: Kevin, M.D. - Medical Weblog - August 17, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/jenny-hartsock" rel="tag" > Jenny Hartsock, MD < /a > Tags: Physician Cardiology Hospital-Based Medicine Infectious Disease Primary Care Source Type: blogs

Doctors: Are you employees, business owners or entrepreneurs?
Hate your job? You may be in the right profession, but the wrong position for your personality. Want to love your life and career? Step one: discover whether you are an employee, a business owner or an entrepreneur. Here’s how to figure it out: Employees are risk averse and like to know the rules. They thrive on structure and predictability. They need clear instructions and direction. Employees play it safe, and they value job security. Knowledge base is narrow. Motivation may vary from low to high, and they’re good at saying yes to the boss. Employees dislike failure, and many require praise to remain motivate...
Source: Kevin, M.D. - Medical Weblog - August 17, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/pamela-wible" rel="tag" > Pamela Wible, MD < /a > Tags: Physician Primary Care Source Type: blogs

PTSD can happen at the end of life
Sheila’s jaw is clenched. Sweat is beading on her forehead. I make a slow audible inhale, non-verbally inviting her to do the same. We’ve been talking about the nightmares which started shortly after she began receiving help with personal care. I remind her that she is safe — the day she was raped is decades in the past. Her conscious mind knows this, of course, but for people with posttraumatic stress disorder (PTSD) the brain, body and nervous system remain on high alert, responding to trauma reminders and traumatic memories as though the event were occurring in the present. Though she never sought prof...
Source: Kevin, M.D. - Medical Weblog - August 17, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/scott-janssen" rel="tag" > Scott Janssen, MSW, LCSW < /a > Tags: Conditions Emergency Medicine Palliative Care Source Type: blogs

Is it OK for a physician to retire early?
This is a tough post to write. I struggle with this issue daily. Is it OK for a physician to retire early? The obvious answer is: yes. Each individual should live their life as they see fit. But with a continued shortage of physicians (granted this is more in rural areas and not big metropolitan cities), and the time, money and resources required for training physicians, is it selfish to quit early. Should we be working until 65? Here are some doctor downsides: Doctors retire early? If I look back at my career (albeit a short one thus far), it is rare to see a physician retire in their 40s. Most of us don’t start wor...
Source: Kevin, M.D. - Medical Weblog - August 17, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/dads-dollars-debts" rel="tag" > Dads Dollars Debts, MD < /a > Tags: Physician Primary Care Specialist Source Type: blogs

What do primary care doctors need? More time.
While in training, we were told that we were not efficient if we couldn’t see 20 or more patients and complete our notes for billing. We were told that primary care offices were asking our residency program for our efficacy data before consideration of hire. This was the line drawn in the sand by our new health care system. We would either rise to the occasion or be harassed by the administration and coding department because we were not producing. These efforts were done in the name of efficiency for us to be “better doctors.” Unfortunately, this blind faith in productivity was squeezing every ounce of h...
Source: Kevin, M.D. - Medical Weblog - August 17, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/cole-zanetti" rel="tag" > Cole Zanetti < /a > Tags: Physician Primary Care Source Type: blogs

8 ways to be your own health advocate
In 1996, I had an illness that nearly killed me. I was exhausted, felt awful, could barely stand up and had trouble remembering things. Yet, I somehow had to find the energy not only to take care of my newborn and 5 year old, coordinate our upcoming move, consult with doctors and other medical providers on my condition and treatment, and receive treatments that might or might not help me regain my health, but also track our quite substantial medical bills in order to forestall what would have been economic ruin for us. At the time, most of our medical providers did not file insurance claims, so that task fell to me. One of...
Source: Kevin, M.D. - Medical Weblog - August 17, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/lisa-mark" rel="tag" > Lisa Mark < /a > Tags: Patient Hospital-Based Medicine Patients Primary Care Source Type: blogs

We are on the brink of a crisis-level physician shortage in the United States
. How did we get here? And what can we do now? Jamie Katuna is a medical student.  She can be reached on Facebook. Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - August 16, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/jamie-katuna" rel="tag" > Jamie Katuna < /a > Tags: Policy Primary Care Public Health & Source Type: blogs

A physician-comedian on the ridiculousness of paperwork and health insurers
“It’s my hope that one day the health plans will reimburse everybody for a comedy rental.” Enjoy the comedy stylings of Brad Nieder, MD. See more at the Healthy Humorist. Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - August 16, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/admin" rel="tag" > Admin < /a > Tags: Physician Primary Care Public Health & Policy Source Type: blogs

A commencement address to anesthesiologist assistants
A commencement address delivered on August 5, 2017, to the 2017 class of anesthesiologist assistants (AAs), Emory University. Distinguished faculty, graduates, honored guests: It is a great pleasure and an honor to be here, and to congratulate all the graduates of the Emory University Class of 2017 on your tremendous accomplishment. Just think about all you have learned in the past two years. You’ve transformed yourselves into real anesthesia professionals, able to deliver first-class care to patients at some of the most critical times in their lives. Today is a great time to become an anesthesiologist assistant. Jus...
Source: Kevin, M.D. - Medical Weblog - August 16, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/karen-s-sibert" rel="tag" > Karen S. Sibert, MD < /a > Tags: Physician Hospital-Based Medicine Surgery Source Type: blogs

How can we ensure medical leadership includes more women?
I read something recently that shocked me. Despite working in health care for 15 years, I had no idea that nearly 80 percent of the U.S. health care workforce is comprised of women (according to the Bureau of Statistics.) I did know, however, that women make up less than 20 percent of executive boards and less than 40 percent of middle management in health care. Those that do exist in the C-suite are typically in the role of chief nursing officer, or human relations officer. Very few women hold positions such as chief executive officer, chief medical officer, chief information officer or chief financial officer. That is a ...
Source: Kevin, M.D. - Medical Weblog - August 16, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/sasha-k-shillcutt" rel="tag" > Sasha K. Shillcutt, MD < /a > Tags: Physician Hospital-Based Medicine Source Type: blogs

We must make the word “diagnostician” the most prestigious term in medicine
The Society to Improve Diagnosis in Medicine has on its website this quote: 1 in 10 diagnoses are incorrect. Diagnostic error accounts for 40,000-80,000 U.S. deaths annually — somewhere between breast cancer and diabetes. Chances are, we will all experience diagnostic error in our lifetime. The current focus on diagnostic error raises an interesting question:  Is this a larger problem in 2017 than in the 1970s and 1980s? Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - August 16, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/robert-centor" rel="tag" > Robert Centor, MD < /a > Tags: Conditions Hospital-Based Medicine Primary Care Source Type: blogs

A lesson learned after seeing a tick-borne illness
It was late afternoon. The woman who had seen my colleague, Dr. Wilford Brown, a few days earlier was sitting in my exam room. Her chart note read like a typical unnameable virus: headache, body aches, fatigue, low grade fever. She had always seemed like a level-headed resolute woman, but she had called three days in a row for medical advice because she felt so poorly. And it all sounded like a simple virus that a few more days of rest would take care of. She did have a good sized boil in the middle of her back, but that wouldn’t make her feel that sick. The rest of her exam was perfectly normal. Continue reading ......
Source: Kevin, M.D. - Medical Weblog - August 16, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/a-country-doctor" rel="tag" > A Country Doctor, MD < /a > Tags: Conditions Infectious Disease Source Type: blogs

To those who want government-run health care: Be careful what you wish for
“Hello Dr. Payne, thanks for calling back, there’s a consult I’d like you to see.” “What’s going on?” “Well there’s a patient up on 7 East who …” “Wait a minute. 7 East … isn’t there some other specialist covering there?” “No Dr. Payne, the schedule says you on Wednesdays.” “Oh, I’ll check that.” Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - August 15, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/suneel-dhand" rel="tag" > Suneel Dhand, MD < /a > Tags: Policy Hospital-Based Medicine Primary Care Public Health & Source Type: blogs

Why pediatricians should not kick out unvaccinated children
We in the medical community believe wholeheartedly in the prevention of all illness, especially by vaccination. Science and history continue to show that vaccination dramatically decreases both the mortality (death rate) and morbidity (severity of illness) of infectious diseases. And, more than 98 to 99 percent of the general population (non-medical) agrees with those statements as well. Yes, it is absolutely frustrating when parents refuse to follow our advice and protect their children. But, the law respects the right of a parent to not vaccinate his/her child, and we as health professionals should not ignore that law ei...
Source: Kevin, M.D. - Medical Weblog - August 15, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/michael-d-pappas" rel="tag" > Michael D. Pappas, MD < /a > Tags: Physician Pediatrics Source Type: blogs

Physicians should not tolerate racism from patients
It’s 7 a.m. We sit down around a table in the physician’s lounge to discuss and our patients.  I am a general and critical care surgeon.  Every fourth week I’m “on service” for the ICU.  This is my week. I was off over the weekend.  I’m refreshed and ready to go.  I’m excited.  I enjoy the challenge of taking care of critically ill patients. I get sign out from my partner.  It was a busy week for him.  He is happy to be handing over the service. A patient was recently admitted to the ICU after a serious trauma that required an emergent operat...
Source: Kevin, M.D. - Medical Weblog - August 15, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/farshad-farnejad" rel="tag" > Farshad Farnejad, MD < /a > Tags: Physician Critical Care Surgery Source Type: blogs

Physicians are being murdered for not prescribing opioids
Good pain physicians are dying. Recently, Dr. Todd Graham was shot dead in a parking lot over refusing to prescribe opioids to a man’s wife. Physicians who care deeply and try to do the right thing are being murdered for not prescribing opioids. I prescribe very few opioids in my chronic pain practice. I do so in a judicious and safe manner for my patients. I have excellent training, and I care deeply about the health and welfare of each and every one of my patients. Why is it that I as a double board certified pain physician have to consider whether or not I should have a firearm in my office to protect myself or my...
Source: Kevin, M.D. - Medical Weblog - August 15, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/jessica-jameson" rel="tag" > Jessica Jameson, MD < /a > Tags: Meds Pain Management Psychiatry Source Type: blogs

How Frozen saved my son in a way medicine couldn ’t
At 3 1/2 years old, my son was the picture of health. I have an actual picture. He is in jammies, wearing my sunglasses, laughing and chalk coloring the driveway while the sun is shining on his blond hair. That picture frequently flashes in my mind. I posted it on Facebook, my happy, healthy boy. There was no warning and nothing to prepare me for the months ahead. First, it was a cough and runny nose. I am a PA and work in the ER. It was just a cold, then pneumonia. Antibiotics were necessary, but later started copious diarrhea. C. difficile. The antibiotics upset the gut and toxins were released in the intestines. We gave...
Source: Kevin, M.D. - Medical Weblog - August 15, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/nikole-hedges" rel="tag" > Nikole Hedges, PA-C < /a > Tags: Patient Emergency Medicine Gastroenterology Pediatrics Source Type: blogs

A physician struggles with customer service. Can she still be a good doctor?
I struggle with customer service. I truly never anticipated that it would be such a big part of my career. I never fathomed that it would be something that I struggle with on a daily basis. Well, honestly it does not happen every day and does not occur at every facility that I work at. Yet, it happens often enough that it has affected where I work, how I interact with clients and I often now it affects my ability to engage in meaningful patient encounters. I am, often thrown off guard by what people comment about me. There is usually a statement that they will highlight, something I have said that tips them over the edge. ...
Source: Kevin, M.D. - Medical Weblog - August 15, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/anonymous" rel="tag" > Anonymous < /a > Tags: Physician Emergency Medicine Pediatrics Source Type: blogs

The problem with the free market in health care
Competition often works. Competing dry cleaners or donut shops must either improve the quality of their product or keep their prices low, or customers will go somewhere else for their cruller fix. In time, the better businesses — the ones that provide tastier pastries at a lower price — will thrive, and less-good, more-expensive businesses will go away. In the long run, all customers benefit from competition between businesses. That’s how it’s supposed to be in the American marketplace. But the reality in health care is that it’s not a free market, and it can’t be a free market, and we c...
Source: Kevin, M.D. - Medical Weblog - August 14, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/roy-benaroch" rel="tag" > Roy Benaroch, MD < /a > Tags: Policy Public Health & Source Type: blogs

Improve Medicaid with these simple steps
Recently, the Republicans’ health insurance bill was withdrawn, partly because of some Senators’ fear of underfunding Medicaid. The media and Democrats have clearly identified Medicaid as a wedge issue that divides Republicans. Unfortunately, those Republicans that have chosen to support conventional Medicaid, as opposed to supporting a much-needed revamp of this program, have succumbed to false advertisements. So let me review some facts, and suggest some common sense changes that will bring medical care to the poor and disabled, as well as those that are at the low end of the income spectrum. As Charles Blaho...
Source: Kevin, M.D. - Medical Weblog - August 14, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/arvind-cavale" rel="tag" > Arvind Cavale, MD < /a > Tags: Policy Medicare Public Health & Source Type: blogs