How to ask for a great letter of recommendation for residency
This article details how to ensure you get great letters of recommendation. Knowing what constitutes a great letter of recommendation is crucial to obtaining outstanding letters. A strong letter of recommendation clearly conveys knowledge of the medical student, how that student performed and qualities that predict excellent performance in residency. Strong letters of recommendation include the following: A statement about how the attending knows the student and his/her ability to evaluate the student’s performance An overall summary of the student’s abilities A specific evaluation of the student’s perfo...
Source: Kevin, M.D. - Medical Weblog - May 25, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/ted-oconnell" rel="tag" > Ted O ’Connell, MD < /a > Tags: Education Hospital-Based Medicine Medical school Residency Source Type: blogs

We must advocate for our most vulnerable patients
On a Sunday afternoon, I arrived at the hospital for my psychiatry ER shift. As medical students, we keep an eye on the track board for new patients to see. Two names turned bright red, and I chose to follow Jackie Swanson. Her initial ER evaluation read “Patient is a 30-year-old female here for SI, HI, and AVH in context of recent sexual assault and cocaine use.” She was brought emergently by ambulance after being found unconscious at a gas station several miles away. When I walked through the bay area, I saw a patient in every bed. I soon found Jackie at the end of the row. Her hands, arms, neck, and eyes wer...
Source: Kevin, M.D. - Medical Weblog - May 25, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/ton-la-jr" rel="tag" > Ton La, Jr. < /a > Tags: Conditions Emergency Medicine Source Type: blogs

A surprising example of how medicine is learned from our patients
“The patient in room 17 needs an IV line! Hey, have you ever put in an IV before?!” Everybody looked at me at once. I tried my best to maintain a confident outer appearance. But I’ll admit, I was caught off guard. I thought back to my attempted IV insertions throughout my anesthesia rotation earlier in the year. I struggled with getting the IV line smoothly into the vein. I followed all the techniques to a tee, watched numerous YouTube videos about it and attempted it at every opportunity throughout my training. But somehow I just never got to see that salient red gush of venous blood pour into my IV line...
Source: Kevin, M.D. - Medical Weblog - May 25, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/aaron-grubner" rel="tag" > Aaron Grubner < /a > Tags: Education Emergency Medicine Source Type: blogs

6 steps to stop your smartphone from going viral. Literally.
I recently went to an infectious disease educational session sponsored by the Massachusetts Medical Society and the New England Journal of Medicine called “Epidemics Gone Viral.” The focus was preparedness for the next epidemic, which may come from anywhere. John Brownstein talked about how its arrival will be monitored and reported using Twitter and artificial intelligence. With the meeting going viral with excitement as Bill Gates got on stage talking about technology and epidemic medicine, a thought popped in my head: What if the vector for the next epidemic is already at our fingertips — our mobile ph...
Source: Kevin, M.D. - Medical Weblog - May 25, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/matthew-katz" rel="tag" > Matthew Katz, MD < /a > Tags: Conditions Infectious Disease Source Type: blogs

This burned out physician was happier as a resident
I log onto KevinMD every day to get my much-needed dose of physician commiseration. At least once a day, one of us writes an article about burnout. It typically leaves me feeling quite validated. I particularly enjoy reading the comments section, as many of you make me laugh with your physician reality-based humor. I am more burned out than I ever hoped to be. I work in primary care, have a family and my spouse is a surgeon. My spouse and I are equally burned out, despite our differing specialties. I have “PCP burnout” qualified by: patient-centered care, clicks, forms, feeling like a doormat, patient satisfact...
Source: Kevin, M.D. - Medical Weblog - May 25, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/anonymous" rel="tag" > Anonymous < /a > Tags: Physician Hospital-Based Medicine Primary Care Source Type: blogs

What to do if you want to be a cruise ship doctor
In 2013 I began searching for ways I could change my career to reduce my workload, but not give up medicine altogether. During that time I took a cruise and looked at various jobs I could do on a cruise ship. One of the jobs I was qualified for, I thought, was to be a Cruise Ship Doctor. After talking with the ship’s doctor to find out what it was like to be the doctor on a ship, I realized that I would enjoy that life. When I arrived back home I sent in an application to a cruise line. I was promptly informed that general surgeons were not qualified to be a ship’s doctor. They only accept physicians who practi...
Source: Kevin, M.D. - Medical Weblog - May 25, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/cory-fawcett" rel="tag" > Cory Fawcett, MD < /a > Tags: Physician Practice Management Primary Care Source Type: blogs

The skinny on skinny health insurance
The Affordable Care Act (ACA), widely known as “Obamacare,” has survived several repeal attempts by Congress. Storm clouds, however, are still on the horizon. The ACA’s individual mandate obligates every American to be covered by comprehensive health insurance. This requirement has been the most unpopular feature of the law. That’s because healthy people, especially those who are self-employed or between jobs, have found the ACA premiums too expensive. They are not alone. Health insurance premiums continue to rise at a rate of five percent per year. Meanwhile, the average American makes about $...
Source: Kevin, M.D. - Medical Weblog - May 24, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/mark-kelley" rel="tag" > Mark Kelley, MD < /a > Tags: Policy Public Health & Washington Watch Source Type: blogs

A physician ’s personal crisis with pain
Six months ago, I had severe right flank pain. In the ER, I had an ultrasound showing a possible kidney stone. I deferred a CT scan and went home with medication. I fit the textbook picture: I had abnormal imaging, and I was given a treatment and discharged. I was advised to return if the pain worsened or failed to resolve. I briefly improved, but then the pain returned much worse. Ten days later, I returned to the ER. I was given ketorolac and had a CT, which showed no stone. The ER attending advised me to go home and take ibuprofen. At that point, my pain was 8/10, and I was having significant trouble moving despite the ...
Source: Kevin, M.D. - Medical Weblog - May 24, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/heather-finlay-morreale" rel="tag" > Heather Finlay-Morreale, MD < /a > Tags: Physician Emergency Medicine Nephrology Pain Management Source Type: blogs

How to deal with devastating criticism
“Why don’t you just get a shotgun and blow his brains out next time? Better yet, next time stay the hell away from my patient!” I was frozen, and the ICU attending wasn’t even talking to me. My co-intern had barely started her presentation when she met damnation. Mind you — there was a senior resident, a pulmonary fellow, and a team of nurses caring for the patient also. Yet the intern bore the brunt of the criticism. Health care is often like this and can feel like a dog-eat-dog world with a rigid hierarchy and archaic rituals. I still find myself thinking about my internship in 2008, a monum...
Source: Kevin, M.D. - Medical Weblog - May 24, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/varun-verma" rel="tag" > Varun Verma, MD < /a > Tags: Education Critical Care Hospital-Based Medicine Source Type: blogs

Cushioning the fall of bad news
Angela Harris has been here in the hospital for six hours, awaiting the results of her CT scan. I won’t take responsibility for all of that wait time: complicated CT scans and labs do take a significant amount of time to perform. But she didn’t need to wait the last hour. She was waiting on me — her emergency physician — because I needed to confirm her cancer diagnosis with radiology, arrange some oncology follow-up … and find the most appropriate phraseology for: “You have stage IV cancer, but you don’t meet admission criteria.” I’ve delivered this diagnosis five time...
Source: Kevin, M.D. - Medical Weblog - May 24, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/meghan-gaffney-liroff" rel="tag" > Meghan Gaffney Liroff, MD < /a > Tags: Physician Hospital-Based Medicine Oncology/Hematology Source Type: blogs

The dangerous precedent of Alfie Evans
The tragic case of Alfie Evans has roiled Great Britain and the world. Alfie was a two-year-old child in the United Kingdom with an unknown degenerative brain disease who eventually deteriorated to the point that he required life support. His brain had become mostly liquid, and he could not see, speak, or hear. Alder Hey Hospital decided his condition was terminal and irreversible and wanted to stop further treatment. His parents disagreed and wanted to transfer care to another hospital in Italy that was willing to accept him. Alder Hey went to court arguing that it was better that the child be allowed to die because keepi...
Source: Kevin, M.D. - Medical Weblog - May 24, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/vamsi-aribindi" rel="tag" > Vamsi Aribindi, MD < /a > Tags: Policy Hospital-Based Medicine Palliative Care Source Type: blogs

The good, bad, and the ugly of being a medical expert witness
I have spent a good part of my career investing time and energy towards side hustles.  I generally categorize them into two distinct types of ventures.  The lazy side hustle involves starting a business or consulting in a field tangential to ones main hustle.  For example, an accountant who works normally as an auditor may do a few tax returns on the side during tax season.  I call his type of work “lazy” because most likely, the professional does not need any extensive extra training on top of what they already have obtained for their primary career.  The non-lazy side hustle...
Source: Kevin, M.D. - Medical Weblog - May 24, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/docg" rel="tag" > DocG, MD < /a > Tags: Finance Practice Management Source Type: blogs

Don ’t be mean: Treat your team members with respect
“Those emergency room residents are f**king retarded!” This was the comment that rang through the workroom.  I had only been on this hospital service for three days, and I was having a discussion about a patient with my attending when the on-call resident had burst into the workroom and sat down next to me. He was fuming. “Why the f*** would they think I need to be consulted for this? Only a f**king retard would think that.” In a few months I will become one of those “f**king retarded ED docs,” and his outburst immediately made me feel defensive. The resident who uttered this phrase...
Source: Kevin, M.D. - Medical Weblog - May 23, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/aaron-lacy" rel="tag" > Aaron Lacy < /a > Tags: Education Hospital-Based Medicine Medical school Source Type: blogs

Physician, heal thyself: How to thrive in your medical career
One of the things that can help a physician live a balanced life is finding ways to thrive in the workplace. This is currently a work in progress for me, but I am excited to share what I have learned so far. For some context, I was previously practicing as a nephrologist; and I transitioned to being a hospitalist on an as-needed basis to create flexibility in my schedule. This has allowed me to spend more time with my young children. Each specialty and practice comes with its set of challenges. Being a nephrologist entailed long hours and traveling to many different locations in a single day. By switching to a hospitalist ...
Source: Kevin, M.D. - Medical Weblog - May 23, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/nana-korsah" rel="tag" > Nana Korsah, MD < /a > Tags: Physician Hospital-Based Medicine Hospitalist Source Type: blogs

What does curiosity have to do with patient safety?
Why do we say “curiosity killed the cat?” Isn’t curiosity what drives people to ask insightful questions? To keep an open mind? And to continue learning at age 6 or 60, alike? Curiosity is what sets apart people who are fixed in their opinions and beliefs and those who adjust in light of new information. Recently, I read an article in The New Yorker that suggested that Donald Trump doesn’t read books unlike most of his predecessors. One aspect of my transition to academia from industry that continues to surprise me (every day!) is how much people read — they not only read peer-reviewed literat...
Source: Kevin, M.D. - Medical Weblog - May 23, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/elizabeth-lerner-papautsky" rel="tag" > Elizabeth Lerner Papautsky, PhD < /a > Tags: Patient Primary Care Source Type: blogs

Medical education in the era of climate change
In the days after Hurricane Maria made landfall on Puerto Rico, four Yale physicians began an ambitious effort to send thousands of pounds of medical supplies to the storm-ravaged island. Despite having had no prior experience with disaster response, these doctors worked with contacts in Puerto Rico to generate a detailed needs-assessment, determining exactly which medical supplies were needed on the island. Using social media, traditional media, and professional connections, they solicited large-scale donations of medications and supplies, coordinated airplanes to the island, and remotely managed ground transport of speci...
Source: Kevin, M.D. - Medical Weblog - May 23, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/tyler-greenway-and-william-hancock-cerutti" rel="tag" > Tyler Greenway and William Hancock-Cerutti < /a > Tags: Policy Medical school Public Health & Source Type: blogs

My spouse is your doctor. And there ’s no one else I’d rather share him with.
Speeding through town, I had just dropped off a kid at football practice. I raced back to the church to drop off another kid, then drove quickly to a soccer practice for a third. At about 7:00, I start to lose my cool. I’m used to my husband being late. But tonight I was frustrated. I sat in the parking lot with two babies, strapped in their seatbelts, fidgeting and whining behind me. I sent a rather mean-spirited text to my husband. “You said you would be home tonight to help with carpools. Where are you?” He responded, “I’m sorry honey. I just made a grown man cry like a baby. I’m doin...
Source: Kevin, M.D. - Medical Weblog - May 23, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/jessica-ford" rel="tag" > Jessica Ford < /a > Tags: Physician Oncology/Hematology Pediatrics Source Type: blogs

5 things that confuse me about health care today
Say we met ten years ago. And you asked me: Would health care delivery be more complicated in the future? I would’ve said, “No, it would be simpler!” Pointing you to technology trends, I would’ve told you that health care transactions will indeed become more automated, much simpler. Repeatable administrative tasks would be tech-enabled and algorithm-driven. My company started life in billing claims for doctors. Back then I was quite sure billing would become less complicated in the future. Insurances and health care providers would want that. Continue reading ... Your patients are rating you online...
Source: Kevin, M.D. - Medical Weblog - May 23, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/praveen-suthrum" rel="tag" > Praveen Suthrum < /a > Tags: Tech Practice Management Public Health & Policy Source Type: blogs

To change the culture, start with clinical education
The hardest thing about medical school isn’t learning medicine. It isn’t the hours. It isn’t the tests. It’s that you sign away control over years of your adult life. When I started my clerkship year in January, I felt like I was stepping onto a conveyor belt and would not be allowed off for twelve long months. For the entirety of 2018, my days are planned for me, my hours are set, and my attendance is mandatory. I have the distinct feeling that this year is happening to me. My classmates and I are currently marching through a pre-determined set of rotations, the lowest-ranking members on every team...
Source: Kevin, M.D. - Medical Weblog - May 22, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/anonymous" rel="tag" > Anonymous < /a > Tags: Education Medical school Psychiatry Source Type: blogs

It ’s time for hospitals to publicly disclose physician satisfaction, burnout, and suicide rates
We are in the midst of an epidemic of physician burnout, depression and suicide. Although the causes are debatable, there can be little doubt that increasing demands for financial performance and patient satisfaction, decreasing autonomy, and physicians’ individual liability for systemic risk management decisions in a majority of practice settings are significant contributors to these adverse outcomes. At the same time physician burnout, depression, and suicide rates have been rising; tremendous progress has been made in both the culture of safety and reduction of iatrogenic harms in large U.S. health care organizati...
Source: Kevin, M.D. - Medical Weblog - May 22, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/joshua-sonkiss" rel="tag" > Joshua Sonkiss, MD < /a > Tags: Physician Hospital-Based Medicine Psychiatry Source Type: blogs

Why the battle against being called a provider is probably lost
I recently needed to transfer my patient to a larger medical center for some urgent care. As I sat there in my relatively small hospital working out where they would be best served, a famous academic medical center that was not too far away, came to mind. I placed a call to the facility’s bed facilitator, who took the patient’s details from me, and was told to await a callback from the medicine resident team on-call. I didn’t have to wait very long before I got the call. “Hello” “Hello, did you want to talk to us about a patient?” “Yes, I am the attending physician taking car...
Source: Kevin, M.D. - Medical Weblog - May 22, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/suneel-dhand" rel="tag" > Suneel Dhand, MD < /a > Tags: Physician Hospital-Based Medicine Practice Management Primary Care Source Type: blogs

The best medical specialty you ’ve never heard of
The most common response when I introduce myself as a preventive medicine resident is an interjection, “You mean family medicine?” I have come to realize that the majority of the healthcare field has never heard of preventive medicine as a unique medical specialty. It’s a shame, because preventive medicine is truly the best medical specialty you’ve never heard of. Preventive medicine practices at the intersection of public health and clinical medicine — we are population doctors. Sure, we love vaccines as much as the next physician, but we do so much more than give flu shots. We provide clinic...
Source: Kevin, M.D. - Medical Weblog - May 22, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/jennifer-chevinsky" rel="tag" > Jennifer Chevinsky, MD < /a > Tags: Physician Primary Care Source Type: blogs

A Hippocratic Oath for technology
Modern technology needs to do better. This is the message delivered by every CEO after every Silicon Valley scandal in recent memory. This time, they should really do it. Medicine can show them how. Let’s have the professionals building our future abide by industry-wide standards, just as doctors do. As both a startup founder and a physician, this idea makes intuitive sense to me. Drawing on my experience treating patients and running a digital platform, here’s what a Hippocratic Oath for tech might look like. First, it shouldn’t say “first do no harm.” Not that I’m in favor of doin...
Source: Kevin, M.D. - Medical Weblog - May 22, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/joshua-landy" rel="tag" > Joshua Landy, MD < /a > Tags: Tech Mobile health Primary Care Source Type: blogs

The unscientific lure of antibiotics
Although my father did not discover penicillin, he helped do the research showing its effectiveness in curing infective endocarditis. As an internist, he then became enamored with the role antibiotics could play in treating infections. Growing up, my siblings and I can attest to his unbridled enthusiasm, as every time we contracted a cold, we would get a shot of the wonder mold in our butts. The fact that colds were caused by viruses and not bacteria did little to dissuade him from the utility of the treatment. When I finally developed a rash after another shot, I celebrated the fact that the painful solution would never e...
Source: Kevin, M.D. - Medical Weblog - May 22, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/david-mokotoff" rel="tag" > David Mokotoff, MD < /a > Tags: Physician Infectious Disease Primary Care Source Type: blogs

An aging physician muses on end-of-life care
As a retired physician who has written a book about end-of-life issues for elderly patients, I have placed myself in an awkward position. According to most guidelines, at age 67, I am elderly. How will I approach the end of my life? Not only do my personal medical concerns career around in the echo chamber of my own mind, but I have the added challenge of trying to follow my own advice regarding end-of-life decision making. And, there are multiple examples of physicians who did not do that. Witness the example of Francis Warren, Harvard’s most famous surgeon of the 20th century, renowned for heroic cancer surgeries a...
Source: Kevin, M.D. - Medical Weblog - May 21, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/samuel-harrington" rel="tag" > Samuel Harrington, MD < /a > Tags: Physician Palliative Care Source Type: blogs

How I became the debt free terminator by age 31
An excerpt from The Young Physician’s Guide to Money and Life: The Financial Blueprint for the Medical Trainee. Do you have student loans? Won’t you love to destroy them and be debt-free? What would you do with the cash flow you free up once your student loans are paid off? I (Amanda) invite you to join me in a movement to terminate the deadly burden of student loans. 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 - May 21, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/dave-denniston-and-amanda-liu" rel="tag" > Dave Denniston, CFA and Amanda Liu, MD < /a > Tags: Finance Practice Management Source Type: blogs

Dr. Ronny Jackson: A victim of political accusations, or physician burnout?
It is no secret that President Trump’s former nominee to run the Veterans Administration, Navy Rear Admiral Ronny L. Jackson, has withdrawn his nomination amidst allegations related to his behavior: that he drank on the job, was a bully in the office and improperly gave out prescription medication.  He has vehemently denied the allegations and characterized them as false and fabricated. Dr. Jackson is an Iraq War veteran who President Trump has called an “American hero.” The rear admiral has previously also served presidents Obama and George W. Bush as White House physician.  By many accoun...
Source: Kevin, M.D. - Medical Weblog - May 21, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/shawn-c-jones" rel="tag" > Shawn C. Jones, MD < /a > Tags: Physician Primary Care Psychiatry Source Type: blogs

This physician brought his right brain back from the brink of death
I checked my right brain at the door when I started medical school in 1995.  Writing, performing music, and acting didn’t make it in.  How could they?  I had very little free time and why would I want to cling to touchy-feely distractions?  I was prepared to sacrifice personal interests and passions to clear my mental decks.  I wanted to dedicate all my brain power to the promise of learning critical information that would empower me to care for the ill.  It was a left brain dominant exercise for sure.   And walking the hill at my graduation, I remember thinking I had...
Source: Kevin, M.D. - Medical Weblog - May 21, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/brian-yount" rel="tag" > Brian Yount, MD < /a > Tags: Physician Practice Management Source Type: blogs

How Barbara Bush ’s legacy can help us rediscover the benefits of palliative care and hospice
The recent passing of former first lady Barbara Bush, an American icon, also brought a commonly debated discussion to light, palliative, and end of life care. Many articles were published regarding her last days, mentioning she was “foregoing further medical care” or “no longer pursuing medical treatment.” These types of statements are not only inaccurate, they also minimize the incredible medical care provided by palliative care and hospice teams. To realize the utility of these aspects of medical care, it is important to understand them. Palliative care and hospice both focus on managing symptoms....
Source: Kevin, M.D. - Medical Weblog - May 21, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/shikha-jain" rel="tag" > Shikha Jain, MD < /a > Tags: Physician Geriatrics Hospital-Based Medicine Palliative Care Source Type: blogs

Everyone needs someone to be a safe harbor
I met David on the internet. It was to become on of the closest, most intense relationships of my life.  For you see, a few months before he crossed my path his daughter finished the same protocol for the same type of brain tumor that my daughter just had started.  They had successfully traversed the waters that to me were completely unknown — and frankly terrifying.  On the pediatric brain tumor listserv, he seemed to know the pitfalls, the warning signs, the hard stuff as well as ways to make the best of life no matter the circumstance.  David became my anchor keeping me from washing a...
Source: Kevin, M.D. - Medical Weblog - May 21, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/loice-swisher" rel="tag" > Loice Swisher, MD < /a > Tags: Physician Oncology/Hematology Pediatrics Source Type: blogs

Medical residents and academic due process: Know your rights
I recently received a call from a physician resident in the Northeast U.S. who had been notified that she would be terminated from her residency program for a “weak knowledge base.” There would be no contract offered to her for the coming academic year. She reports that her scores are no worse than several of her colleagues and that her accredited program has a history of arbitrarily dismissing residents. She has tried to speak to her program director to plead her case, but she reports being harshly rejected. This resident is now in a crisis state, scrambling to determine how to proceed. Should she fight the fi...
Source: Kevin, M.D. - Medical Weblog - May 20, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/todd-rice" rel="tag" > Todd Rice, MD, MBA < /a > Tags: Education Hospital-Based Medicine Residency Source Type: blogs

Why all physicians need mentors
Having a mentor leads to a more successful and satisfying career for doctors. So how does one go about finding a mentor mid-training or after training? Many medical schools and residency programs have mentorship requirements for trainees. But those mentorship needs may change if a student or resident (like myself!) changes their mind about what they want to be when they grow up. I have been enthusiastic about a different specialty every one to two years during training which led to frequent frantic searches for mentors. Even now as an attending four to five years into my career, I continue to seek advice from peers and mor...
Source: Kevin, M.D. - Medical Weblog - May 20, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/joannie-yeh" rel="tag" > Joannie Yeh, MD < /a > Tags: Physician Medical school Primary Care Source Type: blogs

How mindfulness helped this physician ’s primary care journey
“Paying attention in a particular way: on purpose, in the present moment and nonjudgmentally.” That’s how Jon Kabat-Zinn, PhD, describes mindfulness. In the book Zen Mind, Beginner’s Mind, another thought leader in mindfulness, Shunryu Suzuki, says that, “In the beginner’s mind there are many possibilities, but in the expert’s there are few.” In my experience, I’ve found that cultivating a beginner’s mind opens doors and improves clinical diagnosis. Medical training has phases, and clinicians in different phases think differently. In medical school, students learn...
Source: Kevin, M.D. - Medical Weblog - May 20, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/heather-finlay-morreale" rel="tag" > Heather Finlay-Morreale, MD < /a > Tags: Physician Primary Care Source Type: blogs

I was accidentally accepted to an Ivy League medical school at 17
Want to hear a crazy story? Typical medical school students can relate tales of a college experience that includes summer research or hours spent reviewing for the MCAT. I didn’t even take the MCAT. Read on for the oddest medical school acceptance story you’ve ever heard. I was driven in high school. I’d heard for years about smart kids going off to the Ivy League, and I wanted that experience — to end up sitting on a nice New England college green, taking classes with the world’s best and brightest. Continue reading ... Your patients are rating you online: How to respond. Manage your online ...
Source: Kevin, M.D. - Medical Weblog - May 20, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/eliza" rel="tag" > Eliza < /a > Tags: Education Medical school Source Type: blogs

A doctor cries therapeutic tears with her patient
He wasn’t particularly likable upon first encounter. He wasn’t apt to answer questions asked. He had a long pause and a long drawl and a tangential, winded story — and backstory — all of which he was bound and determined to tell to its detailed completion. With an irregular heart rate in the 170s and a respiratory rate in the 30s, I tried to steer him in the direction of concise answers so I could obtain as much information as possible and do my job. This is an emergency. He is an emergency. An emergency which had waited until the last possible millisecond; we did not have the luxury of time. But he...
Source: Kevin, M.D. - Medical Weblog - May 19, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/cindy-winebrenner" rel="tag" > Cindy Winebrenner, MD < /a > Tags: Physician Cardiology Oncology/Hematology Source Type: blogs

How this physician handles burnout
“Put me out of my misery!” I’ve pleaded to anyone within earshot in the throes of a grueling day, a rant from one feeling burnt out. There are days I want to pull my hair out, even the ones that aren’t gray. One night I caught myself grunting, “I hate my life,” while heading out the door at 12 a.m., after an already exhausting day in the OR. No sane person should ever say that. But the world of medicine nowadays is far from sane. After returning home for two hours of sleep, I drag myself to the office with a full patient-load, which is not bad in itself if it weren’t for that unset...
Source: Kevin, M.D. - Medical Weblog - May 19, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/randall-s-fong" rel="tag" > Randall S. Fong, MD < /a > Tags: Physician Primary Care Source Type: blogs

Stop shaming those with addiction
He was younger than I was — still in his twenties — but the patient had already had his chest opened twice. Deadly bloodstream infections contracted from sharing needles had destroyed his heart valves on two separate occasions. And now six months out from his most recent operation, he was back with fever and chills: ominous signs of another infection. That was years ago. The opioid epidemic hadn’t yet been declared a public health emergency. I had just begun my training in cardiology, and he was the first such patient that I had ever taken care of. In the ensuing years, there would be many more like him: ...
Source: Kevin, M.D. - Medical Weblog - May 19, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/akshay-pendyal" rel="tag" > Akshay Pendyal, MD < /a > Tags: Physician Emergency Medicine Primary Care Source Type: blogs

MKSAP: 28-year-old man with lower-extremity edema
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 28-year-old man is evaluated for a 2-month history of progressive lower-extremity edema, weight loss, and fatigue. Medical history is significant for recreational use of inhaled cocaine; he denies injection drug use. He has no other known medical issues and takes no medications. On physical examination, temperature is 37.2 °C (99.0 °F), blood pressure is 130/90 mm Hg, pulse rate is 90/min, and respiration rate is 20/min. BMI is 28. Temporal wasting is present. The lungs are clear. Cardiac exami...
Source: Kevin, M.D. - Medical Weblog - May 19, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions Infectious Disease Nephrology Source Type: blogs

6 ways to address the opioid epidemic
The devastating opioid epidemic is one of the largest public health problems facing the U.S. Over 2.5 million people in the U.S. suffer from opioid use disorder. Four in five new heroin users started out misusing prescription painkillers. A 2015 analysis by the Centers for Disease Control and Prevention found people who are addicted to painkillers are 40 times more likely to be addicted to heroin. The epidemic actually began more than three decades ago. In 1980, crack and cocaine addiction contributed to the thousands of overdose deaths, whereas now people die from pain relievers and synthetic opioids such as fentanyl. In ...
Source: Kevin, M.D. - Medical Weblog - May 18, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/nabila-el-bassel" rel="tag" > Nabila El-Bassel, PhD < /a > Tags: Conditions Pain Management Public Health & Policy Source Type: blogs

Personal finance lessons from Shaquille O ’Neal
I’m always intrigued by those who earn millions of dollars per year or even per month. Some manage to blow all that money and then some. Others, like a select few NFL players, choose to spend wisely and save prodigiously. Today’s Saturday Selection highlights the habits of one athlete who was among the highest paid NBA stars for many years. The headlines sadly feature athletes with similar income who don’t have a penny to their name. Shaquille O’Neal will not be featured in a story like that. Shaq is a success story. And apparently, he now holds a doctorate. So that’s Dr. Shaq to me ...
Source: Kevin, M.D. - Medical Weblog - May 18, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/james-m-dahle" rel="tag" > James M. Dahle, MD < /a > Tags: Finance Practice Management Source Type: blogs

Physicians are CEOs of their medical floors
The ability to lead is not something that comes naturally to everyone. There are some people out there who are wired to lead right from when they are very young — but these are few and far between. Most of us have to train ourselves, and acquire the necessary leadership skills based on our own learning curve and experiences. The fact is that we are all leaders in one way or another. Whether at home or in our communities, we all find ourselves in positions every day where we are taking charge. In our daily jobs, no matter what our assigned position, there are always little ways to take ownership and lead in our depart...
Source: Kevin, M.D. - Medical Weblog - May 18, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/suneel-dhand" rel="tag" > Suneel Dhand, MD < /a > Tags: Physician Hospital-Based Medicine Source Type: blogs

An old technique to detect atrial fibrillation via smartphone
When I was a cardiology fellow back in the 1980s, I learned about a variety of early tools for evaluating heart health that had been displaced by the modern standards of electrocardiography (ECG, or EKG for the Deutschephiles) and echocardiography. One such technique – ballistocardiography – stuck with me, and may be making a comeback. Ballistocardiography is based on the observation that the mechanical action of the heart leads to subtle but reproducible movement of the whole body. It is the old “every action has an equal and opposite reaction” maxim in, well, action. We literally shudder a little ...
Source: Kevin, M.D. - Medical Weblog - May 18, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/ira-nash" rel="tag" > Ira Nash, MD < /a > Tags: Tech Cardiology Mobile health Source Type: blogs

Too many things need physicians ’ signatures
Just sign here. How many times a day are we asked to do this? “Just sign here.” “Just put down your license number.” “We need a stamp with your doctor’s info on it.” “Give us your NPI.” “Initial here, here, and here.” If we took the time to read all the things we’re signing, we wouldn’t have time to do any doctoring. 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 - May 18, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/fred-n-pelzman" rel="tag" > Fred N. Pelzman, MD < /a > Tags: Physician Practice Management Primary Care Source Type: blogs

Physicians must keep a close eye on their financial advisors
Many doctors don’t want anything to do with investing money. They feel investing is not what they were trained to do and therefore a waste of their valuable time. I think this attitude gets some doctors into trouble. It is true that our time is best spent in our main area of training, but it’s very important for us to also have an adequate knowledge of investing. Being somewhat familiar with investing can help prevent us from being taken advantage of. Doctors are, in general, an “easy mark” for people in the financial world. We are assumed to have a lot of money and are willing to invest in anything...
Source: Kevin, M.D. - Medical Weblog - May 18, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/cory-fawcett" rel="tag" > Cory Fawcett, MD < /a > Tags: Finance Practice Management Source Type: blogs

There ’s no such thing as work-life balance
I believe there’s no such thing as work-life balance. I think this every morning when I leave for work, watching my two-year-old son press his face against the front window and wave at me as I back down the driveway. It comes up again at work, as I guiltily feel relieved when a patient cancels and I have an unexpected half hour to work on a behavioral science presentation for residents. There is always somewhere else that I should be, and something else that I should be working on. As a working mother who has been a chronic perfectionist and overachiever, the pressure is always there. If I’m not careful, this p...
Source: Kevin, M.D. - Medical Weblog - May 17, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/katie-fortenberry" rel="tag" > Katie Fortenberry, PhD < /a > Tags: Education Medical school Psychiatry Source Type: blogs

Bias is widespead on both sides of the political spectrum
Without doubt, the future of medicine will include mandatory education for physicians on their conscious and unconscious biases. The politically and culturally progressive nature of medical education and graduate medical education almost ensure that this will eventually be a deeply-ingrained part of our training and our continuing certification. I’m sure that as our culture purports to discover ever new and egregious forms of bias, we will be endlessly reminded, in our educational endeavors and ultimately our workplaces, that we have to “do better.” I only point to medicine because it is the world in whic...
Source: Kevin, M.D. - Medical Weblog - May 17, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/edwin-leap" rel="tag" > Edwin Leap, MD < /a > Tags: Physician Public Health & Policy Source Type: blogs

A medical student ’s reflection on time, the scarcest resource
One of the best bits of wisdom I’ve ever received is that you can tell a lot about someone by looking at how they spend their time. In medical school, time is our scarcest resource. We’re at this strange and exciting point in our lives, during which we’re responsible for learning an enormous amount of information in hopes that someday we’ll be able to quite literally save lives. Many of my classmates and I are currently starting to study for Step 1 of the national medical board exam, and the breadth of information we’re expected to know feels like it could fill a bottomless pit. We’re al...
Source: Kevin, M.D. - Medical Weblog - May 17, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/natasha-abadilla" rel="tag" > Natasha Abadilla < /a > Tags: Education Medical school Source Type: blogs

When it comes to well-being, one size doesn ’t fit all
Doing a simple internet search, you can find a plethora of information about well-being and health. Being happy and well is a goal everyone should aim to achieve. However, I  find many of the tips out there are simply unattainable. It may be that I am just a fail at true inner peace and that my inner tsunami doesn’t let me rest. Or it may be that the tips just don’t fit into my well-being template. So, how can you achieve well-being without hurting yourself or others? You don’t have to like yoga and/or meditation. Both are great practices that have helped so many people. I will not deny that. Ho...
Source: Kevin, M.D. - Medical Weblog - May 17, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/linda-girgis" rel="tag" > Linda Girgis, MD < /a > Tags: Physician Practice Management Source Type: blogs

The story of how this physician started her blog
Recently someone asked me how I started my blog, Brave Enough. The person, a physician, wondered how I made the jump from safe, traditional academia into the world of social media and blogging about women empowerment. “Did you have one moment? Did something happen? What was it?” The conversation made me reflect, as I have been, for several weeks. Like most things, my introspection ended up as words in my journal. Then, words in a blog. The answer is this: No, nothing major happened. No, I didn’t have a tragedy or major awakening, and I was not visited by a fairy godmother. I didn’t sn...
Source: Kevin, M.D. - Medical Weblog - May 17, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/sasha-k-shillcutt" rel="tag" > Sasha K. Shillcutt, MD < /a > Tags: Social media Practice Management Surgery Source Type: blogs

The lows don ’t mean you are loser
The lows don’t mean you are loser.  To the contrary, they mean something else that is completely antithetical.  They mean you are pushing the envelope.  You’re learning from past mistakes.  The lows mean that you are at an inflection point.  The trick is not to see the pit you are currently trapped in as a pit.  Think of it more as a privileged vista in which to view the pathway laid out clearly in front of you.  See it as the base to build the foundation for your future success.  The beginning of a glorious adventure. My hand is reached out to you.  Let me help you ...
Source: Kevin, M.D. - Medical Weblog - May 17, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/docg" rel="tag" > DocG, MD < /a > Tags: Finance Practice Management Source Type: blogs