The need to marry socioeconomics, public health, and medical care is long overdue
I was recently invited to speak at a conference in what is likely the nicest hotel I have ever set foot in. Partially hidden by an array of palm trees and adjacent to a golf course, I could easily see why the conference rate was $350 per night. Before making my way to the conference room, I paused in the dining area to go over my slides one last time and work on the timing of a few quips: “This is my first time in Scottsdale, and I have to say that this hotel is pretty much what comes to mind when I think of the Garden of Eden, only it’s the price that makes the fruit forbidden.”
As I looked to my left in the dining ...
Source: Kevin, M.D. - Medical Weblog - March 30, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/cory-michael" rel="tag" > Cory Michael, MD < /a > Tags: Policy Health reform Source Type: blogs
5 reasons why IMGs will save U.S. health care
Spoiler alert: I am biased. I graduated from St. George’s University, a medical school in Grenada that graduates more physicians annually than any other medical school in the world. It is a school comprised of people who are so determined to become doctors that they are willing to move to a different country — some taking their families with them, some leaving everything behind — to study medicine. My peers came from all over the United States and Canada and had prior graduate degrees, prior jobs and life experiences. Eventually, we all came to the same conclusion: No career would make us happier than a c...
Source: Kevin, M.D. - Medical Weblog - March 30, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/jenna-t-nakagawa" rel="tag" > Jenna T. Nakagawa, MD, MPH < /a > Tags: Education Residency Source Type: blogs
What should my doctor look like?
Imagine while driving into work, you drive through a green light. When you look to the right, you see a car barreling through the intersection, and then everything goes black. You vaguely remember being taken into the emergency room of a prestigious hospital nearby. In the ED, you hear a doctor’s voice yelling at nurses to give you medications, and then everything goes black. You wake up in a hospital bed. As you open your eyes, there is someone in a white coat standing over you. The person says, “You’re going to be just fine. I’m your surgeon.”
I gave this scenario to a few close friends in New England and asked...
Source: Kevin, M.D. - Medical Weblog - March 30, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/jack-turban" rel="tag" > Jack Turban < /a > Tags: Physician Medical school Surgery Source Type: blogs
Let older people talk about sex
He was referred to me by a colleague with a large geriatric practice for evaluation and treatment for HIV. He was 76 years old and lived in an assisted living facility. He was, however, very independent and only required limited assistance. When asked what he expected from the visit he responded that he had been sent to me by his PCP. Review of his records suggested that in addition to HIV and hypertension which was well controlled he also had some kidney disease. After reviewing his labs from his PCP, I informed him that his kidneys were OK, not great but for a 76-year-old gentleman, his degree of kidney disease was not t...
Source: Kevin, M.D. - Medical Weblog - March 30, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/dr-leonard-a-sowah" rel="tag" > Dr. Leonard A. Sowah < /a > Tags: Conditions Geriatrics Source Type: blogs
Health care cannot be sustainably fixed in broad political strokes
President Trump campaigned on making health care better, cheaper and available to all Americans, regardless of ability to pay. Once Mr. Trump was safely in the White House, the Republican “thought leaders” in Congress were quick to supply him with their stale and superficial “plans” to repeal and replace Obamacare, which were written in protest to President Obama’s policies and were never meant to be implemented. When scrutinized by the rank and file of the Republican Party, it turned out that the Ryan/Price American Health Care Act was neither repealing enough for some, nor replacing enough for others. Neverthel...
Source: Kevin, M.D. - Medical Weblog - March 30, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/margalit-gur-arie" rel="tag" > Margalit Gur-Arie < /a > Tags: Policy Health reform Source Type: blogs
How a physician-mother shapes the future of medicine
This week is Physicians Week, and this is one in a series of interviews with members of the physician community that are bringing a variety of ideas and networks together in order to improve the relationships between physicians and between physicians and their patients.
Dr. Hala Sabry is the founder of a physician social media group, that started with 20 people that has grown in two years to over 65,000 women physicians (who are also parents) of all specialties who graduated medical school.
How did your physician mothers support group get started?
Just a little over two years ago I realized I was going to have three kids u...
Source: Kevin, M.D. - Medical Weblog - March 30, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/hala-sabry" rel="tag" > Hala Sabry, DO < /a > Tags: Physician Primary care Source Type: blogs
Does tough love equate to wellness or destruction?
Heroin abuse in the United States is reaching epidemic proportions. According to SAMHSA, between 2007 and 2012, the number of Heroin users has doubled from an estimated 375,000 to over 665,000. Additionally, in 2010, the number of deaths as a direct result of overdose surpassed auto accident deaths.
It is impossible to avoid the facts about heroin. We are bombarded daily by the national and local media and extensive online resources. So, is tough love the answer? I recently met a family whose daughter is a client and whose son had recently died from a Heroin overdose. The story they recounted was as follows:
Th...
Source: Kevin, M.D. - Medical Weblog - March 29, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/david-kolker" rel="tag" > David Kolker, LICSW, JD < /a > Tags: Conditions Primary care Source Type: blogs
Millennials are the ones who will fix health care
I’m entitled and lazy
A whiny little baby
I’m a disgraceful human in general
Because I am a millennial
And people say we are the worst
Always putting ourselves first
We should get a real job and settle down
But our priorities are reversed
Every old generation
Thinks the new one is mistaken
And so every new generation
Is made fun of and hated
This old adage has been true for ages so
Just embrace it
Because we dictate the future
We are powerful – don’t waste it
To my fellow future healers
Motivated idealistic dreamers
We see a steep uphill battle
That promises to defeat us
As we dedicate our lives to health
Getting r...
Source: Kevin, M.D. - Medical Weblog - March 29, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/jamie-katuna" rel="tag" > Jamie Katuna < /a > Tags: Video Medical school Source Type: blogs
3 lessons I learned about domestic violence in the ER
As a first-year oral and maxillofacial (OMF) surgery intern, I was the first responder to any facial trauma at a hospital in Queens, NY. Therefore in the past 12 months, I was a primary care provider for numerous facial lacerations of women due to domestic violence. And was a 1st assistant in providing care to patients (both men and women) with orbital floor fractures and mandible fractures due to domestic violence. Having garnered these new experiences has caused a shift in my opinion when approaching certain public health issues including domestic violence. Through these practical experiences, I have encountered gaps tha...
Source: Kevin, M.D. - Medical Weblog - March 29, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/maryam-akbari" rel="tag" > Maryam Akbari, DMD, MPH < /a > Tags: Physician Emergency Source Type: blogs
The pitfalls of prior authorization for prescription drugs
A guest column by the American College of Physicians, exclusive to KevinMD.com.
One of the things that I dread the most about January 1 is that it’s the start of “prior authorization (PA) season” for prescription medications. It is time consuming and frustrating, plus it often jeopardizes patient safety and quality of care.
A recent Viewpoint in the Journal of the American Medical Association (JAMA) describes PA programs, including “step therapy,” the requirement that patients try and fail a specific number of preferred drugs before a more expensive covered drug or a non-formulary drug will be approved. The artic...
Source: Kevin, M.D. - Medical Weblog - March 29, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/yul-ejnes" rel="tag" > Yul Ejnes, MD < /a > Tags: Meds Medications Source Type: blogs
Why Internet privacy matters for patients
Most of us have grown accustomed to Google and Facebook. When I had an Android phone, I quickly got over the initial creepiness factor of going into a restaurant, bar, or store and having a message from Google popping up with reviews, menus, or coupons. I liked that Google could recommend times to leave or asked if I went to a certain spot often. But Facebook and Google are basically large advertisers. They sit on our data and offer their “eyeballs” to companies. S.J.Res. 34, a bill that has passed both the Senate and the House is something different. By rolling back Obama-era Internet protections, the bill would allo...
Source: Kevin, M.D. - Medical Weblog - March 29, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/jonathan-coleman" rel="tag" > Jonathan Coleman < /a > Tags: Policy Patients Source Type: blogs
I felt that I couldn ’t let him face this journey alone
From my wife’s grandparents’ Manhattan apartment, I could hear the noises of traffic and pedestrians in Central Park seven floors below. The sounds were a refreshing change from the beeping monitors, overhead pages and ringing phones that are the usual backdrop to my work as a physician in a large Philadelphia medical center. Here the only background conversations I heard were those of loved ones in the kitchen, not those of patients’ family members, overheard through flimsy curtains ringing an adjacent bed.
The hospice nurse quietly moved about the apartment. My wife sat close by her grandfather, Werner ...
Source: Kevin, M.D. - Medical Weblog - March 29, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/jonathan-gotfried" rel="tag" > Jonathan Gotfried, MD < /a > Tags: Physician Primary care Source Type: blogs
The physician as a health care innovator
This week is Physicians Week, and this is one in a series of interviews with members of the physician community that are bringing a variety of ideas and networks together in order to improve the relationships between physicians and between physicians and their patients.
Dr. Colm Murphy is a cardiologist and the founder of a tech company that is about building a community of physicians in order for them to help one another. With physicians from all over the United States and Canada involved, their software platform provides a place for physicians to share their knowledge and educate each other on the latest insights so they...
Source: Kevin, M.D. - Medical Weblog - March 29, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/colm-murphy" rel="tag" > Colm Murphy, MD < /a > Tags: Tech Health IT Source Type: blogs
When should you introduce gluten to your baby?
Infants with a first-degree relative (parent or sibling) with celiac disease, and who carry an at-risk (DQ2 or DQ8) gene, have a higher risk of developing the autoimmune disorder triggered by gluten-containing foods. Many parents, especially those with a family history of celiac disease, are understandably nervous about introducing gluten into their child’s diet. They wonder whether there is an ideal time to introduce gluten, if they can prevent celiac disease by never introducing gluten, and for those with celiac disease, how to incorporate gluten into their child’s diet without getting sick themselves.
Previously it ...
Source: Kevin, M.D. - Medical Weblog - March 28, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/maureen-leonard" rel="tag" > Maureen Leonard, MD < /a > Tags: Conditions GI Pediatrics Source Type: blogs
This doctor beat burnout by doing these 5 things
Burnout syndrome is a state of emotional, mental and physical exhaustion caused by excessive and prolonged stress. I burned out early. Right out of fellowship, I no longer wanted to be a doctor. The grueling hours, my grumpy co-workers, and distant patient engagements left me totally exhausted. However, over the course of a year, I was able to rediscover my passion for medicine.
Some tactics were deliberate, mindful behaviors, some occurred by accident, and some started with a different goal, but eventually helped ease my burnout and anxiety.
Continue reading ...
Your patients are rating you online: How to respond. Mana...
Source: Kevin, M.D. - Medical Weblog - March 28, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/roozehra-khan" rel="tag" > Roozehra Khan, DO < /a > Tags: Physician Intensive care Source Type: blogs
