Physicians ceded control of health care. It ’s time to take it back.
In the not-to-distant past, American health care was the gold standard. It offered job satisfaction and autonomy, was financially rewarding and was considered by many to be the most honorable profession. But as we all know, over the last two decades, increasing health care costs and demands and increasing competition for insurance contracts have changed the face of medicine. Metrics ranging from quality and safety (which are needed and were not a priority) to patient satisfaction, wait times, access, EMRs, decreased ancillary staff and revenue have changed the face of medicine. Long gone are the days of seeing one’s ...
Source: Kevin, M.D. - Medical Weblog - April 21, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/anonymous" rel="tag" > Anonymous < /a > Tags: Physician Health reform Source Type: blogs
To fix health care, we need to examine our shared values
When the political process is not working, one option is to examine the shared values of most Americans. Values are learned, clarified and even negotiated. They are the algebraic axioms from which the formulas of public policy are derived.
Examples include:
Society should care for the sick, written into the EMTALA law that prohibits turning patients away from emergency rooms.
Free enterprise is the engine of material prosperity.
The government must correct the dangers and inefficiencies of free enterprise through regulation and provision of services such as national defense, roads, airports, etc.
Diagnostic and therapeutic...
Source: Kevin, M.D. - Medical Weblog - April 21, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/thomas-birch" rel="tag" > Thomas Birch, MD < /a > Tags: Policy Health reform Source Type: blogs
The far-reaching consequences of medical school debt
From a young age, I knew I wanted to be a physician. There were no physicians in my family, but I had interacted frequently with doctors as a child and felt a strong desire to similarly help others as I grew older.
To this end, I focused on academics. In choosing a university, I chose the one I felt was academically best, despite being a private school in an expensive city far from home. I didn’t think about the price tag, not because I had a college fund, but because I simply didn’t think about it. My parents were immigrants who arrived in America thirteen years before I started college with nothing but two kids and t...
Source: Kevin, M.D. - Medical Weblog - April 21, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/kelly-g-elterman" rel="tag" > Kelly G. Elterman, MD < /a > Tags: Physician Medical school Residency Source Type: blogs
Welcome to planet medicine
, where four rides around the sun earns you a golden ticket to study more, to train more, and to enjoy splicing two sacred letters onto the end of your title. The days are long, the weeks go fast, and sleep is optional. In this world, all-star draftees leave their immaculate collegiate careers as masters of memorization and intellectual puzzle solvers only to still be no more qualified to check a pulse than a two-year-old. Day one is the first and last day you will ever wear your pristine and spotless white cape — soon to be decorated with pen marks, coffee stains, and HIPAA-protected body fluids. It all begins as yo...
Source: Kevin, M.D. - Medical Weblog - April 21, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/bevan-johnson" rel="tag" > Bevan Johnson, MBA < /a > Tags: Education Medical school Source Type: blogs
Larry Nassar and physician misconduct: No more code of silence
I am a bioethics researcher who studies physician misconduct. I am also a former gymnast.
I haven’t really kept up with gymnastics since I quit when I was 17. With the exception of the most recent Olympic Games, I avoid watching it on TV. The taciturn criticism from the commentators is too much for me to bear. I think, of course, she didn’t stick the landing. She just flew through the air at top speed doing something no human has ever done before! Then I throw the remote. Twenty-five years later, I’m obviously still a bit raw. So I have tried to ignore the Nassar story. But given that I am a bioethics researcher who ...
Source: Kevin, M.D. - Medical Weblog - April 20, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/emily-e-anderson" rel="tag" > Emily E. Anderson, PhD, MPH < /a > Tags: Physician Source Type: blogs
This physician delayed residency to take paternity leave
“Daddy, time to wake up! It is morning time!”
I open my eyes to our four-year-old daughter at the foot of the bed smiling, her hair meticulously braided. I get up and wake her younger brother from his crib and carry him downstairs. The baby is still sleeping. Soon come shouts of “coffee!” as we enter the kitchen — they know my routine well. After breakfast, we all get dressed, I pack my daughter’s lunch, and the three of us suit up for the trek to the bus stop. March 2 marks one year since CaRMS Match Day, and rather than being on call or spending time in clinic, I’m on paternity leave.
On Match Day, I wa...
Source: Kevin, M.D. - Medical Weblog - April 20, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/kevin-dueck" rel="tag" > Kevin Dueck, MD < /a > Tags: Physician Primary care Source Type: blogs
Normal aging: A steady loss of organ and process function
Part of a series.
The percentage of the population that will be “elderly” is rising fairly dramatically. In 1900 only four percent of the population was over 65 and only one percent over 75. By 1950 it was eight and three percent, respectively. By 2000 it was thirteen and five percent, and now it’s about fourteen and six percent. By 2030 it will be substantially more again.
There are many different concepts about aging, but for our purposes, we’ll consider aging gracefully or perhaps aging wisely. Most people would prefer to have a long life with the proviso that it is with good health while having some element of ...
Source: Kevin, M.D. - Medical Weblog - April 20, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/stephen-c-schimpff" rel="tag" > Stephen C. Schimpff, MD < /a > Tags: Conditions Geriatrics Source Type: blogs
Physician leaders ’ role in preventing burnout
A few weeks ago, I had the opportunity to interview a faculty physician at a large academic medical center. We spoke about burnout in students and faculty in general terms. He was aware of the problem yet did not seem affected himself.
I asked him how he managed to avoid burnout. He talked about remembering his purpose in entering medicine — that the profession is a calling, not just the daily tasks involved — by re-reading thank you cards from patients, residents, and students. He talked about taking time to chat with the staff in the clinics where he works, getting to know the schedulers by name, for example,...
Source: Kevin, M.D. - Medical Weblog - April 20, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/diane-w-shannon" rel="tag" > Diane W. Shannon, MD, MPH < /a > Tags: Physician Primary care Source Type: blogs
An emergency physician frozen by fear, and what she learned from it
This article originally appeared in Emergency Medicine News.
Image credit: Shutterstock.com
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 - April 19, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/sandra-scott-simons" rel="tag" > Sandra Scott Simons, MD < /a > Tags: Physician Emergency Source Type: blogs
Will robots ever be able to perform surgery independently?
And if they can, should they?
In recently post, I wrote about some unresolved issues with driverless cars and ended by saying “So are you ready to have an autonomous robot perform your gallbladder surgery? I’m not.”
But the robots are coming. A recent paper in Science Robotics proposed six different levels of autonomy for surgical robots.
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 - April 19, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/skeptical-scalpel" rel="tag" > Skeptical Scalpel, MD < /a > Tags: Physician Surgery Source Type: blogs
My kids are vaccinated because I love them
Most of you know me — if you know me at all — as a pediatrician.
But I’m a parent, too, just like you. I have three fantastic girls that I love dearly. Let’s talk.
My first daughter was born before I knew anything about medicine. She has taught me more than I could have imagined. I’ve watched as she has grown from a tiny and helpless infant into the child she is today — a mature and caring girl whose generosity puts me to shame.
Our second daughter came while I was in medical school. She looks just like her big sister, but has a very different personality. As a baby, she was … we’ll call it “f...
Source: Kevin, M.D. - Medical Weblog - April 19, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/chad-hayes" rel="tag" > Chad Hayes, MD < /a > Tags: Physician Pediatrics Source Type: blogs
How useful is a cardiac calcium CT scan?
Being a radiologist, I rarely speak to patients, but I was asked to counsel Mrs. Patel (not her real name), who was worried about the risks of radiation from cardiac calcium CT scan. Because of her risk factors for atherosclerosis, her cardiologist wanted her to take statins for primary prevention, but she was reluctant to start statins. They eventually reached a truce. If she had even a speck of calcium in her coronary arteries, she would take statins. If her calcium score was zero, she wouldn’t. This type of shared decision making is the most frequent reason why cardiologists order calcium scans at my institution.
A ca...
Source: Kevin, M.D. - Medical Weblog - April 19, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/dr-saurabh-jha" rel="tag" > Dr. Saurabh Jha < /a > Tags: Conditions Radiology Source Type: blogs
5 effective strategies for pacing when you ’re sick or in pain
Pacing refers to spacing out your activities during the day so that you’re able to stay within the limits of what your body can handle without exacerbating your symptoms. Another way to think of it is that pacing is a way to keep you inside your “energy envelope” — the envelope that contains your energy stores for any given day.
First, an admission: Even though pacing may be the single best “treatment” for me, I have a love-hate relationship with it. On the one hand, I love pacing because it keeps my symptoms from flaring. On the other hand, I hate pacing because it keeps me from doing everything I want to ...
Source: Kevin, M.D. - Medical Weblog - April 18, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/toni-bernhard" rel="tag" > Toni Bernhard, JD < /a > Tags: Patient Patients Source Type: blogs
Is health care a right or a privilege? Why can ’t the answer be both?
Election Day 2016 should have been Christmas morning for Republicans. Long awaited control of the White House and both houses of Congress. A chance to deliver on an every two-year election cycle promise to repeal and replace Obamacare. In 2010 Republicans needed the House. They got it. In 2014, it was the Senate. Delivered. But we still need the White House they said. Asked and answered with President Donald Trump.
So, what happened a few weeks ago when the House bill fizzled like a North Korean missile launch? Disparate factions within the House couldn’t unify behind Speaker Paul Ryan’s plan, despite pressure from the...
Source: Kevin, M.D. - Medical Weblog - April 18, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/brian-c-joondeph" rel="tag" > Brian C. Joondeph, MD < /a > Tags: Policy Health reform Source Type: blogs
The Saddest Encounter
I had an upsetting encounter the other day with a 22-year-old woman of color, who mentioned (secondary to the purpose of the visit) that she was pretty sure she had breast cancer.
Why did she think that?
She’d found a lump in her breast.
(Somewhat unusually for the specific setting, she let me do a breast exam. All I felt was a small area of lumpy breast tissue, possibly a fibroadenoma at worst. Of course I would recommend ultrasound and possibly excision, but I wasn’t acting in the capacity of her primary care physician.)
Had she seen a doctor about it?
No.
Why not?
The answer that sent my jaw to the floor:
Ca...
Source: Musings of a Dinosaur - April 18, 2017 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
