
The Podcast by KevinMD
2,158 episodes — Page 41 of 44
How writing can change minds and make you a better physician
Meet the physician who has written multiple widely-shared articles on KevinMD. How does writing change minds and bring people together? Why is humor such an important part of her pieces? Explore how her articles come together, and why writing has made her a better physician. Rada Jones is an emergency physician and can be reached at her self-titled site, RadaJonesMD, and on Twitter @jonesrada. She is the author of Overdose. She shares her story and discusses her KevinMD article, "How masks are like your underwear." (https://www.kevinmd.com/blog/2020/08/how-masks-are-like-your-underwear.html)
To better take care of patients, we need to take care of ourselves
"I wonder what keeps us physicians going? What makes us show up to work every day? Even though it might sound clichéd, for most of us, it's the love for medicine; it's the love to be there and still be able to make a difference. And maybe money too. Here I have some self-help tips/tools that could potentially help us through these tough times. We cannot change our surroundings. We can certainly adapt." Manju Mahajan is a family physician. She shares her story and discusses her KevinMD article, "To better take care of patients, we need to take care of ourselves." (https://www.kevinmd.com/blog/2020/08/to-better-take-care-of-patients-we-need-to-take-care-of-ourselves.html)
Search engine optimization for physicians
"What is SEO? In short, it is the process of optimizing content found online in order to help it be seen by those searching for the information found in that content. It used to be that people would just stuff their poorly written, short, and low-quality blog posts with their keyword, and they would rank for that keyword. Long gone are those days, and it's a good thing because when it comes to health care and medical content, that kind of content has no place being seen. If we all start putting out quality medical content, soon there will be no room on page one for all of the noise that not only provides low-quality information but can actually put people's lives and health in danger." Andrea Paul is a physician-entrepreneur and can be found on Instagram and Facebook. She shares her story and discusses her KevinMD article, "Search engine optimization for physicians." (https://www.kevinmd.com/blog/2020/09/how-the-google-algorithm-update-helps-doctor-written-content-rank-higher.html)
How coaching prevents and treats physician burnout
"Physicians are advocates of health. This must include our own. Physicians identify threats to health. This must include those that threaten our own – burnout is proven a grave threat. Physicians seek, prescribe, and perform curative treatments. We have the treatment for burnout available – we must prescribe it for each other and seek it for ourselves. Physicians advocate for vaccination as prevention. We have the inoculation for burnout – we must make it widely accessible and encourage collective participation to gain the necessary herd immunity. We have available to us a single solution that fulfills both prevention and cure for the pandemic of burnout – this single treatment will sustain the workforce that is needed to navigate the other pandemics we face. Coaching empowers us to continue our work in advocating for health, identifying and eliminating threats with our compassion, expertise, empathy, and lives intact. We must lead by example, ask for the help we need, use prevention as medicine, and emerge together immune to the toxicities threatening our profession and eradicate the disease of burnout through coaching." Amelia L. Bueche is an osteopathic physician and founder, This Osteopathic Life. She shares her story and discusses her KevinMD article, "How coaching prevents and treats physician burnout." (https://www.kevinmd.com/blog/2020/07/how-coaching-prevents-and-treats-physician-burnout.html)
3 coronavirus facts Americans must know before returning to work and school
"We can't un-bungle our nation's COVID-19 response. Political leaders acted too slowly; health agencies committed unforced errors with testing kits and, amid the confusion, an information fog settled over the land. Americans remain afraid, perplexed, and chronically misinformed (despite wall-to-wall coronavirus coverage across the leading cable news programs and print publications). To counter the uncertainty, any plan to get us out of the coronavirus crisis must first acknowledge and broadly communicate three immutable, scientific facts." Robert Pearl is a plastic surgeon and author of Mistreated: Why We Think We're Getting Good Health Care–And Why We're Usually Wrong. He can be reached on Twitter @RobertPearlMD. He shares his story and discusses his KevinMD article, "3 coronavirus facts Americans must know before returning to work and school." (https://www.kevinmd.com/blog/2020/05/3-coronavirus-facts-americans-must-know-before-returning-to-work-and-school.html)
A terminal diagnosis for my baby
"Eventually, this thankfully passed. Now, almost three years later, I know that this loss will always be with us. Miriam was beautiful, she was our only girl, she was perfect for our family, and she's always missing. Still, my memories of being in the hospital are incredibly sad but also peaceful. In part, this is due to the incredible support and love we got from our family, friends, rabbi, and community. But in a big part, this is due to the clear and honest way we got Miriam's diagnosis and the support, concern, and compassion from her medical team." Sophia Zilber is a patient advocate. She shares her story and discusses her KevinMD article, "Getting a terminal diagnosis for my baby." (https://www.kevinmd.com/blog/2020/01/getting-a-terminal-diagnosis-for-my-baby.html)
A physician experiences unprofessional behavior. What happened next?
"Setting: An impersonal, windowless conference room within a hospital Characters: A nurse in charge (NIC), a department chair (DC) and me (ME) NIC: Thank you for joining us to discuss the report you made of unprofessional behavior in the operating room. We'd like to start by letting you know that in this institution, we have a culture of informality. When I first got here, I found it unsettling that doctors were called by their first names in meetings. DC: Yes, this culture was also surprising to me. At [Ivory tower institution 1], where I trained, no one would have ever called a physician by their first name! And at [Ivory tower institution 2] where I worked before moving here, no one would have dreamed of calling a doctor by their first name. Can you imagine someone calling Dr. [Worldfamous Surgeon at Ivory tower institution 2] Steve? It never would have happened! He would have been so angry! But here, I get called by my first name pretty regularly. I've gotten used to it, and now I don't even mind. ME: We're not here because someone called me by my first name. DC: What do you mean?" Sarah M. Temkin is a gynecology-oncology physician. She shares her story and discusses her KevinMD article, "A discussion about unprofessional behavior: a play in 1 act." (https://www.kevinmd.com/blog/2020/08/a-discussion-about-unprofessional-behavior-a-play-in-1-act.html)
Telehealth is the future but it is obscured by a dismal present
"Will the unfavorable regulatory environment permit telehealth to flourish? Perforce we're beginning to see a relaxation of restrictions that have hitherto obstructed progress. Recently, federal officials approved interstate licensing, thereby prompting greater telehealth conversion, utilization, and expansion. Medicare's 1135 Waiver is also encouraging, and, in as much as it serves the same ends, the Drug Enforcement Administration's leave to prescribe via telemedicine without a prior in-person meeting is a similarly promising development. In light of circumstances, anything that might reduce cost, improve delivery, and wrest control from bloated, dysfunctional health care systems is viable." David Hanekom is an internal medicine physician. He shares his story and discusses his KevinMD article, "Telehealth is the future but it is obscured by a dismal present." (https://www.kevinmd.com/blog/2020/07/telehealth-is-the-future-but-it-is-obscured-by-a-dismal-present.html)
Can what you eat worsen your ADHD?
"Suzy was a bright and hardworking student. However, even though she was conscientious and generally cheery, her grades began to fall during her senior year, and she started to feel depressed. She also constantly had an upset stomach, which she had just accepted as a way of life. She'd had an ADHD diagnosis since she was younger, but while Ritalin had helped her focus on her work in the past, the effect seemed to be dwindling as she built up a tolerance. I noted that her diet seemed to have shifted toward more comfort food. Her meals were cereal with milk, a sandwich, pizza, or pasta. She was eating a lot of dairy and gluten, and it's no coincidence that both of these dietary components can exacerbate the symptoms of ADHD." Uma Naidoo is a nutritional psychiatrist and author of This Is Your Brain on Food: An Indispensable Guide to the Surprising Foods that Fight Depression, Anxiety, PTSD, OCD, ADHD, and More. She shares her story and discusses her KevinMD article, "Can what you eat worsen your ADHD?" (https://www.kevinmd.com/blog/2020/08/can-what-you-eat-worsen-your-adhd.html)
Sexual offender treatment during COVID-19
"Let's not suffer more hardship then already incurred by COVID-19. Recognizing that both the psychosocial stressors arising from COVID-19 and the withdrawal of effective sexual offender treatment increase the risk of sexual violence, public safety demands that offenders have access to treatment. Without sexual offender treatment during COVID-19, we exchange one public health crisis for another." Renée Sorrentino is a psychiatrist. She shares her story and discusses her KevinMD article, "Sexual offender treatment during COVID-19." (https://www.kevinmd.com/blog/2020/07/the-withdrawal-of-effective-sexual-offender-treatment-during-covid-19.html)
Be an upstander and not a bystander
"The incident bothered me all day and the following many days. I couldn't quite put a finger on what it was and brushed it aside and stopped thinking about it. In the wake of recent events, it dawned upon me that it wasn't the patient's comments that bothered me. It was the fact that no one standing in the room witnessing the conversation stepped in. Not during the conversation, and not after. Considering I've worked with my colleagues every single day, and in the same place for the last 12 years, I felt strangely betrayed. Stories like this happen every day and are sadly more common than we realized. There will always be racist, insensitive, inappropriate comments by people across life. Its how we react to them is what will shape our lives. Most individuals have asked how they can help. Well, start by being an upstander and not a bystander. That will mean the world to us, people of color, and immigrants. And let's start teaching and training students in medical school, nursing, and technical schools how to identify and stand up to inappropriate comments. It may take us a few generations to make seismic changes, but we must start now." Aasma Shaukat is a gastroenterologist and can reached on Twitter @aasmashaukatmd. She shares her story and discusses her KevinMD article, "Be an upstander and not a bystander." (https://www.kevinmd.com/blog/2020/07/be-an-upstander-and-not-a-bystander.html) This episode is sponsored by The Nuance Dragon Ambient eXperience (DAX). The Nuance DAX solution makes it possible to forget the tech-toggling and reduces documentation burdens no matter how or where care is being provided. (www.kevinmd.com/nuancedax)
What it's like to write about COVID-19 while it's killing your mom
"My mom was beyond vulnerable to the virus. May of 2020 marked two years since she'd become a nursing home resident—receiving care for several chronic illnesses. She died of failure to thrive due to Coronavirus 2019 on June 1, 2020, at the age of 75. As her oldest child, her health care proxy, and a health care writer for more than 15 years, I knew that a positive result in a long-term care facility was statistically almost sure to end one way. She'd already been showing signs of global decline for months, and had a DNR order in place. Professionally, I'd been immersed in COVID almost from the time it began. I was writing articles about physicians' liability exposure during the crisis and how clinicians could seek resources for help coping with trauma related to the pandemic. Personally, I was connecting with my mom the best I could (asynchronous videos, cards in the mail). I was defending her final wishes. And I was preparing mentally to say goodbye, even if it couldn't be in person." Debra A. Shute is a journalist. She shares her story and discusses her KevinMD article, "What it's like to write about COVID-19 while it's killing your mom." (https://www.kevinmd.com/blog/2020/07/what-its-like-to-write-about-covid-19-while-its-killing-your-mom.html) This episode is sponsored by The Nuance Dragon Ambient eXperience (DAX). The Nuance DAX solution makes it possible to forget the tech-toggling and reduces documentation burdens no matter how or where care is being provided. (www.kevinmd.com/nuancedax)
What does a physician's ideal life look like?
"You are a physician. You have put in years of hard work and sacrifice getting here. Now what? Does your life look and feel exactly how you imagined it would? If not, what does your ideal life look like? Certainly, answers to this question are deeply personal, and will vary depending on the individual. As physicians, we need to engage in a process of self-discovery to create the lives we want and deserve. This requires each of us to examine our lives as they currently are, envision what they could be, and take inspired action to make the changes that are necessary to achieve our goals. To start, you might ask yourself the following questions: What aspects of my career and personal life do I find the most rewarding and fulfilling? What aspects am I simply tolerating? And what aspects actually make me feel unhappy, or unsettled?" Gina Geis is a neonatologist and physician coach. She shares her story and discusses her KevinMD article, "The path toward your ideal life." (https://www.kevinmd.com/blog/2020/07/the-path-toward-your-ideal-life.html) This episode is sponsored by The Nuance Dragon Ambient eXperience (DAX). The Nuance DAX solution makes it possible to forget the tech-toggling and reduces documentation burdens no matter how or where care is being provided. (www.kevinmd.com/nuancedax)
A medical student volunteers with the medical corps
"An email arrived inviting med students to join the State of Georgia's Medical Reserve Corps (MRC). The MRC is an organization of doctors, nurses, PAs, EMTs, and med students who are the first medical boots on the ground for disasters in Georgia. They establish mobile hospitals and provide medical care. With extra time in isolation, I signed up and shortly received a notice for locations at food banks available to students. I requested an assignment, received my orders, and deployed the next day to serve for two weeks. When I arrived, the food bank was in desperate need of volunteers. With the state shutdown, more people needed food, but fewer people were able to help. The Georgia State Defense Force (GSDF), a statewide Army branch of volunteers, assigned soldiers to work at the food banks since normal volunteers were under lockdown. I was assigned as medical support for the soldiers." Mason Bennett is a medical student. He shares his story and discusses his KevinMD article, "A medical student's unique education in a pandemic." (https://www.kevinmd.com/blog/2020/07/a-medical-students-unique-education-in-a-pandemic.html) This episode is sponsored by The Nuance Dragon Ambient eXperience (DAX). The Nuance DAX solution makes it possible to forget the tech-toggling and reduces documentation burdens no matter how or where care is being provided. (www.kevinmd.com/nuancedax)
Free speech, cancel culture, and taking down statues
"History cannot be changed and should not be erased. The First Amendment was placed first for a reason. It is the bedrock of our nation's ability to overcome despots like Hitler and to abolish slavery. However, it comes at a price. You may hear things you don't like or make you uncomfortable. You may see statues or places like the Old Slave Market that offend you because of what they represent. But you also see works of art like the Declaration of Independence. You cannot have one without the other. To limit speech or erase history because you do not personally like it, or because it doesn't fit your narrative is a step towards liberal and/or conservative fascism. Personal liberty is sacrificed." Andrew Pickens is an emergency physician. He shares his story and discusses his KevinMD articles, "The cancel culture and the erasure of less just times and imperfect people" (https://www.kevinmd.com/blog/2020/06/the-cancel-culture-and-the-erasure-of-less-just-times-and-imperfect-people.html) and "The DNA of the United States of America." (https://www.kevinmd.com/blog/2020/07/the-dna-of-the-united-states-of-america.html) This episode is sponsored by The Nuance Dragon Ambient eXperience (DAX). The Nuance DAX solution makes it possible to forget the tech-toggling and reduces documentation burdens no matter how or where care is being provided. (www.kevinmd.com/nuancedax)
A physician receives a derogatory email. Here's what she did next.
"The disparity of women physicians in research is a systemic issue that should be mitigated appropriately. Women, especially minorities and immigrants, need institutional support to succeed as clinician-investigators. Medical institutions should actively participate in increasing funding mechanisms available solely for the development and promotion of female clinician investigators. Funding for research projects, in terms of time effort and supplies such as data management tools, is vitally important to address gender inequities in research. Protected time for planning, conducting, and writing grants and manuscripts for the project is also essential. Women and men in medicine need to become better at involving the appropriate clinical expertise in research projects. Research, in general, will benefit from the increased collegiality and partnerships among medical specialties." Tina S. Ipe is a pathologist. She shares her story and discusses her KevinMD article, "A physician unmutes herself after receiving an email." (https://www.kevinmd.com/blog/2020/07/a-physician-unmutes-herself-after-receiving-an-email.html) This episode is sponsored by The Nuance Dragon Ambient eXperience (DAX). The Nuance DAX solution makes it possible to forget the tech-toggling and reduces documentation burdens no matter how or where care is being provided. (www.kevinmd.com/nuancedax)
How physicians can be activists
"We dealt with the death, uncertainty, and fear of COVID-19 with a stiff upper lip. But our hearts broke when George Floyd was murdered by the police on May 25. George is a symbol of an immense problem. A study reported that one in every thousand Black men can expect to be killed by the police. One in every thousand! Racially directed violence by the police is a public health problem. Clinicians cannot be silent. Clinicians will not be silent." Karim Khan is an infectious disease fellow. He shares his story and discusses the KevinMD article that he co-wrote, "White Coats for Black Lives: How to transform anger into action." (https://www.kevinmd.com/blog/2020/07/white-coats-for-black-lives-how-to-transform-anger-into-action.html) This episode is sponsored by The Nuance Dragon Ambient eXperience (DAX). The Nuance DAX solution makes it possible to forget the tech-toggling and reduces documentation burdens no matter how or where care is being provided. (www.kevinmd.com/nuancedax)
COVID-19 misinformation is a public health crisis
"Government officials, regardless of political affiliation, should seek sound medical advice before communicating with their constituents. Appropriate public health information should be shared so that constituents are not harmed by following misinformed medical information. Government officials, news media, and social media platforms should account for the health information they spread. We must combat misinformation during the COVID-19 pandemic so that we are better prepared to handle a potential second wave or any viral outbreaks in the future." Jacob Uskavitch is a medical student. He shares his story and discusses his KevinMD article, "COVID-19 misinformation is a public health crisis." (https://www.kevinmd.com/blog/2020/07/covid-19-misinformation-is-a-public-health-crisis.html) This episode is sponsored by The Nuance Dragon Ambient eXperience (DAX). The Nuance DAX solution makes it possible to forget the tech-toggling and reduces documentation burdens no matter how or where care is being provided. (www.kevinmd.com/nuancedax)
What is the future of telehealth?
"Almost overnight, the COVID-19 pandemic has completely disrupted how we deliver primary care to patients. Before the pandemic, telehealth seemed to be a way to deliver urgent care for acute issues to a select group of tech-savvy patients. Now, at least in my practice, the majority of primary care (acute care, chronic disease management, and preventive care) is being delivered through "telehealth," meaning that we conduct visits virtually via video or telephone. While, of course, this is currently safer, many patients also seem to value the improved convenience and accessibility of these visits compared to traditional office-based care. However, as we continue to move forward providing virtual care to patients during the pandemic and beyond, we need to recognize our current deficiencies in providing this type of care and acknowledge that providing the full scope of quality telehealth will require more than just a video connection with a patient." Cara Litvin is an internal medicine physician. She shares her story and discusses her KevinMD article, "Envisioning the delivery of true primary care telehealth." (https://www.kevinmd.com/blog/2020/08/envisioning-the-delivery-of-true-primary-care-telehealth.html) This episode is sponsored by The Nuance Dragon Ambient eXperience (DAX). The Nuance DAX solution makes it possible to forget the tech-toggling and reduces documentation burdens no matter how or where care is being provided. (www.kevinmd.com/nuancedax)
Medical students are benched during the pandemic
"There is no single culprit responsible for this shift in medical education. However, two, in particular, should be noted. The first is the culture of defensive medicine, or more bluntly, CYA (cover-your-ass) medicine. This culture has been insidiously infusing itself within the modern health care system for decades. The fear of being sued for malpractice is ever-present. Undoubtedly, this has led to hesitations in allowing medical students to be involved in patient care. Another important consideration is our capitalistic health care system. In an era when physicians are being pressured by hospitals to see more patients, coupled with intense bureaucratic demands and documentation requirements, it is no secret that learners slow down productivity and drive down the bottom line. As a result, education suffers. What is the consequence of all of this? The 'finish line' keeps getting pushed back further and further. More resident physicians are deciding to pursue fellowship before becoming an attending. For instance, in the field of general surgery, 80 percent of residents decide to pursue a fellowship. It is unclear how this will affect patient care in the future. Undoubtedly though, it begins at the medical student level. The decision to remove medical students from the hospitals in the midst of this crisis is the ultimate reflection of a much larger problem, that being, the regression of the role of medical students." Clayton Korson is a medical student. He shares his story and discusses his KevinMD article, "Medical students are benched during the pandemic." (https://www.kevinmd.com/blog/2020/08/medical-students-are-benched-during-the-pandemic.html) This episode is sponsored by The Nuance Dragon Ambient eXperience (DAX). The Nuance DAX solution makes it possible to forget the tech-toggling and reduces documentation burdens no matter how or where care is being provided. (www.kevinmd.com/nuancedax)
How to minimize virtual medicine liability risk
"Telehealth has come into focus during the COVID-19 pandemic as physicians face an immediate need to reduce exposure by providing care—or at least triage—remotely when appropriate. Under usual circumstances, telemedicine is comparatively low risk. That said, telemedicine does bring specific risks to patient safety and physician/practice liability. Minimizing those risks calls for adapting daily practice routines around informed consent, documentation, and other standard components of a patient encounter, as well as adjusting the practice's insurance coverage." David L. Feldman is chief medical officer, The Doctors Company and Healthcare Risk Advisors. He shares his story and discusses his KevinMD article, "7 tips for telehealth during COVID-19." (https://www.kevinmd.com/blog/2020/04/7-tips-for-telehealth-during-covid-19.html) This episode is sponsored by The Nuance Dragon Ambient eXperience (DAX). The Nuance DAX solution makes it possible to forget the tech-toggling and reduces documentation burdens no matter how or where care is being provided. (www.kevinmd.com/nuancedax)
Human trafficking survivors and trauma-informed care
"As a physician working with human trafficking survivors, I have become accustomed to those with a history of surviving violence. But the patient in question is in my general primary care practice. This should highlight to care providers that there may be many more patients out there who have been exposed to trauma in their past, and we need to take this into account. One way to be inclusive is to incorporate the substance abuse and mental health services administration principles of trauma-informed care into practice." Andrea Reilly is an internal medicine-pediatrics physician. She shares her story and discusses her KevinMD article, "The challenge of trauma-informed care in the age of COVID." (https://www.kevinmd.com/blog/2020/07/the-challenge-of-trauma-informed-care-in-the-age-of-covid.html) This episode is sponsored by The Nuance Dragon Ambient eXperience (DAX). The Nuance DAX solution makes it possible to forget the tech-toggling and reduces documentation burdens no matter how or where care is being provided. (www.kevinmd.com/nuancedax)
A message from a pediatric emergency physician: Be kind
"As I read about Dr. Breen, saddened by the fact that we have been robbed of yet another young, promising, motivated physician, I am reminded that as bad as this pandemic is — and truly believe it is awful — when it gets better (and I have to believe that it will), we can't forget. Because all the other things that have always been there but got shoved to the back burner by COVID will be there again. And no matter what kind of medicine you practice, there will be unique (and some not-so-unique) stressors. We are always expected to be kind to our patients. But my plea to you is to be kind to each other and, more importantly, yourself. You're worth it. And I promise there is someone out there who understands what you are going through. Sometimes you just have to ask." Annalise Sorrentino is a board-certified pediatrician and pediatric emergency medicine physician. She can be reached at her website, on LinkedIn, and on Twitter @BlazerMD. She shares her story and discusses her KevinMD article, "A message for health care workers: Be kind to yourself." (https://www.kevinmd.com/blog/2020/08/a-message-for-health-care-workers-be-kind-to-yourself.html) This episode is sponsored by The Nuance Dragon Ambient eXperience (DAX). The Nuance DAX solution makes it possible to forget the tech-toggling and reduces documentation burdens no matter how or where care is being provided. (www.kevinmd.com/nuancedax)
Patient advocacy is more important now than ever
"In the best of times (and these are certainly not), all patients need advocates all the time; now more than ever, vulnerable patients need them more but don't have access to them. Vulnerable populations have more at stake when visitors are limited or prohibited. What's more, vulnerability may be exacerbated due to youth, advanced age, disability, cognitive impairment, illness acuity, language – or, as we have come to realize of late – implicit bias. Advocacy can take many forms. For the patient who cannot report accurately on their medical history and symptoms, the furnishing of information to health care professionals can speed accurate diagnosis and minimize test and imaging fishing expeditions. Personal advocates, when present, may provide comfort and be a conduit to nursing staff when pain is present, and other physical needs are unmet. Equally important, vigilant personal advocates can be instrumental in offsetting nursing responsibilities by feeding and mobilizing patients, preventing falls, and even initiating rapid response codes. Finally, for patients limited by expressive disorders or constraints, the personal advocate can inform staff about individual preferences, priorities, and values, so that goals of care are aligned with patient wishes." Bonnie Friedman is the author of Hospital Warrior: How to Get the Best Care for Your Loved One. She shares her story and discusses the KevinMD article that she co-wrote, "Making time for patient advocacy is more important now than ever." (https://www.kevinmd.com/blog/2020/07/making-time-for-patient-advocacy-is-more-important-now-than-ever.html) This episode is sponsored by The Nuance Dragon Ambient eXperience (DAX). The Nuance DAX solution makes it possible to forget the tech-toggling and reduces documentation burdens no matter how or where care is being provided. (www.kevinmd.com/nuancedax)
It's so important for medical students to share their stories
"As a medical student, you find potential patients everywhere. Whether you're on an airplane or on a romantic dinner date, we've all heard those famous words, 'Is there a doctor in the house?!' Here are some of my favorite 'patient' encounters. The best friend curbside. I was playing ball with my boys – that's right FIFA on the PlayStation – when my buddy drops the question, 'So listen man, you're a doctor, right? I need some advice about my knee; it's been killing me! I landed weird after jumping during soccer the other week, and now it's been aching ever since.' Assessment and Plan: 27-year-old man, clearly delusional as he thinks I'm a doctor, presents to FIFA night complaining of right knee pain. Obviously, he should rest, ice it, use compression, and elevate the leg, right? He continued, 'So I went to my primary care doc, and he told me to rest, ice it, use compression, and elevate the leg! Isn't that the dumbest thing you ever heard?' Uh oh, I couldn't blow my cover, 'Yeah totally … maybe you should get that checked out!'" Daniel Azzam and Ajay N. Sharma are medical students and founders and editors-in-chief, Diary of a Medical Student. They share their stories and discuss their KevinMD article, "As a medical student, you find potential patients everywhere." (https://www.kevinmd.com/blog/2020/09/as-a-medical-student-you-find-potential-patients-everywhere.html)
How coronavirus took my grandfather's life
"One of the calls you dread making as a doctor is telling a family member their loved one is dying. That was the call I received when my grandfather decompensated. We grow accustomed to making the call as clinicians, but we never expect to get it ourselves. I felt for his pulse. Slow but faint. As a doctor, you become desensitized over time. You frantically think of the next steps that will save this body's life, until you realize that body is someone you know. Death here during this time has no dignity. I've experienced a lot in my career by trade. But this one feels particularly brutal. Patients are not allowed to have visitors and often die scared. Someone codes, someone dies, and on you go to save the next life. A few days later, I prepared to head back to work. I thought about all the patients I treated for COVID, never thinking my grandfather would be one. As I headed into work at around 7 p.m., I hear the sounds of people cheering outside. At that moment, I was no hero. I had just lost a war. And back I went to the battlegrounds that altered my family forever. Society needs to redirect energy to alleviating the struggles of workers rather than glorifying it. The government faltered, but it is community advocates and organizers of grass-root campaigns that create reproducible change. The fact of the matter is, nobody wants to be a hero right now. We just want to live to see another day." Zaki Y. Azam is an internal medicine resident. He shares his story and discusses his KevinMD article, "How coronavirus took my grandfather's life." (https://www.kevinmd.com/blog/2020/05/how-coronavirus-took-my-grandfathers-life.html)
COVID-19 through the eyes of my kids
"Living the surreal experience of the COVID-19 pandemic challenges us on multiple levels. As a physician, I feel the responsibility to understand the magnitude of the situation and implement the best measures to protect my patients, trainees, my family, and myself. I experience the fear of getting sick or losing a loved one and the sadness and frustration of seeing millions of lives affected by illness, desperation, isolation, and death. COVID-19 has challenged me even more in my role as a mother. Living the quarantine with two energetic boys has transformed motherhood into an emotional rollercoaster. The combination of COVID-19, taking care of two boys, and continuing working has, at times, been overwhelming, even while having the support of my wonderful husband. I have found myself being absorbed by the challenges, almost forgetting the positive things that still surround me." Miriam Zylberglait Lisigurski is an internal medicine physician. She shares her story and discusses her KevinMD article, "COVID-19 through the eyes of my kids." (https://www.kevinmd.com/blog/2020/07/covid-19-through-the-eyes-of-my-kids.html)
Inside the mind of a surgeon writer
Explore why this general surgeon wrote a novel, and how writing helps with the stresses that accompany a surgery career. What is his #1 tip for those interested in surgery? What are the challenges facing the profession today? How can surgeons find that elusive work-play balance? And why should aspiring doctors start a journal? Arthur Williams is a surgeon. He shares his story and discusses his book, The Surgeon's Obol. (https://amzn.to/2FIdDmz)
This pulmonary physician has a message for you
"To the people who say that wearing a mask perpetuates the conspiracy: Tell that to the health care workers who have put their lives at risk to face firsthand an unknown disease. Tell that to the families of frontline workers who have contracted and succumbed to COVID-19 while their loved ones save everyone else. To the people who say that COVID-19 does not exist; that COVID-19 is just another cold or flu: Tell that to the families who did not have the opportunity to hold the hands of their loved ones as they passed; the families that had to say goodbye to their loved ones through a video chat or a phone call; the families who never dreamed that when they dropped their mothers, fathers, spouses, and siblings off at the ER, the next time they'd see them would be in a casket." Fady Youssef is a pulmonary and critical care physician. He shares his story and discusses his KevinMD article, "A frontline physician has a message for you." (https://www.kevinmd.com/blog/2020/07/a-frontline-physician-has-a-message-for-you.html)
My mother has Alzheimer's: a caregiver's story
What is caregiver burnout? How can you recognize the symptoms? What are tips for new caregivers? What can caregivers teach clinicians? R. Lynn Barnett is the author of What Patients Want: Anecdotes and Advice and My Mother has Alzheimer's and My Dog Has Tapeworms: A Caregiver's Tale. She can be reached on Twitter @rlynnbarnett1. She shares her story and discusses her book, My Mother has Alzheimer's and My Dog Has Tapeworms: A Caregiver's Tale. (https://amzn.to/2ZXHq1u)
Reflections of a critical care nurse
"Grandma Lilly is 87-years-old and in the ICU. She's on a ventilator with her wrists restrained to the side of the bed. Grandma can barely see because her eyes are puffy: scleral edema. And her heart races: 140 beats per minute. Her blood pressure is low and Levophed and vasopressin drips are ordered. Her family can't talk to her as she phases in and out of existence. For her, end-stage renal disease means dialysis. And respiratory failure equals ventilator. She's a brittle diabetic with uncontrolled fluctuating blood sugars. Grandma Lilly can't eat, and we feed her by a tube that goes into her nose and to her stomach. Tomorrow, she gets a PEG tube surgically inserted to feed her. She's been on the ventilator too long. Next comes the ICU package: ventilator, dialysis, pressers, restraints, trach, PEG tube. Any second of clarity or awareness is pure brutality. There's no pretty ending to this torture except through death. Poor Grandma Lilly." Debbie Moore-Black is a nurse who blogs at Do Not Resuscitate. She shares her story and discusses her KevinMD article, "Go quiet into the night." (https://www.kevinmd.com/blog/2019/01/go-quiet-into-the-night.html)
Lifestyle medicine is a prescription to treat physician burnout
"Lifestyle medicine equips practitioners with the tools to affect change. One of the biggest job satisfiers for physicians is positively impacting the trajectory of their patients' lives. Having a parent tell you that their child is 'a different person' because of the time you spent with them is priceless. This is why I believe if more physicians studied and applied the principles of lifestyle medicine to their lives and their practices, we could put a dent into the burnout many of us face. We can build up resilience to the rigors of our work and experience higher levels of job satisfaction as we see our patients get better. In essence, lifestyle medicine is a prescription for physician burnout. In many ways, I feel that my journey into lifestyle medicine is the legacy my mom gave to me. Arising from the emptiness of my early motherhood, I landed on a path leading me to flourish personally and professionally. I will be forever grateful to her not just for the life that she gave me, but for the life she is giving me." Cherie Chu is a pediatrician who blogs at Wellness Pediatrician. She shares her story and discusses her KevinMD article, "Lifestyle medicine is a prescription to treat physician burnout." (https://www.kevinmd.com/blog/2020/07/lifestyle-medicine-is-a-prescription-for-physician-burnout.html)
Treating cancer patients in a pandemic
"As an oncologist, perhaps the hardest part I play is as witness. I am there to give a diagnosis that, more often than not, will alter someone's life forever. For some, I see resignation—a sense that they've known something was wrong and that it's what they thought they had. For others, I see an almost immediate acceptance and, with it, perseverance; they are prepared to fight, to win. But for those where cancer comes without much warning, I see terror. Cancer is a threat to who they are, how they live, and yes—how long they have. It's hard to see someone struggle this way, knowing that no matter how much time I spend with them, holding their hand, crafting a way forward, they leave my office with cancer." Don S. Dizon is an oncologist. He shares his story and discusses his KevinMD article, "As an oncologist, this is the hardest role I play." (https://www.kevinmd.com/blog/2020/07/as-an-oncologist-this-is-the-hardest-role-i-play.html)
Incremental risk amid COVID-19 re-openings: What do we value most?
"Grocery shopping is not optional; it's necessary. But if you go every day and to multiple stores, you are increasing the chance you will be exposed. From my informal survey, this practice is extremely common. Yet, experts advise to consolidate shopping. In fact, in my experience, there is always at least one person (shoppers AND workers) in every store I have visited who is either not masked or masked incorrectly. Many people report that they are going stir-crazy without seeing friends and family members or being among others. So the trade-off is clear: maintaining sanity is prioritized. Everyone wants things to return to normal, so they are doing normal things, albeit with precautions. In reality, there is still so much that is unknown about coronavirus transmission, so it is too soon to attempt 'normalcy.'" Sara L. Merwin is an epidemiologist and co-author of The Informed Patient: A Complete Guide to a Hospital Stay. She shares her story and discusses her KevinMD article, "Incremental risk amid COVID-19 re-openings: What do we value most?" (https://www.kevinmd.com/blog/2020/08/incremental-risk-amid-covid-19-re-openings-what-do-we-value-most.html)
Essential health messaging tips for physicians
"Advocacy by moms is not new, but advocacy by physicians has been less common. Moms have been fierce advocates on a variety of causes ranging from Mothers Against Drunk Driving to Moms Demand Action, the anti-gun violence mom activist group led by Shannon Watts that has now helped launch moms into public office. As physician moms navigating a global pandemic, we are invested in ensuring that our patients, communities, and our children are safe. So, when misinformation threatens basic and effective public health measures, subsequently risking the health and safety of the public and of children, expect a wall of physician moms." Shikha Jain is a hematology-oncology physician who blogs at her self-titled site, Dr. Shikha Jain. She can be reached on Twitter @ShikhaJainMD. She shares her story and discusses the KevinMD article that she co-wrote, "Physician-moms fight back against anti-maskers and anti-vaxxers." (https://www.kevinmd.com/blog/2020/08/physician-moms-fight-back-against-anti-maskers-and-anti-vaxxers.html)
A new approach to Medicare for all
Why should we reform the health care system to a physician-led approach? How will that look like? Would a Medicare for all system cure what ails the system? What are some obstacles to implementation? Ken Terry is a journalist. He shares his story and discusses his book, Physician-Led Health Care Reform: A New Approach to Medicare for All. (https://amzn.to/2ZxhqtE)
In the age of misinformation, here's how physicians can help
"There are two battles waging from the COVID-19 virus this year: the obvious fight for human life but also the attack on science. During philosophical and political debates, one steadfast weapon has been the scientific method. Opinion doesn't matter. State the facts. The thing about facts are, though, that one has to be willing to change previously held points of view with new information. One of the most devastating things observed during this pandemic with regard to human behavior is an absent quest for verity. Instead, it's 'click, copy, and paste.' Somewhere in there, the part where the information is evaluated was lost." Alicia Billington is a plastic surgeon. She shares her story and discusses the KevinMD article that she co-wrote, "In the age of misinformation, don't be a contributor to the problem." (https://www.kevinmd.com/blog/2020/07/in-the-age-of-misinformation-dont-be-a-contributor-to-the-problem.html)
Meet the physician who became a life coach
"For the past six months, I've spent my free time becoming a certified life coach. I'm a hospitalist, but a little more than a year ago, I was introduced to life coaching. I love the changes it has produced in my life – particularly how it's changed me as a mother. Coaching helps me to be more present for my family and more emotionally available for my kids. It's changed the way I approach life, and it's changed what I teach my children." Trina E. Dorrah is an internal medicine physician and the author of Physician's Guide to Surviving CGCAHPS & HCAHPS. She can be reached at Dr Trina Dorrah Life Coaching. She shares her story and discusses the KevinMD article that she co-wrote, "When we coach, we change the lives of our children." (https://www.kevinmd.com/blog/2020/09/when-we-coach-we-change-the-lives-of-our-children.html)
Genetic testing: Could there be unintended consequences?
"Both clinical and direct-to-consumer genetic testing have become significantly less costly and more common, providing people with access to a wealth of information about everything from their ethnicity and family lineage to their risk for certain diseases and how they will respond to medications such as blood thinners and antidepressants. But before you decide to take the plunge into your gene pool, there are a number of issues you should carefully consider. Genetic testing can have unintended consequences, both personal and medical, so it's wise to weigh the value of any information you may gain against the potential issues that the testing may raise." Miles J. Varn is chief executive officer, PinnacleCare, and can be reached on LinkedIn. He shares his story and discusses his KevinMD article, "Genetic testing: Could there be unintended consequences?" (https://www.kevinmd.com/blog/2020/04/genetic-testing-could-there-be-unintended-consequences.html)
Locum tenens contracts: Maximize opportunities and minimize risks
"Locum tenens means 'to hold the place of, to substitute for' and locum tenens contracts are a common form of agreement for physicians who provide temporary medical services in place of full-time physicians. Now, during the COVID-19 pandemic, increased demand puts physicians in a better position to negotiate their locum tenens contracts. However, too many practitioners sign them without fully understanding their implications. This is a mistake. A well-drafted locum tenens contract (a) protects the physician's interests beyond compensation, (b) anticipates and addresses disputes, and (c) limits risks." Jack A. Gordon and Andrew E. Sarti are attorneys, Kent, Beatty, & Gordon, LLP. They share their story and discuss the KevinMD article that they co-wrote, "Anatomy of locum tenens contracts: a physician's guide to understanding contractual provisions to maximize opportunities and minimize risks." (https://www.kevinmd.com/blog/2020/07/anatomy-of-locum-tenens-contracts-a-physicians-guide-to-understanding-contractual-provisions-to-maximize-opportunities-and-minimize-risks.html)
Bridging the COVID-19 health recommendations divide
"Misinformation about COVID-19, if propagated, can be deadly. The stakes are high. Physicians need to have a voice in this discussion and work towards impacting policy in a positive way. Physician-led groups such as IMPACT aim to advocate for evidence-based solutions for the protection of communities and serve an advisory role to those in charge of public policies. As physicians, our primary purpose is the well-being of our patients. We owe it to them to share not only information about sinus infections and sore throat, but how to protect themselves from COVID-19. We must share what we know. We can and should begin to reintegrate into society, but as physicians, our responsibility to the community is to educate and protect. We should not shy away from sharing our expertise with others. This may include uncomfortable conversations with friends and family whose views differ from our own, but if we come from a place of respect and understanding, we can and will get through this together." Inna Husain is an otolaryngologist. She shares her story and discusses the KevinMD article that she co-wrote, "Physicians' role in bridging the COVID-19 health recommendations divide." (https://www.kevinmd.com/blog/2020/07/physicians-role-in-bridging-the-covid-19-health-recommendations-divide.html)
Patients without traditional support systems, and the doctors who stereotype them
"When doctors ignore the evidence showing that a support system doesn't have to be traditional in order to be effective, that's not a medical judgment. It's a personal prejudice that puts singles at serious risk. Classifying patients as married or unmarried when studying the effects of social support undoubtedly makes research easier, with groups determined by a simplistic either-or. But since social support is not, in fact, limited to marriage, the results of such studies are bound to be flawed — not to mention perpetuating discriminatory treatment that can cost single people our lives." Joan DelFattore is a writer. She shares her story and discusses her KevinMD article, "Patients without partners, and the doctors who stereotype us." (https://www.kevinmd.com/blog/2016/11/patients-without-partners-doctors-stereotype-us.html)
Is now the time for single payer?
"Single payer is the solution. And the time for it is now. A single-payer system would guarantee health care coverage immediately to every American. So whether a loved one gets sick from COVID, has a heart attack, or gets in a car accident, she will receive the care she needs without it causing financial hardship. A single-payer system will eliminate employer health insurance contributions. This will provide huge relief to hundreds of thousands of struggling small businesses across the country. The money saved can go towards paying their employees a living wage or hiring new workers, which will help get our economy back on track. A single-payer system will relieve the burden of finding health insurance from individuals. Freelancers and gig, self-employed, and per diem workers can pursue employment without having to worry about providing health coverage for their families. And with families relieved of the insecurities created by surprise medical bills and massive out-of-pocket costs, they will be more likely to contribute to our consumer-driven economy. COVID has absolutely quelled consumerism; single payer can help to bring it back." Toby Terwilliger is an internal medicine-pediatric resident. He shares his story and discusses his KevinMD article, "Is now the time for single payer?" (https://www.kevinmd.com/blog/2020/07/is-now-the-time-for-single-payer.html)
Why cultural competency courses should be requisites for medical school
"Doctors are people, and people are capable of prejudice and discrimination. But, in medicine, there is no place for prejudice and discrimination because a patient's life is at stake. Stereotyping a customer and assuming that they cannot afford a certain product is emotionally hurtful, but it is far less dangerous than stereotyping a patient and misdiagnosing a life-threatening condition. The nature of the medical profession is handling a patient's life; doctors are the last line of defense between life and death. As such, doctors have to balance every aspect of the patient when choosing the right treatment, and ample evidence suggests that a patient's culture, including race, ethnicity, and class, is an important factor in determining a health outcome. With the stakes this high, it is vital that doctors understand the intersection of culture and medicine, and they understand it as soon as their journey into medicine begins." Shvetali Thatte is a premedical student. She shares her story and discusses her KevinMD article, "Why cultural competency courses should be requisites for medical school." (https://www.kevinmd.com/blog/2020/07/why-cultural-competency-courses-should-be-requisites-for-medical-school.html)
When physicians get sick: We are just as human as the patients we treat
"My experience with recent knee surgery that left me significantly disabled for over a month brought this to my attention yet again. I was completely dependent on others for basic self-care since I was unable to get in and out of the tub/shower without help. I was only able to walk with significant pain on crutches and was completely incapable of navigating stairs. Driving was out of the question. I experienced acutely the loss of independence that my older patients feel about having to surrender their driving license. I was unable to cook, clean, and interact with family since I was fairly bed-bound and sedentary until I regained my mobility. I learned several important lessons from this experience." Rizwana Khan is a pulmonary and critical care physician. She shares her story and discusses her KevinMD article, "When physicians get sick: We are just as human as the patients we treat." (https://www.kevinmd.com/blog/2020/08/when-physicians-get-sick-we-are-just-a-human-as-the-patients-we-treat.html)
COVID-19 is rattling the nerves of preemie parents
"With COVID-19, all of those memories have come flooding back. It is as if I am back in the NICU staring at that tiny infant and worried that she would get sick. Only now I have to pull myself out of that horrific daydream and stare at my teenager and pray that she will get through this. I am not alone in this. Parents of premature babies worldwide and some of whom had children on the very edge of viability are absolutely terrified. I also worry about the parents in the NICU now. I worry about the preemies that are now teens, young adults, adults, and in the elderly years. Each of them has at least one underlying health condition that can turn COVID-19 into a severe and yes, fatal case. To health responders and the health care professionals on the front end: I hear you on the seriousness of this illness. Thank you for guiding us on the challenges with COVID-19. You have us parents of vulnerable children and your former tiny patients backing up your concerns completely. To the general public heeding that concern to #stayhome and do the right thing by the young and the old and the immunocompromised, again, we are grateful. You are all our heroes." Deb Discenza is co-author of the Preemie Parent's Survival Guide to the NICU and founder, PreemieWorld. She shares her story and discusses her KevinMD article, "COVID-19 is rattling the nerves of preemie parents everywhere." (https://www.kevinmd.com/blog/2020/03/covid-19-is-rattling-the-nerves-of-preemie-parents-everywhere.html)
A palliative care physician's brain bleed
"As a runner, my pulse rests around fifty, but the ICU team had worried when it dipped to thirty-five, and my blood pressure hovered around ninety over fifty. Understandably, bags of saline were hung, and steroids were added. My headache improved, but my ankles disappeared, and I was often short of breath. Upon discharge, I went into full diuresis mode and spent the whole night after Thanksgiving toddling to and from the bathroom. As I passed through my parents' room, my mom, brows furrowed, muttered: 'You are going to pass out if you keep going like this.' Early in the morning, I was shaky and frail but wanted to take full advantage of the large oval bathtub with the delicious array of bath oils and loofas. I crept to my mother's side and informed her that I was going to take a bath, ignoring the nausea that was just starting to burn deep in my throat. I sat astride the tub and felt the warm stream of water flowing into the lattice of bubbles." Eve Makoff is an internal medicine physician. She shares her story and discusses her KevinMD article, "A physician's story: 'Please come quickly. My brain is bleeding.'" (https://www.kevinmd.com/blog/2020/06/a-physicians-story-please-come-quickly-my-brain-is-bleeding.html)
COVID-19 reveals gaping holes in locum tenens contracts
"I called the locum agency in the morning to air my concerns. To their credit, they admitted that the COVID-19 pandemic is an unprecedented event for which no one could have planned. They had developed a fund through which they could support health workers in need. If I took ill, I would have to call them for support. My health care will depend on the benevolence of the locum agency. My other concern predates COVID-19, but the potential of getting sick helps to clarify all sorts of work-related risks. If I were to develop a cough with sniffles and unable to work around children, I wouldn't have a timesheet to submit, and that would mean no income for the week to ten days while I am off sick. Now that my locum contract is over, but the COVID-19 pandemic rages on, I'd be hard-pressed to take another locum contract without health insurance and income protections. Locum agencies must be as meticulous with asking that their contractors have health and disability insurance, with the protection of incomes, as they are with credentialing and malpractice protections. These benefits should be offered by the agency just as they provide medical liability coverage." Koye Oyerinde is a pediatrician. He shares his story and discusses his KevinMD article, "The COVID-19 pandemic reveals gaping holes in locum tenens contracts." (https://www.kevinmd.com/blog/2020/07/the-covid-19-pandemic-reveals-gaping-holes-in-locum-tenens-contracts.html)
Health care should be apolitical, but it isn't
"COVID-19 is a tragedy that could have easily been prevented if our leaders cared more about the well-being of their citizens instead of economies, stock markets, and their political campaigns. To all those arguing about how the economy is more important, I ask, how will sick and dead people contribute to an economy? How will sick and dead health care workers contribute to our already broken health care system, which is a critical part of any economy? Before we decide to sacrifice our loved ones for the economy, we must remember that a nation cannot flourish if its citizens are not healthy." Rabia Jalal is a physician. She shares her story and discusses her KevinMD article, "Health care should be apolitical, but it isn't." (https://www.kevinmd.com/blog/2020/07/health-care-should-be-apolitical-but-it-isnt.html)
Anesthesia touches nearly every area of medicine
"I suppose those of us between zero and ninety-three are blessed in our own way as well. We are here, swirling in a jumble of the inconsequential and consequential. We've enjoyed some of the world's beauty and reserve the potential to experience more. Some of us will have longer than others, but perhaps we should focus on savoring rather than quantitating it. Even if it's only one more year. That's life. I have it on good authority that you can't get through it without a little pain. In the meantime, let us remember that it's never too late to chase dreams." Hailey Amick is an anesthesiologist who blogs at Facing Monsters. She shares her story and discusses her KevinMD article, "Anesthesia touches nearly every area of medicine." (https://www.kevinmd.com/blog/2020/07/anesthesia-touches-nearly-every-area-of-medicine.html)