I must confess that I love my job as a hospital medicine doctor. To me, very few specialties in medicine can be as rewarding as the one I’ve had the privilege of practicing for the last five years. We manage an array of medical illnesses, interact with staff from across the hospital in every different specialty, and follow our patients all the way through their—hopefully very short—hospitalization. We take ownership …
Please don’t call me a hospitalist
“My wife gets migraines—really bad ones—and now my daughter seems to be getting them too. She’s only 7! Is she just copying what her mom does? Can a child really start getting migraines?”
Oh, yes they can. Migraine is very much a childhood disorder. About 5% of adults have migraines, and half of them started having their migraines as kids.
As in adults, migraines in children can be severe and debilitating. However, …
Migraine is very much a childhood disorder
Medicine is about balancing risk and benefit. Certainly, as healthcare providers, we attempt to provide the best care for our patients based on available evidence. Physicians often are seen as shepherds, helping to guide patients through disease and therapy. As I have mentioned in previous blogs, ultimately medicine will be personalized and tailored to one’s particular genetic make-up. However, the need for a clear discussion of treatment options …
We must change how we discuss procedures with our patients
We think the reason doctors rarely make house calls is money. Doctors can charge, but it is hard to charge enough to justify the time it takes to drive door-to-door, fill the tank and attend lengthy visits. Thus, the house call has faded into history. However, I have another theory about the end of this valuable service: perhaps it is increased emotional distance between patients and their doctors.
I watched an …
Another reason why the house call is dead
I first picked up an ultrasound transducer 17 months ago, at an emergency medicine ultrasound course at Harvard University. I had just barely heard about using ultrasound as a clinical tool and was vaguely interested. The course was 3 days long and cost a little under $700 and changed my life forever and made me a better doctor.
Emergency physicians have embraced the …
Bedside ultrasound tips for the general internist
How should doctors behave online? This is a funny question, isn’t it?
Medical establishment loves rules and hierarchy. Social media does not. Social media levels the playing field of who gets to talk; it gives real caregivers a voice. That’s very cool.
This is just a guess, but I suspect there are many more acts left to play out in the healthcare social media play.
The American College of Physicians and the Federation …
10 simple rules for doctors on social media
A guest column by the American College of Physicians, exclusive to stg-kevinmd-staging.kinsta.cloud.
English is the international language of medicine, according to many. Regardless of whether that is true, what is becoming increasingly clear is that English is the second language of medical documentation. For those of you who blame EHRs for this, the replacement of English by something else started …
English is the second language of medical documentation
As a physician, I experience first-hand the impact that internal communication at a hospital—both good and bad—has on patient care.
If I am able to quickly access clinical systems, analyze patient information and collaborate with colleagues, I can diagnose and interact with the patient much more efficiently and effectively. Conversely, breakdowns and inefficiencies in the communications process can inhibit the delivery of quality patient care by bogging down workflows, creating delays …
The impact of outdated communications technologies in healthcare
Part of the KevinMD toolkit series.
“How can I find a doctor online?”
A seemingly simple question, but patients are often confronted with too much information on the Internet, with variable quality.
Finding a doctor a similar to completing a puzzle. Like puzzle pieces, there are many resources available, including word of mouth, hospitals, insurance companies, and physician …
Finding a doctor online and researching your physician on the Internet
My interview series continues, this time with local litigation attorney Andrew Thompson, Esq. The topic this time is medical malpractice. I asked him a bunch of questions. He answered. See what you think.
1. In your opinion, is there a medical malpractice crisis in this country?
No. This is not even a close issue. The concept of a “crisis” or dramatic increase in the number of medical malpractice cases is a fabrication …
A surgeon interviews a medical malpractice attorney: Read and decide
Should doctors be able to write?
At first glance, this might seem like a question with an easy answer.
Yes, you might say, doctors receive a doctorate and are trusted with communicating to and about people at critical moments in their lives. Or you could reply, No, they are scientists and so need to be functional communicators able to write basic notes and prescriptions, and …
With the announcement that the FDA granted 510(k) approval for the AliveCor EKG case for the iPhone 4/4S, the device became available to “licensed U.S. medical professionals and prescribed patients to record, display, store, and transfer single-channel electrocardiogram (ECG) rhythms.”
While this sounds nice, how, exactly, does one become a prescribed patient? Once a doctor prescribes such a device, what are his responsibilities? Does …
The legal risks of prescribing the AliveCor ECG
Too often patients feel like they’re in the passenger seat when entering the hospital. Even in the best of circumstances — such as planned admissions — patients often don’t feel in control of their own care.
One of the most unnecessary issues facing patients when they enter the hospital is untreated (or undertreated) pain. Often the focus of the medical team is to treat a condition, and controlling a patient’s pain …
How to have a hospital stay without pain
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Psychotic and manic depressive disorders can not only disrupt the life of the person suffering with one of these illnesses, but the lives of family and friends as well.
You should seek professional advice if you suspect that you, a friend or a relative or even a spouse may be experiencing a psychotic or bipolar disorder. It’s important not to attempt a diagnosis yourself. There are many external factors that can …
Understanding psychotic and bipolar disorders
I am a physician, an anesthesiologist. I care for the sickest of the sick every day – struggling NICU babies born only hours earlier, victims of major traumatic accidents, and critically ill patients with life threatening illness. In this job, I must both connect with the patient, but also maintain a distance from them at the same time. Dealing with life threatening …
Being a caregiver has made me a better doctor
If you’ve read my reviews of the new medical TV show Monday Mornings, you’ll know I’ve been critical of many things about it. I was particularly disappointed with the way the show handled one of its central themes: the morbidity and mortality (M&M) conference.
I thought it might be useful to tell you how most real M&M conferences are run. M&M conferences generally take place at hospitals with residency training …
What really happens in a morbidity and mortality conference
One of the more contentious topics on my site is the scope of practice for non-physician providers, such as nurse practitioners. This echos the debate on the national stage where leaders of physician organizations, who want to protect their scope of practice, conflict with those of nurse practitioners’, who want to perform the tasks that physicians traditionally have.
Simply Google “nurse practitioner” on this site, for instance, and you’ll see …
How I would end the war between nurse practitioners and doctors
Ah, the addictive power of modern food. Never underestimate it.
On a recent trip to New York I happened to be flipping through the channels on my in-flight TV when I ran across Mike Huckabee doing an interview on Fox News. I was surprised to see that he had gained his weight back. The former governor of Arkansas and presidential candidate had staked quite a bit on the success of his …
Did Mike Huckabee foreshadow his journey back to obesity?
I used to be a stickler for time. One of my first blog posts was about how it felt to go to work without my wristwatch.
I also used to be very particular about knowing the purpose of each visit, partly to help me manage my time, and partly to help me feel prepared and in control of the visit.
I often questioned why my colleagues’ patients would sometimes end up in …
What is the role of the physician in today’s health care system?
Here’s a joke I love: A man goes to an old-school psychiatrist who, at the first session, administers some Rorschach tests.
“Just tell me the first thing that comes to mind,” the doctor instructs the patient as he shows him the ink blots.
“Sex,” answers the patient.
“I see,” says the doctor. “And this one?”
“Sex.”
“And this one?”
“Sex again.”
“Well,” says the doctor, “I see we will have to work on your obsession with sex.”
“Me??” …
The controversy over DSM-5 and the cataclysm in mental health
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