Category: KevinMD

The unintended consequences of keeping hospital patients in bed

Dorothy Twigg was living on her own, cooking and walking without help until a dizzy spell landed her in the emergency room. She spent three days confined to a hospital bed, allowed to get up only to use a bedside commode. Twigg, who was in her 80s, was…

Crossing the threshold when residency begins

Today, I’m thinking about the end of residency. But first, let me tell you about the beginning of residency. My first day of clinic, my very first week of residency, I had a grand total of one patient scheduled. A seasoned, outgoing resident had given …

Expensive Medicare patients aren’t who you think

Over half of Medicare spending is concentrated in 10 percent of patients. With Medicare expenditures rising at an unsustainable clip, reigning in the costs of those patients is key to controlling health care spending. So who are those patients and what…

We need physician leaders who understand our problems

You cannot work in medicine today without being inundated with burnout statistics and commentary on your feed, coming to your inbox, or spoken from stages about the state of medicine we are in. The data is dire: we are disengaged, we are making mistake…

4 significant misconceptions about universal health care systems

Recent polls show a majority of Americans support Medicare for all, but few seem to realize that no other system in the world operates like the current single-payer proposals in Congress.  I addressed the concept of single-payer health care, with Cuba’…

How internal medicine got its name

A guest column by the American College of Physicians, exclusive to KevinMD.com. Of all medical specialties, perhaps the most difficult to understand is internal medicine. While the name suggests that those who practice internal medicine focus primarily…

When you’re a physician, you’re a detective

A professor recently romanticized my idea of clinical reasoning as he began our session by saying, “When you’re a physician, you’re a detective.” He elaborated: “Every fact you have, every piece of evidence you have, must …

Why we need more transplant physicians

During the 25 years I’ve been a transplant doctor, I’ve cared for hundreds of patients who received lung transplants. I’m now worried about the growing number of people who will need this lifesaving procedure in the future but who won’t have enough tra…

Why this medical student chose to pursue medicine

Pain and suffering together is a universal language. It is unspoken, one that a person of any age feels when they see a loved one die, or when someone sees another human being suffer when nothing more medically can be done. I once saw a Vietnam War vet…

How “Joker” gets mental illness wrong

Spoiler alert: Plot points of the movie “Joker” are revealed in the following piece. “Joker” opened to a mix of rave reviews and criticism on October 2, 2019, amid fears of mass-shootings at theaters in the U.S. This left law en…