Category: KevinMD

The Resident and Fellow Bill of Rights

Last June, I became a freshly-minted young doctor, bright-eyed, and enthusiastic about heading off to my dream residency program. By August, I found myself crossing the street on my way home, wondering if I had made a horrible mistake that could have h…

We must hold the government accountable for the health of the most vulnerable

898. This is the number of cases of mumps that occurred in migrant detention camps in a 12-month period between September 2018 and August 2019. According to the Center for Disease Control (CDC), 84% of the migrants who contracted the illness did so whi…

Applying for residency? Read this first.

Residency application season has begun! When I was applying last year, I spent a lot of time thinking not just about what programs I wanted to go to, where I wanted to live and how best to answer “Where do you see yourself in five years?” —…

Moral injury from a primary care perspective

The backbone of a great health care system is its primary care task force. From Singapore to France, elite health care systems rely on these cerebral doctors to provide preventive, urgent, and acute care along with chronic disease management. Primary c…

Physicians: Constantly focus on raising your game

A couple of months ago I was having a conversation with a good friend of mine, who is a doctor in England. We were talking sports, specifically tennis at Wimbledon and the superb performance of Roger Federer. He made a remark that I thought was great o…

Our doctors are dying in medical school

It’s fascinating — the strange clarity that a little panic brings. I remember thinking this in the days after, startled at the level of detail in my memories of the first time I watched a patient die. “Just got a call, transport’s bringing in a code. Y…

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…