In the emergency department, we see them all the time. The person with a medical problem too serious to ignore, but not quite bad enough to require admission. The patient referred to the specialist who comes back to the ER. “I couldn’t afford t…
Category: KevinMD
“I did not want a baby”: A medical student faces her hardest choice
I did not want a baby. As a 26-year-old third-year medical student who had quite recently ended a far from ideal relationship — of this, I was certain. On vacation, in New York City, walking in Soho carelessly, I laughed with my friend Noelle ov…
How to structure financial incentives in our health care system
Next in a series. In my previous post, I explained the basics of my Healthcare Incentives Framework, which enumerates the jobs we want a health care system to do for us and links them to the parties in the health care system that have the greatest ince…
MKSAP: 28-year-old woman follows-up after a pre-employment physical examination
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 28-year-old woman undergoes follow-up consultation regarding a pre-employment physical examination. She reports feeling well, with no recen…
Parallel thinking won’t solve problems in health care
A lot of media attention, including television, print, and online sources, is focused on various plans to revolutionize the delivery of health care in America. Critics point to medical errors, waste of resources, and lack of access among the numerous …
What physicians should know about good debt vs. bad debt
As a young college student or post-grad, you may have accumulated credit card debt. I certainly did. However, somewhere in the process of “adulting,” you may have realized that having lots of debt isn’t a good thing. You may have even heard investment …
The devastating impact of being told one has cancer
As an oncologist, I have seen the devastating impact of being told one has cancer. The reaction I most often see among my patients is fear that they’ve been given a death sentence, an urgent need for a plan, and hope that they will survive. I often wan…
Cancer can be an adventure into the soul
Storytelling is as old as humanity. In telling our stories, we share, learn, and ideally pass along wisdom. As Isak Dinesen once wrote, “To be a person is to have a story to tell.” This story starts with PW’s cancer diagnosis in 2009….
Psychological safety in health care: simple, important, fragile
With the epidemic in health care of overwork, stress, and burnout, psychological safety is a crucial factor in achieving the highest levels of quality of care and quality of work environment. While simple in concept, psychological safety is also quite …
Data has become a four-letter word in primary care
We primary care physicians hate data. Taken on their own, numbers are benign, but when we hear the word “data,” physicians are reminded of a litany of related issues that make our lives far more difficult: checkboxes. Regulatory compliance….
