Category: KevinMD

The brother I never knew. The mother I never had.

The brother I never knew. He was buried in an unmarked grave with other dead babies. 1960. I am now the age my mother died. She was 64 years old: colon cancer. She was a vacant, negligent mother. During one of my psychology classes in nursing school, w…

A psychiatrist can’t help patients anymore

I bid farewell to four people this month who I’ve been caring for in my outpatient psychiatry practice — all under sensitive circumstances but ultimately moving in positive directions. As I write formal discharge letters, the unique role psychiat…

What is the Trump health plan for 2020?

The Republicans don’t yet have a health care plan less than a year before the 2020 elections. But based upon their 2017 Obamacare repeal and replace efforts, as well as a major document recently issued by the House Republican Study Committee, wha…

Let’s do better for patients with limited English proficiency

I’ve noticed a theme in my clinic since I started practicing medicine: when a patient understands what is being said about their care, treatment, and services, they’re more likely to fulfill critical health care responsibilities. No one sho…

MKSAP: 60-year-old man with exertional chest discomfort

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 60-year-old man is evaluated for a 5-month history of exertional chest discomfort that improves with rest. His symptoms have progressively …

The erroneous belief that the elderly have the healing power of younger individuals

A wise professor of medicine always told me as a young physician, “Eighty-year olds are to be revered and not messed with.”   This is especially true for those 90 or older.  Here in South Florida, there is always some senior citizen telling us today’s …

Chronic illness? Have faith in medicine.

I am healthy, a mom of two boys, a wife, and an emergency medicine PA for the past 12 years. I don’t just say I’m healthy to say it, but I really am. I’ve never taken medications, until now. It’s New Year’s Eve, and I&#821…

A paradoxical fix to physician burnout: more patients, less supervision

Most physicians recall the rigors of their residency training through a mixed lens. In prior generations, a single-duty shift could stretch to 36 or more consecutive hours, but the exhaustion was buoyed by the camaraderie of sleepless on-call nights in…

How special interests won big and consumers lost big

As the year winds down and must-pass year-end spending bills are completed — and with that, any chance of attaching and approving health care legislation — the special interests have won big, and consumers have lost big. Employers, unions, …

Doctors: Always be prepared to suture wounds

Ninety minutes before my Sunday night shift, my two-year-old, Titan, comes screaming up the stairs looking like a scene out of a slasher horror movie. His older sister sheepishly admitted to chasing him into the edge of a door frame. We created an ED b…