Category: KevinMD

Is direct contracting an answer to soaring health costs?

Colorado’s ski resort areas in Summit County have a high cost of living, among the highest in the country. The people who visit these places — Keystone, Breckenridge and Copper Mountain ­— can afford it. Many of those who live and work there can’t, esp…

The medical record often doesn’t capture the care of the clinician team

While my forty-year parts warranty expired some time ago, leaving me with a snapped fibular styloid process not long after, the ensuing twenty-five years have not resulted in any serious medical encounters until last week.  Following a very pleasant ea…

Communicating honestly with patients about uncertainty

When looking at the way medical education and patient care is delivered, there is no question that there is a culture of “knowing.” From the moment a pre-med enters high school, they are bombarded with tests that assess knowledge. This extends througho…

Communicating honestly with patients about uncertainty

When looking at the way medical education and patient care is delivered, there is no question that there is a culture of “knowing.” From the moment a pre-med enters high school, they are bombarded with tests that assess knowledge. This extends througho…

It’s time for physicians to bring clarity to their lives

I meet doctors in different arenas.  I meet them in clinical settings, at conferences, and by referral. I am noticing a trend. We are keenly aware of what we do not want in medicine. We talk about physician burnout and the impact it has on doctors’ liv…

Health insurers and physicians are not partners

On the face of it, this seems like a fairly simple business arrangement. My patients or their employers pay money to a health insurance corporation so they, in turn, have sufficient funds available to pay medical claims for services I render. That simp…

When Medicare stops covering a test without warning

There are two versions of “the conversation” we have with men: One is for teenage boys, and it is about wet dreams, sexually transmitted disease, unwanted pregnancy and at one point also about testicular self-examinations. Those have now been edited ou…

Convincing patients to stop cancer screening isn’t always easy

During my training to become a primary care physician, the importance of preventive cancer screening was ingrained in me. The idea of catching cancer at an early stage so we can better treat it made intuitive sense. But as I’ve learned over the years, …

What is low-value care, and why does it matter?

Doctors and policy wonks hear a lot these days about “low-value care.” What exactly is that, and should you care? The term refers to tests, medications, and procedures that add little to a patient’s health or well-being but which cost them or the syste…

Work getting you down? What you watch on TV might be making it worse.

As a trauma surgeon, it’s my job to diagnose and fix the violent destruction of the human body. One of the questions I get asked very frequently is, “How do you deal with that?” My standard answer is, “After a while, you get used to it.” And while I re…