Category: KevinMD

MKSAP: 75-year-old man with progressive dysphagia

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 75-year-old man is evaluated for progressive dysphagia of 8 months’ duration for both solid food and water, and the necessity to indu…

A disturbing study about children and guns

Children are relatively healthy overall. Although 25% of the American population is under the age of 19, only 2% of annual deaths occur in this age group. There was a time when the contributions of diseases to pediatric death rates were much higher. De…

How opioids can destroy the most beloved of personalities

“I feel like a caged animal” — My patient offered me this lens through which to view his life seeped in chronic pain. For him, pain dictated his entire sense of being — it was something that simply could not be distilled down to a single value on a 10-…

How opioids can destroy the most beloved of personalities

“I feel like a caged animal” — My patient offered me this lens through which to view his life seeped in chronic pain. For him, pain dictated his entire sense of being — it was something that simply could not be distilled down to a single value on a 10-…

Fixing physician burnout means changing the culture of medicine

A talented young physician was concerned about her job at Michigan Medicine, where we both work. She thought she might have to leave the organization because she could not meet mandatory early-morning start times for procedures or outpatient visits. Sh…

8 ways to go broke as a doctor

So much of personal finance and investing isn’t about winning; it’s about not losing. That’s because investing is a single-player game; it’s you against your goals, not you against your neighbor or your partner or some yahoo on an internet forum. Howev…

Patients turn to GoFundMe when money and hope run out

Tammy Fox wanted to help after a friend took ill with a rare and difficult-to-diagnose autoimmune disorder that required many trips to the Mayo Clinic. Although Fox couldn’t do anything medically, she knew there was a way to ease some of the burden of …

The culture of permission in medicine

During the recent winter break, I went home and visited my yearly slew of doctors for check-ups: vision, dental, gynecology, etc. In the exam room, my new gynecologist instructed me to put my feet up in the stirrups. I had recently learned in a seminar…

A shortage of Kayexalate leads to an ER visit

Last week I had a patient with mild kidney disease and a high potassium. I thought that it would be easy to take care of. We called around to all the pharmacies from Bangor to Ellsworth to Belfast, and nobody had Kayexalate, the time-tested antidote, i…

Health care organizations have to take better care of their employees

Anybody who has even a passing interest in health and wellness knows the sobering fact that a large number of medical problems that plague society today are the result of unhealthy living habits. Conditions such as heart disease and diabetes, which are…