Category: KevinMD

A physician contemplates Medicare blended rates

I am a terrible coder. I think I am a pretty good doctor, but when it comes to coding, the process of figuring out which billing code to pick to assign to a bill for an office visit, I am hopeless. No matter how many times I have had the rules explained to me, or […]

The many ways to describe chest pain

There are at least 50 words in the Eskimo languages for snow, 25 in mainstream Swedish, and supposedly 180 or so in the Sami language of the nomadic inhabitants of the northernmost parts of Norway, Sweden, and Finland. But there are even more words than that for “chest pain” among my patients, many of whom […]

Don’t worry, this psychiatrist won’t analyze you

“Oh, you’re a psychiatrist? I hope you won’t analyze me!” I never know what people actually mean when they say that upon learning that I work as a psychiatrist. I think they’re saying, “I hope you’re not going to spend our time together trying to discern my flaws.” Nobody wants people to seek out, highlight, and […]

Behold the power of gratitude

Gratitude may be more beneficial than we commonly suppose. One recent study asked subjects to write a note of thanks to someone and then estimate how surprised and happy the recipient would feel – an impact that they consistently underestimated. Another study assessed the health benefits of writing thank you notes. The researchers found that […]

Sorry doctor, you’re already an actor

Following one of my recent articles on how physicians can improve their communication skills and ultimately help attain better patient outcomes, I received an interesting comment from a physician. It went something like this: “Sorry, but I’m not an actor.” This response typifies a small (but not insignificant) subset of responses I get when I’m […]

Structure case conferences as a primary way to teach and learn

When we studied ward attending rounds, the thought process represented the top attribute that learners valued.  Learners can learn facts from textbooks, but using those facts requires experience and role modeling. I have given many lectures on clinical reasoning, and I have attended many lectures on clinical reasoning.  These lectures can entertain, but one lecture […]

Dear science: an appreciation

Dear science, Today my sons, Oliver and Victor, are 15 years old. It is not a miracle; it is thanks to you. Unable to get pregnant I needed infertility therapy. If you had not isolated the hormones, developed tests, and then designed medications for ovarian stimulation and to trigger ovulation I would never have become […]

Hospital mergers and the risk to patient safety

“Better patient care” is the reason hospital and health systems usually give when they merge or acquire one another. Our research suggests that mergers and affiliations might, paradoxically, increase the risk of harm to patients in the short run. Improving the safety of patient care is possible during mergers and affiliations, but requires intentional efforts. […]

4 disturbing trends in health care

It’s easy to get excited about technological advances such as nanobots that swim in blood to deliver drugs or 3-D printers that print human tissues. However, in our enthusiasm to find the next fix, we are failing to notice the ground slipping underneath the health care industry. Here are four trends that are changing health […]

Think you have an iodine allergy? You may want to reconsider.

Let’s begin with a quiz question: Patients may be allergic to: A. oxygen B. carbon C. iodine D. none of the above If you answered anything but “D,” better keep reading. Consider this scenario: If a patient is allergic to penicillin, you would document “penicillin” in the medical records. It would never occur to you […]