Category: KevinMD

You can measure the pulse of a hospital by its coffee shop

I think you can tell a lot about how things are going in a hospital based on the amount of consumption of coffee by its employees. Visit the Starbucks, Au Bon Pain, Roasterie, Einstein Brothers, or whatever coffee shop inhabits square footage in your h…

Doctors are pawns of the health care system

Doctors and other caretakers are the pawns of the health care system. We provide the services that allow hospitals and medical groups to bring in big revenue.  Unless we are contracting directly with insurers, doctors will never realize the true financ…

Physicians are trapped between patient satisfaction and unnecessary prescribing

I don’t mean to pick on McDonald’s. Insert any other large retail business where customer satisfaction massively trumps every other consideration of the relationship between employee and customer. Telemedicine companies have exploded the past few years…

The carefully crafted way of how health misinformation spreads

Effective clickbait doesn’t just happen. It’s carefully crafted. Take this wildly misleading article from CNN: Not exercising worse for your health than smoking, diabetes, and heart disease, study reveals. It’s one example — among many generated daily …

The main difference between functional medicine and evidence-based medicine

Figuring out what’s actually true is far harder than most people realize. Our brains are both hypothesis-generating machines and incredibly credulous. As a result, most of the things we believe to be true turn out to be false. We don’t just mistakenly …

PSA-based screening for prostate cancer: Interpreting the changing guidelines

Comparing the 2018 U.S. Preventive Services Task Force (USPSTF) recommendation statement on prostate cancer screening in the October 15th issue of American Family Physician with its previous recommendation, the first question family physicians ought to…

Urgent care isn’t the answer to our broken system

I’ve only worked four shifts of urgent care so far, but four 12-hour shifts means I’ve seen a lot: a lot of patients, a lot of different ailments, a lot of different reasons that people come to urgent care centers. I have to admit that this…

A medical student as storyteller and story-listener

“Sondor” is a made-up internet neologism that captures the fleeting but poignant sense of “the realization that each random passerby is living a life as vivid and complex as your own — populated with their own ambitions, friends, routines, worries and …

A CT scan for kidney cancer? It may depend on where you live.

About one in fifty people reading this essay will be diagnosed with kidney cancer at some time in their life. In fact, one out of one people writing this essay has already been diagnosed with kidney cancer. (I had a small tumor removed from my left kid…

We need more behavioral health treatment in primary care

I don’t know how many times a patient has told me, “I was in therapy once, and it didn’t help.” My response is always: “That’s like saying ‘I saw a movie once and I didn’t like it’.” That usually breaks the ice just a little. In primary car…