Net promoter scoring (NPS) measures customer experience and predicts business growth. Recently it is becoming more common for health networks to adopt NPS. The word “customer” should be a red flag. In medicine, we do not have customers; we …
Category: KevinMD
An approach to prior authorization insurance denials
Patient access to care is a high priority for all neurosurgeons. Unfortunately, many of our practices are thwarted in these efforts from unwarranted insurance denials. Know, you are not alone. Take this common scenario: When Ms. Mary Smith (not the pat…
How to transfer residency programs
Even though physicians do not talk about transferring residencies, it is more common than is often believed. According to the AAMC website, about 30 percent of residents do not finish the initial program they started. Quantifying that number further, t…
We need to change the way we talk about climate change
There was a point in my life when the words “climate change” would recall pictures of polar bears marooned on precarious chunks of ice, bobbing aimlessly in some foreign landscape of tundra and sea. While tragic, the environmental drama playing out at …
Having a baby makes you a very different physician
Beeeeeeeeeeep. The unmistakable long beep of my bright-red code pager broke the rhythmic sound of my trusty breast pump. I grabbed the pager silently praying it was a “test page.” No such luck. As I read the Code 45 message, I heard the overhead announ…
Stop shoving metrics down nurses’ throats
One time, I applied for an emergency department (ED) nurse manager position. I thought I had the job locked up until I was asked during the interview how I would “enforce metrics.” “Enforce.” My holistic, qualitative research-based response to this aut…
The pros and cons of practicing medicine in a rural setting
This article is sponsored by Careers by KevinMD.com. Wide open spaces. Fresh, clean air. No people for miles around. The advantages of rural living are plentiful, but there are disadvantages, too, especially when it comes to health care; being way out …
MKSAP: 25-year-old woman with ankylosing spondylitis
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 25-year-old woman is evaluated during a follow-up visit for an 18-month history of ankylosing spondylitis. She has minimal lower back pain …
Conversation with older patients is common sense
My 81-year-old patient came in several weeks ago and disclosed that he had stopped taking his aspirin after watching a news report on television. “They said I didn’t need it anymore,” he told me. I gently informed him that this news didn’t apply to him…
Non-therapeutic relationship or human kindness?
About two months ago, a 15-year-old Native American male was riding around in a stolen car on the reservation. “M” and the driver were drinking. And somehow, after he exited the vehicle at 4 a.m., the car struck him. Hours later, it became clear that s…
