Category: KevinMD

Health care needs more physician CEOs

If Atul Gawande’s first week as CEO of a health care startup was anything like mine, I hope he is able to get away from it all and enjoy a completely relaxing weekend. He will have earned it. After Gawande was named to head the joint venture between Amazon, Berkshire Hathaway, and JPMorgan, some critics said that choosing a […]

A physician’s gratitude

“Expressers significantly underestimated how surprised recipients would be about why expressers were grateful, overestimated how awkward recipients would feel, and underestimated how positive recipients would feel.” – Undervaluing Gratitude: Expressers Misunderstand the Consequences of Showing Appreciation The past 30 days have been unusual because of the number of professional gestures of gratitude I’ve received: I received […]

After you die, what will your legacy be?

As part of my job as an anesthesiologist, I get called to truly horrific airway events.  Sometimes they are down in the emergency department after a bad car accident, drowning, or burn.  Others are in ICU’s.  Sometimes they are even in hallways or bathrooms where people have stopped breathing or collapsed from cardiac arrest.  It’s […]

Love smart functions in your EMR? This doctor doesn’t.

How smart do we want our electronic health record to be? Somewhere between as dumb as a piece of paper and a pen, and too smart for our own good. Many, many years ago, before we spent the majority of our office visit staring at a flatscreen LED and typing away, our charts were simple […]

MKSAP: 46-year-old man with intermittent rectal bleeding

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 46-year-old man is evaluated for intermittent rectal bleeding of 3 months’ duration. He is otherwise well and takes no medications. His father had a few polyps removed from the colon when he was 71 years old, but no other details […]

Why medical errors can never be completely eliminated

A patient with progressive neurologic disorder had a gastrojejunal tube placed for feeding. In a nursing home, the tube fell out and was replaced with a Foley catheter. He was sent to the hospital for placement of a new tube. When he arrived in the interventional radiology suite, the Foley catheter was not visible. A […]

The surprising secret to mental wellness

When did it become a bragging right to say that you only get four or five hours of sleep a night? We would think it is ridiculous for someone to brag that their labs came back with only half the normal hemoglobin level as we would recognize that as clearly unhealthy. So when did we […]

A case for paying doctors more

Engaging in an economic conversation about the conventional compensation of a physician leads one to believe that doctors are well-to-do. In the minds of most citizens, school-tuition board members and even local neighbors, if you’re a physician the presumption is that you are economically prosperous, maybe even rich. This sociological assumption probably sounds false to […]

A physician’s group disability nightmare

My last operative day was October 15, 2009. My last attempt at getting to understand my group disability policy was on May 10, 2018. I’m a disabled anesthesiologist who lost his career when my left median nerve stopped functioning properly. I had two disability policies, a private and a group. My dealings with these two […]

Is there a case against shared decision making?

In a matter of less than a decade, “shared decision-making” (SDM) has emerged as the uncontested principle that must inform doctor-patient relationships everywhere.  Consistently lauded by ethicists and medical academics alike, it has attracted the attention of the government which is now threatening to penalize doctors and patients who do not participate in SDM prior […]