Category: KevinMD

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…

How do health insurance companies harm patients?

Health care policy has been a hotly debated political topic for many years now. In recent years, new laws passed the halls of Congress while others failed to gain any traction. Despite the rules that have rolled out, health insurance companies have bee…

Be a master at your craft by taking time each day to truly rest

I am bad at taking vacations — really bad. It’s not that I don’t take days off or even travel on days off. It’s my near inability to actually unplug and not bring work with me. Despite recovering from a level of burnout a few years ago that left me con…

This attending learned so much from her residents

While riding shotgun in the family minivan on the way home from a fall break water park trip, I received the following text message: I thought of you today! One of the residents here had done a great job with a complex (and really sad) labor and delive…

Are physician wellness programs just another checkbox?

Recently, I saw a photo of a slide from the American College of Surgeons Clinical Congress: “The Program Directors Guide to Implementation of Well-being Programs.” While I applaud the ongoing focus in medicine on wellness for both trainees and faculty,…

We are in danger of hospitals no longer being safe havens

On the outside, most American hospitals appear completely modernized. If resources are utilized correctly, they appear equipped for any disaster, any CMS audit and any surprise joint commission inspection that may come. The procedural appearance of hos…

Have difficult conversations now to avoid chaos later

“Before I leave, I want to talk to you about something very important. I want to make sure that nothing is ever done against your wishes, so it doesn’t matter if you’re 18 or 98 years of age, if you’re a patient being admitted to the hospital, I …

A patient’s experience of chemotherapy and radiation

I had my first mammogram at age 35, and for the next 35 years I had mammograms regularly. On my way, I’d pass the entrance to the Thomas Johns Cancer Hospital, outside of Richmond, VA, never thinking that I’d one day cross that threshold my…

This is what the face of resilience looks like

At the age of 17, my younger sister Elisabeth noticed a change in her body — enlargement of the front of her neck. “I just thought I was building muscle from working out,” she innocently rationalized. A series of laboratory tests and imaging followed a…