Category: KevinMD

The Wild West approach to PICU practice

I spent my early and mid-career years working in a pediatric intensive care unit (PICU) at a large academic center. We did almost everything except for a few things esoteric at the time — small bowel transplants, a few kinds of experimental surgery. I’…

The millions of dollars hospitals spend for inspections

Two of my local hospitals just invested 3 to 4 million dollars in preparation for an inspection of the facilities by the Joint Commission. The cost of the inspection runs in the $10 million dollar range after the preparation costs. The inspection is a …

A community-based program that brings patients and pathologists together

When I was in medical school, I loved pathology. The visual learning and deep understanding of disease were attractive enough that after second year, I took an extra year before clinical rotations to work as a post-sophomore fellow, working as a reside…

Is it possible for physicians to oversave? And what can you do about it?

Q. Have you ever thought about doing a post on oversaving? I realize most docs probably have the opposite problem, but I bet there is a subset of the FIRE crowd that this may apply to. Does this ever come up in all the interactions you have? A. It was …

What you need to know about acute flaccid myelitis

You’ve probably seen it on the news – a rare, polio-like illness is causing cases of paralysis in children. Here’s the latest info, based on our best current knowledge from the CDC. Acute flaccid myelitis (AFM) is a sudden illness that causes weakness …

What you need to know about acute flaccid myelitis

You’ve probably seen it on the news – a rare, polio-like illness is causing cases of paralysis in children. Here’s the latest info, based on our best current knowledge from the CDC. Acute flaccid myelitis (AFM) is a sudden illness that causes weakness …

Disability can be a devastating outcome to a doctor’s career. Here’s how handle it.

Disability can be a devastating outcome to a doctor’s career and self-image. Think about it: You busted your butt to learn how to do a Whipple procedure, end up getting into a skiing accident that ends your career right there. No worries, because you p…

Medical clinicians are being stress fractured

An excerpt from Leadership Lessons from History: A Study Guide Written for Physicians & Other Healthcare Leaders. In June 1812, Napoleon invaded Russia along with an army of 600,000 men; fewer than 100,000 made it back. During their ignoble militar…

Emergency physicians: You rock!

I am a critical care physician and spend a good amount of time in the emergency room seeing consults. As an internal medicine resident, we were often in the ER, admitting new patients. In my three years of residency, we spent only two to four weeks wor…

A medical student takes a look into the abyss. Here’s what he learned.

After my surgery rotation, I was in a very bad place. I felt like two months of grueling work hours and relentless studying were wiped away in an instant by a bad test score. That single number somehow mattered more to me than every positive comment I …