Category: KevinMD

What’s life like after not matching? A physician’s story.

Match Day is the culmination of a medical student’s education: the day all graduating seniors and non-traditional applicants find out where they will spend the next three to seven years to train in a desired specialty. I fell in love with obstetrics and gynecology (OB/GYN) as it was the perfect way to combine my passion […]

MKSAP: 25-year-old man with dark-colored urine

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 25-year-old man is evaluated for dark-colored urine for 2 days, swelling of the face and hands for 1 day, and severe headaches this morning. He reports having an upper respiratory tract infection 1 week ago with fever, sore throat, and […]

The rewarding and grueling process of residency application

I woke up to the sound of a faint “ding” from my bedside table. It was 5:24 a.m. Shaking off my lethargy, I scrambled over to my phone because the ding meant one thing: my first residency interview invitation. Looking back on that moment, as I responded in the dim light of the morning, I […]

The fine line between dementia, sex, driving, and money

How do we balance freedom and safety for those with dementia, particularly in the risky domains of sex, driving and money? In 2014, Henry Rayhons, a 78-year-old Iowan, was arrested because he allegedly had sex with his wife. Wait. What? The Rayhonses, both previously widowed, met while singing in a church choir. Over time, Mrs. Rayhons […]

A physician mother and her son

Recently I was saying goodnight to my oldest son, who is now 14 and about to enter high school. I was standing in his bedroom looking at his midnight blue walls, which are covered in each of the planets. He looked up at me from his Pottery Barn bunk bed and said, “Mom, I need […]

Can direct primary care save us from the tapeworms of insurance?

When Amazon, Berkshire Hathaway, and JP Morgan (AmBerGan) announced their health care partnership, Berkshire CEO Warren Buffett declared “the ballooning costs of health care act as a hungry tapeworm on the American economy.”  He is right. Our broken system is infested with tapeworms. Tapeworms are parasites; they exploit their hosts, drain resources, and suck the […]

Why this gastroenterologist decided to treat hepatitis C patients

In a prior post, I shared my heretofore reluctance to prescribe medications for my hepatitis C (HCV) patients.  In summary, after consideration of the risks and benefits of the available options, I could not persuade myself — or my patients — to pull the trigger.  These patients were made aware of my conservative philosophy of medical practice. […]

A physician’s first financial advisor

I usually simplify things here on the blog.  Sometimes it is easier to glaze over a part of the story instead of pulling out all the details.  Others, the point is clearer when not bogged down by tangentially related details.  What’s lost in nuance, however, often adds shades of complexity to the picture.  Occasionally another […]

Artificial intelligence in medicine: not ready for prime time

July was an interesting month for artificial intelligence in medicine. A study from MIT found when human doctors order tests on patients, they factor in something that artificial intelligence is not currently aware of. The authors analyzed charts of about 60,000 ICU patients admitted to Beth Israel Deaconess Medical Center in Boston. By looking at […]

It’s time for an army of people to help take care of our patients

This was the end-of-the-hallway conversation with an elderly patient after wrapping up a recent office visit, as we walked away from the exam room toward the front desk to schedule her follow-up appointment, and she realized that we were “celebrating” 20 years together. I met her when she was admitted as an inpatient when I […]