Category: KevinMD

Reconciling consent culture and bodily autonomy with pediatric care

Every day, children are cared for in clinics and hospitals. And every day, some of them are unhappy about it; some of them deeply unhappy about it. The contemporary practice of nursing and medical care includes health care providers having to touch the…

Losing a patient in an emergency

“Are you f*cking serious! What are you doing to my son! How can you have him tied to the bed like this!” Michael’s* mother was irate and yelling at my resident as I stood at the back of the room. Michael had HIV/AIDS with a CD4 count of 20 and dissemin…

How to build trust and therapeutic relationships in 15-minute office visits

It is well known by now that a physician’s demeanor influences the clinical response patients have to any prescribed treatment. We also know that even when nothing is prescribed, a physician’s careful listening, examination, and reassurance about the n…

Why physicians should have courageous conversations

Many doctors make the decision to pursue a career in medicine in their youth.  They have an experience that points them in this direction.  And once the decision is followed by a firm commitment, we seldom change the course.  Medicine here I come! At t…

Use technology to fix medical education

Medical training is lengthening as students increasingly take gap years before and during medical school. Excessively long training times contribute to many problems. Trainees show high rates of burnout, depression, suicidal ideation, and alcohol abuse…

Stressed is desserts spelled backward

Tiramisu, chocolate mousse, red velvet cake, freshly baked cookies, and warm brownies topped with ice cream. These are some of my favorite desserts and the things I start thinking about when I am under intense stress. I often gaze at the bakery section…

Prescribing medication from a patient’s and physician’s perspective

At least a few times a year, I am asked to prescribe antibiotics to people who are not my patients. From my point of view, there is only one answer that makes sense here – no. I have the same reaction when patients call me for a refill or advice when I…

A health care headache from a patient’s perspective

As a relatively healthy Medicare patient, I do not visit doctors often. I have had digestive issues most of my life — probably from too many antibiotics when I was a child with recurring strep throat, or so I’m told. My husband and I had just ret…

You think insurance is confusing? Try being a patient.

My husband is a type 2 diabetic with mild chronic kidney disease, which has been well controlled on 500 mg metformin BID plus saxagliptin (AstraZeneca’s Onglyza). At the end of last year, he got a letter from his Medicare Advantage PPO, UnitedHea…

A doctor’s foray into meditation

It was mid-January, and I found myself catching some rays on a rooftop in Cancun with 15 other physicians — all women of varying ages and medical specialties. Besides enjoying the sand in my toes and a martini glass in my hand, I was there to attend th…