“If you are happy with where you are in the current system – that is wonderful, continue what you are doing. However, if you are feeling trapped, frustrated, or like the work you are doing is no longer meaningful, then there are plenty of opportu…
Category: primary care
A student’s volunteer experience at a mobile outreach clinic
In my junior year of high school, I applied for and went on an educational mission trip to the Dominican Republic. Being the son of Uruguayan immigrants, I felt at home in the rural setting while my many classmates marveled at their first view of a cul…
The health care documents needed at each stage of life
If your 85-year-old mother was rushed to the hospital, would you be able to get the information you need about her condition from the doctors treating her? If your college-age son showed signs of severe depression, could you talk to his therapist? What…
Metric shock: the unintentional consequence of measuring
Health care in U.S. hospitals is suffering from three under-recognized conditions that I will refer to as “Metris,” “Severe Metris” and “Metric Shock.” Metris occurs when a health system begins to focus more on achieving certain metrics than on improvi…
Rest in peace, primary care [PODCAST]
“The corporatization of medicine has destroyed primary care as a specialty. The primary care physician is supposed to be your go-to doctor, your advocate, the coordinator of your health care. Now that corporations buy out hospitals and private pr…
Physicians should heal themselves first
I was trained in delivering bad news. I knew what to expect. I knew the questions that would come. I have learned the stages of grief. More importantly, I had done this before many times in the past 15 years. This is my job and my responsibility, I tol…
Bloated notes are a huge problem and a time suck
In a moment of caffeine-depleted delirium, I volunteered to head the creation of a “notes committee” for my 80-member hospitalist group. I placed myself on a 72-hour hold and quickly established a group consensus: “Bloated notes are a huge proble…
Reflections of an aging physician
A guest column by the American College of Physicians, exclusive to KevinMD. I recall with crystal clarity the day I finished my residency training and thinking to myself that at that point in time, I probably knew the most medicine I ever would. Fast f…
An acupuncturist’s take on the doctor-patient relationship [PODCAST]
“Every professional I have done the exercise with admitted that their ideal patient was inspired by someone they were close to in their personal life. It was usually a family member, a best friend, or themselves. The ones who carry the most unbea…
What role does the science of complexity play in medicine? [PODCAST]
“The science of complexity lays a conceptual foundation for understanding “complex adaptive systems.” What all complex adaptive systems have in common is that they are all bound by the same set of physical laws. Their “behavior,” i.e., growth, ma…
