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…
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…
“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…
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…
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…
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…
“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…
“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…
“That’s great. You want to start a women in medicine program! How are you going to pay for it?” This is the most common question and potential barrier from colleagues, leaders, and those who understand the value of these programs. We found that our tw…
Medicine is very much like driving. As an emergency physician, when you see a patient, you ask the same questions, “What brought you in today? What’s bothering you?” and go through the normal flow of the history and physical. You order the same labs an…
