In medicine, contrary to common belief, it is not usually enough to know the diagnosis and its best treatment or procedure. Guidelines, checklists, and protocols only go so far when you are treating real people with diverse constitutions for multiple p…
There was a time, before treatment algorithms, when physicians would rely on the detailed bedside and/or office observations of their patients in conjunction with the most recent published peer-reviewed studies. Time spent with each patient was conside…
One of my elderly relatives was in line at the grocery store one day and saw the person ahead of him, charging what looked like a cart full of junk food to her food assistance card. My relative was incensed: Why, should his hard-earned tax dollars be u…
A guest column by the American College of Physicians, exclusive to KevinMD.com. Regardless of specialty, medical practice is challenging in today’s health care landscape. Increasing demands related to workload and job inefficiencies, an ever-increasing…
Take 100 patients who are candidates for colorectal screening. We know that a group of them will try to avoid the procedure or postpone it for as long as possible. Evidence of this, for example, would be rescheduling appointments multiple times to late…
My brother and I are both physicians. He is a pediatrician; I am a geriatrician and palliative medicine doctor. We are both getting older. My brother has been a practicing pediatrician for almost 50 years. He had a remarkably successful solo practice i…
I scribbled my signature on a pharmaceutical rep’s iPad today for some samples of Jardiance, a diabetes drug that now has expanded indications, according to the Food and Drug Administration. This drug lowers blood sugar (reduces HbA1c by less than 1 po…
When I graduated from residency, I was too worried about killing my first few patients to examine the meaning of being an attending physician. An early patient, a 97-year-old retired doc, brought it to my attention. “Being an attending physician means …
As we approach Christmas, you only need to go to the nearest mall to witness the frenzied activity in preparation. People scurry around trying to find the perfect gifts for their loved ones and co-workers at the lowest prices. While gift-giving indeed …
So many primary care patients have several multifaceted problems these days, and the more or less unspoken expectation is that we must touch on everything in every visit. I often do the opposite. It’s not that I don’t pack a lot into each visit. I do, …
