Like many primary care physicians in this health care marketplace, I found myself operating on a hamster wheel of volume care, seeing more and more patients and spending less and less time with them. The pressure on my practice, my patients and my sta…
Category: primary care
When should you be tested for vitamin B12?
Two recent patient experiences prompted this post. In the Wall Street Journal, Dana Hawkins-Simons described several years of being seen by specialist after specialist for her complaints of tiredness, dizziness, ringing in the ears, palpitations, short…
In our health system, who “owns” patients?
A guest column by the American College of Physicians, exclusive to KevinMD.com. When talking with patients – particularly those with multiple, complicated medical issues – it often doesn’t take very long to hear about their increasingly sub…
When gender identity confuses the electronic health record
One little thing. Somehow, with the changeover to the latest release of our electronic medical record, something happened to some of the demographic information on our patients. Suddenly, an enormous number of patients were now labeled as choosing not …
School vaccine exemptions must be for medical conditions only
No, vaccines do not cause autism. No, vaccines do not cause cancer. No, vaccines are not toxic. No, getting the disease is not safer than vaccination. Yes, they are safe. Yes, they are effective. As a pediatrician, I spend countless hours each week tal…
School vaccine exemptions must be for medical conditions only
No, vaccines do not cause autism. No, vaccines do not cause cancer. No, vaccines are not toxic. No, getting the disease is not safer than vaccination. Yes, they are safe. Yes, they are effective. As a pediatrician, I spend countless hours each week tal…
The role of hatred in medicine
Most Saturdays, I join a therapy session down the hall from where I do my walk-in clinic. A patient of mine has a weekly session just before the Alcoholics Anonymous meeting at noon in our big conference room. Last weekend he told my behavioral health …
When pain management goes right
My eyes flitted down to the electronic medical record in front of me. I was conducting a physical assessment of a patient new to my clinic and the area. The forty-five-year-old male sat down before me, and I noticed immediately that he was morbidly obe…
The self-inflicted death of the physician
The eulogy of a profession should be a relatively uncommon undertaking. And yet, the death of the physician appears to be such a fait accompli that one feels late to the wake. It has been a long and lingering death, like the proverbial frog in the pot,…
A family physician changes the culture of his department
“He died because he’s Black!” screamed his mother, inconsolable in the intensive care unit as her unresponsive teenage son underwent a formal neurologic examination. We had done all that we could. Mr. M had experienced a cardiac arres…
