Category: primary care

Changing the focus from physician burnout to physician well-being

Physician well-being is a major focus of many physician organizations and is frequently highlighted in popular media.  Some have described the root of the problem as a disconnect between expectation and reality.  This is a helpful framework for situati…

Make your 15 minutes with a patient memorable

Compassion. Empathy. These are some of the words commonly thrown around in medical school and residency training. If you ask most medical students why they chose medicine, they will respond with something like this: “ I love to help people,” or “I want…

The complex expectations of patients toward their physicians

When my father reached his mid-80s, an accelerating accumulation of physical and mental functioning issues persuaded him to switch to a primary care physician in a concierge medical practice. Although the doctor’s pedigree proclaimed his competence, he…

Physicians are trapped between patient satisfaction and unnecessary prescribing

I don’t mean to pick on McDonald’s. Insert any other large retail business where customer satisfaction massively trumps every other consideration of the relationship between employee and customer. Telemedicine companies have exploded the past few years…

The main difference between functional medicine and evidence-based medicine

Figuring out what’s actually true is far harder than most people realize. Our brains are both hypothesis-generating machines and incredibly credulous. As a result, most of the things we believe to be true turn out to be false. We don’t just mistakenly …

PSA-based screening for prostate cancer: Interpreting the changing guidelines

Comparing the 2018 U.S. Preventive Services Task Force (USPSTF) recommendation statement on prostate cancer screening in the October 15th issue of American Family Physician with its previous recommendation, the first question family physicians ought to…

Urgent care isn’t the answer to our broken system

I’ve only worked four shifts of urgent care so far, but four 12-hour shifts means I’ve seen a lot: a lot of patients, a lot of different ailments, a lot of different reasons that people come to urgent care centers. I have to admit that this…

We need more behavioral health treatment in primary care

I don’t know how many times a patient has told me, “I was in therapy once, and it didn’t help.” My response is always: “That’s like saying ‘I saw a movie once and I didn’t like it’.” That usually breaks the ice just a little. In primary car…

Why patients don’t do what physicians tell them

A guest column by the American College of Physicians, exclusive to KevinMD.com. Those of us who provide clinical care inevitably have patients who simply don’t do what we tell them.  And this isn’t limited to only primary care but is encountered in all…

We need to make better use of the health team and technology

Nearly a quarter of a century ago (good heavens, I can hardly believe I have to say that!), when I was just starting out as a junior faculty attending, I remember one of my mentors taking me to the hospital with him on morning rounds to see all of his …