Category: primary care

Love smart functions in your EMR? This doctor doesn’t.

How smart do we want our electronic health record to be? Somewhere between as dumb as a piece of paper and a pen, and too smart for our own good. Many, many years ago, before we spent the majority of our office visit staring at a flatscreen LED and typing away, our charts were simple […]

Is there a case against shared decision making?

In a matter of less than a decade, “shared decision-making” (SDM) has emerged as the uncontested principle that must inform doctor-patient relationships everywhere.  Consistently lauded by ethicists and medical academics alike, it has attracted the attention of the government which is now threatening to penalize doctors and patients who do not participate in SDM prior […]

Tips to manage chronic pain on summer vacation

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. It’s officially that time of year. Summer is in full-swing, and all of America is getting ready to take a much-needed holiday. However, some Americans, particularly those who suffer from chronic pain, often dread getting away. They are afraid their chronic pain might prevent them […]

When someone claims something is healthy, be skeptical

I stood in line at the grocery store waiting to pay for my items. The woman behind me, who would be categorized as obese, was eyeing some of the snacks so conveniently placed in the checkout aisle. She grabbed a meal bar and analyzed it for a few seconds, then said aloud to me: “You […]

Managing your freedom after residency

The first time I was asked to provide a bio — in this case, it was to appear on my residency’s website — I wasn’t sure what to include. It was supposed to be short, not really an autobiography or memoir and it was supposed to make our program look approachable, impressive and balanced. I […]

Both physicians and CEOs need time to think

I’ve always likened the job of a primary care physician to that of a chief executive officer of a small business. Family doctors manage the “business” of delivering and coordinating care for more than a thousand patients at an average cost, in the United States, of $8,500 per year: an $8 to $12 million business. […]

Both physicians and CEOs need time to think

I’ve always likened the job of a primary care physician to that of a chief executive officer of a small business. Family doctors manage the “business” of delivering and coordinating care for more than a thousand patients at an average cost, in the United States, of $8,500 per year: an $8 to $12 million business. […]

Why are we treating outpatients like inpatients?

Repercussions. Every action that is taken, especially when it comes to healthcare, has ripple effects, which often end up being more far more significant than we anticipate, turning that ripple into a tidal wave. Every time somebody besides actual health care providers steps into the mix and tell those of us taking care of patients […]

The social determinants of a physician’s path

Poverty is known to be an important determinant of a person’s health and longevity. A person’s zip code is more relevant than genetic code. Does a physician’s zip code – that is where they were born and raised – have an effect on where they practice? Specifically, do rural born and raised physicians return to […]

The satisfaction of Suboxone treatment

My second foray into Suboxone treatment has evolved in a way I had not expected, but I think I have stumbled onto something profound. Almost six months into our in-house clinic’s existence, I have found myself prescribing and adjusting treatment for about half of my medication-assisted treatment (MAT) patients for co-occurring anxiety, depression, bipolar disease […]