Category: primary care

Every doctor should have a plan B. Here’s why.

I’ve written previously that financial independence is plan B.  Plan A, of course, is life.  Your work and time are precious, and life is too short to be wading through a morass of unhappiness only to get to some endpoint or goal. While I definitely believe in front-loading the sacrifice, the cost should not have to be […]

How urgent care rejuvenates this primary care doctor

I volunteered to work Saturdays. And to do walk-ins. And to take all comers, not just our patients. It has been an interesting journey. Some clinics put their newest, least experienced clinicians on the very front line of doing urgent care. Here, it’s the opposite. I’ve got 39 years under my belt, and I see […]

The pathologic manifestations of professionalism

Four years ago after moving back to Iowa City, I needed to find a new primary care doctor. I went to the University’s website and scanned the list of general internists. There I noted a physician that I had known when she was a medical student during my prior stint at the University of Iowa […]

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. […]