"There is a lot of confusion and outright falsehoods about fasting. You can search the internet for clarity and end up more confused than when you started. The fact is, fasting can be a very effective tool to improve your metabolic health, increase insulin sensitivity and help you lose weight. But, who should and shouldn’t use fasting for weight loss and how long to fast for effective weight loss are questions that need to be answered before you rush into fasting. The main thing to consider is t...
Apr 29, 2022•16 min
"In St. Louis, asthma is the greatest health care inequity, with African-American children having an incidence rate greater than 10x that of white children. Children in St. Louis are afflicted by rates of asthma 3x higher than that of the national average, and asthma is currently the leading chief complaint at St. Louis Children’s Hospital. Underserved communities face a multitude of issues that exist beyond the medical aspects of health care. And unfortunately, asthma is not only an issue due t...
Apr 28, 2022•14 min
"As a family physician for more than 40 years, I have seen countless patients struggling to alleviate chronic pain, with far too many turning to self-destructive coping methods such as alcohol and opioids. Unfortunately, the struggle with chronic pain isn’t going away – and more alarming is the fact that those suffering from it are getting younger and younger. The latest data on chronic pain show patients between age 18 and 34 are reporting the most chronic pain, and they are desperately seeking...
Apr 27, 2022•17 min
"COVID has brought us new challenges and a genuine opportunity to be part of the critical response to optimize the care we deliver not just to our patients but also to their families and caregivers. I am lucky, blessed to do this work every day and carry such a deep passion. We are making a difference and impacting care in positive ways. We support not only patients, families, and caregivers but also each other, our colleagues, and other members of the health care teams. We are all in this toget...
Apr 26, 2022•26 min
"I spent the first three days sitting next to my dad’s hospital bed, watching his chest rise and fall slowly. He was asleep the majority of the time, fighting off something unknown. Anytime he moved, I jumped up from my chair and stood where he could see me just in case his eyes fluttered open for a split second. I wanted him to know that I was there, that I cared. I sat for hours listening to the unfamiliar noises in the room, like the IV pump, which sounded like a miniature helicopter hovering...
Apr 25, 2022•16 min
"What these substances have in common is that they are widely considered to fall into the category of psychedelics. What else they have in common is that the vast majority of us physicians learned nothing about them in medical school or residency, as most psychedelics are classified as Schedule 1 substances, which suggests they have no currently accepted medical use and pose a high potential for abuse. With these psychedelic-based therapies, clinicians are now presented with options to help pati...
Apr 24, 2022•20 min
"Greater demands in the U.S. for billing and regulation-related documentation contribute to the excess time burden of EHR systems compared with other countries. A high volume of clinical alerts and other distractions in the EHR, as well as various other inefficiencies (such as locked computer screens and repetitive sign-in requirements), encumber physicians as they navigate the EHR. As a result, physicians can spend half of their total EHR time on clerical and administrative tasks, and another q...
Apr 23, 2022•16 min
"The COVID-19 pandemic has been raging in the United States for over two years. Health care workers across the country have been chronically pushed to their limits as we navigate difficult situations on a daily basis. The advent of the COVID-19 vaccine, although a powerful tool in our crusade against the pandemic, has created a new branch of emotions for health care workers towards unvaccinated patients or those with vaccine hesitancy. The empathy we are often expected to have without fail can b...
Apr 22, 2022•13 min
"I remember our first day in the cystic fibrosis clinic like it was yesterday. I cried in the parking garage and struggled to nurse my daughter in the waiting room. And then it happened. That moment is forever etched in my mind. The pediatric pulmonologist took my hands, looked me in the eye, and said, 'Your daughter is going to live a long and full life.' She went on to say that it was her job as a physician and my role as a parent to help enable this. At that moment, she recognized me as a mot...
Apr 21, 2022•20 min
"So how can health systems and clinicians provide patients with an improved, consumer-friendly experience while also making strides to decrease provider administrative burden and burnout? They need to embrace virtual care beyond just video visits and look toward asynchronous telehealth. Asynchronous care allows providers to treat patients for common, low-acuity conditions online without a real-time, face-to-face interaction. It automates both the patient interview and clinician documentation, an...
Apr 20, 2022•20 min
"She kept quiet, but she had planted the seed. Interestingly I did not talk much about work during the appointment, so her question stirred my thoughts. Why did she think it was work-related? I started to look at my daily routine. I was able to recognize where I needed to set boundaries at work. At home, I delegated some simple chores to the kids. I must say kids are excellent learners if given the right directions. Small steps and changes made my life much more manageable. My somatic symptoms w...
Apr 19, 2022•19 min
"Pfizer has a particular onus to help intervene globally as one of the largest and most profitable pharmaceutical companies in the world. With its immense capital power, Pfizer should shift some of their spending from national ads promoting their vaccine product in a country that has large booster vaccine availability to sharing the technology that can help countries self-produce and vaccinate their citizens much faster. Even if new production facilities had delays from receiving the mRNA techno...
Apr 18, 2022•20 min
"Too often in medicine, health care providers assume what patients want or need. Like the crocodile, we may assume all patients would want a tire removed in order to help extend their life – even if the cure meant losing the only thing that made their unique life worth living. The burden of changing health care should not rest on the shoulders of patients facing major medical decisions, suffering symptoms, worrying about their future, and struggling to advocate for themselves. It is important we...
Apr 17, 2022•20 min
"I am ashamed of the callous, avoidant goodbyes that have been made in my name, and I regret the distress caused by this widely accepted standard. The determined patients will figure it out anyway, and the less-resourceful ones are left confused, hurt, and more likely to avoid important medical care." Karen Dong is a family physician. She shares her story and discusses her KevinMD article, " The missing doctors’ goodbyes ." Did you enjoy today’s episode? Rate and review the show so more audience...
Apr 16, 2022•14 min
"It turns out that living beings are less like bags of sloshing water, as I imagined in grade school, and more like a stew. While water makes up most of it, water alone is thin and empty of the organic molecules from which organisms are built—the stew thickeners. Water alone is lifeless. Instead, it is the mucus in our bodies that—so long as it has the correct qualities and consistency—is the key to a healthy life. The 'fact' that our bodies are made mostly of water is misleading. What we are ac...
Apr 15, 2022•14 min
"Unconscious bias in health care describes associations or attitudes that reflexively alter our perceptions, thereby unintentionally affecting behavior, interactions, and decision-making. Health care organizations need to be actively discussing this subject at the highest level to find gaps and learn where to dedicate resources for improvement, even if it means confronting awkward topics and having uncomfortable conversations. The time has come for organizations to be deliberate in their efforts...
Apr 14, 2022•18 min
"We need to address the underlying preventable factors that cause more Black Americans to die of heart attacks and strokes and suffer from high blood pressure and diabetes complications than white Americans instead of focusing on non-existent biological differences. I would like to see the scientific disciplines unite to call out the mislabeling of race as a biological category and stop using race in place of structural racism, toxic stress caused by discrimination, and systemic inequities in so...
Apr 13, 2022•18 min
"There is something about physically putting pen to paper, that connection between your mind and your body that is just very health-inducing. And it takes time. And often we do not dedicate the time to taking care of ourselves and something as simple as writing in a journal, writing these, you know, these pieces. In eight minutes, you can get a lot done. It's been amazing what people come up with. And so I think the first part is just committing the time and giving yourself the space to do somet...
Apr 12, 2022•16 min
"Two issues drive teen substance use: drug availability and perception of risk. Availability: Today’s teens know that obtaining substances is far too easy. For example, 70 percent of high school seniors say marijuana is either “fairly easy” or “very easy” to obtain. Seventy-seven percent say getting their hands on alcohol is very easy and twenty-one percent of seniors believe it is easy to find MDMA (ecstasy). Thirty percent say getting their hands on amphetamines is also very easy. Perhaps more...
Apr 11, 2022•15 min
"It was probably in early 1803, as Jenner’s fame swelled and more doctors were adopting vaccination, when Bell met a farmer with a curious story. The farmer’s name was Benjamin Jesty, from the Downshay farm in a nearby village. Seeing the growing practice of vaccination, Jesty was eager to tell his story and claimed he deserved rewards just like Jenner. Bell, probably intrigued, recorded Jesty’s account." Rod Tanchanco is an internal medicine physician and can be reached on Twitter @rodtmd . He ...
Apr 10, 2022•19 min
"I suspect that some of the nearly 20 percent of physicians who have quit their jobs during this pandemic needed to feel this relief, too. They needed to feel the relief of having no plan. No 'if this, then that.' They needed to just exist in the now. Because who knows how long the now will be around anyway? Will we wake up one day and find that years have gone by without knowing it because we were so busy planning ahead for scenarios that never occurred? This is not something that worksite well...
Apr 09, 2022•16 min
"Reducing the occurrence of comorbid mental and physical disorders will require an integrated model combining medical and behavioral health care services. The window of opportunity is open for health insurers and employers to invest in employee assistance programs and telehealth platforms and build on a newfound acceptance of mental health services. Additionally, health care providers can mitigate the cost of care and improve their outcomes with an increased focus on interdisciplinary training t...
Apr 08, 2022•16 min
"If we want a more effective health care system, it needs to be re-engineered to revolve around the true center of gravity – the patient. We must involve patients early and often in the design of health policy, health technology, and health care ecosystems. We must reinvent health care payment models to tie incentives to what is of value to patients. And we must give every American access to a high-quality PCP. Until we do this, we’ll continue to pay too much money for too little value, and we’l...
Apr 07, 2022•19 min
"I do not hesitate to share what I endured. I recognize that there is a code of silence that must be broken when one is involved in legal action. It is imperative that we speak out to patients, legislators, and other physicians against these types of injustices. The sense of isolation can be overwhelming. I do not want anyone to go through what I have gone through, questioning myself, my skills, and my self-worth. Hopefully sharing our stories will help to give other physicians added strength. I...
Apr 06, 2022•19 min
"Now more than ever, our profession needs to move toward racial healing. There is an urgent need for nursing to acknowledge its history of racism, boldly confront racism wherever it shows up, and address the racism that nurses witness when delivering care to those they serve. This will not happen until nurses engage in self-awareness and reflection as well as confront any personal racist attitudes and behaviors. When nursing demonstrates a commitment to creating an antiracist culture within the ...
Apr 05, 2022•19 min
"What exactly is my obligation to medicine? Am I supposed to practice medicine forever? Is it my duty? Do I have to continue serving my patients, the hospital, and society because of these expectations? The answer is simple: You get to decide. Most physicians I know love practicing medicine. It is and has always been a calling. The problem lies only in the thought that you should practice medicine. When used in this way, the word should is a cognitive distortion. A cognitive distortion is a patt...
Apr 04, 2022•14 min
"Deeming individuals 'non-decisional' for misinformed beliefs that are not representative of a psychiatric illness is inappropriate, unfairly medicalizes the narrative and incurs a risk of further public distrust of the health care system. It is not the province of psychiatry to adjudicate uncomfortable social discourse so much as to elicit it. Empathic listening — curiosity rather than social judgment — has always been the most profound and powerful tool at our disposal, and it must remain so."...
Apr 03, 2022•17 min
"Far from signaling weakness, asking for and receiving help is not only a sign of strength, but a sign of courageous leadership. And so, I ask you to put on your own oxygen mask, and then to reach out and help your colleagues put on theirs, too. As physicians, the trauma we’ve experienced through our decades-long education and training, through our competitive medical culture, and through years of silence and self-sacrifice have created a common bond and an unspoken understanding. We must give o...
Apr 02, 2022•17 min
"With government and industry working hand in hand, we can develop and stockpile monoclonal antibody therapeutics in anticipation of variants to come. We need to be thinking several moves ahead to keep ahead of variants so that stockpiles of therapies do not become obsolete as they have now. Our government needs to ensure the proper funding to support the development and manufacturing of such therapies, and we need to begin demanding they do so. These are highly complex and time and resource-int...
Apr 01, 2022•15 min
"I have spent years in silence about my career decisions, nervous that my inability to take call and inability to thrive while sleep-deprived could be seen as weaknesses. Being afraid to admit I was advocating for my mental health and my life. That’s a problem. I am experiencing fear for advocating for the health and safety of myself and others for concern that I may sound weak. That’s a big problem. Silence is not the answer. Avoiding talking about it is not the answer. I cannot avoid call hard...
Mar 31, 2022•19 min
