"This plea for help is on behalf of every hospital worker who has been on the front lines of the COVID-19 pandemic — from the environmental services staff and medical assistants who are often not recognized, to the social workers and chaplains who are surrounded by distress, to the physicians and nurses who continue to stand and receive the sick — we need more time off in the coming year. Some hospital workers will need to continue to be paid; others will just need permission and people to back-...
Jul 08, 2021•17 min
"The right choice of words, at the right time, can lift a person out of despair and literally save a person’s life, while an ill-chosen word, or worse, a purposely harsh one, can scar a person. The entire field of narrative medicine is formed around the principle of reviving empathy in doctors towards patients and their colleagues so that we keep the inner human alive in us as we treat the obstacles we are faced with daily. If you are a physician seeing a multitude of patients daily, try spendin...
Jul 07, 2021•20 min
"'That’s great. You want to start a women in medicine program! How are you going to pay for it?' This is the most common question and potential barrier from colleagues, leaders, and those who understand the value of these programs. We found that our two-year Women Leaders in Medicine program improved burnout, retention, and engagement of the over 400 women physicians who participated. However, funding remained the chronic barrier to sustainability. I will introduce you to ten possible funding st...
Jul 06, 2021•19 min
"We know the ER’s revolving door will continue to spin for so many children and adolescents who seek help in the heat of their personal crisis. Some will need to stay in the hospital – to heal their bodies and minds and even fight for their lives. Some – the lucky ones – will be able to go home, but by no means are they out of danger. Their lives too are threatened, and they will need ongoing support from parents, family, friends, teachers, and mental health providers – who will likely care for ...
Jul 05, 2021•20 min
Listen to psychiatrist Emily Watters' work with the homeless population and how she got her start writing cartoons, educating patients using out-of-the-box communication strategies. Emily Watters is a psychiatrist and can be reached at The Cartoon Shrink . She shares her story and discusses her KevinMD articles, " Blood clots and the Johnson & Johnson vaccine: a comic explanation " ( https://www.kevinmd.com/blog/2021/05/blood-clots-and-the-johnson-johnson-vaccine-a-comic-explanation.html ) a...
Jul 04, 2021•18 min
"For the folks who are either physicians or becoming care providers, I hope you choose to familiarize yourself with this odd yet common form of loss. I encourage you to respect a woman’s right to decide at what point and to what degree her fetus and its life or loss has meaning to both her regardless of your views. I implore you to become familiar with laws, regulations, and general procedures surrounding fetal death and disposal of remains in the state(s) in which you choose to practice and how...
Jul 03, 2021•18 min
"I often think about how I can make you see these things about yourself that others see. I think about the ways I can tell you that things will get better even though the darkest of days is upon you right now. But I know I can’t make you see these things; no one can. I know these things may not be helpful to hear, irrelevant, noisy. So instead of trying to convince you, dear one, I’m going to be here for you. I’m going to listen to you. I’m going to advocate for you. I’m going to help pull you o...
Jul 02, 2021•17 min
"As a species, we have been an abject failure in dealing with a worldwide crisis. We politicize things for money, political reasons and some kind of weird power, even when it kills us in the process. We already have a World Health Organization (WHO). Would it be so difficult to staff it with the best scientists from every country, without any political pressure and follow their recommendation worldwide, without local bureaucratic interference? The first vaccine approved by the WHO — no prizes fo...
Jul 01, 2021•13 min
"From a charting standpoint, the sins of commission easily outnumber the sins of omission. Our group’s progress note template begins with a summary that eventually becomes the narrative for the discharge summary. Most of the time, most of the important stuff is in there. It’s just obscured by what data scientists technically describe as 'oodles' of no-longer-relevant details. Like a package of cheap ramen, the single cube of chicken meat is in there. Your job is to find it. Why do we do this to ...
Jun 30, 2021•20 min
"We believe optimal postoperative pain management should provide adequate pain relief, minimize adverse effects, and reduce chances of drug misuse. While we cannot undertreat pain, we also cannot go back to the practice of over-prescribing or unnecessarily prescribing opioids for minor operations. There needs to be a carefully nuanced balance in treating pain, especially for pediatric and adolescent patients. Going forward there needs to be continued parent and patient education about expectatio...
Jun 29, 2021•25 min
"The symptoms of EDS aren’t limited to the musculoskeletal system and commonly affect everything from hearing and vision to integumentary issues such as prolonged wound healing and easy bruising. It also became apparent that the specialists I had seen had contributed valuable information to the overall puzzle but were simply not able to put it all together. I had accrued an impressive list of diagnoses commonly associated with EDS: migraine, gum disease, anxiety, fibromyalgia, chronic fatigue, r...
Jun 28, 2021•18 min
"The impact of the pandemic on the lives of Americans will be felt for years, if not generations, to come. This includes its alarming effect on health behaviors that contribute to the already formidable challenge of obesity in this country. Now, more than ever, we must look for creative solutions within the broader health ecosystem that can help individuals adapt their behaviors, in spite of socio-environmental challenges, to prevent, manage, and maybe even reverse chronic disease. The very heal...
Jun 27, 2021•22 min
"Interviewing for medical schools was intense, excruciating, and terrifying. Despite the difficult questions, there are three that stand out to me. The first was to differentiate sympathy from empathy, where I spent 30 minutes defending my answer to be met with complete silence. He could have asked me anything, yet he sat in silence for almost my entire interview and asked me to explain emotional differences between two incredibly similar words. Or are they? I have been left to contemplate this ...
Jun 26, 2021•15 min
"Mid-career colleagues: it’s time to go back to the future. Time to learn again. Time to build professional and social networks at work. Take a lunch break. Bring home a few fewer RVUs. I recently started a monthly journal club for our small section of gastroenterologists as a way to recreate some of what I loved about residency. A case conference to discuss difficult cases is next. While the rewards of these diversions are not quantifiable, they are still valuable. I hope my colleagues feel the...
Jun 25, 2021•15 min
"COVID was ominously not only drowning people in their own spit but struck in different shades to alter human personality that kept helplessly getting lost in the maze of their own minds. It made the young maniacal, hearing voices and talking to walls in a schizophrenic frenzy. It made the elderly become muted in silence. The face of helpless madness. Every now and then, the balm of soothing whispers would lull them to slowly break free from this trance. This strange malady kept fogging up brain...
Jun 24, 2021•19 min
"We all go through our early lives in the S-curve of our medical education–college, medical school, residency, early practice. As you reach the mastery phase, I would posit that there is a downward dip as we realize that we are no longer in that exciting hypergrowth phase. The search for a new curve happens, the desire to ascend the second mountain, to find a more meaningful purpose. How do you begin to find that purpose? Some people take a sabbatical or quit their job entirely. Some physicians ...
Jun 23, 2021•15 min
"We won’t know until 2022 or later whether there will be an increase in claims related to the pandemic. When a medical error occurs, it’s not like an automobile accident. Everybody nearby knows when there’s been an automobile accident because they hear screeching tires, a loud crash, and then sirens. But when a medical error occurs, generally speaking, neither the doctor nor the patient immediately knows that something is amiss. It can take months or years for people to realize that something un...
Jun 22, 2021•21 min
"We know this is true in our hearts and minds, but we also know it to be true in documentable terms. Studies have proven that strong, empathic engagement between doctors and their patients increases patients’ willingness to report symptoms and concerns. That in turn improves diagnostic accuracy. Empathy increases patient engagement and compliance. Some studies suggest it even improves survival rates. Connection is a powerful intangible—like family, or love, or hope. So how can a doctor bring con...
Jun 21, 2021•26 min
"How do we combat all these beliefs that can make doctors into bad investors? I have a few thoughts. First of all, don’t panic. Most of us are indeed starting behind the eight-ball when it comes to wealth accumulation. But even with a shorter runway, physicians make enough money to make up for lost time. With a well-constructed financial plan, you can hit your goals, whatever they might be. Second of all, be humble. Recognize that vast scientific knowledge doesn’t always translate into financial...
Jun 20, 2021•22 min
"These are extraordinary times. Leaders have the opportunity to seize the day, to lean into this turning point in health care delivery, to drive organizational transformation, and to emerge from the devastation of the pandemic with an organization in which patients and clinicians thrive. You simply have to ask yourself, are you willing to change? Are you willing to dive into the fray and adapt to save your clinicians with the same commitment that your clinicians have demonstrated throughout the ...
Jun 19, 2021•19 min
"We can move from being a reactor to creator. Creators think of the future and make it start happening today. Reactors are just dealing with the crisis at hand, not progressing, feeling stuck, feeling like life is unfair. Reactors are people-pleasing, reacting to everything said, constantly worrying about how to win the approval of others. That’s the trouble with people-pleasing: You are always reacting. We think we are making others happy, but we despise ourselves and resent others. We should s...
Jun 18, 2021•15 min
"With the obvious accounted for, we turned to the obscure, the area of medicine where judgment and experience come into play. Fortunately, we received sound advice and guidance from the infectious disease physicians. Stick to the basics, they stressed, only do them better. We continued our patient on the first-line anti-TB drugs he had been on, this time at a slightly higher dose, and added one dose intravenously since he had inflammation in his abdomen and likely wasn’t absorbing a lot of the m...
Jun 17, 2021•14 min
"We need you to join the ranks of this time-honored profession with new eyes and determined minds and eyes that see medicine’s problematic foundations and minds that are willing to act on it. Because it is you, future medical students, who will soon take up the mantle of pushing medicine to change — as medical students have done for generations. We look forward to working alongside you. Welcome to medicine." Kathryn Crofton, Jay Hwang, and Catherine Jay are medical students. They share their sto...
Jun 16, 2021•17 min
"Ever the teacher, the Dr. Lown we knew modeled 'The Lost Art of Healing' (the title of one of his books) in the clinic, the laboratory, and the halls of power. As health professionals, we watched him listen carefully to his patients; as citizens, we saw him listen deeply to our neighbors. We heard him importune our health care enterprise to do what is best for democracy with an eye on the future, instead of what helps today’s bottom line. And he entreated us to bear witness to the harms and ris...
Jun 15, 2021•17 min
"Legislative advocacy has become difficult for the severe autism population since the DSM-5 lumped Asperger’s syndrome with autism spectrum disorders (ASD). Further complicating the matter, a new population recently emerged who identify as “autistic” without having a diagnosis from a qualified health care professional. Without a clear distinction for various parts of the spectrum, we are comparing apples and oranges. We will not render meaningful information, and we make it difficult for the ent...
Jun 14, 2021•17 min
"My thoughts immediately went to the tragic loss of one of my best clients, a physician who recently passed away after battling COVID-19. I remember him not only as an excellent physician but even more so as a great person. Unlike many physicians I speak to in the course of my work, this client had the foresight to do some careful estate planning. While his loss cannot be measured, this planning has provided his grieving family with some financial peace of mind and allowed them to focus on him d...
Jun 13, 2021•19 min
"Even though there has been a lot of progress, LGBTQ youth are still struggling with discrimination. I am disheartened that 40 percent of LGBTQ youth surveyed by the Trevor project in 2020 seriously considered suicide in the previous 12 months, and the amount of LGBTQ youth reaching out to the Trevor project crisis centers has doubled at times during the COVID 19 pandemic. I have pediatric patients in my clinic tell me that they are nervous to reveal their sexual identities to family and friends...
Jun 12, 2021•17 min
"Taking control of distress is done by embracing the concept of 'mental fitness.' Being mentally fit enables one to overcome the negative emotions that have traditionally sabotaged our lives, both personally and professionally. Similar to physical fitness optimizing our bodily strength, mental fitness promotes achievement in our performance, relationships, and sense of well-being. Much research has been done in neuroscience, cognitive and positive psychology, and performance science, showing the...
Jun 11, 2021•18 min
"Before COVID-19, I left the practice of medicine for what would turn out to become an entire year. While away, I found a new way of seeing our hearts and bodies as humans in the medical profession, allowing me to return. Here are five lessons I learned in the hope they might help others." Jennifer Lycette is a hematology-oncology physician and can be reached on Twitter @jl_lycette . She shares her story and discusses her KevinMD article, " What I learned from stepping away from medicine for a y...
Jun 10, 2021•19 min
"Don’t be the patient that says: 'Doc, just tell me what to do …' Instead, you should ask for information to empower yourself to make decisions about your healing process. Framing questions around the clinician’s experience is always a good starting point; pretend to be the doctor for just a moment and consider the difference in how you might answer the following questions: 'Is there something wrong with the X-rays of my spine?' 'In your experience with patients like me, do most people get back ...
Jun 09, 2021•15 min
