"As we know, diabetes is a comorbidity that can cause more severe symptoms in COVID-positive patients. This knowledge, along with the sense that diabetes is overwhelming the entire body, can quickly deplete a patient’s reserve of positive energy. Despite all their best efforts, diabetes is a disease that can often spiral out of control and make a patient feel helpless. While it’s critical to maintain this “whole body” approach, it’s also important to prioritize complications. One of the most deb...
Feb 28, 2022•22 min
"Setting boundaries can look like setting a time limit for patient appointments, availability for email responses, the number of shifts worked this month. You can set boundaries by saying 'no' to low compensation, setting a time limit on conversations with friends, setting a limit on our after-hours availability for work-related texts and emails and taking time off as a 'pause' rather than getting to a point where we are so burned out we lose any interest in medicine and leave. Boundaries help t...
Feb 27, 2022•19 min
"Remember the things that we’ve discussed as the majority of people are broke. And just because your friends are showing off the 'stuff' things they buy doesn’t mean they can actually afford them. Once you realize that everybody in the world is after your money, the quicker you know how the 'money game' is really being played. Just don’t get played yourself." Jeff Anzalone is a periodontist who blogs at Debt Free Dr . He shares his story and discusses his KevinMD article, " How not to be a broke...
Feb 26, 2022•20 min
"There’s a new best practice emerging, one that lets you deliver a high standard of care today but that well-prepares you for a shift to value. We’ve been talking about it throughout this article series in terms of doing more with less and making the system work for you: it’s group coaching combined with remote patient monitoring. And, based on the coding changes and expanded reimbursements, the data show that patient outcomes are vastly improving under this new model. The conclusion: It’s time ...
Feb 25, 2022•20 min
"It is hard to understand and communicate the uncertainty that comes with evolving science, the changing recommendations as we learn more, the vaccine that didn’t do all that was initially promised. It has become even harder with the erosion of trust and civility. Back to the poop. It stinks. It’s not pleasant to slip and slide in, and even today, I saw a bag hanging from a tree! Was that owner practicing his pitch? Trying to hit a squirrel? Or did she toss it to the heavens for God to catch? On...
Feb 24, 2022•14 min
"Have you ever been to a new city and realized you’d been pronouncing a street or a town name all wrong? Have you ever been from one of those cities and has it broken your heart to hear someone call Copley Square Cope-ly? Or pronounce the Schuylkill River or Worcester how it is spelled? This is how neurologists feel when you call a stroke a cerebrovascular accident, or a CVA. It’s just … not what we do. Maybe it was in 1992, and maybe it is in the world of billing and coding, but it’s not 1992, ...
Feb 23, 2022•13 min
"Tears and sweat drown my face as I try to rip off my PPE and exit the room. I didn’t want to leave him, but I couldn’t bear another second in that reality. A whirlwind of emotions crash over me, and my knees weaken. I thought, “If I can just get this gown and mask off, I’ll be able to breathe again.” Even after ripping the damp N95 from my face, I was still breathless, speechless, and broken in disbelief of what happened in that room. I was suffocating. I nearly collapsed as I stepped through t...
Feb 22, 2022•19 min
"The starting point is to do our best to approach discussing COVID and vaccination with the appropriate type of empathy and understanding. To understand that our patients don’t have access to the same level of data and research that we do, and even if they did, they might not understand it. To understand, they likely have fears underlying their reticence. Understand you may not ever reach them, or you may need to back off for a short time. This can all be done without acknowledging their conspir...
Feb 21, 2022•15 min
"Instead of trading up for a faster horse by drawing in the exam room, it felt like I’d just built a motor car. I created a new workflow around my digital assets. When patients checked in for a clinic visit, I scanned the chart for their visit diagnosis and fired off a content link with the relevant videos. My MA roomed the patient and they watched content while I completed other tasks. When I enter the room, their questions are more targeted, insightful and our visits are faster and more satisf...
Feb 20, 2022•16 min
"When my patients asked me about losing weight, I would say, 'Eat less and exercise more.' I know that it is more complicated than that. There are psychological and socioeconomic factors. There is bariatric surgery and there are medications. But 'eat less and exercise more' is common sense, and every intervention should include 'eat less and exercise more.' Limiting guns is common sense too. If people do not have guns, they cannot kill and maim others with guns. They cannot kill teenagers playin...
Feb 19, 2022•18 min
"A resurgent CDC is necessary to recapture the vitality of U.S. medical science. A scientific researcher alone cannot do this work. This will also require heavy managerial work and restructuring and charting a different course altogether. CDC will need a double-headed leader approach, one excelling in scientific expertise and another proficient in managerial miracles. The current messaging algorithms at the CDC are misplaced. The CDC tried to placate diverse constituencies at different times wit...
Feb 18, 2022•16 min
"I’m a small-time doc in a small town, and I work at a small hospital in the Midwest, and I’m proud of it. The huge university hospitals (like Cleveland Clinic) get all the glory (especially in society and in the press), but small hospitals like mine drive this country. It has been really weird working at a small hospital, where it seems like the emotions are more magnified than in the big city. A year ago, it seems like there was a local community group every day bringing food or treats for the...
Feb 17, 2022•21 min
"This last mile of the COVID pandemic—Omicron or not—is a painstaking one-on-one endeavor. As is most of primary care. Sadly, we now have to deal with political epidemiology as much as emotional and clinical epidemiology. We’ll sit with each of our patients, listening as much as possible, attempting to understand and address their concerns. With some, the bloc of silence may be impenetrable. This is heartbreaking, especially for those of us who’ve penned more condolence cards this past year than...
Feb 16, 2022•20 min
"Medical-legal consulting is a great way to use your medical training in a non-clinical field that helps people. I started this field 14 years ago and have trained over 1,600 physicians to be medical-legal consultants. Most physicians do medical-legal consulting as a part-time side gig. All of the work is pre-litigation and pre-trial. I don’t act as a medical expert, and I don’t participate in medical malpractice cases. There are over a dozen services and types of consultations I offer attorneys...
Feb 15, 2022•18 min
"Instead of trying to earn a spot on a talk show to help a person dealing with costly treatments for illness, perhaps it is best to lobby policymakers to pass legislation that impacts big numbers of patients dealing with the high costs of treatment, ultimately including that person. Perhaps encouraging businesses, institutions, and organizations to allot funds for health care programs is a more salient idea. Talk shows end. The need to close the gap in medical funding does not." Amanda LaMonica-...
Feb 14, 2022•16 min
"In the ongoing saga of the pandemic, there is the debate whether to wear a mask or not. These are physical masks that temporarily hide our face, but we all wear another type of mask, a metaphorical mask. These are the masks we put on to present who we want the world to see. People who are referred to as having “high functioning autism” often put on the greatest masks of all; masks that society does not allow them to take off. “High functioning autism” is a term used to describe people with auti...
Feb 13, 2022•21 min
"As a clinician who has received two Pfizer doses and a booster without any side effects, I wholeheartedly embrace vaccination to solve this pressing public health crisis. The key is for policymakers to identify the best tool for the job (i.e., Covaxin) and utilize it effectively to solve the widest-ranging public health crisis of the past century." Tayson DeLengocky is an ophthalmologist. He shares his story and discusses his KevinMD article, " Why is the world’s first universal coronavirus vac...
Feb 12, 2022•17 min
"At the beginning of my time as a CMIO, I needed to remain clinical to build camaraderie with my colleagues. This proved essential as the health system was going through a transition to a new EMR. The medical staff needed to know that every decision I made affected me as much as it affected them. As time went on and the EMR matured, it became less relevant if I practiced and more critical to perform as a change agent. However, I elected to still practice in a part-time fashion because of my love...
Feb 11, 2022•20 min
"Patients die. This is a tragic truism in the world of medicine. Usually, the patients who die are elderly. Patients die from diabetes and kidney disease, or from alcohol abuse and liver failure, or from heavy smoking and lung disease. Or patients die from cancer. As a physician, I take these deaths in stride. I try to provide comfort care as they lay dying. Patients often pass into a dreamlike state, at the end. They are not fully conscious. I provide morphine for any pain, which may or may not...
Feb 10, 2022•19 min
"The U.S. health care industry has large challenges that can be overcome if we remember why our systems and services exist. We are here to help patients, and we must obtain the needed staffing capacity to drive throughput so patients can receive the care they need. Our system will cease to exist if hospitals are forced to close or begin to limit services offered due to financial concerns. As stated in the title of this paper, the 'goal' is in peril. However, by remembering and instituting key pr...
Feb 09, 2022•23 min
"Absolutely, there are times when you need to be face-to-face with your patient. Yet looking at the broader picture, COVID-19 has shown us that in many instances, we can perform at an optimal level while remote. In my experience, I’m often able to see more patients, and the quality of the connections I form with them is higher when I don’t have to shuffle them around in an office. Aside from the bonds I’m able to create with my patients, I’m also more productive without the distractions of sitti...
Feb 08, 2022•16 min
"Gastroenterology clinics in rural areas have the unique opportunity to innovate the field by working with local community organizations and farms. Patients and physicians develop a deeper understanding of the root cause for chronic disease, particularly digestive diseases using a food as medicine approach. Cultivating gut microbes in the soil and gut can re-shape the management of chronic diseases rooted in inflammation and metabolic dysfunction. Rural gastroenterology clinics can be at the for...
Feb 07, 2022•23 min
"In the end, the patient-physician relationship is crucial to overall decision-making for any plan of care, treatment, or surgery. There are many variations in the reviewed studies in health care literature as to the cost-effectiveness of second opinions in medicine. These studies could be easily misconstrued that there are no benefits to second opinions, thus possibly leading to little pay or no pay by insurance companies. A patient should consider the substantial short and long-term implicatio...
Feb 06, 2022•14 min
"The more I spoke with individuals who had experienced a shared crossing event, the more I also noticed repeating patterns. A woman in West Virginia and a woman in Australia with deeply similar experiences around the loss of a baby. A grown daughter in California and a grown daughter in Pennsylvania; a woman in Alabama and a man in Spain. None had met, yet each spoke a common language. Again and again, I found that this moment of shared connection that they had experienced also changed their liv...
Feb 05, 2022•19 min
"As individual patients, we often don’t think about these costs. In my Instagram poll, nearly everyone taking Descovy reported receiving the drug effectively for free, largely due to Gilead’s copay coupons. However, as with anything in life, nothing really ever is free. More patients taking Descovy rather than generic Truvada means higher overall spending by insurance companies. This eventually comes back to haunt us in the form of higher premiums, and is why we shouldn’t simply adopt a costlier...
Feb 04, 2022•14 min
Emergency physician and financial planner Noah Kaufman gives a general cryptocurrency market update. He discusses the state of Bitcoin and the impact of fiscal tightening by the Federal Reserve and also comments on Paul Krugman's recent New York Times column comparing cryptocurrency to the subprime mortgage crisis. Finally, we talk about Crypto Pulse, a free newsletter he runs with Chris Palmer, MD, educating clinicians about Bitcoin and cryptocurrency. Noah Kaufman is an emergency physician, fi...
Feb 03, 2022•29 min
"When I came into the business world, I saw a huge spectrum of ethics and am still shocked at how there aren’t any standards. Why must one be in a professional career only to have some guidelines and/or rules to follow? I don’t currently have patients in the entrepreneurial world, but I do have a lot of people in my sphere with whom I have the ability to educate and empower. I am bringing the Hippocratic Oath into the field of venture capital and entrepreneurship in an effort to impact the world...
Feb 02, 2022•19 min
"Lifestyle medicine’s foundational pillars include a specialized look into diet, physical activity, sleep, stress, mood, substance use, and relationships. Creating a patient-centered plan of care based on these areas are proven successful in preventing, treating, and reversing chronic diseases. Some may say that health care providers do not have time to focus on intensive lifestyle modification in their visits with patients. This is true in the current fee-for-service, physician-dominated care d...
Feb 01, 2022•15 min
"Ultimately, patients need doctors to help them be healthy, and need their doctors to be healthy to help them! Unless interventions are done now, our health care system risks a downward spiral. While the pandemic has brought increased levels of stress and burnout, it has prompted us to take action on mitigating this serious issue. Hospitals, practices, administrators, and physicians must realize that working together to combat burnout is essential for the health of our entire health care system....
Jan 31, 2022•20 min
"Anyone can win at poker when dealt a royal flush. But what can you do when the cards you are dealt don’t appear winning at all? My answer: Make the best of what you have. Recently I learned of a colleague who sustained a broken back in an accident. He continues to work, wearing a brace and not taking pain medication. I know from watching his videos that he routinely handles the most complicated eye surgeries. Such cases are challenging to any seasoned ophthalmologist, without physical constrain...
Jan 30, 2022•16 min
