The one immigrant who has nothing good to contribute to the American story

--------------------------------------------------------------- Here are the stories you missed on KevinMD. Thank you for your continuing readership. --------------------------------------------------------------- Sponsors [The 2017 hospital’s guide to secure mobile messaging success](. Secure mobile messaging success requires the right people, process, technology, and pre-defined, measurable goals. This eBrief explores who, why and what and includes a step-by-step guide. [Read the ebrief now](. [Is your hospital communication system trapped in the dark ages?]( Just like a medieval page boy, pagers are annoying and inefficient. This leads to delayed patient care, frustrated providers, and potential HIPAA breaches. Learn why you need to ditch your [Page Boy]( today. [Will doctors be replaced by computers?]( Health technology continues to grow and change at an incredible pace -- bringing to light [new perspectives on the future of medicine](. [Case study video](. University of Utah Health Care's CMIO and CIO share how the organization has improved communication among clinicians and with patients, increased the efficiency of multiple departments, and sped response in emergencies where every second counts. [Watch the video](. --------------------------------------------------------------- KevinMD Today: Mar. 20, 2017 [The one immigrant who has nothing good to contribute to the American story]( To be clear, this is about one person. It warms my heart to know that people want to come and start new lives as Americans. Some of the best doctors got their education and training overseas. Not only have I worked with many of them, I’m related to three by marriage. Most people have heard […] [My mother isn’t a drug-seeking patient. She’s in pain.]( The patient, age forty-nine, complained of abdominal pain. She was taking both slow- and fast-acting oxycodone to manage the pain, and she also took antidepressants and a sleeping aid. She’d come to the hospital several times in the past year, always with the same complaint. This time, not feeling well enough to drive, she’d come […] [The feds say restrict opioid use. Now what?]( The federal government has declared, through its major health policy agencies, that the number of pain patients on opioids and the dosages they are on should be severely restricted. The Center for Disease Control (CDC), Veteran’s Administration (VA) and Centers for Medicare and Medicaid Services (CMS) have all issued new guidelines within the past year […] [This the one thing that makes me feel like everything is OK]( “Too many times I feel We are losing time once shared And only when you’re in ecstasy You seem to really care” I recognize the song immediately — Chuckii Booker’s “Turned Away.” Not the regular version, but the extended one. As the words rush over me, caressing my nostalgia, a memory, a moment comes back. […] [The decisions that changed this physician’s career]( I knew the moment when my career in pediatrics was over. I was in the fourth year of my med-peds residency, taking overnight call in the pediatric ICU. Nights were busy, stressful and I was alone. A young boy came in as an unrestrained MVA after his father hit another car. Dad was OK (although severely […] [The AMA’s letter on the American Health Care Act was too narrowly focused]( I am a member of the American Medical Association and chair the Delegation from the Florida Medical Association. As an advocate for the medical profession, I am very proud of the work that we do, but I also realize that much more is needed. In particular, we desperately need to address the growing disconnect between […] [A resident’s guide to being a medical student: In the OR]( As a medical student, I had nightmares about my first day in the OR: scrubbing incorrectly, contaminating a sterile field, forgetting the anatomy I had so carefully studied the night before. It seemed like the only thing I could do in that artificially lit room was mess up. After a few cases I came to […] [The fundamental problem with the American Health Care Act]( As the immediate past-president of the Society of General Internal Medicine (SGIM), the major professional association of academic general internists, I participated in SGIM’s Hill Day on March 8, 2017. Hill Day is when an organization mobilizes its members to visit the offices of Senators and Congresspersons on Capitol Hill in Washington, DC to discuss […] [How do physician-mothers do it all?]( So, how do you do it all? It’s a Monday morning. After a flurry of activities, I am walking into the office at 8:00 a.m. I think back to the past 2 to 3 hours. I was up at 5:30 a.m., and in my workout clothes soon after. I managed to squeeze in a 20-minute […] [How to apply business to medicine]( Just after I started at Stanford’s Graduate School of Business, I wrote an article on why I’m doing an MD/MBA. I argued that business school can help clinicians develop a new perspective, acquire important skills and build bridges between doctors, policymakers, and administrators. I heard from dozens of students, faculty, and physicians who supported the […] [What does it mean to be well? Ask an opiate addict.]( Wellness. It’s all the rage these days as we try to manage our crazy work schedules while still maintaining balance in life. We have wellness committees, wellness workshops, wellness coaches, and wellness apps for our smartphones. So, then, what does it mean to be well? To the average person, and to the dictionary, to be […] [It’s 2017. There’s no excuse to be disconnected.]( “I attribute my success to this-I never gave or took any excuse.” -Florence Nightingale I was publically thanked today for doing my job. No, really. By two of my coworkers, actually. It sort of took me aback just a bit. Over the past Christmas holiday a couple of patients, being human as we all are, […] [Today’s version of the Hippocratic oath]( I swear by Epic, by eClinicalWorks, by Allscripts, by AthenaHealth, and by all the coders and accountants, making them my witnesses, that I will carry out, according to my ability and judgment, this oath and this indenture. To hold my mouse in this art equal to my own hand; to make it right-click as well […] [Finding contentment in rural emergency medicine]( The frenetic pace and chaos of working in an urban trauma center are addicting — at least for a while. Interesting, unusual, and tragic patients test the mettle of even seasoned physicians. For some, the lure is too strong to step away. For others, the attraction of a quieter life and promise of a more […] [How hospital executives wish their hospitalists would act]( Recently, I wrote a letter to hospital executives, urging them to deliberately invest their own personal time and effort in fostering hospitalist well-being. I suggested several actions that leaders can take to enhance hospitalist job satisfaction and reduce the risk of burnout and turnover. Following the publication of that post, I heard from several hospital […] [It’s time to teach residents money management skills]( The scene at the resident teaching session was all too familiar: Awkward silence with either blank stares or brows furrowed in deep valleys of confusion. As I scanned the room, I recognized the moment many lecturers experience: I had completely lost my audience. And, whatever I had planned for the next 10 minutes, would now […] [How hospice helped my mother find peace]( There was a lot about that place I didn’t want to see or hear. The buzzing and whirring of ventilators; the loud call bells; near-dead patients; nurses running around with IV pumps and tubes dangling along behind them; the heart-stopping “Code Blue” warning; or the electrical sizzle of a patient getting shocked as someone screams, […] [How the ER touches the untouchables in society]( I met a man recently who had wandered about life dragging the rotting corpse of his arm barely attached to the rest of his body for over a year. His limb carried such a pungent malodor he stopped eating months ago because the noxious stench of his own dripping pus made him perpetually nauseous. A former […] [The scary evolution of direct-to-consumer advertising]( One night in 1997, as Americans watched Touched by an Angel they were touched by something else unexpected: an ad for a prescription allergy pill called Claritin, sold directly to patients. Prescription drugs had never been sold directly to the public before — a marketing tactic called direct-to-consumer or DTC advertising. How could average people, […] [MKSAP: 28-year-old man with elevated liver chemistry test result]( Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 28-year-old man is evaluated in follow-up for elevated liver chemistry test results, which were performed to assess a 3-month history of fatigue. He has no history of liver disease and has not had abdominal pain or fever. His medical history […] [These 2 words can soothe patients who have been harmed]( When Donna Helen Crisp, a 59-year-old nursing professor, entered a North Carolina teaching hospital for a routine hysterectomy in 2007, she expected to come home the next day. Instead, Crisp spent weeks in a coma and underwent five surgeries to correct a near-fatal cascade of medical errors that left her with permanent injuries. Desperate for […] [The dangers of inexpert diagnosis from a noisy crowd]( The current American climate seems to champion those outside the establishment and eschew the experience of career professionals. Medicine, like politics, has not been immune to the rise of populism. There exists a growing distrust of traditional medical institutions and a movement to concede medical expertise to the public, particularly evidenced by the development of […] [What are the real environmental factors linked to autism? Let’s focus on those.]( The publication of Andrew Wakefield’s notorious and now discredited research on autism and vaccines in 1998 triggered a surge of worry about vaccine safety. Since then, questions about a purported connection between autism and vaccines have been asked and definitively answered: There is no link. But there are other factors linked to the development of autism that […] [The answer to depression isn’t always an antidepressant]( Many patients are referred to me as a psychiatrist to treat their depression. The new patients that come to me for depressive symptoms usually expect that I will be recommending and prescribing an antidepressant for their depressive symptoms because that is what a psychiatrist does, right? Not always. Often times these patients come to me […] [Will telemedicine take your job?]( Telemedicine is often in the news and until recently I had only casually glossed over the latest articles. The details I paid little attention to, but the headlines I would remember. “Great for rural areas” I would read! “Extend physician reach!” “Get specialists to greater numbers of patients with unique conditions!” As a nearly graduated anesthesia […] [The irony of the “sick” caring for the sick]( “Why do you eat so healthy?” or “Where’s your kale today?” I would hear regularly. For as long as I can remember, my colleagues and friends have often smirked at my lunch choice. To me, I always ate what I enjoyed (even if it was the occasional french fry), and my diet and lifestyle were […] --------------------------------------------------------------- [Follow on Facebook]( | [Twitter]( --------------------------------------------------------------- You are receiving this email because you subscribed to the KevinMD e-newsletter. 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