With my transition to opioid-free, I went from a mindset that this is a necessary evil for controlling pain for my patients after surgery so that they can achieve the outcome of having a repair or reconstruction to this is not necessary. And I approached my patients with that mindset…
"How do we manage this? All patients meet with the physical therapist before surgery and within two days after surgery. They use transcutaneous electrical nerve stimulation (TENS) before and after surgery. They get a regional anesthetic block from one of our anesthesiologists, supplemented with local injection during surgery. They use…
Lifestyle medicine is the medical specialty that uses evidence-based lifestyle and therapeutic intervention as a primary approach to prevent, treat, and often reverse the chronic diseases that are so common today. And it does that by addressing the root causes. It looks at the whole person and enables people to…
When patients don't feel heard, and that's often the case when we as physicians have very little time to see them and they are confused about the type of information, or they don't feel heard because they don't really have the time they would like with their physician. When that…
"Scientific research impacts our lives, however, and much more profoundly than we generally appreciate. Considering the wide-ranging benefits, science is not just for scientists. Research discoveries are often translated to tools and applications down the road, usually without reference to the original science behind them. Without science, we would not…
In the previous practice, we had 20 minutes for a new patient and 10 minutes for a routine visit. I allot 55 minutes for a new visit or an annual check-in in my practice. And 25 minutes for a routine visit. I also buffer every appointment, so after every appointment,…
The administrative role in medicine has grown exponentially over the past four decades. Doctors are required to work harder and harder, spending less and less time with patients and diverting revenue to overhead, and the result has. Corporatization results in doctors spinning the hamster wheel as fast as they can,…
"My quality of life is outstanding. I leave work every evening only after every call is answered, fax addressed, a prescription delivered, then retreat to my home a mile away. The proximity makes it easy to see patients after hours, on weekends, and on holidays; I promise to see patients…
I feel like a lot of systems, especially hospital systems, are telling doctors there's no negotiating. You just sign it, you DocuSign it. I disagree because I always get changes, and it's always about leverage. And so I always talk to my docs about what leverage you have. Because trust…
I think doctors sometimes forget that they're running a business with people. And so anytime you're dealing with human beings, you're going to have some tension and some stress, and you need to know, are you classifying them correctly, and what do you do when they file an employment discrimination…
"Being a transactional lawyer for physicians is never dull because the more the regulations, guidance, and laws change, the more questions everyone has. But it’s more than just getting an answer to a question and being in compliance. Doctors are feeling overly worn down and out of control, and the…
60 percent of physicians are burned out. They would share and write their story on KevinMD, and then other physicians would chime in to comment and say, “I feel that way too. This is my story.” And then they'll share their story in a comment. And that normalizes burnout, right?…
There is no more physicians' lounge anymore at the hospital. You have hospitalists, and then you have outpatient physicians, and we never see each other. In fact, I'm an outpatient primary care physician. I don't know the last time I rounded in a hospital. It must have been 15 years…
In this special episode, I'm on the other side of the microphone. I'm interviewed by CMEfy's Brian Cohen on the Co-Learning Clinician podcast, and we discuss the concept of physician co-learning, opinion pieces vs. gold standards in medicine, what I learned from interviewing physicians, physicians being more than their degrees,…
What makes it great for business because there's homogeneity, a predictability. Steve can be replaced by Mary and Joe and Sean and whoever else. If all I am is a servant to a corporation that has no real importance to them other than the ability to service their cascade, I…
I've watched the art of medicine decline. So doctors now have a doctor-computer relationship where the doctor has a relationship as an employee, or they have a relationship with their staff, like an ER doctor, radiologist, or pathologist, but no relationship to the patient. Steven Kamajian is a family physician.…
"The art and craft of being a physician and finding meaning in our care of others are to make poetry out of our lives." Steven Kamajian is a family physician. He shares his story and discusses his KevinMD article, "As doctors, caring is our poetry." The Podcast by KevinMD is…
It is remarkable the honor and the privilege that patients give us as physicians in revealing those kinds of deeper things. If they think you're really sincere and you're hearing them, you're not just typing on your computer and that kind of thing. So listening is a key component, and…
“Give us an example of how other cultures have taken that healing role better than we have. Because what you're saying is completely right. There are so many obstacles that interfere with our healing of the patient. There are so many time constraints. In your view, what other cultures do…
"My lifelong quest to become a healer — over 40 years as a family physician, scientist, and researcher with the National Institutes of Health, the World Health Organization, the Walter Reed Army Institute of Research, and the Department of Defense — has led me to conclude that the best way…
Boundaries mean I want to be in a relationship with you, even if you are an organization. And so I need to define what's OK and what's not for you. And so I help physicians develop scripts about how to do that and weigh the pros and cons so they…
People were confusing resilience with grit, and we've been asking physicians to adapt to unhealthy oppressive symptoms and systems and show perseverance despite huge amounts of emotional exhaustion. And so, they wanted people to be grittier when physicians were already showing huge amounts of perseverance despite challenges during COVID and…
"It’s not that physicians need to be more resilient. We’ve failed to provide them with the goodwill to be human and embrace their “whole selves” (people who are resilient often but not always), access to safe and consistent relationships to heal, and systems that support their well-being. Physicians have persevered…
“What kind of questions should one be asking themselves if they want to consider having a colonoscopy with or without anesthesia?” If the doctor recommends a colonoscopy, go ahead and do it. If there is a doubt, don't leave any stone unturned, and many people don't know that colonic polyps…