Sunday, May 27, 2007

Darth Vader's Psychopathology

Shrink Rap speculates on whether Darth Vader has a personality disorder:
Huh? BPD is not the first diagnosis I would come up with. I would've thought Narcissistic PD before BPD. Needs at least 5 of these :
has a grandiose sense of self-importance
is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
believes that he or she is "special" and unique and can only be understood by other special people
requires excessive admiration
strong sense of entitlement
takes advantage of others to achieve his or her own ends
lacks empathy
is often envious or believes others are envious of him or her
arrogant affect.I think he had them all.

Narcissistic PD is the diagnosis I came up with 2 years ago in this classic post.

Saturday, May 26, 2007

A Reader Request

This was posted in the comments section of a recent post:
Hello. I'm Cary Byrd and I write the eDrugSearch Blog. I know that you're a reader of Kevin, M.D. as I am, so I thought you might be interested in an interview I just posted with Kevin. You can find it here:

Saturday, May 19, 2007

Which Physicians should make the most money?

A frequent topic on other medical blogs is the relative compensation of various physician specialties/practice types: proceduralists vs. cognitivists, primary care vs. specialists, surgeons vs internists, hospitalists vs. officists. Should the healthcare pie be recut, enlarged, both, or neither?
Here are some of my preliminary thoughts on the matter:
1. Emergency/urgent services: When I develop heart problems, the cardiologist treating my heart attack is going to have a lot more leverage than the primary care doc who later manages cardiac risk factors.
As a society, we need to ensure that certain emergency services- such as neurosurgical treatment of brain bleeds, is available on a timely basis. If there is a shortage of dermatologists, neurologists, psychiatrists etc in an area, a majority of Americans can afford to travel elsewhere to seek these services. If you have just been in a car accident, the lack of nearby neurosurgical care can mean you're dead or permanently disabled.
I feel that those who provide emergency services deserve higher compensation than doctors who don't.
2. After Hour Services: Over-useage of ER's would decline if more docs had evening/weekend hours. Doctors should be able to charge patients extra for seeing them outside of the normal work week. I would personally be willing to pay my doctor more out-of-pocket for the convenience of evening hours. If doctors were allowed to charge surcharges for after-hour services, busy professionals would benefit. Retired persons and the unemployed could continue to go to physicians during normal daytime hours. The only group that wouldn't benefit is the working poor.
More to come on this topic later- maybe.

Wednesday, May 16, 2007

10 Years

I've been a doctor exactly 10 years, over half of that time in residency/fellowship training. Burnt out and cynical already.
If anyone who graduated with me at the University of Iowa College of Medicine is reading this, please post a comment.
I'm still trying to decide on whether I should go the September Class of '97 reunion. If I do go, I'll be sure and drop by the Alpha Kappa Kappa house.