Dr. Kurtis Kim has become a top doctor in the world of vascular compressions.  He is well-known in support communities for the conditions, and someone patients seek for care.  He specializes in helping those who have been told they are beyond help, and gives hope to those who have suffered for years.

Vascular compressions are where certain blood vessels are compressed by, or are compressing, other structures of the body.  Dr. Kim specializes in abdominal compressions, which are:  May-Thurner Syndrome (compression of the iliac vein by the iliac artery), Nutcracker Syndrome (renal vein entrapment), SMAS (Superior Mesenteric Artery Syndrome, or the compression of the duodenum between the aorta and superior mesenteric artery), and MALS (Median Arcuate Ligament Syndrome, or compression of the celiac artery by the median arcurate ligament.  While symptoms vary for each compression, all cause damage to the blood vessel itself, like stenosis (enlargement and thickening of the affected vessel), systemic inflammation, issues with blood flow, organ damage, and extreme amounts of pain.  The compressions can also contribute to secondary conditions like headaches and fatigue, high blood pressure, and postural orthostatic tachycardia syndrome (POTS).  

These issues are thought by the general medical community to be incredibly rare.  The physicians who treat them, however, understand they are not actually rare, but are often overlooked or misdiagnosed as other conditions.  Dr. Kim has worked with providers in many specialties, both within his home network at Mercy hospital and outside of that network, to increase awareness of these conditions, leading to more patients getting proper diagnosis.  He has also presented his findings at vascular specialty conferences, inspiring conversation about treatment options and ways to achieve best patient outcomes.  He even re-did one presentation so it could be streamed live so his patients could see it and feel heard and represented (watch here).  

Dr. Kim is also an incredibly compassionate provider.  These are complex conditions, and ones that patients have lived with for years.  For many, he is the first provider to not only listen and believe patients, but to give them answers.  He understands the impact these conditions have had on the lives of his patients, and wants to do all he can to get them treated and able to live a life without the pain they had become so familiar with.  He helps his patients not only with vascular conditions, but also refers for other known co-occurring conditions as well.  This means that patients get properly diagnosed and treated, many achieving symptom relief for the first time - sometimes suffering for decades, or even their entire lives.

In addition to being incredibly accessible to his patients, Dr. Kim uses his own personal time to raise awareness of compressions in other areas.  He is active on social media, raising awareness, and helping patients understand their conditions and the diagnostic process.  He has traveled to consult with physicians to learn more.  He thinks "outside the box" for how to treat difficult patients, trying new techniques, consulting other specialties, and truly going "above and beyond" to give people back their lives.

But hospitals cannot bill for "above and beyond".  There is no CPT code for compassion.  A doctor does not have freedom of his own personal time - they are a doctor first and foremost, and often contractually obligated to their network.

So on Friday, December 3, Dr. Kim's patients were informed that he was no longer employed by Mercy Hospital in Baltimore, MD.  He was asked to change his approach to patient care, or to resign.  He refused, because he believes that all patients should have access to the best quality of care, and wished to continue practicing at Mercy.  His employment was terminated by Mercy.

This doesn't just impact Dr. Kim, patients of Mercy, or even just the greater Baltimore area.  This doesn't just impact vascular patients.  Dr. Kim had been a bridge between multiple disciplines and specialties.  He had worked closely with the Endometriosis Center at Mercy, their gastrointestinal specialists, their pediatric department, and many other providers, specialties, and hospitals in the area and across the country.  He had even just returned from a trip to Germany to consult with the top doctors treating compressions in Europe.  

People from all over the US, and even some outside the country, who had planned to travel to see Dr. Kim for consultation or surgical treatment, had their appointments cancelled by the hospital.  They now have to start over.  Patients who were working towards scheduling, getting preliminary testing done thru their primary physicians (and educating them about compressions in the process),hoping to finally get answers, are now left with no options.  Patients who were currently under his care were not contacted by the hospital, but will be reassigned to another physician and just "surprised" with who that will be at their next visit.  Mercy is refusing to even provide referrals to other providers, or to assist with transitioning patients.  

So why does this matter?  What difference does one doctor make?

It's not just one doctor, it's the change in approach to care.  Vascular compressions, the conditions known to occur alongside them, and the conditions they are often misdiagnosed as are all chronic conditions that affect primarily those assigned female at birth.  The diagnostic criteria, however, is based on persons assigned male at birth.  This leads to an incredible lack of proper diagnosis for many patients.  Dr. Kim, however, looks at the patient as an individual person and uses many sources together (symptoms, imaging, testing, history) to diagnose his patients.  Other doctors treat patients like a checklist, expecting each case to be exactly as defined in medical school - practicing medicine "by the book".  Medicine cannot be practiced "by the book" when the book isn't inclusive.  Persons assigned female at birth and BIPOC are regularly excluded from studies, or lumped together as one "minority" subgroup if they are included at all.

Per a CDC report in 2018 (source), 51.8% of adults in the US had at least one chronic illness.  27.2% of them had multiple chronic illnesses.  Again, occurrence was higher in persons assigned female at birth.  Chronic illnesses often have a delay in diagnosis, requiring a patient to see numerous doctors before getting a proper diagnosis.  One study (source) stated a 7.6 year delay and an average number of 8 doctors seen before being correctly diagnosed.  This process repeats for each diagnosis.  But patients who have one chronic illness are statistically more likely to have others.

Simply put: the chronic illness community needs doctors like Dr. Kim. 

Hospitals and provider networks treat patients like checklists, not people.   Providers like Dr. Kim are working to change that.  It's a change that should be embraced, or at the very least allowed.  Mercy has prevented that, because instead of seeing people and the impact on lives, they see only dollar signs and the impact on their bottom line.