January 2018

January 20, 2018Jan 20, 2018

We are now almost 2 1/2 years into this parenting thing. It is a pretty amazing thing, raising a toddler. There are a lot of awesome days, watching him learn and explore his surroundings. The sentences that are coming out of his mouth now are pretty wild. He is funny, has a good amount of potty humor, and is all around a cool kid (at least I think so).

That is …

Health policy

If politicians really want to address the problems in health care, this is what they should do

Linda Girgis, MD

January 20, 2018Jan 20, 20184

Americans witnessed the many failed attempts of our elected officials to reform our broken health care system over the past year. Some call for repealing and replacing the Affordable Care Act (ACA) while others think it is the cure-all for what ails our system. The simple fact that politicians fail to consider is the fact that having health care coverage does equate to actually receiving health care services.

In fact, the …

Conditions and diseases

MKSAP: 55-year-old woman after bariatric surgery

mksap

January 20, 2018Jan 20, 2018

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 55-year-old woman is evaluated during a routine examination. She underwent biliopancreatic diversion with duodenal switch 8 years ago for treatment of obesity-related complications…

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 55-year-old woman is evaluated during a routine examination. She underwent biliopancreatic diversion with duodenal switch 8 years ago for treatment of obesity-related complications and lost 68.0 kg (150.0 lb) in the first year following surgery. Her weight has been relatively stable for the last year. She has had chronic nonbloody diarrhea since her bariatric …

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Physician voices

Young surgeons are learning robotic surgery in the shadows

Matt Beane, PhD

January 19, 2018Jan 19, 20186

Artificial intelligence and robotics spell massive changes to the world of work. These technologies can automate new tasks, and we are making more of them, faster, better and cheaper than ever before. Surgery was early to the robotics party: Over…

Surgery was early to the robotics party: Over a third of U.S. hospitals have at least one surgical robot. Such robots have been in widespread use by a growing variety of surgical disciplines, including urology and …

Physician voices

5 ways poorly thought out health IT can worsen patient safety

Suneel Dhand, MD

January 19, 2018Jan 19, 20182

The frontlines of health care have been transformed over the last decade as electronic medical records have been rolled out across America. Unfortunately, information technology has yet to live up to its immense promise in health care — a topic that I frequently write about. As somebody who has worked with every single major EHR on my travels, I am being brutally honest when I say not a single one …

Physician voices

A 16-page note with little information to help physicians

Niran S. Al-Agba, MD

January 19, 2018Jan 19, 201840

My pediatric practice is one which harkens back to days long ago when physicians knew their patients and pertinent medical histories by heart. My 81-year-old father and I were in practice together for the past 16 years; he still used the very sophisticated “hunt and peck” to compose emails. The task of transitioning to an electronic record system seemed insurmountable, so we remain on paper. Our medical record system has …

Physician voices

Women in medicine: Getting to this point came at a cost

Diane Birnbaumer, MD

January 19, 2018Jan 19, 2018

Sometimes life just walks right up and slaps you in the face. It happened to me while attending the dynamic FIX17 conference in NYC, and it led to an epiphany: At the ripe old age of 59, I am officially…

I was giving a talk on the history of women in medicine. Passionate about the topic, I spent months planning and organizing the lecture, weaving what I hoped was an intriguing tale …

Medical education

Please show more interest in your health than my looks

Misha Armstrong

January 19, 2018Jan 19, 2018

In 2017, more women than men were accepted into medical school for the first time. 2017 also brought attention to the sexual harassment many women face that often goes ignored. Medicine is not immune to behavior that objectifies women and ignores their complaints. My experiences are mild in comparison to many of my peers, but highlights the comfort both patients and physicians feel discussing the appearance of female trainees.

***

I was …

Physician finance

The story of how this physician got into debt

Cory Fawcett, MD

January 19, 2018Jan 19, 201821

When I was a young lad, just heading off to college, I had no debt. I had no credit cards. My family didn’t use debt for purchases other than buying our house. I really didn’t have any knowledge about how to best use debt. My student loan package included a scholarship, a work-study program and $1,500 a year in student loans. I earned about $4,000 each summer working in the …

Physician voices

Physician burnout is caused by systems problems. Here’s how to fix that.

Diane W. Shannon, MD, MPH

January 18, 2018Jan 18, 20184

I am very resistant to burnout solutions that focus solely on the individual, as these seem to imply that the problem originates in the affected person. This approach pokes at a sore spot, because of the years I spent secretly worried that the reason I left practice was personal weakness or inadequacy, something I lacked or failed to do.

When in 2013, I ran across the research on burnout, I learned …

Physician voices

How gauze and tape healed a relationship

Bruce Campbell, MD

January 18, 2018Jan 18, 2018

"You've got to jump off cliffs all the time and build your wings on the way down." - Annie Dillard Months ago, when my patient and his wife were in my office for the very first time, I could already…

“You’ve got to jump off cliffs all the time and build your wings on the way down.”
– Annie Dillard

Months ago, when my patient and his wife were in my office for the very first time, I could already tell that he would resist any display of sympathy from her and she would clearly be uncomfortable with ever being a caregiver for him.

There was tension in the room. He “had not …

Physician voices

What’s the point of a perfect patient chart?

Fred N. Pelzman, MD

January 18, 2018Jan 18, 2018

Last week I made a patient's chart perfect. Not bragging, but ultimately it ended up being pretty easy, and I'll explain how and why in a little bit. This was a patient I had not seen in several years, with…

Last week I made a patient’s chart perfect.

Not bragging, but ultimately it ended up being pretty easy, and I’ll explain how and why in a little bit.

This was a patient I had not seen in several years, with a number of chronic medical problems, for which he had been taking less than optimal care of himself since I had seen him last.

Here for a “checkup,” we talked about his health …

Physician voices

The practice of emergency medicine is a team sport

Sandra Scott Simons, MD

January 18, 2018Jan 18, 2018

"Same team!" bellowed all the frustrated parents from the sideline of a lacrosse game as we watched two teammates clash sticks while fighting to catch the same pass. Both players missed the ball, and the other team scooped it up…

“Same team!” bellowed all the frustrated parents from the sideline of a lacrosse game as we watched two teammates clash sticks while fighting to catch the same pass. Both players missed the ball, and the other team scooped it up and scored, perfectly illustrating to our kids what happens when they battle among themselves.

It’s easy to remind our kids that teammates shouldn’t fight, but it’s harder to remind each other …

Physician finance

A physician cancels his life insurance policy. Here’s why.

DocG, MD

January 18, 2018Jan 18, 20183

My blog is called "DiverseFi" because my path to financial independence was not the typical one. Although I’ll talk more about this in another post, my journey neither started from humble beginnings nor was frugality my guiding principle. In fact,…

My blog is called “DiverseFi” because my path to financial independence was not the typical one. Although I’ll talk more about this in another post, my journey neither started from humble beginnings nor was frugality my guiding principle. In fact, it was only after discovering the FIRE community, did I realize that I was indeed financially independent.

That changed my life. Changed my habits. I slowly became more …

Physician voices

Patient satisfaction surveys are worthless. Here’s why.

Skeptical Scalpel, MD

January 17, 2018Jan 17, 201821

For several years, Medicare has tied hospital reimbursement to its definition of quality of care. Poorly performing hospitals can be penalized as much as 2% of their Medicare payments. As part of Medicare’s assessment of quality, surveys are used to…

For several years, Medicare has tied hospital reimbursement to its definition of quality of care. Poorly performing hospitals can be penalized as much as 2% of their Medicare payments.

As part of Medicare’s assessment of quality, surveys are used to measure patient experience and satisfaction. One of the components of the Medicare survey is pain management, which Medicare describes as follows:

I’m not sure who, if anyone, …

Physician voices

Bad things happen to every doctor

Sam Ashoo, MD

January 17, 2018Jan 17, 2018

The fact that unexpected outcomes and rare events occur is one of the realities of medicine that is difficult to comprehend until you have personally experienced it. There are over 130 million emergency department visits annually, over 16 million of which require admission to a hospital. With that many encounters, even the rarest of events becomes possible. However, practicing medicine is impossible if you are constantly looking for the 0.0001 …

Read more…

Bad things happen to every doctor

Physician voices

The patient is your only focus

Gil C. Grimes, MD

January 17, 2018Jan 17, 20185

It was another weekend of training in Hakomi. We were working on figuring out our resources (those things in our lives that help us get through tough times). It was the second day of training for this block, and my…

“Why don’t you take me through a usual day then, how do you start seeing your …

Read more…

The patient is your only focus

Physician voices

How Harvard changed my health care leadership career

Tiffany Love, PhD

January 17, 2018Jan 17, 20184

As a senior health care executive, I plan continuing education carefully each year to ensure I am maintaining competence and pursuing excellence in leadership development. Unsettled by barriers perceived for women in leadership locally and nationally, I did not expect the career development programs offered through my agency would meet my needs. My search led me to the “Career Advancement and Leadership Skills for Women in Healthcare” offered through Harvard …

Physician voices

A patient accused this doctor of sexual harassment

Thomas D. Guastavino, MD

January 17, 2018Jan 17, 201875

It was a typical weekend on call. The usual number of surgeries, ER calls and consults. I was called to consult on 47-year-old female who had been admitted with four days of left shoulder pain. She had gone through a cardiac workup and was cleared by her internist. So now, a consult was called to see if there was an orthopedic cause for the patient’s pain — not an uncommon …

Physician finance

18 ways for physicians to invest $25,000

Passive Income, MD

January 17, 2018Jan 17, 2018

So a new year is upon us! 2017 was a fantastic year for investors in general, so I hope it was a prosperous one for you. I believe that 2018 will be a great year as well and filled with…

So a new year is upon us! 2017 was a fantastic year for investors in general, so I hope it was a prosperous one for you. I believe that 2018 will be a great year as well and filled with multiple opportunities for everyone. A quick wish: May your 2018 be filled with much joy, great health, and hefty growth of your passive income streams.

Now back to the post – One …

January 2018

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