I could wallpaper a rather large wall with my diplomas, certificates, awards, and licenses. Each gilded slip of paper demarcates a moment in the last 20 years when I finished, graduated, certified or did any one of many steps required to become a board certified physician. Yet, after all of the sleepless nights, deferred self-care and catastrophic debt — after all this — 3 years ago I sat at my …
How I became the doctor I always wanted to be
Did you see this recent post on MedPage Today? “Burnout: Is Medical School the Staging Area? Burnout prevention starts in medical school.”
The article describes important new work at the University of Chicago Pritzker School Of Medicine to improve medical student resilience. It’s great to see medical schools addressing burnout and equipping students with valuable coping mechanisms.
As the post states, “One way to do this is to induce a greater resiliency …
Lean provides a way to prevent physician burnout
Perhaps the greatest flaw in medical training is our blatant avoidance of any education related to the business of medicine. Primarily focused on treating illness, trainees often don’t want to hear about how they are going to be compensated in the future, and medical school administrators fear that such training would further decrease interest in specialties that reimburse at a lower rate per unit time. Some doctors get 10s and …
This is the greatest flaw in medical training
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I spent the past month working on an inpatient medicine team at our tertiary care hospital. As a referral center, we often care for incredibly complex patients who require multiple consulting services. One of the most vexing parts of caring for our patients is attempting to track their care through many previous hospital systems.
Unless a patient is both extremely vigilant about his or her medical care and highly health literate, …
How poor interoperability affects patients
I watch as my almost-2-year-old daughter awkwardly climbs the stairs. I do not hold her hand, but I do not turn my back on her either. She is still clumsy, and her little-bowed legs often miss their targeted landing spots. She holds on to the rail with a vice grip that steadies each monumental step forward and upward.
Every so often she wobbles as she miscalculates the distances and her toes …
Are we training a generation of soft doctors?
For decades, many physicians have been pushing for comprehensive tort reform on the national level. Malpractice claims in the U.S. are twice those of other developed countries such as England, Canada, and Germany. Payouts in a U.S. claim can easily reach 3 million dollars or more; in Germany most claims are around $30,000 or less.
A survey conducted by RAND in 2011 estimates that 99 percent of American physicians in high-risk …
Why doctors will continue playing defense in the clinic
Spend spend spend — that’s the push by marketers and websites this time of year. Except from me. Here are three holiday gift things nobody needs. Save your money, or buy something else if you must, but stay away from today’s featured items:
1. Crib bumpers. The American Academy of Pediatrics has called for banning these things since 2007, but they’re still sold. And they’re still killing babies. A Read more…
Don’t buy these 3 gifts for babies this holiday season
With the depths of winter just around the corner, doctors and nurses everywhere know what’s about to hit them over the next few months. The inevitable surge in hospital admissions during colder weather is almost as predictable as knowing the leaves will be falling off the trees in the fall.
As someone who has worked in several different hospitals over the last few years, ranging from small rural institutions to large …
Hospitals and doctors should better prepare for winter. Here’s how.
There is only one correct, perfect, absolute approach to life and decisions near its end. This truth relieves the doctor of final decision. The right way lifts the burden of anxiety, confrontation or guilt. The perfect path makes giving care at a very hard time, much easier. That correct course, the only way to treat every patient and every family, is exactly what the patient and family say it is.
This …
For each cancer patient, there is one perfect path
So, you’ve finished all your job interviews and think you’ve found a perfect fit. Graduating from residency is exciting, but did you get any training on what it all means to sign on the dotted line?
Below is a quick and dirty run-down of the contracting process from an industry insider.
1. Non-compete clauses. Non-compete clauses are not just a big med phenomenon; they are part of contracts in many different clinical settings. …
7 things doctors should consider before signing for a new job
The clues are usually there, even in the hardest of cases. They just aren’t presented to you on a silver platter.
Gwen Stephenson had an ill-defined polyarthritis and had been on methotrexate for some time. Her rheumatologist, Norm Fahler, had tapered her off the medication while keeping an eye on her inflammatory markers and they had leveled off at just above the normal range.
Seven or eight years ago, Gwen had suffered …
A low-grade fever that humbled this physician
I am constantly coming across articles of physicians with strong voices. Physicians that are jaded. Physicians that didn’t go into medicine to be defined by patient satisfaction surveys. Physicians that didn’t go into medicine expecting that people wouldn’t trust in their training because the Internet begs to differ. Physicians that cringe at the drive-through mentality that patients can present with diagnoses in hand and demands for tests to be done. Physicians …
Physicians are jaded, but this is what keeps them in medicine
“Words are, of course, the most powerful drug used by mankind.”
– Rudyard Kipling
I read Drs. Dhand’s and Carbone’s post with great interest: Physicians are not providers: An open letter to the AMA and medical boards. I began writing a comment; it turned into an essay.
I support Drs. Dhand and Carbone in this endeavor. The word “provider” diminishes the people who cure, treat, and heal, whether they’re physicians, nurses, …
The word “provider” dehumanizes any person who cares for patients
The past year had been a tremendously exciting time to be an oncologist, and to be a lung cancer oncologist in particular. It seems we hardly have time to get used to one newly approved agent before another one becomes available. In 2015, we have seen gefitinib (don’t I know you from somewhere?), afatinib, nivolumab (twice), pembrolizumab, necitumumab, and osimertinib all …
This is why a computer algorithm cannot ever fully replace a doctor’s judgment
I can’t tell you how many people have flung this Facebook item at me since last night, starting with my wife. It’s already approaching 25,000 shares.
Listen, people: Googling does not mean I think I’m a doctor. It’s a sign of being an engaged, empowered “e-patient.”
I partner with great doctors — I don’t tell them what to do. And they welcome me doing it.
I personally am completely …
Googling is a sign of an engaged patient
Between September 9th and October 6th, 2015, the consumer-level computer world was turned completely on its head. In early-September, Apple hosted its annual iPhone press release that announced the redesigned iPhone 6s and the iPad Pro. A little over one month later, Microsoft announced a bevy of new devices, including a redesigned Windows Surface Pro (they are now up to the Surface Pro 4) and the unanticipated but incredibly intriguing …
Should physicians carry 2 sets of mobile devices?
The fact that primary care is undervalued by Medicare and other payers has been long understood to be driving the precipitous decline in the numbers of new physicians choosing primary care internal medicine or family practice, and a growing exodus of established primary care physicians.
Efforts to address this undervaluation have traditionally been to, 1) bump up the payments (relative value units) for the office visit codes traditionally billed by primary …
7 new Medicare codes primary care doctors can use to increase payments
As a third year medical student, I am as green as they come. As much as I feign familiarity in the hospitals, each day of every rotation brings a host of firsts: first time suturing, first natural delivery, first terminal patient, first 24-hour shift, first code blue. The novelty of these experiences is equal parts exhilarating and overwhelming. As future physicians, we have invested the better parts of our time, …
May my humanity heal where my science cannot
At some point in our lives, and it probably happens more often than we’d like to admit, we fake it.
Let’s get real, shall we friends?
Think about it. Your mother is having heart surgery in a small town across the country. You are, frankly, worried sick. Do you tell anyone in the operating room, especially your patient?
What would you do?
If you’re like me (OK, this was me recently), you fake it. You smile at your …
How can physicians know when to fake it?
A presentation given to the bioethics committee, Sacred Heart Hospital, Pensacola, FL.
My presentation today is about the challenge, professionally and emotionally created by certain external forces, which encompasses bioethical issues when one’s roles merge.
I am privileged and blessed to have many roles in my life: physician, wife, daughter, mother, now grandmother, sister, aunt, friend, and colleague. At times, these roles blend, other times, they are murky and can cause intense …
The ethical implications when physicians’ roles merge
