What do organized crime and health care have in common?

Policy
May 8, 2019

During college and medical school, my summer employment acquainted me with members of organized crime families. Now, reflecting on my full career as a primary care clinician, geriatrician, and researcher on health care delivery improvement, I have discovered that several insights from organized crime could guide medical professionals’ responses to our country’s health care crisis.

Organized crime and the U.S. health care industry have more in common than might be immediately …

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The journey of being a parent in medical school

Education
May 7, 2019

One big life event for me was having my son Matthew during medical school. It has been a fulfilling and interesting journey.

I met my husband Andrew during college, and we were lucky to matriculate together at the University of Minnesota Medical School. I decided to do a dermatology research year between the third and fourth years of medical school, and Andrew did a neurology research year at the same time. …

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$34,000 to save mothers and their children from postpartum depression

Physician
May 7, 2019

A swimming pool. Most of a Tesla. Not nearly enough to have your kid swapped out during their sham SAT test. Nor would an ICU bill for a stay that resulted in survival — $48,744 is the cost of that. What costs an alarming amount more is the bill the US Government pays annually on erectile dysfunction medications for servicemen — a whopping $8.7 million according to a 2016 Rand …

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Where is the nurses’ lounge?

Policy
May 7, 2019

If you have worked in the hospital setting for any length of time, you likely are aware of the physicians’ lounge. It’s the protected space where the hard-working medical staff can escape to catch a break or grab a hot beverage. The physicians’ lounge is absolutely necessary. Medical staff members need a space where they can refuel and exhale the stresses that caring for the sick and dying will often …

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Death through the eyes of a medical student

Education
May 6, 2019

Growing up, I was discouraged from becoming a doctor; I was too emotional. My mother, a geriatrician, worried about my attachment to patients and the volatility of inpatient medicine. To some degree, I understood her concerns; I’m tearful during goodbyes and inconsolable at funerals. Yet my interest in medicine persisted, and I began medical school. In my third-year, I experienced the innumerable emotions associated with witnessing patients’ deaths. I was …

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If medical students are already experiencing burnout, how are they going to survive residency?

Education
May 6, 2019

My interest in understanding burnout among medical trainees started during my second year of medical school. With Step 1 nearing, I noticed a dynamic shift in my classmates. The growing tension, petty arguments, and constant worry surrounding our futures took over. This led to a research project assessing burnout risk factors that stood out like a red flag on my application for residency. I found most of my interviewers were …

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Why doctors crash planes

Policy
May 6, 2019

Physicians actually make good pilots. But, in 1966 they received a bad rap due to a report published by the FAA’s Chief of Aviation Medicine, Dr. Stanley Mohler. Mohler had a point. Physicians were crashing planes at a higher rate as opposed to the general aviation population. His report would be a cautionary tale for all of us. It would be three decades before we even began to understand why …

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Many diseases represent an arbitrary number

Conditions
May 4, 2019

A wag once said: “There is no such thing as a healthy person, just one who has not had enough tests.”

As we make every minor deviation from the average into a disease, that jest is becoming uncomfortably close to the way our current medical system behaves.

Part of the problem is that many diseases represent an arbitrary cut-off of a number. Thus, hypertension is defined as a blood pressure above a …

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Thank you for letting us be a part of your child’s life. You truly are the heroes of medicine.

Physician
May 3, 2019

The following is something I wrote for our annual memorial service for children who have died at our Children’s Hospital. But these same thoughts are with me every day.

It’s an honor to be here with you to celebrate the lives of our patients. Thank you for being here. Thank you for sharing your children’s lives with all of us. Speaking for the staff of the children’s hospital, thank you for …

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How to spot a narcissistic doctor

Physician
May 3, 2019

How is it possible that endemic bullying persists in medicine despite myriad initiatives to improve awareness, mutual respect and medical culture?

In some cases, we can blame health systems issues, such as medical workforce shortages, lack of funding and unsafe hours. But in other cases, we must take collective responsibility for failing to hold individual doctors to account for their damaging behaviors.

Most doctors readily change after being counseled about poor social …

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Stop the anti-doctor media bias

Physician
May 2, 2019

The April 18, 2019 CNN headline was a prime example of clickbait: “Feds charge doctors in 8 states in opioid bust, including ‘Rock Doc’ accused of trading pills for sex.”

The only problem with this headline? Of the 60 individuals charged, half were not physicians. More importantly, Jeffrey Young, the so-called “Rock Doc” who prescribed nearly 1.5 million pills of opioids and benzos often in exchange for …

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We need a Hippocratic Oath for administrators

Policy
May 2, 2019

The biggest change in medical practice that has occurred during my 25 years as a physician is the open acceptance of physician employment. Compared to this change, the ACA, EMRs, “Gorillacillins,” and the latest sepsis protocol, combined, aren’t even worth mentioning.

Physician employment was, and is, obviously an intrinsically flawed structure that was considered absolutely unacceptable for obvious reasons for the entire history of medical practice! Now, suddenly physician employment is …

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When physicians are cyberbullied: an interview with ZDoggMD

Social media
May 2, 2019

Pseudoscience hate groups of all kinds are targeting physicians who openly advocate for public health issues. This is a favorite intimidation tactic used by anti-vaccine activists: When pediatrician colleague Jen Trachtenberg posted a video for National Immunization Awareness Month 2018, she was blasted with thousands of horrible comments and fake online reviews. I wrote a blog post in her defense, and immediately, I was similarly targeted, …

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New medical students: Here are 10 tips for success

Education
May 2, 2019

1. Stop comparing yourself to others. You got into medical school, that is an extraordinary achievement. Whatever you have done so far has worked,  you already have proven your intelligence and study habits. You need to trust that you are capable of succeeding in medical school. Every student has different study habits, and different things work for everyone. Just because your classmate is pulling an all-nighter before an exam doesn’t …

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“I earned it. I’m proud of it. I am a doctor.”

Physician
May 2, 2019

I follow a Facebook group of physician moms.  We share and offer feedback on everything from a clinical puzzle to a frustrating patient encounter, and we offer our tricks for how to find balance in a crazy medical life.  I’ve seen several recent posts about women being called Mrs. even when it is known they are a physician.  Most recently there was a long post where a female physician at …

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How often did doctors treat you with courtesy and respect? 

Physician
April 29, 2019

During this hospital stay, how often did doctors treat you with courtesy and respect?   Seriously?  Why is this question even necessary?  Obviously, because it doesn’t always happen.  Well, that’s interesting.  Maybe interesting isn’t the word.  Maybe the word is, “shocking.”  I can’t fathom treating any patient with anything less than courtesy and respect.   I just don’t get it.

I’m not accusing anyone of being rude to patients.

Remember, HCAHPS are not necessarily …

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Pause before writing your personal statement

Education
April 28, 2019

Trust me: The time you spend thinking about your personal statement before you start writing will make the actual writing process much, much easier.

Before you even start writing a word, spend some time reading personal statement examples. Read good ones, read bad ones, read strange ones. The reason for this is to give you an intrinsic idea of what you personally liked and didn’t like. Moreover, you will begin to …

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4 reasons why this physician specialized in infectious disease

Physician
April 27, 2019

The last sunlight of the day was slanting through Joseph’s hospital window. As the sun descended, it burned the sky crimson, and the mists rolled away, disappearing into Rwanda’s seemingly endless hills. I had just arrived in Kigali for global health work with a goal of medical education and, as I looked out, I felt at peace with my recent decision to apply to an infectious disease (ID) fellowship.

Earlier, while …

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How diabetes education programs can help busy primary care physicians

Conditions
April 26, 2019

Busy primary care physicians have a lot on their plates. But when it comes to helping people with diabetes learn how to improve their health, they don’t have to do it all themselves. Diabetes self-management education and support (DSMES) programs, led by a diabetes educator, can provide vital assistance by helping people with diabetes maintain a healthy weight, quit smoking, begin an exercise routine and integrate other self-management behaviors into …

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