You are not “asleep” under anesthesia

Conditions
August 5, 2021

“You will be asleep for your surgery,” anesthesiologists often reassure their patients. Just before the start of anesthesia, a patient may hear the nurse saying, “Think of a nice dream as you go off to sleep.”

While these statements are intended to soothe patients during a stressful time, they gloss over this critical fact: Anesthesia is not like normal sleep at all. That’s why you need medical doctors – anesthesiologists – to take …

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You are not “asleep” under anesthesia

The pancreas of the future?

Tech
August 5, 2021

Hidden in the epigastric region of the abdomen concealed by a curtain of peritoneum is a moody, often forgettable little organ. Of course, the term organ is a somewhat generous description for this rather overqualified gland. The pancreas has its own set of rules as it mischievously lurks behind the stomach waiting for its cue for chaos.

In a moment of theatrical exaggeration, it can go from completely forgettable to a …

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The pancreas of the future?

Why physician-specialized private counseling practices are important

Physician
August 5, 2021

Last year, a physician friend began experiencing what she believed was burnout. She felt constantly overwhelmed, had difficulty sleeping and eating, and began to dread going into her office. She worried excessively about patient outcomes, decisions she had made, and whether she was actually a good doctor. She even began to cry unpredictably. Like so many physicians who struggle with these kinds of symptoms, she avoided seeking help until she …

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Why physician-specialized private counseling practices are important

How to recover from a bad electronic health records implementation

Tech
August 4, 2021

Is your health care organization reeling from a bad EHR implementation?

There have been rumblings from hospital leadership and congressional committees about the Veterans Administration (VA) Hospitals’ implementation of the Cerner Corporation electronic health record (EHR) replacing the VistA EHR.  The $10 million EHR overhaul has been controversial since the staggered rollout started in Spokane, Washington.  One report noted that months after the go-live, fewer users knew how to operate the …

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How to recover from a bad electronic health records implementation

Primary care: I love the variety and the intimacy of the problems that are placed before me

Physician
August 4, 2021

An excerpt from Becoming Doctors 25 Years Later: Twenty five physicians sharing the journey from medical student to retirement.

If I get out of bed now, I can squeeze in that ten-minute morning yoga routine on YouTube. But it feels so nice lying here, sunlight streaming in, sips of coffee warming my body and boosting my heart rate up a notch. If …

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Primary care: I love the variety and the intimacy of the problems that are placed before me

Be the Simone Biles of health care

Physician
August 4, 2021

In a world full of white coats, wear a leotard.

The news of Simone Biles’s recent withdrawal from the Tokyo Olympic Games shocked the world. What was surprising to many was the reason—not a physical injury, but a commitment to prioritizing her mental health. Biles later revealed that she had been experiencing a case of the “twisties.”

So, what are the twisties?

Twisties is a term that refers to a mental block or …

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Be the Simone Biles of health care

Do you have an anti-fat bias?

Conditions
August 3, 2021

When Linda said she wanted to weigh 150 pounds, her doctors balked. In the fall of 2020, Linda weighed over twice that number. Her obesity was causing her debilitating knee pain, leading her to miss work as a mammography technician, a job she loved.

Wanting to return to what she enjoyed, Linda underwent bariatric surgery. With a large portion of her stomach removed, she began a stringent diet and exercise regimen, …

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Do you have an anti-fat bias?

Don’t let anyone tell you to stay in your lane

Physician
August 3, 2021

Do you ever wonder why some issues are global or universal? It does not matter if you are a surgeon, a mega soccer star or a world-class runner—we all have things in common. Whether you are at the top of your game or just climbing your way, we must always fight for equality, for basic rights, for humanity?

While driving home, I heard an NPR interview with Megan Rapinoe, the U.S. …

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Don’t let anyone tell you to stay in your lane

Can doctors have personalities?

Physician
August 3, 2021

Can doctors have personalities? I get this question a lot, or, rather, I get told by patients as a running joke that physicians typically lack the fun gene. Understandably, we have dedicated our youth to the medical profession and have missed out on most of our twenties and thirties by completing rigorous training and building our new careers to where we do lose a crucial time in early adulthood development. …

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Can doctors have personalities?

Take back the power and joy of being a doctor

Physician
August 2, 2021

I cannot accept that others have control of how I feel, act and think. I admit it’s easier to blame others — the disrupted system, the incompetent “leaders,” the unhealthy environment and the micro-aggressive behaviors. But I refuse to give that power to others! I’m the owner of my goals, thoughts, feelings and actions. And I refuse to burn out!

Burnout

Dr. Freudenberger first coined the term in 1974 to define …

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Take back the power and joy of being a doctor

The future of general internal medicine is bright

Physician
August 2, 2021

A 2020 President’s Message by Dr. Douglas DeLong struck a reassuring, optimistic note regarding the future of general internal medicine, a primary care specialty that has struggled in the last decade with decreasing numbers of residents choosing to join its ranks. Data shows that since 2011, the percentage of U.S.-trained physicians who have matched into primary care positions has been on the decline.

Many factors …

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The future of general internal medicine is bright

A conversation on death and hope a pediatric palliative care physician

Physician
August 1, 2021

As rising fourth-year medical students, we talked about caring for dying patients with Dr. Angie Anderson (AA), a pediatric palliative care specialist. An abridged version of our conversation is transcribed below.

Lindsey Pileika (LP): Honored to speak with you, Dr. Anderson. I just wanted to preface our interview with experiences that I’m bringing to this conversation. During my third year, I was working on the pediatric hematology-oncology service, where we frequently …

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A conversation on death and hope a pediatric palliative care physician

Robotic surgery’s impact on training the next generation of surgeons

Education
August 1, 2021

While we’re not there yet, we may be approaching a point where we’re facing a significant skills shortage among surgeons. A 2017 study by Meritt Hawkins found that 52 percent of orthopedic surgeons were 55 and older, as were 48 percent of general surgeons. As many surgeons approach retirement age, there is a pressing need to up-skill and up-level the next generation of surgeons, especially with demand …

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Robotic surgery’s impact on training the next generation of surgeons

Why becoming a “doctorpreneur” made me a better physician 

Physician
July 31, 2021

I have been a “doctorpreneur” for the past decade.  I’ve done everything from locums work to real estate to coaching women physicians and residents to advising companies and venture capital firms, and the list goes on.  If it’s inspiring to me, I dive in.  What I’ve found out from all of my business ventures is that once I decided to make medicine something I did because I loved it, and not my primary …

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Why becoming a “doctorpreneur” made me a better physician 

This obstetrician recommends midwifery care

Physician
July 30, 2021

In 2014 I learned about the worsening maternal mortality statistics in the U.S. and the racial disparities in maternal health, which socioeconomic or medical risk factors could not explain away. I decided a community-based solution was necessary because, as an African American obstetrician, I had no expectation that my fellow obstetricians would soon recognize how racism permeated our specialty and impacted …

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This obstetrician recommends midwifery care

Burnout and bias? Or medical gaslighting?

Physician
July 29, 2021

Five years into my practice as an academic allergist/immunologist, my perceptions continue to evolve. Though once primarily informed by my mentors’ wisdom, I continue incorporating my experiences as both physician and autoimmune patient to guide my practice. Though we all know medicine isn’t like it used to be, nostalgia is bittersweet. In its wake, the real question remains: how are we going to respond to ongoing changes and fight for …

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Burnout and bias? Or medical gaslighting?

If Simone Biles were a doctor she would be vilified, not praised

Physician
July 28, 2021

When the greatest-of-all-time gymnast Simone Biles withdrew from the Olympics to focus on her mental wellbeing, most observers applauded her decision, viewing it as an act of courage and bravery, an eye-opener for breaking the stigma around mental health. Many felt it was a positive step (no pun intended) because it reignited conversations about elite athletes and other high-stress professionals and their ability to perform under psychological adversity. However, does the …

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If Simone Biles were a doctor she would be vilified, not praised

President Biden’s tax proposal and its effects on estate and income tax planning for physicians

Podcast
July 28, 2021
YouTube video

This article is sponsored by Wall Street Alliance Group.

While physicians provide a vital service to the U.S., they often have blind spots when it comes to maintaining their own financial health. Many in the …

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President Biden’s tax proposal and its effects on estate and income tax planning for physicians

The Apgar Olympics: The race is on

Physician
July 28, 2021

The page comes during a lull on an otherwise busy day in the well-baby nursery (WBN). My pager’s shrill cry rouses me like the blast of a starting pistol.

DI-DI GESTATION. 37 WEEKS. BABY A WITH NON-REASSURING HEART TONES. BABY B BREECH. OPERATING ROOM A. COME STAT.

Translation: Twin birth. Baby A is STRESSED. Baby B attempted a front flip but got stuck. HURRY.

The race is on, and I am determined to …

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The Apgar Olympics: The race is on

CDC updates indoor mask guidance

Conditions
July 28, 2021

Due to emerging science about transmission in vaccinated people, the CDC now recommends all teachers and students wear masks in school, and that people living in COVID-19 hotspots, or areas of the country with large outbreaks, wear masks indoors, CDC officials said on Tuesday.

CDC Director Rochelle Walensky, MD, attributed this updated guidance to new science surrounding the Delta variant, showing that “some vaccinated people infected with the Delta …

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CDC updates indoor mask guidance

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