Over the last several years since I graduated from residency, I’ve worked in many different hospitals up and down the east coast. These have ranged from large urban medical centers to rural community outposts. In all of these places I’ve felt the inevitable conflict that exists between physicians and administrators — to varying degrees.
It almost seems like a rite of passage that the world of clinical medicine and administration are …
Physicians today are increasingly viewed and treated as skilled workers instead of professionals. The difference is fundamental and lies at the root of today’s epidemic of physician burnout.
Historically, there have been three learned professions: law, medicine, and theology. These were occupations associated with extensive learning, regulation by associations of their peers, and adherence to strong ethical principles, providing objective counsel and service for others.
Learned professionals have, over many centuries, worked …
Hope is a tricky thing. On the one hand, false hope can lead patients to opt for painful, futile treatments at the end of life. On the other, unnecessarily bleak outlooks can lead to depression and inaction. When health is at stake, presenting information with the right amount of hope can guide patients away from both suffering needlessly and/or succumbing to treatable disease.
I was reading a sad story about a …
This question has been circulating in the academic medical world for years. As an intern and resident, I would hear complaints about how “unready” they seemed. The grievances often include adjectives like ill-prepared, lazy, or uninterested. The complaints have burgeoned over time, and the examples are numerous in my institution: Students show up late to rounds with coffee in their hands; one med student had the gall to go directly to the attending and …
It is exactly 49 steps from my bedroom to my garage. It is a 23-mile drive to the hospital and 75 steps to the unit. It takes 10 seconds to walk to the nursing station. I can measure what it takes to get me to work each morning with absolute certainty. I know because I have measured it a million times hoping something will prevent me from reaching my destination. …
I order pregnancy tests on men. In fact, I do it pretty frequently.
Now before you go and question my professional competency, let me assure you that I went to a good medical school. I also completed a four-year residency in emergency medicine at a top-notch residency program. I was board-certified less than one year after finishing and have maintained that status ever since.
Despite this, I still order pregnancy tests on men.
Perhaps …
Sometimes, it’s difficult to recall that single defining moment or person that sends you on the path you’re meant to take in life. I was fortunate in that I found that experience halfway through my undergraduate career at the University of California, Davis. I had recently lost my grandmother; although I’d wanted to help, all I’d been able to do at the hospital was translate for her. That overwhelming sense …
You may be aware of Ezekiel Stephan, a 19-month-old boy, who died in 2012, after his parents chose home remedies and naturopathy for the treatment of viral meningitis. The parents currently are on trial in Canada for failing to provide the necessities of life.
Over the course of many days, Ezekiel’s condition rapidly deteriorated, but his parents chose to “give him as much natural product as possible,” including syrup, frozen …
Pamela Wible, M.D., takes on physician suicide in her TEDMED talk (delivered on November 18, 2015). Learn more about Dr. Wible and her talk at TEDMED.com. Full transcription below:
I love the three things that people fear the most: death, disease, and public speaking. Here’s how it all started. At four, I was so talkative (and bossy) no babysitter would stay with me. So I tagged along with Mom, …
In the hour after I heard the news, I experienced the full spectrum of typical reactions to a physician suicide.
One end of the spectrum came from the attending in a clinic, who when asked if the residents could go home and mourn their friend who just committed suicide, proceeded to tell me a story of how when her grandpa died before a final exam in medical school. She decided to …
There are several Tumblr sites where people submit their actual name and compare it to the name the Starbucks employee writes on the cup. There’s “Starbucks Name Fail,” “The Starbucks Name Game,” “Starbucks Can’t Spell My Name,” and “That’s Not My Name, Starbucks.”
There aren’t Tumblr sites for calling out Starbucks when they biff your drink. “Starbucks F***** Up My Drink,” “Would You Just Look at This Beverage,” and “There’s No …
An excerpt from What It’s Like to Become a Doctor: The Year-by-Year Journey From Medical Student to Practicing Physician, Greenbranch Publishing, 2016.
My third year of fellowship: June 2010 — July 2011
In July 2010, I began my third and final year of fellowship. This year was focused on honing all the skills we …
A guest column by the American College of Physicians, exclusive to KevinMD.com.
More than ever before, patients are receiving laboratory test results, with some of their numbers in bold or with “H”s or “L”s next to them. In some cases they’re getting them straight from the lab, in accordance with federal regulations. If not from …
This Medcomic highlights some of the main features of multiple sclerosis (MS). Although the exact cause of MS is unknown, the disease is thought to occur as an immune-mediated attack on the central nervous system (CNS). As you can see in the illustration, the white blood cells are attacking the neuron and causing inflammation, demyelination, and axonal degeneration that can manifest through …
Mamas don’t let your babies grow up to be surgeons.
Really. Don’t.
As the mother of a soon-to-be fellowship-trained surgeon, I know what I’m talking about. Listen to me. Ignore Willie Nelson. You don’t want your babies to be doctors; you want them to be cowboys.
Really.
Yeah, yeah, I know, your daughter is a whiz at all things mathematical and/or spatial. And your son is a science prodigy. Their eye-hand coordination is legendary …
No matter how early I rise with the intention of getting my workout done before my children wake up, I’m rarely able to do it alone. Most days my 3-year-old daughter climbs out of bed and comes straight down to our home gym and watches me do my workout.
Often times she’ll sit quietly in the corner, but sometimes she’ll join in and follow the trainer on my workout DVD and …
Every month or two I see a patient, usually a man with prostate cancer, who is concerned that if he has intercourse with his spouse, he will give her cancer. The question is asked with sincerity, and I can see the worry in the man’s eyes. His spouse is often equally worried but she often looks embarrassed too, almost as …
As emergency physicians, we write prescriptions for patients that we discharge home for all manner of presenting complaints. I used to believe that the overwhelming majority of these prescriptions would be filled by the patient after discharge.
It turns out I was wrong.
Research estimates that patients discharged from emergency departments (EDs) fail to pick up their high urgency prescriptions, like antibiotics, nearly 35 percent of the time.
This is problematic because failure …
On January 5, 2016, emergency crews were called to Our Kids Daycare and Learning Center in Middleton, Idaho. The reason: concern for carbon monoxide poisoning. The daycare center’s director Robin Hagaman noted that some of the 12 toddlers in the classroom were acting strangely when they awakened from their naps and were also noted to have dilated pupils. In addition, two of the teachers were simultaneously experiencing headaches and …
Every fall, medical schools welcome nearly 20,000 college graduates. They arrive anticipating endless hours of lectures, too much coffee, and infinite facts to memorize. There is one thing they do not expect, however. I know. Forty-nine years ago, I was one of them.
The first day I walked onto the wards was in spring of 1967. I was in St. Louis, doing my second year of medical school. Previously my presence …
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