It was my first day of orientation at medical school. In a hallway stood a coat rack overflowing with white garments. I set down my accumulated papers, reached for a hanger and — for the first time ever — shrugged first one arm and then the other into a white coat.
It was too large, but I had no other options. The unisex coats ran from XXS to XXL, but the …
The day when the white coat can be worn with no hesitation at all
I spent my early and mid-career years working in a pediatric intensive care unit (PICU) at a large academic center. We did almost everything except for a few things esoteric at the time — small bowel transplants, a few kinds of experimental surgery. I’m now in my late career (but have no plans to quit anytime soon!) and work in a smaller PICU. I am frequently confronted with the issue …
The Wild West approach to PICU practice
Disability can be a devastating outcome to a doctor’s career and self-image. Think about it: You busted your butt to learn how to do a Whipple procedure, end up getting into a skiing accident that ends your career right there. No worries, because you purchased the appropriate coverage of own-occupation disability insurance, right?
Having disability insurance certainly provides a protective cushion, especially you are the sole breadwinner. This is a no-brainer, …
Disability can be a devastating outcome to a doctor’s career. Here’s how handle it.
This article is sponsored by Careers by KevinMD.com.
After spending a decade in college and medical school, followed by internships and residency, seeking additional guidance at the beginning of your career may seem excessive. You’ve already taken direction from dozens of leaders; isn’t it time to cut your own path?
Yes and no. You’ll make plenty of your …
Why mentors are so important in medicine
A guest column by the American College of Physicians, exclusive to KevinMD.com.
I distinctly recall during residency a much older and well-respected clinical teacher periodically opining that what was needed in a particular patient case was “a dose of the tincture of time.”
For those less familiar with more historic terminology, a tincture is an alcoholic …
The power of the tincture of time
It’s been a little over two years since I started this journey of blogging about passive income, and I’ve learned so much along the way. The term “passive income” has come to mean something very different to me over these years.
I used to think that passive income was simply earning money in a way that isn’t proportional to the time you put in. And while this is …
How physicians can get started with passive income
I was recently seeing a rather complicated medical patient in the hospital. We were treating both a heart and kidney condition, and things were not going so well. To spare anyone non-medical who is reading this the scientific details of the bodily processes involved, we were essentially balancing hydrating, with the need to get rid of excess fluid. After seeing the patient, I spoke with the nurse, went over the …
There’s no room for ego in health care
First impressions are critical. We are taught early in our careers that first impressions truly matter. Whether interviewing for medical school or a residency program, our goal is to make a positive first impression in hopes of making the cut at each checkpoint in our early careers.
These processes in our academic lives and careers are exhausting. As residencies and medical schools are becoming more competitive, the importance of first impressions …
You must make a good first impression with patients
To my wife,
Let’s just start at the beginning.
When we first met, you thought I was arrogant and prideful. For two and a half years we would rarely talk while we walked past each other in our small college town. At the time, we never could have imagined that one day we would get married. In a twist of irony, two weeks before we started dating you still didn’t know as …
A physician’s letter to his wife
A number of media outlets recently featured a story about a Florida general surgeon who removed a normal kidney from a woman who was undergoing spine surgery. How could this have occurred?
The 51-year-old patient who had been injured in a car crash was scheduled for an anterior lumbar interbody fusion (ALIF) of the fifth lumbar to the first sacral vertebra. The general surgeon’s role was to provide …
A surgeon mistakes a kidney for a tumor. How can this happen?
Have you ever been to a doctor’s office and felt that your evaluation was rushed? Have you been seen in the emergency room and felt that you were just a number in a long series of patients? Have you ever seen the same doctor for years and felt like the doctor just met you for the first time each visit?
Chances are we’ve all experienced this as patients. If we’re honest, …
Here’s what the corporatization of medicine is doing
This article is sponsored by Careers by KevinMD.com.
As rewarding as working in emergency medicine can be, it also comes with some significant potential downsides. According to some recent studies, stress and burnout rates in the emergency room are some of the worst in the medical field. But don’t let that dampen your enthusiasm. Managing the proper …
How to reduce burnout in emergency medicine
When Jason Kilar graduated from college he experienced tremendous personal and professional adversity. Three days after graduation, Kilar’s father ended his own life after battling bipolar disorder.
Kilar also battled professional valleys. In the months after graduation, the work-life he had long envisioned couldn’t have seemed further from the reality he faced.
After building shelves at a local store and hustling to find a job that he actually loved, this is what …
Physicians who pursue financial independence and early retirement are not wrong. It may save them.
Moving to the Bay Area from the Midwest was a culture shock in many ways. I was amazed by the diversity, the food, the openness of opinions. And I was struck by the traffic, the stark differences driving from one community to another and the homelessness — you could see signs of it everywhere. As time went on, I acclimated to these changes. Working in the hospital, I got used …
The problem with mental health funding and prisons
Corporate health care mentality set up nurses up to be inhuman while holding us to superhuman expectations. We’re told to be caring — but not allowed to do it. It’s time to demand that we stop being abandoned and dismissed by dysfunctional leadership.
Early in my nursing career, I was assigned to the pediatric area for one shift in a busy emergency department (ED). Our team received notification of an incoming …
A couple of years ago, I read an article by Dr. Profeta at LinkedIn called “These four words that may offend you … may also just save you.” He was invited to talk about burnout in medicine and did not get a warm reception.
“It’s just a job.”
The “it” in this case is medicine. Medicine, just like any other, is just a job. Let that sink in. Everything …
“Alice Woods” is dying of metastatic breast cancer, but she cares little for awareness efforts like pink ribbons and catchy hashtags like #stage4needsmore. You see, Alice has akathisia due to an adverse effect from discontinuing Klonopin — a condition that has caused her far more suffering than her terminal cancer. It has also prevented her from receiving adequate cancer treatment and is, therefore, ending her …
Don’t miss this adverse drug reaction when tapering benzodiazepines
“Where there is no struggle, there is no compassion.”
-Frederick Douglass
Growing up with sickle cell anemia exposed me to the field of medicine. As I go through the pain and complications, it humbles me to the point that motivates me to work harder to be the doctor I want for myself. I want to be a physician-scientist that conducts clinical research targeted toward patients like me. I believe that as a …
How sickle cell anemia influences a medical school journey
In 1976 I graduated from medical school and proudly joined the medical profession. Thirty-seven years later, I retired as an employee of the biggest business in the country. In 2016 the medical industry was responsible for 3.3 trillion dollars of expenditure, comprising 18 percent of the United States GDP. For perspective, there are only four countries with a GDP more than the amount spent on health care in the United …
Medicine: noble profession or big business?
This article is sponsored by Careers by KevinMD.com.
Working in the emergency department or emergency room is not for health care practitioners who want to just chill. Although television’s portrayal of the ER on dramas like “ER” or “Chicago Med” is admittedly high on drama, life and work in the ER really are high pressure.
In 2016, the Read more…
Make peace with stress in the ER
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