Cultivating your personal partnerships as a physician

Physician
February 12, 2020

The center of a physician’s job is the doctor-patient relationship.  Without a healthy one, the physician is unable to help the patient make meaningful changes in their life to maintain a state of wellness.  Too often, in the process of medical training, a physician’s personal relationships suffer the consequences of long hours, financial strain, and the ever-present danger of Burnout.  If embracing the concept of personal wellness is …

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Cultivating your personal partnerships as a physician

How minor fixes can help with resident burnout

Medical Education
February 11, 2020

“How did you like it there?” I ask, sitting down next to a new fellow (between bites of a plump sandwich, hoping there is no spinach in my teeth).

I expect to hear the standard resident talking points — long hours, frequent call, and ballooning student loans. Instead, she surprises me.

“Do you know how much they charged us to park there every month?”

I frequently text friends who are residents at her previous program. It is a …

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How minor fixes can help with resident burnout

Cervical cancer guidelines leaves women confused about annual pelvic exams

Conditions and Diseases
February 11, 2020

There is good news and bad news in the world of women’s health.

The good news is that women do not need annual Pap smears. The bad news is that, upon hearing the good news, many women incorrectly assume they no longer need annual pelvic exams, either.

Historically, Pap smears were performed annually, and during the same time as pelvic exams, so it is understandable why women would conflate the two. But …

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Cervical cancer guidelines leaves women confused about annual pelvic exams

Why doctors need life skills

Physician
February 11, 2020

Medical school prepares doctors for patient care: perform a history and physical, and based on the findings, consider the next diagnostic tests to order, review all data, and develop a treatment plan. By graduating from medical school, you are skilled to perform those duties with a certain level of competency and confidence.

Success in the next phase of this journey and the rest of your life depends on honing those skills …

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Why doctors need life skills

3 reasons why some physicians aren’t burned out

Physician
February 10, 2020

I have gotten to the stage where I take a more philosophical approach to the issue of physician burnout and job dissatisfaction. I see it all around me, and it’s impossible to miss some of the sobering statistics just browsing online any medical publication or social media feed.

There’s definitely a very real issue that’s been compounded by changes to health care delivery and the nature of the job itself (i.e., …

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3 reasons why some physicians aren’t burned out

A surgeon on the other side of the operation

Physician
February 10, 2020

Today started like any other day. I woke up, got ready, drove into work. I dropped my bag in my office, changed into scrubs, and wandered down to pre-op. After a few minutes of small talk with the staff, I found the patient I was looking for. He was awaiting a major operation. I spoke with him and his fiancé́ and laughed. They shared a few tears.

As I often do, …

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A surgeon on the other side of the operation

Prior authorization is another barrier to cost-effective care

Physician
February 10, 2020

The Affordable Care Act, aka “Obamacare,” has improved patient’s access to health care since its passing in 2010.

The increase in coverage, however, does not address the restriction of prior authorization (PA), where a physician is required by a patient’s insurance company to obtain special approval from the insurance company for a medication or treatment. PA is not only needed for medication, but also for scans, potential …

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Prior authorization is another barrier to cost-effective care

Medical residents need parental leave

Physician
February 10, 2020

My wife and I had a baby a few months ago. Or, more accurately, she birthed a child while I sat in the corner, contemplating the miracle of reproductive physiology in a vasovagal fugue. In the months leading up to and following that wondrous moment, we found ourselves navigating the labyrinthine complexity of parental leave in graduate medical education.

To start with the positive, we are both residents in the same …

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Medical residents need parental leave

Health care is like lions for lambs

Physician
February 9, 2020

I just watched the movie 1917 at the theatre. Shot in a unique way giving an immersive experience, showing the frontline reality of war through an unforgettable human story, it has to be one of the greatest war movies ever made. I’d encourage everyone to go watch it. I learned a fair bit about the First World while I was in high school in the United Kingdom. Its stories are …

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Health care is like lions for lambs

Margaret Mead was right about health care

Health Policy
February 9, 2020

One of my graduate school professors proclaimed that what is wrong with our society is that most people have not reached formal operations or have not been in psychotherapy.

Formal operations is the stage of development, described by French researcher Jean Piaget, where we learn to take the perspectives of others, to disagree while maintaining a relationship, and to understand that we are not the center of the universe.

Psychotherapy is where …

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Margaret Mead was right about health care

Why medical students shouldn’t always fall in line

Medical Education
February 9, 2020

As I saw the fellow purposely manipulate her fractured ankle, I knew I was wrong in not stopping him.

Three hours earlier, Mr. Sanchez*, a past boxer, and soccer player, came in with a broken pinky. He was moving from Atlanta to Houston, and in the process of moving boxes, a rock smashed his finger against something. Odd story, but he was the nicest patient I ever talked to up to …

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Why medical students shouldn’t always fall in line

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Everyone has their moments. Even doctors.

Physician
February 9, 2020

I sit in Dr. Victor’s small crowded waiting room, awaiting my turn. I am seated between two women, the one on my left probably 45, and the one on my right, somewhat older, both though younger than me.

The lady on my right doesn’t have much to say beyond telling me where she is from, and she is seeing Dr. Victor for the second time. The woman to my left is …

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Everyone has their moments. Even doctors.

How health care is like a convoluted financial investment scheme

Health Policy
February 8, 2020

The business of medicine is unlike any other type of standard “business” in that health insurance and hospitals confound what would appear to be a simple exchange of services for a set price.  You know that the confusion is bad when neither doctors nor the patients fully understand how the insurance system works.  I have seen patients going into surgery for a lap chole being quoted a price that ended …

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How health care is like a convoluted financial investment scheme

How you can show patients you are listening

Physician
February 8, 2020

Being a physician is an important role. It’s easy to forget the impact that you have on a patient just by being at their bedside.

It’s huge.

Have you ever been a patient? It’s an incredibly vulnerable experience.

You’re not really sure what’s happening and what is going to happen next.

People are really putting their faith in you to understand their needs and to ease their suffering. It’s a powerful thing to ease …

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How you can show patients you are listening

MKSAP: 32-year-old woman with loose stools, bloating, and weight loss

Conditions and Diseases
February 8, 2020

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 32-year-old woman is evaluated for a 6-month history of loose stools, bloating, and a 3.2-kg (7-lb) weight loss. Her medical history is otherwise unremarkable. Her brother has type 1 diabetes mellitus, and her mother has autoimmune thyroid disease. She reports no other symptoms and takes no …

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MKSAP: 32-year-old woman with loose stools, bloating, and weight loss

Goodbye, Benadryl: It is time for you to retire

Medications
February 7, 2020

Sometimes, old ideas and time-tested treatments remain the best. Newer doesn’t always mean better. Except in the case of one of our oldest antihistamines, tried-and-true Benadryl. It is time for that old drug to be retired, sent off to pasture, and never used again. Goodbye, Benadryl. Fare thee well, adieu, and don’t let the door hit you on the way out.

Benadryl (diphenhydramine) was introduced in 1946. The top single that …

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Goodbye, Benadryl: It is time for you to retire

Why Les Miserables should resonate with every physician

Physician
February 7, 2020

“I dreamed a dream my life would be … so different from this hell I’m living.”

Twenty years ago, I would pull out my Les Miserables piano book and pound out “I Dreamed a Dream” while my fellow medical student/roommate would sing along with me to the line above with gusto.

In the scheme of things, we didn’t have it so bad. We hadn’t been abandoned by our lover-baby daddies. We weren’t …

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Why Les Miserables should resonate with every physician

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