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Have you forgotten the most important health care leadership skill?

Physician

September 4, 2019

Physician burnout is a hot topic right now. Some don’t agree with the term and choose to use “moral injury.” Regardless of the term you want to use, the problem is real. Christina Maslach describes burnout as “an erosion of the soul caused by a deterioration of one’s values, dignity, spirit, and will.” I think that sums it up nicely. And while we’ve identified this as a major issue amongst …

If a doctor has a bad day, someone dies. Remember that.

Sarah Reck, MD

Physician

September 4, 2019

For what seemed like an hour, I stood staring at the flat lines scrolling endlessly across my monitor in the OR. The once pulsatile waves, rendered useless and flat due to the absence of a beating heart. After a frenzied six hours of pouring blood into the patient while it poured back out of her just as fast, the surgeons drowning in blood in their attempt to sew the new …

Sometimes it takes more than asking, “Are you OK?”

Anya Golkowski Barron

Medical Education

September 4, 2019

The attending physician looked concerned. My fellow medical student’s face was wet with tears. I knew the next words out of the attending’s mouth would be “Are you OK?” and indeed they were.

I have encountered this phrase many times, almost exclusively in psychologically traumatic situations. It’s a reflex response to an uncomfortable social situation, the “right” thing to say to a student in distress.

As medical students, we learn and practice the …

A primary care physician’s decisions are questioned and second-guessed daily

Steven Reznick, MD

Physician

September 3, 2019

A 67-year-old woman with a high-stress job had a vigorous disagreement with her neighbors last week. She developed severe substernal chest pain and called 911 fearing a heart attack. She is thin, has never smoked, has normal blood pressure and normal cholesterol. She is not a diabetic and runs on a treadmill for two hours at five miles per hour with an elevation for two hours four times a week. …

Explaining Peter Fonda’s lung cancer

Michele R. Berman, MD and Mark S. Boguski, MD, PhD

Conditions and Diseases

September 3, 2019

Actor Peter Fonda, son of Henry Fonda and younger brother of Jane Fonda, passed away August 16 at his Los Angeles home. Fonda, who was 79, is probably best known for his role as Wyatt in Easy Rider, a movie he co-wrote, produced, and starred in. Fonda was nominated for the Academy Award for Best Original Screenplay for that film as …

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Explaining Peter Fonda’s lung cancer

How this resident physician managed to stay happy and resilient in medicine

Emily Jacobs, MD

Physician

September 3, 2019

When I walked into my first shift on labor and delivery as a brand new OB/GYN intern, complete with a freshly starched white coat, I was 33 weeks pregnant. As I listened to my chief resident effortlessly sign out the labor board, I was terrified. As the words pre-eclampsia, chorioamnionitis, and postpartum hemorrhage swirled around the room, I couldn’t get my heart rate under control. “They already hate …

Can entrepreneurial geriatrics fight ageism in health care?

Marc Rothman, MD

Health Technology

September 3, 2019

Ageism in health care abounds. Older adults are often overtreated or undertreated for various conditions. The presence of things like fatigue, chronic pain, arthritis, and even cognitive impairment are often accepted as “normal” parts of aging — by physicians and patients alike — despite the fact that many are preventable.

According to a recent opinion piece by NBC News, “We medicalize the natural process of …

What is patient autonomy?

Ton La, Jr., MD, JD

Conditions and Diseases

September 3, 2019

I yelled for the nurse as I wrapped my arms around Mr. John. He was suffering from a violent acute dystonic reaction from a dose of Haldol the night before. Severe muscle spasms overtook his entire body. I saw the whites of his eyes as his gaze shot to the ceiling. He had lost all control over his body — legs, torso, arms, neck, face, eyes.

“I can’t breathe, I can’t …

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What is patient autonomy?

The patient with a pocketful of IDs

Debbie Moore-Black, RN

Conditions and Diseases

September 3, 2019

All of us nurses and physicians in the ED and ICU knew him well.

He was a young, 21-year-old. A smart, articulate guy who kept going from one hospital to the next. He had a system down … almost.

This young man was a drug seeker. He knew all about seizures and how an Ativan IV push felt during the “seizures” he allegedly was having.

Even though he had several identities and different …

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The patient with a pocketful of IDs

We are anesthesiologists. We got you.

Sasha K. Shillcutt, MD

Physician

September 2, 2019

I am a cardiac anesthesiologist. I want to explain what anesthesiologists do, who we are, and why it is important for the public to know.

Anesthesiologists are physicians.

Anesthesiologists are the guardians of the operating room.

Anesthesiologists are leaders.

If you get in a car accident, we are there.

If you develop an infection and can’t breathe, we are there.

If you are having a heart attack, we are there.

If you need a new knee or …

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We are anesthesiologists. We got you.

My hand surgeon should have been paid $4.5 billion. Instead, he didn’t get even $1,000.

Jay Crawford, MD

Physician

September 2, 2019

I believe that health care providers aren’t paid anything close to what they are worth to society. I don’t mean this in the sappy emotional sense in which the “value of any human’s life is infinite,” or any other subjective standard. I am talking about real-world, measurable economic impacts. Using the entrepreneurs’ 10% reward as a guide, …

In defense of pimping in medical education

Zachary Fredman, MD

Medical Education

September 2, 2019

The definition of pimping in the medical field is different than the colloquial usage by artists like Jay-Z, Snoop, and Kendrick Lamar. Although most people are aware of pimping in the vernacular language (which will not be discussed further, I would suggest avoiding most rappers terminology if you desire to research), the medical use of the word is a little more nuanced and opinions on the practice are split.

Pimping in …

How to get ahead in your finances: Pay yourself first

Altelisha Taylor, MD, MPH

Physician Finance

September 2, 2019

If you’ve ever delved into the world of personal finance, you might have heard of the phrase “pay yourself first.” In fact, many investment gurus mention this approach as one of the keys to getting your finances on track and building your net worth.

This concept can seem confusing initially, so let me break it down. Paying yourself first simply means making yourself a priority. It’s actively choosing to …

There’s a lot about medicine that is pretty good. Sometimes we need a little reminder.

Navpreet Sahsi, MD

Physician

September 2, 2019

Recently, I had dinner with an old colleague that I trained in residency with. It’s been a while since we’ve graduated, but the topic turned to how our lives have changed since those early days. Over drinks, my friend said something that stuck with me and inspired this post.

“You know, things aren’t perfect. But we’ve got really good problems.”

He’s right. I think we sometimes lose sight of the fact that …

An interview with a medical student who failed the boards

Anonymous

Medical Education

September 2, 2019

The first two years of medical school are geared towards learning enough so you can pass your first round of boards. All the sleepless nights and the tears can be overwhelming, but to finally get to the finish line is an incredible achievement. It reinforces that these first two years were worth it and that you learned some things along the way.

However, some students don’t receive the same good news. …

When physicians inappropriately judge

Christopher Johnson, MD

Physician

September 1, 2019

All physicians naturally make judgments regarding the parents they are interviewing. For example, we assess how accurate and plausible their history is. We try to decide if they are telling us the whole story and, if not, if they are inadvertently or deliberately holding something back from us for whatever reason. All experienced physicians do this. What we rarely do, however, is judge the parents’ worth as people, as individuals …

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When physicians inappropriately judge

Why can e-cigarettes advertise on TV?

Michelle Andrews

Health Policy

September 1, 2019

Why does e-cigarette maker Juul advertise its product on TV when cigarette ads are banned? The short answer: Because it can.

For nearly 50 years, cigarette advertising has been banned from TV and radio. But electronic cigarettes — those battery-operated devices that often resemble oversized USB flash drives with flavored nicotine “pods” that clip in on the end — aren’t addressed in the law.

Since launching its product in …

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Why can e-cigarettes advertise on TV?

A nurse’s powerful ER exit letter

Jessica Nandino, RN

Health Policy

September 1, 2019

Dear hospital,

The last three years, I have had the pleasure of working in our state’s renowned emergency department and level-1 trauma center. My departure closes out a decade of my nursing career as an emergency room and flight nurse. This department — the staff, in particular — will forever hold a very special place in my heart. I leave with a great amount of respect and thanks for this exceptional …

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A nurse’s powerful ER exit letter

How nurse practitioners can expand abortion access

Vanessa Shields-Haas, RN

Health Policy

September 1, 2019

It has been a savage few months for reproductive rights, with 12 states passing 26 bills to ban abortion, including measures that ban abortion as early as six weeks into pregnancy, as well as attempting to outlaw safe methods of abortion. In the face of this extreme, unprecedented wave of attacks, several states pursued an alternative route, passing laws that expand the scope of abortion providers …

Today’s medicine is not the medicine I signed up for

Talia Sierra, PA-C

Physician

August 31, 2019

Today’s medicine is not the medicine I signed up for. I am a Xennial. Sandwiched between generation X and millennials, I don’t really belong to either. I didn’t grow up with the technological advancements that the millennial generation enjoy. I grew up with corded telephones, large box televisions, and without a computer in the house. We played in the streets until dark with the neighborhood kids and played board games …

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