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Why physicians should have golden parachutes

Physician

August 28, 2019

Early into my career as an emergency physician, I was seated in the department with a colleague when I inquired about one of our co-workers I had not seen in a while. “Oh, she’s on the mommy track,” my colleague said and picked up another chart. To me, selecting a career path that sacrificed traditional professional advancement for more time to raise children was legitimate. My colleague’s pejorative “mommy track” …

More than three hours late, but somehow still on time

Tasia Isbell, MD, MPH

Medical Education

August 28, 2019

The sound of a clock, hung haphazardly on a colorless cold wall, ticks repetitively — tick, tick, tick. Time continues to pass as my appointment scheduled for three hours ago seems like it will never come. I scheduled this appointment three months ago, and here I sit three hours later. The irony bounces around the room to the sound of the clock ticking. Tick. Tick. Tick.

A door squeaks open.

Just my …

No, phones don’t cause horns to grow on skulls

Roy Benaroch, MD

Conditions and Diseases

August 27, 2019

The Washington Post ran this headline: “’Horns’ are growing on young people’s skulls. Phone use is to blame, research suggests.”

The headline is entirely correct except for a few minor points:

They’re not horns, which point up from the forehead. They’re more like little 1/2 inch nubs protruding downwards from the back of the skull.
They’re not new. There’s no comparison group to show that these are more or less …
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No, phones don’t cause horns to grow on skulls

5 things I wish I had known earlier about chronic pain

Tom Bowen

Patient

August 27, 2019

I’ve been living with chronic pain for more than a decade.

It began in 2009 with nerve damage after emergency groin surgery. Four years later, I fell and hit my head. That fall led to a constant headache, a whistling sound in my ear, back and hip pain, tingling and numbness in my hands and feet, electrical shocks …

Improving health outcomes for children requires us to look at the big picture

Khadijia Tribie, MD

Physician

August 27, 2019

It was a simple chief complaint: sore throat and fever. As expected, the little girl’s rapid Strep was positive. Instructions given. Antibiotics sent. This was Peds 101. But for some reason, before mom walked out the door, she made mention of their stay at the shelter.

Although I had seen this child many times before, somehow, I never knew that she was homeless. Nothing in my detailed history and exam had …

So, how’s medical school?

Maycee Gielow

Medical Education

August 27, 2019

Since starting medical school, I have struggled to answer this question. Because medical school is everything. It’s amazing, challenging, soul-sucking, life-giving, exhausting, dream-fulfilling, anxiety-provoking, interesting, and, dare I say, fun? How can I explain to someone that while I’m pursuing this dream, a dream that so few get the opportunity to pursue, that I have felt the lowest of lows but also the highest of highs?

I typically settle for “It’s …

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So, how’s medical school?

The decision to undergo robotic surgery is a more than just about the length of the scar

Anonymous

Conditions and Diseases

August 27, 2019

Over the last three decades, surgery has slowly but steadily evolved towards a minimally invasive technique. The standard of care for appendicitis now involves creating three half-inch incisions and using a laparoscopic technique to remove the appendix. This technique uses a camera to see inside the body via a large screen. Instruments that are over a foot long are used. Sufficient research has shown that this minimally invasive technique leads …

What role does the science of complexity play in medicine?

Robert Trent

Conditions and Diseases

August 27, 2019

The science of complexity lays a conceptual foundation for understanding “complex adaptive systems.” What all complex adaptive systems have in common is that they are all bound by the same set of physical laws. Their “behavior,” i.e., growth, maintenance, and death, can all be described using the same set of mathematical relationships. These systems (animals, plants, ecosystems, etc.) are the most productive and functionally effective systems known to man.

Unfortunately, our …

Considering CBD oil? This psychiatrist suggests these questions to ask first.

Greg Smith, MD

Medications

August 26, 2019

One question I get asked a lot lately is this: “Is it OK for me to use CBD oil?”

First of all, CBD oil and associated preparations are types of alternative medications, medicines that might not be mainstream or readily prescribed by doctors, but are nevertheless used by many people on their own. Alcohol and marijuana are two substances that are often used as “medicines” by those that think they function …

How closing rural hospitals cost patient lives

Sarah Jane Tribble

Health Policy

August 26, 2019

For more than 30 minutes, Robert Findley lay unconscious in the back of an ambulance next to Mercy Hospital Fort Scott on a frigid February morning with paramedics hand-pumping oxygen into his lungs. A helipad sat just across the icy parking lot from the hospital’s emergency department, which had recently shuttered its doors, like hundreds of rural hospitals nationwide.

Suspecting an intracerebral hemorrhage and knowing the ER was no longer …

Should physicians yearn for the nostalgic ideals of their predecessors?

Ioana Baiu, MD

Physician

August 26, 2019

What has the medical community, once thought of as the “ultimate team,” finally come down to in 2019? The “back in my day” sigh I often hear from more senior physicians has inspired me to read several books about the history of medicine. As I devoured them from cover to cover, the excitement of medical discovery, the anticipation of the near-miracles that were about to be revealed, and most importantly, …

Here’s why your patients disregard prescriptions

Kevin R.R. Williams

Patient

August 26, 2019

Take one-half tablet three times per day with meals, increasing by half each week until reaching a maximum of three tablets three times per day.

Did you get a new prescription from your doctor? If so, there is a 50 percent chance you will not adhere to label directions. Either the instructions are too complicated, the drugs are too expensive, you do not like the way the medicine makes you feel …

Haven’t thought about investing in group homes? You should.

Cliff Janke, MD

Physician Finance

August 26, 2019

Back in 2006, I settled into my career as an emergency room physician. It was then when I started working in multiple hospital groups in several cities in Arizona and Texas to maximize my earning potential.

The strategy worked. I was able to make enough money to service my medical school debt as well as dabble in commercial real estate, buying some duplexes in Central Texas then single-family homes and larger …

I’m a residency program coordinator. My role has changed over the years.

Lori Berryman

Medical Education

August 26, 2019

I was a 22-year-old intern, just about to finish my public health internship. I had an ambitious career ahead of me. I was trained as a public health educator. I was doing wellness fairs, writing newsletters, and excited to get to the next stage of my life. I wasn’t yet certified, however, so when all of a sudden a job opportunity presented itself to me and gave me a chance …

A patient’s family bridges two worlds

Ton La, Jr., MD, JD

Medical Education

August 25, 2019

Toward the end of my clinical rotations, I met Salma, a 34-year-old woman who came from Egypt with her family to the U.S. two years ago. Wearing a latte-colored hijab, she was here at the hospital to care for her father, who had a case of congestive heart failure exacerbation with pleural effusions.

When deoxygenated blood comes to the right side of the heart, it gets pumped to the lungs to …

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A patient’s family bridges two worlds

A nurse comes face to face with her son’s serious illness

Robin Bennett Kanarek, RN

Conditions and Diseases

August 25, 2019

Prior to my 10-year-old son being diagnosed with leukemia, I worked as a diabetes nurse educator at a local hospital. I had been an RN for over 15 years and was able to balance home life with work; I loved educating patients on how to deal with their diabetes and collaborating with colleagues. All that came to a screeching halt when David complained of hip pain and started limping. Within …

Simple suggestions can make such a positive impact

Joyce Hyam, RN

Conditions and Diseases

August 25, 2019

Recently I visited a lady at her home who was a palliative care patient. She was seated on the couch in the living room with a turban on her head and a look of anxiety and depression. Her husband was quiet during the entire visit. He was seated in a chair next to the couch and just looked at his wife and did not participate in the conversation. Her son …

Beware of the potential harms of trust: 5 safeguards

Neil Baker, MD

Physician

August 25, 2019

While “trust” sounds like it would be an inherently good thing to have between two people or in a team, that is not always the case. Depending on what “trust” means to you, it can also be harmful at times.

While it may not at first seem pertinent, driving in traffic can be a helpful metaphor for understanding different definitions of trust in the workplace.

A couple of years ago, I was …

To have success and fulfillment, sometimes you have to edit your life

Nancy Yen Shipley, MD

Physician

August 24, 2019

This year, I learned that to have success and fulfillment, you don’t just do, sometimes you have to undo.

What do I mean by that? The process of undoing — or editing — it a key part of different areas of our lives. For example, we edit in medicine all the time. Think about the medical student’s SOAP note: the subjective story, the objective findings, the assessment, and the plan. Imagine …

An attorney pushes back on a physician’s critique of the medical liability system

Eric Turkewitz

Health Policy

August 24, 2019

I was struck by a post by Dr. Saurabh Jha about his views of the jury system — as some of his comments mirrored things I’ve said to juries in the past.

Some things he got right, which go to the core our civil justice system. Some things, however, not so much.

His perspective comes from growing up in India, which doesn’t exactly have the most efficient of justice systems. And …