As a first-generation college graduate with the honor of earning my MD and PhD at a federally funded medical scientist training program (MSTP) and nearly no debt upon embarking on the journey of residency, I have a lot to live for and am grateful for all that life has offered me with regard to both mental health and capacity. I am a product of the Baltimore City Public School System. My …
A loss of physician support at a time of need
Part 3 of a series.
Patients with advanced cancer are particularly vulnerable to infection due to a compromised immune system. Moreover, the typical symptoms of serious infection, such as fever and chills, may be absent in cancer patients. If not identified and treated early, infection can lead to sepsis, a life-threatening reaction of the immune system that causes organ failure, shock, and death, as …
Why did it take over a week for doctors to initiate treatment?
Retiring early as a doctor is surprisingly difficult given the typical doctor income. There are four main reasons for this – the heavy debt load to enter the career, the very late start to earning a significant salary (most physicians leave residency at an age older than some FIRE bloggers retire at), the temptation of a high income, and the “doctor factor” I’ll get into later. Despite those challenges, it …
How physicians can retire early: 7 steps to follow
Good news is always welcome, especially when talking about something as serious as cancer. And there is plenty of welcome information in the American Cancer Society’s release of our annual report on “Cancer Statistics, 2019” and its accompanying consumer-oriented version of “Cancer Facts & Figures 2019.”
Among the good news in this report: A significant decline in death rates from cancer — especially among some of the most common cancers, significant …
Behind the recent good news in cancer statistics
It seems like natural human tendency to explain ourselves. When we are late to a meeting, we come up with an excuse in case anyone asks. When our kid starts throwing a temper tantrum at the store, people stare at us expecting an apology. In the same way, when we decide that there are things outside of medicine that are more important to us than the job – an explanation …
It’s OK to care more about things outside of medicine
As a woman in medicine, where the odds for pay, promotion, and leadership are stacked against me, I feel obligated to light the path for younger women who come behind me. It has taken me a while to be comfortable with my style of leadership, own my own voice, be able to regroup after rejection, and tolerate feeling on display and yet often invisible.
I wish someone would have told me the following …
5 powerful tips for women in medicine
Two device salesmen recently came unannounced to our small private gastroenterology practice. They were hawking a product that could quickly and non-invasively determine how much scar tissue had formed in a patient’s liver, a useful tool for assessing patients with hepatitis and many other liver conditions.
We are physicians, not entrepreneurs. We do not regard the colonoscope as a capitalist tool. Yet, these two salesmen were barraging us with facts and …
How should salespeople sell to doctors?
It’s easy to judge when you don’t experience the same difficulties that others do. The classic scenario in medicine is an internist, who runs marathons and bikes to work, tells his morbidly obese patient to lose weight. How would the scenario work if the doctor were mildly overweight, or has a body mass index of 30.5?
The same judgment is frequently seen in the online financial blogosphere. Why does a doctor …
Your financial mindset is a baseline for financial success
I have known him for over thirty years. He has been legally blind for the past five.
He tends to be a practical, no-nonsense man. The other day, he seemed restless and very concerned as he lowered his voice and said: “I don’t want you to come to the conclusion that I’m crazy, but I’m seeing things,” he began. “I’m seeing children with elfin faces …”
His large, thin hands were in …
A rare condition that often happens to people with very poor eyesight
Marijuana has been used for reported medical purposes for thousands of years when the plant had THC content of 0.5 to 3%. The most common reported medical use is for pain. Several states and the District of Columbia have some form of legalized marijuana, with many states having legalized for recreational use.
There has been discussion about how cannabis will help curb the opioid epidemic. It’s been reported that medical cannabis …
Marijuana will not fix the opioid epidemic
The movement fueling #ThisIsOurLane may fail Black Americans who endure a significant burden of gun violence. Responding to a tweet from the National Rifle Association (NRA) demanding we “stay in [our] lane” the medical community rose to the challenge. A new hashtag gained traction, thousands signed an open letter, and many shared graphic photos and stories from treating victims of gun violence.
While laudable in its medical unity, as an African-American …
#ThisIsOurLane: Can the movement to end gun violence succeed without addressing racism?
I entered residency self-assured, if not in my scholarly achievements, at least in who I am as a person.
I left slightly broken.
Something happens to you in residency, and you don’t realize the transformation as it occurs. It may be the loss of a patient who died on your watch, or the realization that you have not changed the world. It could be the constant fear of failure or punishment by …
A reflection on the last day of residency
The Association of Schools of Allied Health Professionals defines the allied health sector as “professionals that are involved with the delivery of health or related services pertaining to the identification, evaluation, and prevention of diseases and disorders; dietary and nutrition services; rehabilitation and health systems management, among others. Allied health professionals, to name a few, including dental hygienists, diagnostic medical sonographers, dietitians, medical technologists, occupational therapists, physical therapists, radiographers, respiratory …
Why doesn’t the allied health field play a larger role in the care of patients?
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Many cooks traditionally use broth derived from simmered bones of fish, fowl, or four-footed critters to flavor soups and sauces. Recently, bone-broth bars have popped up around the country and serve a non-caffeinated, nutritious alternative to tea or coffee. In some of these health-conscious establishments, the owners claim that these drinks also have filling, cleansing, and detoxing capabilities.
I decided to see if a daily cup of bone broth should be …
An orthopedic surgeon’s bone broth journey
This article is sponsored by Careers by KevinMD.com.
After several months of intense discussions, “Dr. Joe Smith” thought he was headed from his successful two-physician practice to a respected practice with many more physicians. It was pretty much a “done deal,” until he was told that the senior partner decided he really didn’t want someone with an …
How physicians can investigate their employers
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 56-year-old woman is evaluated during an appointment to establish care. She has a developmental delay, and she is known to have pulmonary hypertension due to a congenital cardiac condition. There is no history of cardiac surgery. She is on low-dose aspirin and thyroid replacement therapy.
On physical examination, blood …
MKSAP: 56-year-old woman pulmonary hypertension
Pain usually cannot be “treated” like a standard ear infection. Treating patients in pain requires setting realistic expectations, using a variety of approaches, and patience. One patient I treated months ago highlights these points.
At 6 a.m., I was ready for the change of shift at the hospital. The night doctor who took care of my patients was frustrated. He snapped, “You really should have had a better plan for her. …
Break the reaction to high pain scores
Are you a media whore? Or do you worry you might be labeled one by your colleagues – if not to your face, then behind your back?
In the process of delivering hundreds of media engagement workshops, I’ve heard dozens and dozens of you express this fear, using precisely this language. You’ve made it clear that the mild put-down of “microphone hog” I was familiar with has now been replaced with …
Academic media: Don’t criticize your colleagues for “dumbing it down”
With nearly 80 percent of internet users searching online for health-related information, it’s no wonder the catchphrase “Dr. Google” has caught on, to the delight of many searchers and the dismay of many real doctors.
What’s received little attention from physicians or the public is the company’s quiet …
How Google is quietly influencing medicine
“Cha-ching!” goes urgent care. For your rhinovirus, adenovirus, or seasonal allergies you get a strep screen, flu swab, CBC, and chest X-ray. You get a steroid shot, Rocephin, and Z-Pak. A week later, you present for medical care again, because your virus is no better, and you want a stronger antibiotic.
In the meantime, your body’s normal healthy bacterial flora has been altered and will take six weeks to six months …
The antibiotics arms race must end
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