5,177.
That’s the current number of “cc’ed charts” as of this morning in my electronic health record in-basket.
While it might sound like a lot, this is not at all an unusual accumulation, partly due to the fact that I receive a notation every time a patient at our practice gets a flu shot, and also every time one of my patients or …
Electronic health records: Separating the signal from the noise
Stefania was a 17-year-old Russian girl who presented herself to a port of entry in the United States seeking asylum. Stefania’s journey to this point was an unimaginable one. In her home country of Russia, she was a happy high school student living with her mother. Her father died of a heart attack six months prior. Then one day on her way home from school, she was kidnapped by the …
The value of an immigrant child
September 2015, a few weeks into my first year of medical school.
Mr. Smith (John) (identifying information and event details altered to protect confidentiality) wore an orange jumpsuit with the letters “COUNTY JAIL” running down his right pant sleeve. At all times, I felt the presence of his police officer sitting right outside the shock room.
As I interviewed John, he had a face void of emotion. I introduced myself as a …
What my first patient in medical school taught me
This article is sponsored by Careers by KevinMD.com.
How satisfied are you in your current health care position? According to the Conference Board, a global, independent business membership and research organization, only 51 percent of employees report overall satisfaction with their current job. In the survey, conducted earlier this year, respondents reported that the job factors …
What to know before moving for a health care job
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 60-year-old man variable 2-hour postprandial blood glucose is evaluated during a routine follow-up examination. He has type 2 diabetes mellitus. Review of his blood glucose log demonstrates fasting blood glucose values ranging from 120 to 160 mg/dL (6.7-8.9 mmol/L) and variable 2-hour postprandial blood glucose values ranging from 50 to 190 mg/dL …
MKSAP: 60-year-old man with a variable 2-hour postprandial blood glucose
For the last 25 years, I have had the privilege of being a designated airman medical examiner by the Federal Aviation Administration. To earn that privilege, it required flying to FAA headquarters and taking a one-week training course followed by refresher training material every three years.
The FAA grades medical examiners annually by our judgment and decision-making. The nature of the questions we are required to ask the pilot candidates, and …
The rewards of being a designated airman medical examiner
I recently attended a cardiology conference where a speaker proudly presented a case of shared decision-making. It involved a young female athlete who had survived a cardiac arrest and was diagnosed as having an anomaly in her heart conduction system, putting her at risk for arrhythmia during exercise.
She had received an implantable cardioverter-defibrillator, and the decision in question had to do with whether she could resume sports activities or not. …
Is shared decision-making applicable to only a minuscule fraction of encounters?
My heart broke a little this week.
When you want to grow a muscle, you have to damage it first. You have to lift something heavy and overextend it. It’s sore for a few days — and then it grows stronger.
That is what happened to my heart.
My oldest son started high school. I got up early to exercise and was running back to the house to have a quick cup of …
A physician mother and how her heart shattered
I am a mother. A wife. A daughter. A sister. A friend. I am a doctor. I am a runner. Just like everyone, there are many pieces to my core identity. These are the traits that encompass the fixed view I hold of myself. These ring true for me, even when (at times) reality paints a different picture.
I just went for my first run in over three months. Viewed from …
We can empower patients by validating their perceptions
Prostate cancer often presents unique challenges to patients and physicians alike. It can be indolent and non-aggressive — or life-threatening and everything in between. Unlike most cancers that have a dedicated roadmap for treatment for prostate cancer revolves around opinions and biases.
To help patients navigate the landmine of prostate cancer, I’ve compiled a list of 10 basic questions to ask when diagnosed with prostate cancer. Here they are:
1. “What is …
Diagnosed with prostate cancer? You must ask these 10 questions.
How can we forget John Bender from The Breakfast Club? How can we forget his tousled wave of chestnut hair, cutoff lumberjack shirt, emanating cool with a cigarette perpetually in hand? In light of the 78 percent rise in e-cigarette use by high school students this past year, what we cannot forget is how deftly he convinced his peers to smoke with him. While the …
What the FDA forgets in the battle against e-cigarettes
“You’re going to fall in love with her,” the nurse warned me, as I stood outside my eleven-year-old patient’s room ready to wake her up for surgery pre-rounds at 5:30 a.m.
I offered back a tired smile and knocked on the door timidly. “Naomi?” I whispered.
To my surprise, I was greeted with a chirpy “Good morning!” and entered the room to find a bright-eyed eleven-year-old sitting up in her bed with …
How a young girl helped me find the light in pediatrics
I’ve always believed in looking the part as a physician. So much so that I even write about it! You may have read my piece that became widely circulated online, about why physicians should always dress to impress. The article generated quite a response, and I received a lot of interesting comments and emails. Of course, not all physicians are in a specialty where they can do …
Why this physician doesn’t dress down when rounding on weekends
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Three years ago, I had a massive, life-changing event. It passed with little notice; it was beyond banal and happened while eating sushi with a colleague in a landlocked state.
Here I am with a young patient at the direct primary care practice I opened in Kansas City, Kansas, after residency.
We were in our last year of residency (he in internal medicine, myself in family medicine) and had realized that we …
Why we need more physician entrepreneurs
Many of us working in the “Gun Sense” field – that is, finding a middle ground position to advance firearm safety and reduce preventable injury in our patients – had an “a-ha” moment that led us to toil in these fields.
Mine was on Nov. 2, 1981, when my friend and co-resident Dr. John C. Wood II was shot right in front of our hospital emergency room at Columbia Presbyterian …
Physicians have an obligation and an opportunity to reach out and speak out about guns
In family medicine, there’s a minor obsession with the word “pipeline.” The term makes me want to scream. Just think about a pipeline. The “line” part is superfluous. A pipeline is actually just a pipe. Our goal is to stuff prospective mission-driven family physicians into a big pipe, confine them there and apply large amounts of pressure to push them through this pipe as quickly as possible, lest the pressure …
A minor obsession with the word, “pipeline”
We’ve all heard about credit card points and miles by now—put enough of your expenses on plastic and you’ll be flying first class airlines all the time, right? We are actually fortunate in American (sorry for those of you residing in, let’s say Japan, who still are stuck in a mostly cash-based society) to be able to have incredible amount of credit card options to squeeze out every penny.
While the …
How physicians can play the credit card reward game
Life is full of potential worries. Personal, professional, and other stresses can make us anxious and reduce our happiness and quality-of-life.
A major source of anxiety in our lives can be financial. A recent survey found that 85% of Americans are at least “sometimes” stressed about money and 30% of Americans state they are “constantly” stressed about it.
In order for physicians to reduce their financial anxiety, they first have to …
7 sources of financial anxiety for physicians
It must have been about a decade ago. It was another snowy day like today. I awoke at the break of dawn, and rushed out the door to the hospital that was several miles away. Leaving so early in the morning, the expressways hadn’t even been plowed yet. I did this often. Jumped into the car during inclement weather. While most were waiting out the storm, I was cruising to …
Retirement from medicine is more healthy than the way this physician used to live
An opinion piece published in JAMA suggests the latter: “Protecting the Value of Medical Science in the Age of Social Media and ‘Fake News’”
The authors argue social media poses a threat to science in several ways:
Is social media a friend or foe of science?
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