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What cancer taught this physician about hope

Physician

December 13, 2018

As an internist, I strived to give patients hope by prescribing therapies that increased their chance — their hope — of the best outcome and by encouraging them with hopeful words. My own hope was to care for patients until I was old.

Just weeks after celebrating my 36th birthday, I was diagnosed with non-Hodgkin lymphoma. Throughout the ups-and-downs of my chemotherapy, I felt the kind of hope I’d wanted my …

The fight to save Howard University College of Medicine

Vicky Li and Naveen Balakrishnan

Medical Education

December 13, 2018

Our country is at risk of losing an iconic institution that has played a pivotal role in the history of medical education. A school, which has produced some of the boldest pioneers in medicine, could lose accreditation upon the opening of a new hospital that will shunt away 40 percent of their current patients. Scores of our brightest potential medical students will be ripped away from the communities that desperately …

How social media leads to a loss of creativity

Edwin Leap, MD

Social Media in Medicine

December 12, 2018

I use social media. Specifically, I use Facebook, Twitter, and LinkedIn. In the beginning, I did so for utilitarian purposes. As a columnist and aspiring writer of books, these were (and indeed are) useful marketing tools.

I have, in the past, carried around a note-pad to jot down ideas. I was never without my note-pad. I always wanted a small legal-pad with a blue or black gel-ink pen. It was my …

Doctors vs. executives: the spending power of $1.5 million

Smart Money, MD

Physician Finance

December 12, 2018

The general consensus among physicians who have a solid grasp on their finances is that they are realistic about their earnings and expenses. Ins and outs. Just like in nephrology, except a net positive in your finances is considered a win. One would expect that doctors ought to be generally conservative in their expenditures, since medicine is a generally conservative profession. But life is unpredictable, and that’s why there are …

Doctor’s orders: Follow these 6 tips to avoid holiday stress

Sevitlana Safaei, MD

Conditions and Diseases

December 12, 2018

For many of us, “the most wonderful time of the year” is anything but. If we let the holiday season get the better of us, we can find ourselves overeating, overspending, and over-extending from now through New Year’s Eve.

Holiday stress has real health implications: The American Heart Association warns that the increased stress we feel this time of year can lead to significant coronary events. The American Psychiatric Association urges …

Nocturia: the underdiagnosed condition patients find extremely distressing

Linda Girgis, MD

Conditions and Diseases

December 12, 2018

As a family physician, I treat patients of all ages – children to those nearing 100 years old. One issue that plagues young and old alike is lack of sleep. In fact, according to the Centers for Disease Control and Prevention’s (CDC) 2016 Morbidity and Mortality Weekly Report, more than one-third of American adults do not get enough sleep on a regular basis. This is a common …

Too much of a good thing when it comes to medicine for older adults

John Muscedere, MD

Conditions and Diseases

December 11, 2018

Prevailing wisdom states that more is better — and it is no different when it comes to our expectation of medical treatments. With the help of the internet, patients and their families have come to expect intensive tests, treatments and therapies at every life stage.

But sometimes, too much treatment can do more harm than good. This is true in all ages but is especially relevant for older adults living with …

The day when the white coat can be worn with no hesitation at all

Shadi Ahmadmehrabi

Medical Education

December 11, 2018

It was my first day of orientation at medical school. In a hallway stood a coat rack overflowing with white garments. I set down my accumulated papers, reached for a hanger and — for the first time ever — shrugged first one arm and then the other into a white coat.

It was too large, but I had no other options. The unisex coats ran from XXS to XXL, but the …

4 financial stages of physicians

John Dameron

Physician Finance

December 11, 2018

As a medical student, you are thrilled to start your residency and to put your four years of studying and clinical rotations to the test. Now the time has come to begin earning a paycheck. This is the beginning of the financial stages of physicians.

As an attending who has transitioned into practice, you may be stressed and wondering if you are on track to meet your financial goals. You are …

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4 financial stages of physicians

The simplest treatment is sometimes the best

Naeem Rahman, MD

Conditions and Diseases

December 11, 2018

“I am really uncomfortable and in pain,” said Elaine tearfully as I met her in the preoperative area for the first time. She had a very sad and difficult history, dealing with complications from childbirth nearly two years ago. She had developed a communication between her rectum and vagina, which allowed feces to come out vaginally. Despite multiple surgeries from reputable medical centers in NYC, the problem recurred. And she …

The Wild West approach to PICU practice

Christopher Johnson, MD

Health Policy

December 10, 2018

I spent my early and mid-career years working in a pediatric intensive care unit (PICU) at a large academic center. We did almost everything except for a few things esoteric at the time — small bowel transplants, a few kinds of experimental surgery. I’m now in my late career (but have no plans to quit anytime soon!) and work in a smaller PICU. I am frequently confronted with the issue …

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The Wild West approach to PICU practice

The millions of dollars hospitals spend for inspections

Steven Reznick, MD

Physician

December 10, 2018

Two of my local hospitals just invested 3 to 4 million dollars in preparation for an inspection of the facilities by the Joint Commission. The cost of the inspection runs in the $10 million dollar range after the preparation costs. The inspection is a high-stress situation for the administration because if you fail, or lose your accreditation, the private insurers will void their contract with you and you won’t get …

A community-based program that brings patients and pathologists together

Matthew Katz, MD

Physician

December 10, 2018

When I was in medical school, I loved pathology. The visual learning and deep understanding of disease were attractive enough that after second year, I took an extra year before clinical rotations to work as a post-sophomore fellow, working as a resident cutting specimens and performing autopsies. I missed patient contact but it served as a great foundation for clinical medicine …

Is it possible for physicians to oversave? And what can you do about it?

James M. Dahle, MD

Physician Finance

December 10, 2018

Have you ever thought about doing a post on oversaving? I realize most docs probably have the opposite problem, but I bet there is a subset of the FIRE crowd that this may apply to. Does this ever come up in all the interactions you have?

It was no surprise to see this question come in as a direct message on the WCI Forum, rather than an email …

What you need to know about acute flaccid myelitis

Roy Benaroch, MD

Conditions and Diseases

December 9, 2018

You’ve probably seen it on the news – a rare, polio-like illness is causing cases of paralysis in children. Here’s the latest info, based on our best current knowledge from the CDC.

Acute flaccid myelitis (AFM) is a sudden illness that causes weakness in one or more extremities – one arm or (less likely) a leg, or any combination of arms and legs. The words in the name express the key …

Disability can be a devastating outcome to a doctor’s career. Here’s how handle it.

Smart Money, MD

Physician Finance

December 9, 2018

Disability can be a devastating outcome to a doctor’s career and self-image. Think about it: You busted your butt to learn how to do a Whipple procedure, end up getting into a skiing accident that ends your career right there. No worries, because you purchased the appropriate coverage of own-occupation disability insurance, right?

Having disability insurance certainly provides a protective cushion, especially you are the sole breadwinner. This is a no-brainer, …

Medical clinicians are being stress fractured

Calvin J. Maestro, MD

Physician

December 9, 2018

An excerpt from Leadership Lessons from History: A Study Guide Written for Physicians & Other Healthcare Leaders.

In June 1812, Napoleon invaded Russia along with an army of 600,000 men; fewer than 100,000 made it back. During their ignoble military withdraw, in the middle of a terrible winter, thousands of …

Emergency physicians: You rock!

Sonali Mantoo, MD

Physician

December 9, 2018

I am a critical care physician and spend a good amount of time in the emergency room seeing consults. As an internal medicine resident, we were often in the ER, admitting new patients. In my three years of residency, we spent only two to four weeks working in the emergency room. It was the one time I had an insider’s view of life as an ER physician. And, man, was …

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Emergency physicians: You rock!

A medical student takes a look into the abyss. Here’s what he learned.

Evan Schauer

Medical Education

December 8, 2018

After my surgery rotation, I was in a very bad place. I felt like two months of grueling work hours and relentless studying were wiped away in an instant by a bad test score. That single number somehow mattered more to me than every positive comment I had received from my patients, colleagues, residents, and attendings. I felt like I had put my heart and soul into that rotation, constantly …

The blood of patients is not a rhetorical device

Andrew J. L. Smith

Health Policy

December 8, 2018

Recently, social media and news organizations have been awash in the physician-led backlash to the NRA’s now infamous “stay in your lane” tweet, and consequently, awash in images of the literal blood of seriously wounded or now deceased patients. Gun control is undeniably a cause near and dear to many physicians, who are duty-bound to try desperately, many times in vain, to save the lives of too many innocent Americans …

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