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How a physician found success and fulfillment living outside the box

Physician

July 20, 2018

An excerpt from the Docs Outside the Box podcast, episode 2: How a physician found success and fulfillment living outside the box

Dr. Nii: I have an exciting guest that I want to showcase for you. Her name is Dr. Melanie Watkins. She’s a psychiatrist who’s practicing in California. I’ve been following Melanie for quite some time on Twitter. She’s been known to have very poignant Twitter messages — whether they are …

Medical training is over. What’s the next chapter?

Manu Prativadi, MD

Medical Education

July 19, 2018

Today is a strange day.

I treated myself to a slice of nondescript doughy hospital pizza for lunch today. If this was an actual pizza place, and I had a choice, I would never order this pizza. But today, the pizza tasted fantastic. In fact, it tasted like the best pizza I’ve ever had.

Why you ask?

Because this would likely be the last time I’d ever eat this hospital pizza. I enjoyed …

A physician’s mistakes as a rookie MD

Rebecca E. MacDonell-Yilmaz, MD, MPH

Physician

July 19, 2018

July is upon us again: that New Year celebrated only by those in the medical field. A time when medical students begin as doctors, interns become residents, residents become fellows and, basically, everyone in every position is one year less experienced at it than the person who held that position the day before.

This July marks the end of my first year of pediatric hematology/oncology fellowship. Finally, after college, grad school, …

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A physician’s mistakes as a rookie MD

Medical students: Welcome to the wards

Zainab Mabizari

Medical Education

July 19, 2018

Dear third-year medical students,

Welcome to the wards.

I remember this stage — basking in the glory of completing pre-clinicals, in the excitement of finally switching heavy textbooks for living, breathing people, in the realization that medical education now lies in the hands of those I wanted to heal. I would be sleeping less, but living more, because this was my purpose.

Remember this moment because this will be the most difficult year …

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Medical students: Welcome to the wards

Make a commitment to ask patients about firearms

John Hunninghake

Health Policy

July 19, 2018

Author’s note: My personal reflection about the Sutherland Springs mass shooting was written before the horrific events at Stoneman Douglas High School and Santa Fe High School. The chorus of voices has only increased in amplitude regarding the calls to responsible action on firearm safety. While a larger debate continues in Washington, DC, I ask myself again: What can I do now as a medical provider to make a difference? …

A physician’s attempt to seek psychiatric help

Anonymous

Physician

July 19, 2018

Physicians all around us are dying from suicide. For me, some deceased colleagues I knew more closely, others were faces that you would pass on the wards. Even two physicians that I knew peripherally died just this past week.

The issue of physician suicide is in the news now, and facts are available. At least a whole medical school class worth of physicians dies by suicide each year. The suicide rate …

The case against physician side hustles is weak

DocG, MD

Physician Finance

July 19, 2018

As many of you know, I am a big fan of side hustles. I see them as a financial independence superpower that not only leads to increased revenue and diversification, but also joy and passion. I am not, however, unaware of the fact that many feel they are a waste of time. The case against side hustles is real. There are many reasons why an individual may decide …

How do you come back after losing a battle?

Andrea Bischoff, MD

Physician

July 18, 2018

During my pediatric surgery training, I could easily point out which was the hardest day for the three fellows that were under training on that specific year. It was late evening when I received a call that one of our patients had coded. I was at home, and the drive usually took me exactly seven minutes.

Due to social reasons, this patient was in the hospital with us for months (at …

Managing your freedom after residency

Allison Edwards, MD

Physician

July 18, 2018

The first time I was asked to provide a bio — in this case, it was to appear on my residency’s website — I wasn’t sure what to include. It was supposed to be short, not really an autobiography or memoir and it was supposed to make our program look approachable, impressive and balanced. I gave a quick summary of my background, my education, my interests, why I picked the …

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Managing your freedom after residency

Physician suicide: Putting words into action

Joshua Goldman, MD

Physician

July 18, 2018

“The parts of me that used to think I was different or smarter or whatever, almost made me die. ”
— David Foster Wallace in an interview by David Lipsky

Recent physician-suicides and all those before were committed by people; people caught in an organization rigged against them — one that breeds new and exacerbates existing, mental health issues. Physicians are people. Doctors are people. They happen to be people who care, which makes …

Both physicians and CEOs need time to think

Hans Duvefelt, MD

Physician

July 18, 2018

I’ve always likened the job of a primary care physician to that of a chief executive officer of a small business. Family doctors manage the “business” of delivering and coordinating care for more than a thousand patients at an average cost, in the United States, of $8,500 per year: an $8 to $12 million business. Because the actions or inactions of the PCP impact the need for, and cost of, …

Learn from the prior generation that left little for their own retirement

James Turner, MD

Physician Finance

July 18, 2018

One of my best friends recently sent me an article from the Wall Street Journal discussing the generation that is about to enter into retirement. The article highlighted how this generation will have an unacceptably high proportion of people who are unable to retire. Following a generation that had guaranteed pensions, this left them with the reassurance that they would someday have one, too. Left ill-prepared for retirement, this …

When attendings come to work rounds

Robert Centor, MD

Medical Education

July 18, 2018

Learners value efficiency. As I recall my residency, nothing caused more angst than unnecessarily long rounds. In the 1970s just like in the 2010s, I had much to do after rounds ended.

As an attending physician, my responsibilities involve patient care and aiding learning. I have always worked hard to do that within a time constraint. The time constraint requires that rounds run efficiently.

Like many things in medicine, efficiency only works …

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When attendings come to work rounds

Why are we treating outpatients like inpatients?

Fred N. Pelzman, MD

Physician

July 17, 2018

Repercussions.

Every action that is taken, especially when it comes to healthcare, has ripple effects, which often end up being more far more significant than we anticipate, turning that ripple into a tidal wave.

Every time somebody besides actual health care providers steps into the mix and tell those of us taking care of patients that there is “something else that we have to do,” we often see it open up a …

Why physicians need disclosure coaching

Diane W. Shannon, MD, MPH

Physician

July 17, 2018

In March 2018, The Collaborative for Healing and Renewal in Medicine (CHARM) published an article titled “Charter on Physician Well-being” in JAMA. The piece describes guiding principles and lists recommendations for promoting well-being among physicians. The charter successfully pulls together, in a 2-page document, a comprehensive approach to preventing burnout and fostering well-being among physicians.

One recommendation especially caught my attention. “Anticipate and Respond to Inherent Emotional Challenges …

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Why physicians need disclosure coaching

Are abuse-deterrent opioids the solution to the opioid crisis?

Tiffany Lu, MD

Medications

July 17, 2018

As a primary care doctor who cares for many patients with opioid-use disorder, I am invested in timely and effective strategies to curb our nation’s opioid epidemic. Because so many instances of opioid addiction and overdoses begin with or involve commonly prescribed opioids, we need multiple strategies that address the significant harms associated with prescription opioids.

I am skeptical of one strategy, however: The President’s Commission and the Food and Drug Administration are …

The social determinants of a physician’s path

Dr. Saurabh Jha

Physician

July 17, 2018

Poverty is known to be an important determinant of a person’s health and longevity. A person’s zip code is more relevant than genetic code. Does a physician’s zip code – that is where they were born and raised – have an effect on where they practice? Specifically, do rural born and raised physicians return to their rural roots? The story of Prashant, a physician raised in rural Bihar, India, is …

The satisfaction of Suboxone treatment

Hans Duvefelt, MD

Physician

July 17, 2018

My second foray into Suboxone treatment has evolved in a way I had not expected, but I think I have stumbled onto something profound.

Almost six months into our in-house clinic’s existence, I have found myself prescribing and adjusting treatment for about half of my medication-assisted treatment (MAT) patients for co-occurring anxiety, depression, bipolar disease and ADHD as well as restless leg syndrome, asthma, and various infectious diseases.

Years ago, working in …

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The satisfaction of Suboxone treatment

Guidelines, multiple specialists, and the science versus the art of medicine

Steven Reznick, MD

Physician

July 16, 2018

My 80-year-old patient presented with symptoms and signs of kidney failure. I hospitalized him and asked for the assistance of a kidney specialist. We notified his heart specialist as a courtesy. A complicated evaluation led to a diagnosis of an unusual vasculitis with the patient’s immune system attacking his kidney as if it was a foreign toxic invader.

Treatment, post kidney biopsy, involved administering large doses of corticosteroids followed by a …

Social workers are medicine’s unsung heroes

Richard Gunderman, MD, PhD

Health Policy

July 16, 2018

You can tell a lot about a job and the people doing it by asking them to describe their best day at work. For Ali, a 28-year-old pediatric cancer social worker, that day occurred one year ago. A 17-year-old cancer patient who had been given two months to live made a bucket list. On her list were graduating from high school and getting accepted into college. So Ali and her …

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