Bridging the gap: medical training in the digital age

Medical Education
May 2, 2018

Like most medical trainees my age, I step into the hospital with the entire knowledge base of the world in my pocket. I have apps on my phone to look up disease symptoms and diagnoses, reference drug doses and side effects, estimate the 10-year risk of having a heart attack, determine the correct timing and type of vaccine administration and screening tests, and even display the risks, benefits, and statistics …

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Bridging the gap: medical training in the digital age

It’s time for women physicians to shine on stage

Physician
May 2, 2018

I often speak on stages at conferences. I am often the only woman and sit on what some have called “manels.” I love to teach large groups, and I enjoy medical and leadership conferences.

I used to take pride being “the only woman” on stage.

Not anymore.

For years I would be on panels, and I would be the only woman. Many times I was given the “case presentation.” The more serious panel …

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It’s time for women physicians to shine on stage

The opioid crisis: Doctors cannot lose hope

Medications
May 2, 2018

While our elected officials in Washington spin political rhetoric and quote scary statistics around the opioid epidemic, New Jersey was one of the first states to take actual action. In February of this year,  New Jersey Attorney General Gurbir Grewal declared its plan of combat: a 24-hour response team, improvements to the prescription monitoring program, and over a million dollars in federal grants. In fact, the Office of …

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The opioid crisis: Doctors cannot lose hope

When preventive care becomes upselling in medicine

Physician
May 2, 2018

For many years, I’ve held a brief huddle with my team every morning to make sure we are ready for the day: Anybody with complex problems coming in today? Anybody who’s been in the ER? How is Mrs. Jones’s husband over at the nursing home, is she worried about his condition? Where can we squeeze in more add-on’s?

Now other people have tried to hijack the word “huddle” for a completely …

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When preventive care becomes upselling in medicine

A surprising cause of rectal bleeding

Conditions and Diseases
May 2, 2018

“I can’t stand the site of blood!”

We’ve all heard that adage. Blood can provoke emotional reactions from even steely muscle-bound bodybuilders. We gastroenterologists routinely receive fearful phone calls from patients who have observed even minor rectal bleeding. Fortunately, in most of these cases, there is a benign explanation for the sanguinary seepage.

If blood repels you, then gastroenterology should not be on your short, or even long list of professions under …

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A surprising cause of rectal bleeding

How physicians can save their marriage

Physician
May 2, 2018

My wife and I have befriended multiple people with struggling marriages.  Maybe this shouldn’t be a big surprise given the majority of marriages end in divorce.  That said, every time we end up with friends struggling in marriage, it never gets any less challenging.  Every single time we run into this challenge, I am reminded of some sage advice I received before I got married: “The three most common causes …

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How physicians can save their marriage

A physician makes the case for some routine labs

Conditions and Diseases
May 1, 2018

Many medical organizations have recently been promoting focused and individualized lab testing for routine screening or when pursuing a diagnosis. Research has shown that the “shotgun” approach to lab testing usually leads to further invasive testing which has not been proven to significantly alter morbidity or mortality.

Additionally, tests rely on pre-test probabilities and can have false-positive or negative results and …

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A physician makes the case for some routine labs

No matter where you are, you’re still a doctor

Physician
May 1, 2018

I grabbed a few beach pillows, put on my old worn-out blue beach button down, poured myself a glass of whiskey and walked down to the beach from our villa to watch the sunset. My four friends and I were ten days deep into a two-week vacation. We had already toured Seoul, South Korea for three days, Tokyo, Japan for four days and Hong Kong for three days. So, I …

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No matter where you are, you’re still a doctor

Palliative care: My moral grounds were shaken and my beliefs challenged

Physician
May 1, 2018

A cup of black coffee — such an ordinary request. Behind this request is a mother of a dying son, who due to financial restraints, has slept on the same hospital recliner chair and eaten the same oatmeal and mashed potatoes made from a water kettle every day for months. What can we offer when there is no more chemotherapy, what can we do to alleviate this mother’s struggle? A …

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Palliative care: My moral grounds were shaken and my beliefs challenged

This surgeon changed his mind about having more support

Physician
May 1, 2018

I was in my surgical residency back in the days of “you can go home when the work is done.” A few years before I arrived as an intern, one of my attending surgeons had decided he was going to jump on the trauma train. Trauma was in its infancy back then, and he was convinced (and rightly so) that patients could be greatly helped with this relatively new concept …

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This surgeon changed his mind about having more support

Primary care physicians are on the front line of the opioid epidemic. Help them.

Conditions and Diseases
May 1, 2018

When it comes to the opioid epidemic, physicians are some of the best drug dealers around with almost unrestricted access to the purest substances. As the opioid epidemic spirals out of control, physicians continue to be able to provide their patients with a variety of options, including oxycodone, morphine and fentanyl. Many people would be surprised to know that physicians don’t need any additional training to prescribe opiates to their …

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Primary care physicians are on the front line of the opioid epidemic. Help them.

Is the physician-patient relationship becoming a provider-client one?

Health Policy
April 30, 2018

Given the current state of health care, I have imagined the following hypothetical conversation between a patient and a doctor:

Patient: “Doctor, I’ve come to learn from reading somewhere that the current overarching goal in my care is for the signs and symptoms of my various conditions to be treated, but not the conditions or diseases themselves. Is this true?”

Doctor: “Well, you know, I would love to treat those conditions and …

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Is the physician-patient relationship becoming a provider-client one?

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Do millennials have the key to fight burnout?

Physician
April 30, 2018

Dear millennial,

Mea culpa!

I’m not so old — but old enough to have thrown out my share of jabs at the millennial generation. My quips have been nothing creative: lazy, entitled, lacking work ethic, you know, the usual stuff. These generalizations were how I would describe the work-hour restricted medical residents, the girl behind the Brandy Melville counter, heck even my brothers (one of whom I don’t even think technically classifies …

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Do millennials have the key to fight burnout?

How to give patients bad news

Physician
April 30, 2018

I would like to give some tips to younger doctors regarding how to tell your patient that he is going to die. Your approach should also incorporate your unique personality, as well as published literature and other resources.

For your first case, watch someone more senior tell the patient. See what you think worked and what could be improved. When it is your turn, make sure to have …

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How to give patients bad news

What Mariah Carey’s bipolar revelation could mean for public health

Conditions and Diseases
April 30, 2018

Five-time Grammy winner Mariah Carey is being widely applauded for recently revealing she was diagnosed with bipolar disorder in 2001. Media reports have noted she is one of several celebrities who have opened up to the public about struggling with the illness. It’s a list that includes Catherine Zeta-Jones, Demi Lovato, and the late Carrie Fisher.

Just by openly talking about their mental health struggles, these famous women helped lift mental illness out …

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What Mariah Carey’s bipolar revelation could mean for public health

Why is it difficult to be a doctor?

Physician
April 30, 2018

As part of the interview for my book, I asked why it is difficult to be a doctor. Some of it has to do with integrating information and making decisions.

“The public thinks that we know more or can do more than we can. Ultrasounds don’t mean it’s a perfect baby. All of the tests and technology moves so fast that we don’t know what we see.” A doctor explained, “You cannot know …

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Why is it difficult to be a doctor?

Doctors order a lot of tests. That applies to personal finance.

Physician Finance
April 30, 2018

Doctors order a lot of tests.

Let’s be clear, most of these tests are quite good and help with diagnosis and management. They can help hone down a wide differential diagnosis to a single diagnosis. Once a diagnosis is made, additional tests can help guide physicians on the best treatment.

But there are some tests which are not necessary to order. In some scenarios, the next step in management (whether it be …

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Doctors order a lot of tests. That applies to personal finance.

Let’s make seeking mental health acceptable

Conditions and Diseases
April 29, 2018

As divisive as the gun debate can be, people on both sides of the aisle can usually find common ground on one idea: individuals with mental health issues shouldn’t be afforded access to guns.

Sadly, this is usually where the conversation about mental health in America prematurely ends. After these laws are enacted, what do we do with these people? There is rarely any dialogue or follow up on how we …

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Let’s make seeking mental health acceptable

Doctors, don’t be scared. Here’s why.

Physician
April 29, 2018

It was a twilight summer game, and I was parked as usual in right field among the weeds and snake holes. There was no outfield fence, so muffed balls could roll forever. Not gifted with athletic skills, I also had a secret problem. I was blind as an especially myopic mole rat and couldn’t even see the second baseman. This would be discovered five years later. I knew one thing …

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Doctors, don’t be scared. Here’s why.

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