“I can’t do this anymore,” Mary* said to me after morning rounds.
As third-year medical students, this could have been in reference to a number of things: 5 a.m. rounds, practice sutures, 14-hour days, the list goes on. Though I later learned Mary was simply referring to living.
An article recently published by JAMA showed depression or depressive symptoms among medical students was as high as 27.2 percent and …
Why do medical students kill themselves?
As women in the medical workforce increase, women physicians are faced with the unique position of training the hardest they ever had in their lifetime cutting into precious childbearing years. Many women physicians seek time off or engage in part-time jobs to address the dilemma of fulfilling the obligations of their careers while enjoying the tender years of their babies. Others pursue non-clinical routes such as medical chart reviews or …
How to get back into the medical workforce if you’re a mom
The third year of medical school is when a student experiences the frustrations of medicine firsthand. Once, my team admitted a transfer patient from another hospital to treat a condition that was ravaging the patient’s lungs. But before we could act, we needed to rule out a dormant infection; if our patient was unknowingly infected with tuberculosis (TB), giving our first-line therapies could lead to a disseminated infection — even …
Poor communication between EHRs is unacceptable. Let’s fix it.
CNN recently posted an article online, asking this very question. It was posed in the guise of our leading mega-billionaires, Warren Buffet, Jeff Bezos, and Jamie Dimon, “fixing” our broken health care system. In actuality, these three industry giants announced plans to combine resources to create their own insurance system for their combined 850,000+ employees. A nice gesture, to be sure, but not really a panacea for a nation of …
Why is health care so expensive in the United States?
When I started treating opioid dependence, I began with high expectations. I was frustrated with what had become a mindless, ineffectual exercise in providing medication for chronic pain. I saw too many patients “circling the drain” on opioids. Most admitted they still had chronic pain despite their high consumption of opioids. Many patients needed their medication just to feel normal and avoid withdrawal. Others wished they could stop taking opioids …
What’s our goal with opioid treatment?
Why are there vending machines in hospitals? This seems like an odd question to ponder, and it certainly would seem to have nothing to do with the current state of medicine and health care in our country. But it is a question that I am having a hard time wrapping my brain around. Certainly, most hospitals do have vending machines that sell snacks and soda, and they are by no …
Why are there vending machines in hospitals?
As I walked in the room, I noticed it immediately: Norman was worse. The recurrent invasive cancer in his neck was impairing the drainage of fluid from his face making it difficult for him to turn his head, and it had progressed overnight. Despite his alarming appearance, he seemed calm.
There were no more cancer-specific treatment options: the surgeons had declined to operate again; he had received maximum dose radiation; and …
You don’t know what your patient’s end-of-life wishes are
As I work with people one-on-one as a high-performance coach, I have found that the most important aspect to their wealth accumulation, is their habits. Good habits create good results, and bad habits create bad results. The good news is, habits are learned.
You were not born with any of your habits; you learned them somewhere along the way. That means you can unlearn your bad habits and learn some new …
3 bad financial habits for doctors
It’s February 15, and our country has had yet another school shooting. Seventeen more kids are dead, despite multiple warnings that the perpetrator was high risk. No one wanted this to happen. Across the political spectrum, Americans are appropriately asking what they can do to prevent another shooting. Yesterday many asked for a day to mourn. They said, “tomorrow we take action.” Today is tomorrow.
My liberal friends are calling to …
5 things America can do today to reduce gun deaths
A guest column by the American College of Physicians, exclusive to KevinMD.com.
I recently saw a 35-year-old patient of mine who came into clinic requesting brain imaging. Although she had no specific symptoms, she had a friend who was diagnosed with a brain tumor several months ago and is concerned about the possibility that she …
The challenge of the worried well
During our lifetimes, the role of physician has been shrinking, from healer to technician.
You’ve probably seen the famous painting, Doctor and the Doll, done by Norman Rockwell in 1929. It depicts an old country doc listening with his stethoscope to the heart of a doll held up to him by a worried little girl. Today there’s no time for such play, and no pay for it, either.
The gradual transformation of …
Turning doctors into technicians is a mistake
As a third-year medical student, fresh and green on my clerkship rotations, I was determined to stand out on my general surgery team. I knew this was not going to be easy; I was often the last item on many surgeons’ minds as they rush through morning pre-rounds at the hospital, flying around corners, their Nike sneakers squeaking on the polished white floors.
In the OR, I observed from the corner, …
The dark side of negativity bias in medical school
The ancient Greeks were one of the first groups of philosophers to recognize and describe the complexity of love. Eros: an intense, passionate form of love. Philia: a deep friendship or affection. Philautia: love for one’s self. Agape: an unconditional love for humanity.
These same complexities in love forms described by the Greeks play an important role in how we treat our patients in medicine.
Eros allows us to have the passion …
Don’t let burnout impact our ability to provide selfless love
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As a boy growing up in a small town in Pennsylvania, I never gave much thought to the concept of a kiss. My family gave and received kisses without hesitation. I continue to give and receive kisses from my wife and kids in the same nonchalant manner.
Until one night — on shift.
I work in the ER of a medium-sized town in southern Oregon. It was late into my shift. The …
A kiss changed this doctor’s life
This was a momentous week for me. After 14 years of carrying a hospital-grade old-school text pager to receive messages at work, I finally traded it in for a cell phone app. It should have been easy to get rid of my beeper. But instead, I felt waves of nostalgia when I turned it off for the last time. Those 240-character, pre-Twitter, low-resolution LCD messages follow the arc of my …
Farewell pager, I’ll always cherish the memories
I am a physician in recovery and just celebrated my fifth-year anniversary on October 11, 2017.
While in active addiction, my drugs of choice were benzodiazepines and opioids that I washed down with top-shelf alcohol. Near the end of my usage, I was diverting scheduled drugs in order to feed my addiction. After an unsuccessful suicide attempt, I finally admitted myself for treatment.
As part of the treatment process, I enrolled with …
What’s the cost of being a doctor in recovery?
On September 5th, 2017, the Trump administration denounced the further implementation of Deferred Action for Childhood Arrivals (DACA) and called for its revocation in 6 months. Opponents quickly voiced their concerns towards the unjust decree. Now, the deadline is near and a heightened urgency to act is imperative. To encourage advocacy and help legislators understand the vitality of DACA-recipients, the following displays the power of the undocumented.
Days after news of …
When my children each finished Montessori school, my wife and I researched a bit before choosing the local public option. My area has extraordinary private schools. Although high cost, many of these alternatives provide unique and worthwhile twists on traditional education. We talked extensively with the kids, and after much research, we came to the budgetary friendly decision. The public school, with somewhat fewer bells and whistles, provided an education on …
This physician sent his daughter to private school. But not for the reason you think.
Early this month, Joanna Gaines, co-host of HGTV’s popular Fixer Upper, shared her pregnancy news with the world via a baby bump photo and an ultrasound, both posted to Instagram. The congratulations began pouring in from excited fans. But the conversation took a dark turn when a physician commented that the ultrasound appeared to …
An ultrasound posted on Instagram. Does a physician have a duty to warn?
A study from the National Bureau of Economic Research reports on the results of a large randomized controlled trial of a large employer with over 12,000 employees. Program eligibility and financial incentives were randomized at the individual level. Over 56 percent of eligible treatment group employees participated. The study found that in the first year, the employees who signed up were healthier and had lower medical costs, but, and …
Why workplace wellness programs don’t work
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