There is a lot of talk on the web about having an emergency fund. Typically this is three to six months of expenses. Some would argue to keep three to six times bare bones expenses, and others would argue to keep three to six times the average amount you spend on expenses. Having an emergency fund makes sense to cover life’s unexpected occurrences. What could these be? Well, the biggest …
Do doctors need an emergency fund?
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 36-year-old man is evaluated for a 1-year history of fatigue, intermittent headaches, sore throat, and joint and muscle pain. He reports no difficulties falling asleep and gets 10 hours of uninterrupted but nonrestorative sleep each night. He has seen several physicians over the past year. Evaluation has included a complete blood …
MKSAP: 36-year-old man with history of fatigue
The National Academy of Medicine has launched an Action Collaborative on Clinician Well-Being and Resilience, but there is one missing stakeholder. On July 14th, NAM hosted its first public meeting on establishing clinician well-being as a national priority. The inaugural sponsors include nearly many medical specialty societies, the major insurance companies, the American Associations for hospitals, nurses, physicians and medical colleges, Johns Hopkins, Mass General and …
Can health care executives help with physician burnout?
A colleague said earlier this week, as he bravely disclosed his journey with anxiety and depression that he had “become excellent at hiding [his] depression, especially as an extrovert.”
My colleague brings others along into a wake of happiness he trails but is also able to sit knee-to-knee with the parents of dying patients and empathize in their suffering — to truly let a small part of their pain sit and …
A physician doesn’t hide his depression
As every physician practicing today knows, health care is in a constant state of flux. The latest news from Washington creates even more uncertainty. What we do know is that, for the foreseeable future, there will be an emphasis on team care, coordination, technology and, of course, meeting the requirements of the ever-expanding alphabet soup of acronyms, from MACRA to MIPS and beyond.
As I think about all the changes of …
Do we really have a choice in health care?
On a daily basis, I am introduced to new people from all walks of life. Some sit on the board of directors, some are CEOs, some are presidents, some are middle managers and other administrators, some are investors, others are entrepreneurs, and some are physicians, nurses, case managers and even patients.
I listen to people talk about the big challenges in health care. It costs too much, we have a shortage …
Let’s change the mediocre status quo of health care
Just as summer is in full swing, the back-to-school advertisements are running. This time of year can be exciting for many — the first day of elementary school, high school or college. For the rest of us, we try to be lifelong learners: learning from our successes and failures, learning from others and if we are lucky learning by reading.
Reading is a skill learned in the early school years. Children …
Literacy is a health care problem no one talks about
“He is the best physician who is the most ingenious inspirer of hope.”
– Samuel Taylor Coleridge
I was a third-year medical student on a Sunday morning when the reality of what I had chosen as my life career truly hit me in the gut. At that moment, I realized how intimate the practice of medicine was and that I would have to bring not only my brain and skills to work …
Doctors: Don’t emotionally detach
This is the patient’s eight admission over the course of two weeks. The patient is a heroin abuser and has bacteremia and endocarditis. Their heart valve is failing and they are in and out of congestive heart failure. Every day, dozens of medical professionals converge on the patient to give treatment and advice. And every day after hearing that advice, the patient leaves the hospital against medical advice and goes …
7 ways to combat compassion fatigue
Hate your job? You may be in the right profession, but the wrong position for your personality. Want to love your life and career? Step one: discover whether you are an employee, a business owner or an entrepreneur.
Here’s how to figure it out:
Employees are risk averse and like to know the rules. They thrive on structure and predictability. They need clear instructions …
Doctors: Are you employees, business owners or entrepreneurs?
Sheila’s jaw is clenched. Sweat is beading on her forehead. I make a slow audible inhale, non-verbally inviting her to do the same. We’ve been talking about the nightmares which started shortly after she began receiving help with personal care. I remind her that she is safe — the day she was raped is decades in the past. Her conscious mind knows this, of course, but for people with posttraumatic …
PTSD can happen at the end of life
This is a tough post to write. I struggle with this issue daily. Is it OK for a physician to retire early? The obvious answer is: yes. Each individual should live their life as they see fit. But with a continued shortage of physicians (granted this is more in rural areas and not big metropolitan cities), and the time, money and resources required for training physicians, is it selfish to …
Is it OK for a physician to retire early?
While in training, we were told that we were not efficient if we couldn’t see 20 or more patients and complete our notes for billing. We were told that primary care offices were asking our residency program for our efficacy data before consideration of hire. This was the line drawn in the sand by our new health care system. We would either rise to the occasion or be harassed by …
What do primary care doctors need? More time.
In 1996, I had an illness that nearly killed me. I was exhausted, felt awful, could barely stand up and had trouble remembering things. Yet, I somehow had to find the energy not only to take care of my newborn and 5 year old, coordinate our upcoming move, consult with doctors and other medical providers on my condition and treatment, and receive treatments that might or might not help me …
8 ways to be your own health advocate
A commencement address delivered on August 5, 2017, to the 2017 class of anesthesiologist assistants (AAs), Emory University.
Distinguished faculty, graduates, honored guests:
It is a great pleasure and an honor to be here, and to congratulate all the graduates of the Emory University Class of 2017 on your tremendous accomplishment. Just think about all you have learned in the past two years. You’ve transformed yourselves into real anesthesia professionals, able to …
A commencement address to anesthesiologist assistants
I read something recently that shocked me. Despite working in health care for 15 years, I had no idea that nearly 80 percent of the U.S. health care workforce is comprised of women (according to the Bureau of Statistics.)
I did know, however, that women make up less than 20 percent of executive boards and less than 40 percent of middle management in health care. Those that do exist in the …
How can we ensure medical leadership includes more women?
The Society to Improve Diagnosis in Medicine has on its website this quote:
The current focus on diagnostic error raises an interesting question: Is this a larger problem in 2017 than in the 1970s and 1980s?
In this post, I …
We must make the word “diagnostician” the most prestigious term in medicine
It was late afternoon. The woman who had seen my colleague, Dr. Wilford Brown, a few days earlier was sitting in my exam room. Her chart note read like a typical unnameable virus: headache, body aches, fatigue, low grade fever. She had always seemed like a level-headed resolute woman, but she had called three days in a row for medical advice because she felt so poorly. And it all sounded …
A lesson learned after seeing a tick-borne illness
“Hello Dr. Payne, thanks for calling back, there’s a consult I’d like you to see.”
“What’s going on?”
“Well there’s a patient up on 7 East who …”
“Wait a minute. 7 East … isn’t there some other specialist covering there?”
“No Dr. Payne, the schedule says you on Wednesdays.”
“Oh, I’ll check that.”
“OK, Dr. Payne, well we have this 72-year old, Mrs. Jones, who originally got admitted with pneumonia. She now has unusual inflammatory …
To those who want government-run health care: Be careful what you wish for
We in the medical community believe wholeheartedly in the prevention of all illness, especially by vaccination. Science and history continue to show that vaccination dramatically decreases both the mortality (death rate) and morbidity (severity of illness) of infectious diseases. And, more than 98 to 99 percent of the general population (non-medical) agrees with those statements as well.
Yes, it is absolutely frustrating when parents refuse to follow our advice and protect …
Why pediatricians should not kick out unvaccinated children
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