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5 effective strategies for pacing when you’re sick or in pain

Patient

April 18, 2017

Pacing refers to spacing out your activities during the day so that you’re able to stay within the limits of what your body can handle without exacerbating your symptoms. Another way to think of it is that pacing is a way to keep you inside your “energy envelope” — the envelope that contains your energy stores for any given day.

First, an admission: Even though pacing may be the single best …

Is health care a right or a privilege? Why can’t the answer be both?

Brian C. Joondeph, MD

Health Policy

April 18, 2017

Election Day 2016 should have been Christmas morning for Republicans. Long awaited control of the White House and both houses of Congress. A chance to deliver on an every two-year election cycle promise to repeal and replace Obamacare. In 2010 Republicans needed the House. They got it. In 2014, it was the Senate. Delivered. But we still need the White House they said. Asked and answered with President Donald Trump.

So, …

The burden of the medical profession. Is it worth it?

Jennifer Lycette, MD

Physician

April 18, 2017

The return from a vacation weighed on me physically. This had been a true vacation — an entire week away from clinic and spent with my family. I even managed to unplug to the point of only checking email on my phone twice per day — really!

The tension that years ago took up permanent residence in my shoulders had faded away without my noticing, so that when I awoke to …

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This doctor takes pride in being inefficient. Here’s why.

Matthew Wetschler, MD, MPH

Physician

April 18, 2017

The emergency room is packed. I interject another question to further clarify when exactly Mrs. Smith’s chest pain started, cutting off a story about her daughter — a tactic I would have found unthinkably rude only years before but has now become a necessary technique. After leaving the room, I try to put in orders, but the electronic medical record resets itself, I’m informed an X-ray won’t upload unless I …

The fundamental cause of surprise medical bills and how to fix it

Ezriel Edward Kornel, MD

Physician

April 17, 2017

It’s no secret that health care is an unbelievably complex subject. One of the most complex issues facing the health care system is that of surprise medical bills. Surprise medical bills happen when:

Patients receive emergency care by an out-of-network provider (one not included in their insurance plan);
Patients are unaware that one or more of the providers of their non-emergent care were out-of-network; and
Patients choose out-of-network care without …
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The fundamental cause of surprise medical bills and how to fix it

To the doctor who saved our son’s life

Amanda Kern

Patient

April 17, 2017

I’m convinced this will be a year of reflection for our family — as we’ve witnessed so many transitions in the past year I find myself deep in thought. As I reflect, I’m full of appreciation for the journey we’re on. I’m full of gratitude for so many of the people who have helped us along the way — especially the amazing doctors who have become like family. This past …

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To the doctor who saved our son’s life

How Trump counties should instruct health reform

Suhas Gondi, Evan Beiter, and Vishal Khetpal

Health Policy

April 17, 2017

A few weeks ago, before the demise of the American Health Care Act, President Trump sat down for an interview with Tucker Carlson at Fox News. Citing an article from Bloomberg, Carlson informed the president that the counties which voted for him “would do far less well under the bill than counties that voted for Hillary,” were it to pass. Whether intentional or not, Trump agreed with his assessment, noting …

Heroin is a public health emergency. The time to act is now.

Jarret Patton, MD

Physician

April 17, 2017

Recently, another local family buried their young adult child due to a drug overdose. Sadly, this same story is playing out daily across the nation.

Upon reading the headline, I paused to think about an encounter leaving work one Friday evening. As I was walking in the dimly lit street to my car, I found a small group of shadows huddled over something lying in the adjacent alley. Once closer, I saw that …

I’m equal parts doctor, scribe, and mouse jockey

Physician on FIRE, MD

Physician

April 16, 2017

And I don’t love it.

When I gained acceptance into medical school, I thought I would one day have one amazing job, or at least one job title where I might get to wear several meaningful hats.

I’m a physician anesthesiologist. It’s my duty to play a role in improving the health and the lives of my patients. I studied and trained for many years to have the privilege of understanding the …

Isolation threatens the practice of diagnostic radiology

Cory Michael, MD

Physician

April 16, 2017

During breakfast with my father over the holidays, a friend of his asked me what kind of doctor I am. “I’m a radiologist,” I answered.

I was met with a puzzled expression and a reply of “Oh, I thought you were a doctor doctor.” I smiled and returned to my banana.

Most radiologists, especially those like me who are not physician offspring, are faced with this sort of discourse at least once. …

8 secrets to landing a locum tenens job

Brandy Collier-Pearson

Physician

April 16, 2017

In the market for a locum tenens position? If you search online “How to book a locum assignment?” you’ll likely find vague advice such as “Develop a relationship with a recruiter.” Or “Do your homework when choosing an agency.” Thanks, Internet …

Having worked as a locum tenens recruiter for over 15 years, I have seen consistent trends in how the best clinicians are able to stand out and book jobs. …

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8 secrets to landing a locum tenens job

What life is like for this retired physician

David Mokotoff, MD

Physician

April 16, 2017

I have now been out of the active medicine for two years. I still have dreams about being a doctor and practice. I don’t think you can do the same thing day in and day out for 40 years and not have it be a part of who you are. I am still asked my opinion by friends and family about their health issues, and frankly, I find my fund …

We made it! An open letter to my son.

Karina Chavez, MD

Medical Education

April 15, 2017

“Ya mero llegamos?”

Are we almost there? These become one of the most dreaded words I have to hear every weekend, when I pick you up from the long commute that is from Sacramento to the bay area to spend time with you. Oftentimes I am just as inpatient as you my love. This has been our sacrifice these last few years, being physically away from one another. I take a deep …

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We made it! An open letter to my son.

The pros and cons of moonlighting for medical trainees

Future Proof, MD

Physician Finance

April 15, 2017

Are you a medical resident or fellow? Do you have a family to provide for? Do you feel that your biweekly paycheck is not quite enough to justify the hard work you put in? Luckily for you, your program offers the great benefit of “moonlighting.” Should you take advantage? Here are some of my thoughts on the matter.

What is moonlighting?

Like so many other things we take for granted in medicine, …

Your physician is the everyday champion

Supreeya Swarup, DO

Physician

April 15, 2017

The average amount of time it takes someone to become a physician is approximately 11 years, and for those pursuing further specialization, one can easily add a couple of years to that. The time certainly adds up by investing years in college, medical school, residency, and fellowship. By the time I will be an independently practicing cardiologist, I would have invested about 16 years into my training. That’s almost half …

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Your physician is the everyday champion

MKSAP: 44-year-old woman with a painless right neck mass

mksap

Conditions and Diseases

April 15, 2017

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 44-year-old woman is evaluated for a 2-month history of a painless right neck mass. Medical history is unremarkable, and she takes no medications. She is a lifelong nonsmoker.

On physical examination, vital signs are normal. A 5-cm right anterior neck mass is palpated. The remainder of the examination is unremarkable.

An initial CT scan …

Are newspapers willing to mislead the public, for a price?

Nira Pollock, MD, PhD, Pamela Templer, PhD, Jagesh V. Shah, PhD, and Jenny M. Tam, PhD

Physician

April 14, 2017

Should newspapers sell advertising space to those who propagate misleading or demonstrably false information about scientific issues? Is the paper’s desire to earn “a little extra cash for depleted print coffers,” as the New York Times’ public editor put it, a good enough justification for doing so?

These are questions raised by the recent decisions by the Times and the Washington Post to publish in their print editions full-page, paid advertisements filled …

Stressed and sad as a medical intern? You’re not alone

Lisa Jacobs, MD, MBA

Physician

April 14, 2017

A few weeks after I started residency, two of my peers killed themselves in New York City. No one I knew was surprised.

Intern year is hell, and everybody knows it from TV shows like “Scrubs” and books like “House of God.” Old doctors tell tall tales of working a million hours without sleep before training standards got “soft,” limiting residents’ monthly work hours to 320 and requiring four days off. …

Please call me doctor: In defense of feminist medicine

Jenna T. Nakagawa, MD, MPH

Physician

April 14, 2017

One stunning afternoon I walked into a patient’s room to discuss our plan, informing her that the nurse would come to draw blood.

“You can draw my blood, Miss,” said the male family member sitting in a corner of the room, as far from the patient as possible, his legs crossed, smirking, “We can go into the next room and lock the door.”

His smug grin brought back memories of older men …

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