The other day, I was operating on a little girl with a congenital ear abnormality. Not life and death stuff, but delicate surgery nonetheless. My surgical scrub technician was someone with whom I hadn’t worked before, and I asked him if he was enrolled in the operating room nurse training program, as many of the new folks are.
“No, I’m just a tech.”
I stopped what I was doing and replied: “You …
Not just a tech: Everyone’s important in the OR
The brave teenager was sitting in the corner of the hallway away from other children. A long, torn cloth covered his face, more specifically his mouth. After slowly approaching him, I sat down right next to him. He shifted slightly away from me with a sheepish wide asymmetric grin on his face. As I began to converse with him through a translator, it became obvious he did not want to …
The surgeon who gave a teenager a new smile
Over the past eight months, I’ve rotated at the Palo Alto VA, Santa Clara Kaiser, Stanford outpatient family medicine, and pediatrics clinics, and most recently, at Santa Clara Valley. At the VA and Kaiser, all my patients spoke English. Occasionally, at Stanford’s outpatient sites, our patients spoke a language other than English; however, this never felt like a barrier to care because Stanford had phone interpreters available, as well as …
Should medical school have a language requirement?
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One of my favorite shows to watch as a kid was Bill Nye the Science Guy. I fondly recall being glued to the television as Bill enthusiastically explained the mysterious wonders of the universe with all of his props, gizmos, and gadgets. Unlike science teachers at school, whose seemingly endless lectures bored me, Bill Nye’s hands-on, interactive approach held my attention. He simplified complex science concepts so well that even …
How filmmaking made me a better science communicator
Most physicians are smart and very talented. They’re skilled clinicians and technically superb. But despite such abilities, they fail to get others to follow them, once they take on the role of leader. As a consequence, they’re unable to get physicians to change or improve performance.
Jay Conger, a professor of business at Claremont McKenna College who has devoted his career to the study of leadership, has helped me understand why …
5 reasons why physicians fail as leaders
I’ve been following Marissa Mayer’s tenure for nearly four years at Yahoo. Not just because I was initially tapped to lead athenahealth’s integration of another mature advertising-driven mobile company — Epocrates — but because Yahoo, with its complexity and technology legacies, and highly competitive, fast-paced market environment, reminds me of many of the country’s largest health care delivery systems.
Both are facing significant headwinds to stay relevant in their respective industries …
What health care leaders can learn from Yahoo’s failure
The FIRST (Flexibility in Duty Hour Requirements for Surgical Trainees) trial randomized American surgical residency programs to one of two arms:
Surgeons are human, not superhuman: The agenda behind the FIRST trial
Activism over prescription drug pricing has reached a fever pitch. The recent House subcommittee hearings featuring testimony (or non-testimony in the case of bad-boy Martin Shkreli) from Turing Pharmaceuticals and Valeant executives provided an outlet for public outrage over those companies’ price gouging on life-saving drugs. Meanwhile, presidential candidates Hillary Clinton and Bernie Sanders have both talked up plans to rein in spending on prescription drugs, and even Donald Trump …
Ignore Martin Shkreli. Focus on drug prices instead.
Potential patients — usually parents — occasionally ask me if I am “vaccine-friendly.” After having this question posed to me numerous times, I’m prepared for the conversation that follows. I’ve tried to ease into it in various ways, but none has proven universally comfortable.
The question’s phrasing is telling about a person’s perspective. It implies that their previous experiences with physicians were perceived as “unfriendly.” Also, my defensive side infers it …
Don’t deny access for vaccine skeptics. Here’s why.
There’s stress written all over their faces.
Poised in that precarious time of life, transitioning between the teenage freedom years and the responsibilities of adulthood, those six first-year medical students look anguished. Their collective eyebrows knit together.
I’ve given them a challenging homework assignment: “Write a 500 to 1,000 word essay and read it to the class next week.”
“I’ve got a question,” J says. “You told us to write an essay about …
Doctors should define who they are
It is easy to lose oneself while swimming in a sea of medical facts surrounded by overburdened physicians and high-acuity cases. Initially, it is difficult taking care of one patient, much less a whole service. The transition from student to student-doctor is not as homophonic as the semantics would suggest — and this transition affects the mental health of thousands of medical students each year.
Medicine is less a profession and …
Reduce physician burnout with meditation and mindfulness
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 42-year-old woman is evaluated for episodes of palpitations that last several seconds in duration. They occur once or twice a month and are accompanied by lightheadedness and mild dyspnea. She has not experienced loss of consciousness. The episodes are not precipitated by any particular activity, including exercise. She takes no medications.
On physical examination, the …
MKSAP: 42-year-old woman with palpitations
Disclaimer: I have never had cancer. Therefore, at the most basic level, I do not have the right to pontificate about dealing with the dread disease. Rather, I have been the servant and support of those that struggle with cancer. I thought it might be of some assistance to share my observations from the other side of the bed rail. Perhaps, their secrets of survival may help you.
Cancer is a …
A doctor shares the secrets of cancer survivors
Donald Ross (an obvious pseudonym) has practiced in a medium sized town for around 20 years. I count him as a protege as we worked together during his residency. As a clinician educator, we work with many interns and residents, and sometimes we develop lifelong relationships. Donald Ross and I share a love of golf, ACC basketball (although we root for rival teams), and internal medicine. We periodically communicate through …
A story of how one physician overcame burnout. He is not alone.
There comes a time in most people’s training when adversity threatens to become overwhelming and swallow them whole. It could be as a medical student, while spending countless hours in the library or when on demanding rotations.
Or, it could be during residency, from the 80-hour work weeks or the stressful patient care situations. It might even happen well into training, when the weekly grind just becomes too much. Burnout, generally …
This doctor never gave up. And look where he is today.
I’ll just come out and say it: I love movies. OK, perhaps not the most scandalous statement of 2016. Yet after a long, stressful week of caring for sick patients, watching the big screen, spellbound by the expressive dialog and thrilling action sequences, my mind subconsciously gravitates to one thing: the medical aspects of the film. Even when one would least expect it, as in the finance and mortgage juggernaut, …
The medical subplots of 2016’s Oscar-nominated films
It’s 2:00 a.m., and the fluorescent bulbs flicker gently overhead along the quiet hallways of the intensive-care unit.
Tonight I’m the ICU resident on call, and the weight of that title sits heavily on my shoulders. My team is in charge of keeping our critically ill patients safe from harm overnight. Although the supervising physician is only a phone call away, I’m the acting team lead for any codes called during …
No textbook can teach doctors the stages of grief
May I whine for a few sentences, please? My staff and I have a high-deductible medical insurance plan. As the costs of coverage increased each year, we had to find a product that we could afford for our small private practice. As any small business owner knows, margins are tight, revenue is declining and expenses inexorably rise. And physicians, unlike other retailers, cannot raise our fees. Would you want to …
Fix high-deductible health insurance. But it won’t be easy.
I recently told you of my admiration for Dr. Mona Hanna-Attisha, the Michigan pediatrician and epidemiologist whose strong research and advocacy was able to finally bring a shining light to the problem of lead in the water supply of Flint.
Continuing with a theme, I now bring you the story of Dr. Adriana Melo of Campina Grande, Brazil.
Dr. Melo is an OB-GYN who subspecializes in maternal-fetal medicine (MFM), the …
This inspiring doctor proved Zika virus doubters wrong
I was at a dinner meeting for our hospital last week, and before everyone went in to sit at their tables and hear the evenings’ speeches, there was some time for the usual networking over wine in the reception room. I got chatting to an established local primary care physician, a respected member of the hospital staff who has been in practice for over 30 years.
He’s quite a presence and a …
The stories have gone from medicine and that’s a shame
