As a board-certified internal medicine physician and hospitalist with over 12 years of experience, I find myself grappling with an unsettling thought: I cannot, in good conscience, encourage medical students with clinical ambitions to pursue any general medicine field.
This may seem like a harsh assessment, but in my opinion, the writing is on the wall for general physicians. While those of us already established in practice are likely to have …
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The allure of joining a startup as a health care professional is undeniable. With over 70 percent of physicians now employed by health systems and other corporate entities – we often feel like invisible cogs in a machine and feel excluded from any opportunities to contribute to real change. Social media is seemingly filled with success stories of physicians founding or joining startups and being involved in innovation, impact, and …
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“Don’t leave. There are miserable people in this world, and then ones more miserable than the others. My assessment is that you’re in the second category.”
Although it has been over a decade since I resigned from my ophthalmology residency after completing my PGY-2 year, I still remember this attending physician’s words and how they reverberated in my consciousness. I was terrified at his prophecy. Earlier that week, I had requested …
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We don’t talk about burnout.
I recently reunited with a former medical school classmate for lunch and realized that I talked more to him in two hours about my experiences over the past few years than with my hospitalist colleagues at work or my closest friends. I’ve only ever dared to mention anything to my wife and brother (both physicians).
Lots of sources define burnout as the accumulation of stress over time …
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Physicians often make mistakes when it comes to their personal finances and wealth-building strategy. We are human, after all. Private forums, blogs, and podcasts are filled with horror stories of physicians being scammed into buying expensive whole-life insurance, having disability insurance that didn’t include own-occupation coverage, and being steered toward high-fee investment vehicles by financial advisors. There are also countless situations, such as messy divorces, the risks of doing business …
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Multiple times a week, I get messages asking some variation of, “How are you holding up?” I am neither an anesthesiologist, critical care, or ER physician, so I’m not three inches away from exposure while intubating patients with coronavirus. I am also not a nurse or respiratory therapist in a room dozen of times a day administering life-saving medications, performing vital assessments, or carefully managing the oxygen lifeline. I’m certainly …
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It has been a month since the first case of SARS-CoV-2 presented in my hospital in South Jersey. The virus has been causing devastation around the globe since December 2019, and before the United States – China, Italy, and Spain suffered the greatest casualties. Like many physicians, I continue to blog in order to spread awareness and also to ensure that we are well-prepared as a society to face an …
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“Before I leave, I want to talk to you about something very important. I want to make sure that nothing is ever done against your wishes, so it doesn’t matter if you’re 18 or 98 years of age, if you’re a patient being admitted to the hospital, I need to ask you some questions. You’re stable — so I hope I don’t alarm you with this discussion. Have you ever …
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Being a hospitalized patient is perhaps one of the most disempowering experiences an individual can face (besides being in war, or a prisoner). Patients face constant uncertainty; having no idea what time their physician will visit, when they will be taken for their tests, or who will suddenly interrupt them again with a demand – perhaps an early morning blood draw, or yet another round of interrogation and uncomfortable examination …
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Will physicians go extinct? Artificial intelligence, legislation, profit motives in the health care industry, and clever lobbying by non-physician providers may all contribute to our demise. However, I believe the existential threat to our profession stems from the ranks of physicians themselves.
1. Unwillingness to embrace activism
Pathologist and writer Rudolph Virchow once said: “The physician is the natural attorney of the poor.” Like most physicians, my goal is to provide evidence-based …
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Even though my own internship was a decade ago, I vividly remember the transition from student to resident. Residency was monumental in my path to becoming a physician. There were obvious changes: People now called me “doctor,” my misshapen short white coat was upgraded to a more comforting full length one, and I was often the first one paged to respond to patient problems. Coupled with the positive aspects though, …
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Mr. F points a slender index finger to the heavens and states calmly: “It’s OK doctor. Jesus will protect me.” I had just said I was sorry there was nothing more we could offer, and he was going to die. He understood … right? It had been a difficult few months for my unfortunate patient. He smiles at me softly, nasogastric tube cascading over his right cheek and then closes …
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“Why don’t you just get a shotgun and blow his brains out next time? Better yet, next time stay the hell away from my patient!”
I was frozen, and the ICU attending wasn’t even talking to me. My co-intern had barely started her presentation when she met damnation. Mind you — there was a senior resident, a pulmonary fellow, and a team of nurses caring for the patient also. Yet the …
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We had no choice in becoming the “crazy” family that left a hospital against medical advice. Our four-day-old daughter was completely helpless, her condition deteriorating and the staff was ignoring our concerns. I carefully turned off the blue lights, removed her from the isolette, placed her in a car seat and eloped from the pediatrics unit.
As a hospitalist, I constantly obsess over medical errors. The majority are more subtle than …
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As a physician, is it acceptable to say no? After working as a hospital medicine physician across five different states and internationally, I’ve realized that saying no is actually imperative. Physicians are stretched thin, abused, demonized and expected to be superhuman when it comes to patient care. We secretly complain in online forums, we commiserate with other physicians in on-call rooms, sometimes we even seek mental health help, but rarely …
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Medicine has undoubtedly come a long way. Paternalism has been ditched in favor of a shared decision making approach, diagnoses and treatments are (largely) based on scientific evidence, and information is not outright withheld from patients out of some misplaced belief that they are not capable of handling the truth. Some of the modern pain points that patients now face involve access to specialists, skyrocketing cost, misinformation and miseducation surrounding …
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One would expect that in an era where smartphones are more powerful than our computers were 5 years ago, health care providers would have an arsenal of health care IT solutions to enhance patient care but also optimize their own workflow.
Shockingly, in 2014 most health care IT solutions (such as EHR systems) are incapable of basic functions that we take for …
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There are words in many languages that have no good English equivalent. During my work in Haiti, I’ve noticed my Haitian colleagues on occasion exhaling a phrase — “tet chaje” — which literally means “head charged.” More accurately, it describes a sense of being overwhelmed or conveying disbelief or frustration. Based on my limited experiences in the field, I can only begin to imagine the burnout that local providers face …
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This post is a question, an invitation and a challenge. How can we bring technologies we take for granted back home to those in the developing world? Many before me have spoken with outrage about the reality of two worlds: one of abundance, and the other where people live like they have in centuries past.
The situation is more complicated since even poor people may have some technologies like cellphones now, but vital lifesaving technologies …
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