The 5 secrets to setting boundaries at work
Let’s talk about hierarchy and priorities in medicine
Life is full of hierarchies — whether you are the older brother in the family, the supervisor in a company, a chief resident in medicine. There is always a hierarchy. It is a pecking order that keeps our society organized. You know where to look for guidance. Who is the person above your title that can help you with a challenge you are facing?
Even within surgical specialties, there is a …
Why it’s important to embrace dialectical thinking
“Embrace dialectical thinking, stupid!”
That’s the mantra I repeat when I catch myself getting worked up about a deep-seated belief, idea, or cause. Understanding the flip side of the equation helps me to neutralize powerful negative feelings like righteous indignation, bitter disappointment, and utter disgust with the incompetence of fill-in-the-blank.
Dialectical thinking is the ability to view an issue from multiple perspectives. Embracing it helps us recognize that it’s almost always possible …
Exclusion of BIPOC from VIP floors in an academic medical center
Omar Mirza is a psychiatrist and comic creator. In this comic, he discusses how Black, indigenous, and other people of color are excluded from VIP floors at an academic medical center (click to enlarge):
Omar Mirza is a psychiatrist.
Image credit: Omar Mirza
I learned the most about medicine from my dad’s death
I had just finished a grueling orthopedic residency. Yet once again, I was on the run and bearing bad news. I was sprinting from a well-known Mumbai hospital to a nearby hotel room. But this time, the bad news wasn’t for the family of one of my patients. It was for my mother.
As I waded through the crowd whose constant overflow from the sidewalk onto the road left a shifting …
3 mistakes physicians make that triple charting time
Let’s face it, what’s getting most physicians down is not their patients. No, ask any group of physicians what the hardest part of the job is, and you’ll like get a pretty consistent response: It’s the EMR! With studies showing that we spend, on average, two hours on “paperwork” for every hour in the room with a patient, there’s no question that it is a massive time suck for most. …
Doctors and the 5 stages of grief
Thanks to the marvels of medicine, newly vaccinated Americans are returning to life as normal and partying like it’s 2019. Doctors, who are emerging from the pandemic as national heroes, would like to turn back the clock even further—to the halcyon days of 20th-century medicine.
But doctors, unlike their maskless and freewheeling patients, will be disappointed with what the future holds.
Trying to turn back the clock
Physicians have had a rough century, …
The burden of the documentation and administrative tasks on physicians needs to be lightened significantly
It takes a special person to care for people during their most vulnerable states, to keep intimate details about people while remaining compassionate even toward the seemingly vilest of persons. The white color of a physicians’ coat can be a metaphor for the purity expected of physicians. A physician’s signature or words carry weight. With such power comes the responsibility to be trustworthy.
Documentation is an important part of patient care. …
Survivorship bias and abandoning legacy thinking in residency
A challenge: Pick a time during residency training where the burden of patient care and education coalesced with scarce family time or social life, and the urge to quit lingered on the back of the tongue. Think about someone you reached out to, whether it be a co-resident, attending, mentor, and think about their response. Was it positive? Or was it something along the lines of: “You’re lucky, I didn’t …
A word of advice from one chief resident to another
Chiefs, remember, one of those interns is going to fill your shoes in a few years. They may model you in that role, so you want to raise them well! As a former chief resident, I have lots of pearls for those entering residency. However, what I will tell you now is different from what I would have told you then. I have since learned that there are possibilities to …
A morning code blue for a COVID patient
An excerpt from An Eschatological Isolation.
At 12:11 p.m., the overhead speaker announced: “Code Blue, Three West.” She repeated, “Code Blue, Three West.”
Shit. I started my stopwatch and saved the patient note I was writing in the back office of Three West, the intensive care unit of a community hospital in Tampa Bay. Already wearing a sealed N95 mask, …
So, are you committed to medicine — or your baby?
I had just received a call that I had been accepted to medical school, and I had immediately pulled up a Google search: “best time to have children in medical training?” I was certain that this was not how most people celebrated news of their acceptance to medical school, but this was a priority for me. A quick scan of the results of my Google search was clear, “Don’t do …
The psychological repercussions of patient complaints
In any industry, there will always be unhappy customers. Having a formalized method of dealing with complaints is absolutely necessary to protect consumers and patients. What isn’t discussed enough is the severity of these complaints’ psychological repercussions on physicians and other medical providers.
Most providers spend years of their lives in school, sacrificing family plans, social events, and sometimes their own well-being, all on a mission to care for others. Despite …
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A holistic approach to health and wellness requires openness and vulnerability
The health care crisis is a difficult one to face. Health care budgets have skyrocketed, and rates of chronic illnesses have increased much faster than before. As physician leaders, what if we each took personal responsibility for the crisis? Perhaps it all boils down to how many people trained in health care know what is necessary for living healthy lifestyles. Yet, that knowledge often doesn’t materialize in excellent health outcomes. …
Stop blaming others. You need to own your actions.
Own it.
People sometimes say, “Own it.” Own your mistake. We use it less frequently to say own reactions or actions instead of blaming others and external forces for our actions. Life coaches call it being in a state of “emotional childhood.” It means that instead of saying you are responsible for your thoughts, feelings, and actions, you blame others for these.
“The situation is bad.”
“I am angry because it is not …
The profound experience of being naked with other doctors
I am sitting in hot springs deep in the dark and crisp air woods – naked. It has been a day of lectures and workshops at a retreat with my fellow physicians. We are all naked in the effervescent, warm bubbles of the springs. In the dark, I can recognize who people are by the fluorescent necklace each wears. You know, the kind that you crunch and shake to activate …
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The unfair blame on primary care physicians
When plastic surgeon Dr. Robert Pearl published his Los Angeles Times op-ed, “How Doctor Culture Sinks U.S. Healthcare,” a polemic essay critical of primary care physicians like me, he set off a firestorm. While he made some valid points, Dr. Pearl also blamed many of the preventative health failures in the U.S. squarely on the shoulders of primary care physicians without acknowledging that our health care …
Telemedicine in Nepal during COVID-19
My phone rings.
“Namaskar! My cough is really bothering me. What should I do?” says a middle-aged man.
“Namaskar! I am Astha Prasai. I am here to help you. Please bear with me while I ask you your problem in detail,” I answer.
Mr. Kafle from Kathmandu is worried about this nagging cough he has, and it has been a month since he has tested positive for COVID- 19. After talking to him …
Physicians: Stop dreading call
Even though I completed residency almost 15 years ago, it is easy to remember the dread I experienced before taking hospital call. The sinking feeling in my stomach as the call date loomed near, the hypervigilance and terror every time my beeper went off in the middle of the night, the fear of imagined catastrophes that would by necessity be my fault.
My anticipation of call was usually worse than reality. …
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Reflections from a former intern
July 1 is a day that marks the new era when student truly becomes doctor, where hundreds of residency programs start day one of the three-year or longer residency, a life-changing rite of passage. Where the initial hours start the tens of thousands of hours of experiential full immersion training. Looking back, intern year was one of the hardest years of my training and definitely one of the hardest years …
