Physician

Remembering my grandmother in the ICU

Physician

August 18, 2022

ICU psychosis is a common phenomenon in hospitals. Most of us as clinicians deal with it well.

However, the ordeal changes when your loved one is struck with it. My grandmother, always admired for her storytelling skills, is now admitted with intestinal obstruction, and her worsening Parkinson’s has just escalated the intensity of her psychosis.

Now she tells me a story of a woman carrying knives, seeing blood everywhere, selling half the …

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Remembering my grandmother in the ICU

Does patient-centered care really meet human-centered care?

Dr. Vivek Podder

Physician

August 18, 2022

This episode was during my elective time in India in the late winter of 2017. It was a patient-centered learning opportunity for students around the world who has an interest in medicine. I was excited about this because of my earliest clinical exposure to patient encounters as a medical student. I was excited to meet the patients, talk to them, and help them despite the uncertainty and emptiness in my …

Ayman al-Zawahri: the doctor who dispensed death

Osmund Agbo, MD

Physician

August 17, 2022

On May 2, 2011, a few minutes past 1 a.m. Pakistan Standard Time, a U.S. Navy SEAL Team Six left the Bagram Air Base in the Parwan Province of Afghanistan and headed for the compound of a high-value target in Abbottabad, Pakistan, located just a few miles away from that nation’s military academy.

It was an operation that lasted 38 minutes, following which U.S. forces returned to Afghanistan with the slain …

The true art of medicine

Susan J. Baumgaertel, MD

Physician

August 17, 2022

There have been countless references to the art and science of medicine over the years. I, for one, certainly have embraced both in my long career as a physician in internal medicine. However, I have always had a special connection to the art part.

My late mother was an artist, so I grew up with …

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The true art of medicine

An experience of shame in training

Brett Linzer, MD

Physician

August 17, 2022

Early one morning in 1996, after a sleepless night on call, I stood with my team in the VA hospital, outside room 102. I was a 28-year-old intern in the general medicine service. We were making rounds on twelve patients that my intern partner, myself, and our supervising resident had admitted overnight. We would walk room to room, and the intern would present the information regarding the patient by gathering …

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An experience of shame in training

How privileged a physician’s knowledge is

Cia Bishop, MD

Physician

August 16, 2022

I was warned about it before we walked into the room.

So when I did walk in, I made sure my eyes stayed focused on his eyes, my gaze high and attentive. I smiled, possibly more than normal, to make sure he felt comfortable. Like a puppeteer holding up his doll, I knew it wasn’t time for me to drop down my eyes yet.

The resident with me began the routine visit …

Financial survival for physicians in private medical practice

Curtis G. Graham, MD

Physician

August 16, 2022

There are two valuable reasons why all physicians, especially medical students, should obtain or demand from their medical school academic business education.

About 98 percent of physicians and medical students have never had an academic business education. About 30 to 50 percent of graduating medical students prefer private medical practice—which requires business and marketing knowledge to reach their optimal potential in private medical practice as described below.

Private medical practice is a …

Academic medicine on life support: a letter to a newly appointed CEO of a leading academic medical institution

Anonymous

Physician

August 15, 2022

Congratulations on our leading academic medical institution (LAMI) yet again making it to the top ten list of the U.S. News & World Report!

You have taken the reins in perilous times (globally and domestically), and what you do and what you stand for will determine if this great hospital will not just survive but survive with its brand and reputation intact. Getting hired as a physician who grew up in …

Trauma and burnout among frontline health care workers

Naheed Ali, MD, PhD

Physician

August 15, 2022

Thinking back to 2020, concerning the emergence of COVID-19 and the first hard lockdowns all over the world. Individuals from all walks of life were frightened, locking themselves in their homes for fear of being infected. Yet, frontline providers and health care workers had to carry on with their daily jobs. Were they less scared than the nonmedical layman or immune to the virus? Unfortunately, they weren’t. They were just …

How doctors can regain control of their software

Drea Burbank, MD

Physician

August 14, 2022

I spent a year as a UCSF postdoc with the leaked tobacco documents. And this article is taken directly from the tobacco-control playbook. In the tobacco wars, we learned that: when a disease is caused by a for-profit industry, the only successful approach is regulation first, followed by treatment.

Here is exactly how and why doctors should regulate EHR and regain control of their cognitive …

I didn’t know her name until it was over

Sid Schwab, MD

Physician

August 14, 2022

I didn’t know her name until it was over, much too late. What I knew was she was thirteen and that on this winter day, someone in her family had been pulling her behind their car on a sled. No doubt laughing and looking in the rear-view mirror, the person driving had whipsawed around a corner, and the young girl — probably screaming (fear? delight?) — held onto the sled …

Misaligned expectations lead to conflict, burnout, and disillusioned physician leaders

Amanda Brisebois, MD

Physician

August 12, 2022

Would you expect the chef at a restaurant to be told that they are not only required to prepare the food in the kitchen but also deliver it to each of the tables and manage the billing? What about sorting out the restaurant’s finances or understanding the number of patrons that need to flow through per night to optimize income? If this sounds unreasonable, how did we end up asking …

Breaking the vicious cycle of medical malpractice lawsuits

Howard Smith, MD

Physician

August 11, 2022

Lawsuits are conventional in medical practice.

An unhappy patient hires a malpractice attorney, who hires a medical expert, who interprets the standards of care and generalizes a departure from the standards of care and proximate cause. The preponderance of evidence is 50% certainty plus an ill-defined scintilla, which needs to be only 0.01% to be good enough.

The lawyer sues the doctor, who notifies the malpractice carrier, hires a defense counsel, and …

Learn to round on yourself

Victoria Silas, MD

Physician

August 11, 2022

I always think of the beginning of July as the New Year in medicine. It’s when medical students become interns, interns become residents, and residents become newly minted attendings. With each change is an increase in responsibility.

I remember paying even more attention to the history and physical each time I crossed that threshold. With an increased sense of purpose and responsibility. This was true in the office and during admissions …

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Learn to round on yourself

Boundaries for women physicians

Tammie Chang, MD

Physician

August 10, 2022

An excerpt from Boundaries For Women Physicians: Love Your Life And Career In Medicine.

My story is similar to that of countless other women who have chosen careers in medicine. I am a pediatric hematologist/oncologist. A few years ago, I was driving home one afternoon after having spent several hours with …

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Boundaries for women physicians

Comparing charity evaluation websites: What do those ratings mean?

Recha Bergstrom, MD

Physician

August 10, 2022

The majority of people who donate money don’t research or compare charitable organizations. Only 1 in 3 research before giving, according to one of the biggest charity ratings websites, Charity Navigator. Giving 2.0 author Laura Arrillaga-Andreessen says only about three percent compare charitable organizations.

These numbers were both surprising and not surprising to me. I have done most of my donating with no more than a cursory …

Certainty is a fading flame in a failing body

Mukund Gnanadesikan, MD

Physician

August 8, 2022

“You should prepare for the future. Your son will never be independent.”

I do not recall hearing those words at their source, but I was only eight when they were relayed to me by my parents. At the time my diagnosis, now characterized as juvenile myoclonic epilepsy, was poorly understood and often confused with more virulent disabling neurological conditions. Despite this fact, I have used the doctor’s prediction as fuel for …

Monkeypox and the prolonged COVID pandemic could seal the fate of the health care system

Tomi Mitchell, MD

Physician

August 8, 2022

I understand it’s been over two years since the World Health Organization announced the coronavirus pandemic, and we are tired.

I speak for the thousands of health care workers and frontline workers: We are exhausted, we feel taken for granted, and for many of us, we are leaving the industry. In some cases, we went from health care heroes being villanized as if we somehow benefited from the pandemic. So many …

We’re reacting to medical errors the wrong way

Vidya Raju, MD

Physician

August 7, 2022

Medical mistakes are as old as the practice of medicine itself, but it wasn’t until 1999 that the United States started paying more attention to them.

Over twenty years later, we may be reducing medical errors — a recent study published in the Journal of the American Medical Association found significant decreases in mistakes in cases of pneumonia, acute myocardial infarction, heart …

As we live in fear, there is still hope

K. Maravet Baig-Ward, MD, PhD

Physician

August 6, 2022

Fear. It means something different to each person, but collectively we can all agree that fear can be something that drives us to succeed (fearing failure), causes us to take care of ourselves (fear of poor health), and can even promote experiences that wouldn’t otherwise be pursued (fear of missing out, affectionately known by the acronym FOMO). This isn’t the kind of fear I had this past Sunday sitting in …

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As we live in fear, there is still hope