I started my hospitalist shift like any other day. I arrived at 5:30 a.m. for shift hand-off at 7 a.m. A full hospitalist load and endless administrative tasks to complete, the duality of both roles punctured me like a venomous snake bite. I had two full-time jobs to complete in 12 hours. Impossible! Or was it? I added one and one-half hours to my shift at the beginning–time hidden behind …
My “dig deep button” is officially out of service
Get off the field.
Go back to the dugout and rally your team.
Create your rules of engagement.
The structure and hierarchy of medicine teach doctors to compete with one another. From the beginning, we’re told there are a finite number of acceptance letters sent to aspiring physicians. In medical school, we compete for one of a limited number of slots in highly selective and competitive training programs. And as attendings, we have …
Physician success is a team sport, so why are you on the field alone?
It’s been two and a half years post-pandemic, and I still don’t feel normal.
There’s a dark veil hanging over my life. I feel oppressed, unable to practice the way I want, unable to live and think in ways other than this abnormal new biological pseudoscience I’m not expected to question so that I’m more inclusive.
There’s a sense of lost purpose like I no longer work to feel fulfilled. Instead, I …
Why doctors should write poetry
Imagine that you are a brand-new attending in a hospital. You have your new starched white coat and stethoscope around your neck. Before you enter your patient’s room, the nurse says, “Whew! Good luck! The patient’s dad is really angry! He’s been yelling for the last ten minutes!”
Are you prepared? Do you know what to do?
The boundaries of unacceptable behavior have eroded in the past few years. Politicians, law enforcement, …
People behaving badly: 4 steps to de-escalate hostile people
A recent JAMA article showed that starting salaries for female physicians were lower than that of their male counterparts in most subspecialties.
New physicians are not expected to have many differentiating factors besides gender, yet the starting salaries differ. It is important to note that specialties with a higher percentage of women also have lower salaries for bother men and women. As the percentage of women physicians in a given …
We are all responsible for women physicians’ pay discrepancy
I lay on an examination table while a plastic surgeon surveyed my skin to determine if a suspicious mole should be excised. I joked with him that I had once considered plastic surgery as a career. I knew he still worked at the hospital and fired a rhetorical question at him, enquiring if the hospital was still as busy as it was two years ago when I had worked there? …
The New Zealand health system in crisis: We need to look after our clinicians
“You’re my last hope.”
The words come from a patient I have no prayer of helping. He has had decades of back pain. He has had several surgeries, injections, hardware in, hardware out, but nothing has helped. He is unable to work. His struggle with back pain has ruined relationships, ruined his financial stability, ruined his mental health. His goals and mine are aligned. We both want to make his life …
The patient I cannot help and a gun
What they want is power, control, and to take all the credit. In short, they want what you have.
Vision. Even more so, the ability to manifest a vison. Even more so, they want your energy. Your passion.
“Candy Everybody Wants” by 10,000 Maniacs is an epic song. I know every word.
Hey hey give ‘em what they want
If lust and hate is the candy
If blood and love taste so sweet
Then we give …
What it takes to build a pediatric weight management program
I left practice 25 years ago when I saw portents of clinical practice as it exists today: impersonal, with electronic records and assembly-line labor heralding the movement to institutional employment over private practice.
But it was also my genuine interest in population health and pharmaceutical medicine that propelled me into a nonclinical career. The jobs I chose in this millennium were with health insurance and pharmaceutical companies, …
If you don’t practice, don’t move, or you’ll probably lose your license
An excerpt from Determined: How Burned Out Doctors Can Thrive in a Broken Medical System.
Let’s address the elephant in the room. The word “burnout” has come under fire recently (pun intended). The reason is that burnout, which was first coined by German psychologist Herbert Freudenberger in the 1970s, implies to …
The word “resiliency” has been lauded, applauded, and buzzed about in talks about physician burnout.
When I hear it, I tune out.
My stomach churns. I feel sick.
Why?
Because physicians are resilient.
We are, in fact, the walking, talking, breathing personification of the word.
We cannot manage to get through medical school, residency, and boards, without being resilient.
And remember, we do this by choice.
Lots of schooling and academic demands.
Inhumane hours.
Little sleep.
Extraordinary amounts of information to …
Less resiliency may heal burnout
My first patient of residency was Mr. John. He endured life-threatening injuries that left him without speech or the ability to move his limbs. Every day had obstacles, and I met most of his family over time. Mr. John was a family man who looked after others first before himself. A self-made man. He was a man who was physically strong and dedicated to every project and goal he set …
Doctors need to advocate more for their patients
Do not become a doctor. This was the piece of advice my parents gave me when I initially shared my desire to do so.
No, neither parent is in the medical field. As I’m finishing medical training today, I fear this will be the advice I will give my daughter one day. Once wide-eyed, I now look in the mirror and barely recognize myself. Seven years into post-medical school training, I …
When I started my internal medicine practice in 1996, the medical arena was vastly different than it is today. Back then, having an MD after my name actually meant something.
A letter from me to an insurance company would get a needed medication covered for a patient––a time before preauthorization existed. Dr. Google was not yet born. “Provider” exclusively belonged to the insurance industry.
My patients called me “doctor” and referred to …
Microaggressions are common, subtle, offending behaviors and attitudes that stem from implicit (unconscious) bias. Individuals targeted by microaggressions are different than us — different in their look, skin tone, gender, sexual preference, socioeconomic status, educational level and age.
Implicit bias refers to unconscious stereotypes, assumptions, and beliefs held about an individual’s group identity. They affect our understanding, actions, and decisions and increase Read more…
Do microaggressions persist after practice?
Nurses are notoriously tough, resilient, and caring. Their ability to deliver health care with a mindful spirit is uncanny. Multitasking is soon ingrained in even the greenest of this kind.
Go ahead, inundate them with requests, some admittedly regretful, and you will witness amazing things being accomplished with few exceptions. They can be mischievous as well. After all, they’re human, right? Surely the new haughty unsuspecting intern deserves a 2:45 a.m. …
The nurse who walked a million miles
Your parents likely spent months searching through baby name books, polling the family, and looking through the photo albums of ancestors to pick the perfect name for you.
Maybe your parents had to see your face before they could pick the perfect one. Names have history, they have power, and they embody your personality.
My daughter was officially named Daniela, yet we called her Bimbi months before she was born. That is …
I’m a physician, not a provider
Completing my second year as an attending during a pandemic has been, well, interesting. It has brought up a variety of emotions. It’s all you’ve dreamt about for the past 7+ years of training, finally making it — the ability to “call the shots.” It is exhilarating yet mortifying, all wrapped in one!
You have those occasional cases you have never been exposed to during training. You lean on colleagues for …
Health care takes its toll. Look for the moments that remind you why you’re in it.
We’ve all heard the tired cliché about July being the most dangerous time of the year to go to a hospital. All new interns — freshly minted doctors straight out of medical school — are on the loose. And you better watch out, the tale goes. That’s demonstrably false, and July is as safe as any month for medical care.
But there is still a big reason to worry — not …
What no one tells you about being a new doctor
Are you a perfectionist?
Did you know that perfectionists are actually some of the biggest procrastinators? Yes, really.
In theory, perfectionism sounds like a good thing. Who doesn’t want to do and be their best? It can even seem like a harmless way to motivate yourself.
But the reality is, nothing is perfect.
What does “perfect” even mean? What does it look like? Who has the instruction manual?
It’s different for everyone. What’s “perfect” in …
Perfectionism is a myth: Are you ready to hear the truths about perfectionism?
Get free updates delivered free to your inbox.
