Physician

What happens when patient capacity and autonomy diverge?

Aula Ramo, MD

Physician

July 6, 2020

“I can’t take this, doc. It’s gonna kill me. I can’t. I just can’t,” exclaims my patient with persistent refusal of his medication. My frustration is met with my patient care team’s hesitation to give him the medication with fear of further conflict and possible escalation to violence. But who’s at fault? Any of us? All of us?

My second patient, lying on the MRI table, shaking his head swiftly in …

The emotional side of being a doctor during the COVID-19 pandemic

Jasminka Vukanovic-Criley, MD

Physician

July 5, 2020

It was a Thursday. It was supposed to be one of those “regular” evening shifts. Then, at 6:15 p.m., my first page went off: Bed 11, Mrs. R., Dr. H. needs to talk to you. The page came from the COVID section of the emergency department.

I immediately called back. It saddened me when I learned that our patient was a young woman health care worker in her early 50s. She …

9 tips for new pediatric residents

Gabriella Gonzales, MD and Alexander Rakowsky, MD

Physician

July 5, 2020

It’s that wonderful time of year when new interns take their first steps into hospitals as practicing physicians One of us has just completed her intern year and the other quite a while back (but recently enough to still remember some of it), so we wanted to share some tips for the pediatric interns about to start this wonderful adventure.

1. Don’t be overly anxious (as a little anxiety is expected). …

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9 tips for new pediatric residents

I don’t care what your cardiologist says

Stephen Freiberg, MD

Physician

July 5, 2020

Yeah.

I said it.

As an anesthesiologist, especially as a cardiothoracic anesthesiologist, there are few things I am more interested in than how well or how poorly your heart functions and why. And a cardiologist can help me obtain a lot of vital information in that regard. But there several things a cardiologist cannot, and I argue, should not do, when it comes to the perioperative care of patients.

First, a cardiologist’s assessment …

A graduation speech to a residency class

Deborah Edberg, MD

Physician

July 4, 2020

I feet truly honored to have been asked to speak at your graduation and to have a chance to share on this day with all of you. We are experiencing a truly singular moment, and I imagine you are hoping that I might say something that would be comforting or inspiring, and I really can’t think what that could possibly be.

For the last half of your third year of residency, …

COVID-19 is a grim reminder of my roots

Josh Budhu, MD

Physician

July 4, 2020

Ever since the COVID-19 pandemic gripped New York City, I have come to dread calling home to my parents. Every conversation ultimately leads to the question: “Is everyone okay?” This is always followed by a pause as my parents consider how much to tell me. Over the past few months, I learned on an almost weekly basis of a new family member, family friend, or neighbor who was hospitalized, transferred …

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COVID-19 is a grim reminder of my roots

We should communicate like we are in a code blue

Adewale Ajumobi, MD, MBA

Physician

June 30, 2020

The alarm goes off! Code blue! Code blue! The code blue team rushes to the scene. The patient is unresponsive. There is no pulse. The leader of the code team looks at the monitor and takes charge. The patient is in ventricular fibrillation (cardiac arrest) and would very well flat-line if prompt action is not taken. The leader gives clear instructions: Start chest compression. Fred, you will handle the defibrillator. …

Advice for new interns: How to earn respect the right way

Randaline Barnett, MD, Kelly Chamberlin, MD, and Carolyn Quinsey, MD

Physician

June 29, 2020

July is a very special time of year in the medical community. We welcome thousands of newly minted physicians donning their spotless white coats and nervous smiles as they begin what will be one of the most difficult but also most rewarding and exciting times of their lives. Reflecting back on that first day as a brand new intern, I can’t help but think of how nervous I was over …

10 lessons from my first year as a female attending physician

Sanjana Vig, MD, MBA

Physician

June 25, 2020

1. Change is slow. In fact, it’s much slower than I ever imagined. Part of the issue is that people don’t like change; another is that workplace culture often doesn’t support new ideas.

Tackling this issue: Shift your focus. Get to know people first. Be present. Changing perceptions and convincing people to change first requires that you know them, and they know you.

2. Patience is a virtue. …

When Brooklyn meets Alabama: a physician story from a 50-year career

Ronald Halweil, MD

Physician

June 25, 2020

I never expected to have a friend from Alabama. My upbringing in Brooklyn, New York, didn’t include anyone from the South, and this was a time in American history when the South was in turmoil. I recall black and white images on our family’s TV showing federally enforced integration of schools and communities, swelling civil rights marches, and disturbing scenes of riots and attack dogs used to intimidate …

The day you finish residency is just a normal day for everyone else

Sarah Reck, MD

Physician

June 25, 2020

I was listening to a podcast the other day about this woman who kayaked the inner passage from Puget Sound to Juneau, Alaska. She was describing the end of her journey, the day she paddled into Juneau, and she noted that it was so anticlimactic. She paddled in, after 66 days and there was no one to celebrate the end of the journey with, the harbormaster was badgering her to …

The superhero within during the time of COVID-19

Lauren Fine, MD and Vijay Rajput, MD

Physician

June 25, 2020

Over the past few months, my 6-year-old daughter and 3-year-old son have been confined almost entirely to our house and backyard to shelter them from the coronavirus pandemic. They know that “the virus” is dangerous and invisible. However, like superheroes facing adversity, they found their own escape from the confines of their world to their imaginary world of superheroes. During the day, my son insists on wearing a frayed and …

Understand your resident contract: What you don’t know may hurt you

Todd Rice, MD, MBA

Physician

June 17, 2020

When I matched into anesthesiology residency in 2002, I assumed that the entire four years of training were guaranteed to me, barring any gross failure on my part. A package deal, essentially. I hadn’t heard of anyone not finishing.

For me, residency was exhaustingly tolerable, yet gratefully formative – interspersed with warm camraderie, the occasional difficult patient or frustrating attending, satisfying progress, and finite episodes of survivable misery. I had a …

A better way to screen police officers

Alex El Sehamy, MD

Physician

June 8, 2020

I’m exhausted. I don’t think I’ll be able to forget these sleepless nights with the sight and sound of protesters in the streets right outside of my apartment. I’ve lied awake until 2 a.m. watching videos on Twitter taken by protestors themselves, torturing myself with the displays of violence that are complex to understand, but shocking nonetheless.

As I watched police officers and protestors clash on the lightbox in my hands, …

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A better way to screen police officers

We need to stop seeing patients as dollar signs

Anonymous

Physician

June 7, 2020

I am a newly minted surgical specialist, less than one year into practice. Residency was no walk in the park, but the clinical experience, along with hours of studying, reading papers, and reviewing practice guidelines, undoubtedly gave me the tools to practice modern, evidence-based medicine. As residency came to a close and the light at the end of the tunnel grew bigger and brighter, my excitement to move on to …

Health care workers in the time of COVID: reluctant superheroes?

Ankur Sharma, MD, MPH

Physician

June 7, 2020

Invisible and unassuming, the radioactive spider slowly descends from the ceiling, and before he knows it, Peter Parker’s life has changed forever. With that one bite, he is transformed from a normal man into a reluctant superhero. Only, that infamous spider is COVID-19, and Peter Parker is a health care worker during these troubled times.

It may surprise you to know that many of us in health care are uncomfortable being …

How MOC is contributing to the demise of physicians

Torie S. Sepah, MD

Physician

June 5, 2020

Let me start by saying that I am a diplomate (i.e., “board-certified”) by the American Board of Psychiatry and Neurology. I was completely in agreement that to display competence in my specialty after four years of residency, I should pass the oral and written exams required by the ABPN, further to prove I have maintained my skills, I have always found it …

Does the EMR improve or worsen patient safety?

Danielle Ofri, MD, PhD

Physician

June 2, 2020

An excerpt from When We Do Harm: A Doctor Confronts Medical Error.

One of the selling points for the electronic medical record (EMR) was that it would be a boon for patient safety. Just having all the medical records in one place is a monumental improvement over …

I transitioned to a non-clinical career. What did that mean?

Michelle Mudge-Riley, DO

Physician

May 31, 2020

Career transition is talked about a whole lot more these days than it was in 2004. Maybe I just notice it more now. Back then, I felt like I was the only one doing it. You know how it is when you are going through something difficult, and you feel utterly alone and unsure about what you’re going to do tomorrow? That was me, only I also felt like a …

Why is it hard to find a good dermatologist in a competitive market?

Dina D. Strachan, MD

Physician

May 30, 2020

We’ve all heard the phrase, “survival of the fittest.” It suggests that in the competitive, “free market” world, it is the “best” who survives and it’s “the cream” that rises to the top. But is that true for doctors? Do patients get better care when competition rules the health care marketplace?

A few years ago, a doctor from a large primary care group contacted me to give a talk to the …