Physician

The rewards of being a designated airman medical examiner

Physician
December 21, 2018

For the last 25 years, I have had the privilege of being a designated airman medical examiner by the Federal Aviation Administration. To earn that privilege, it required flying to FAA headquarters and taking a one-week training course followed by refresher training material every three years.

The FAA grades medical examiners annually by our judgment and decision-making. The nature of the questions we are required to ask the pilot candidates, and …

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The key to successful rounding

Physician
December 15, 2018

A wonderful senior resident helped me understand the goal of rounding.  Rounds should focus primarily on understanding the key problems and the diagnostic and therapeutic approaches to those problems.  She suggested that some rounds spend too much time on “minutia” that the resident could handle, and not enough on understanding the big issues.  According to her, rounds work best when we spend our time addressing the problems that the patient …

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There’s no room for ego in health care

Physician
December 4, 2018

I was recently seeing a rather complicated medical patient in the hospital. We were treating both a heart and kidney condition, and things were not going so well. To spare anyone non-medical who is reading this the scientific details of the bodily processes involved, we were essentially balancing hydrating, with the need to get rid of excess fluid. After seeing the patient, I spoke with the nurse, went over the …

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You must make a good first impression with patients

Physician
December 4, 2018

First impressions are critical. We are taught early in our careers that first impressions truly matter. Whether interviewing for medical school or a residency program, our goal is to make a positive first impression in hopes of making the cut at each checkpoint in our early careers.

These processes in our academic lives and careers are exhausting. As residencies and medical schools are becoming more competitive, the importance of first impressions …

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The evolution of residents’ hours

Physician
November 23, 2018

It was the 24th hour of my call shift, and I was running on fumes. Despite my weariness, I could see the first rays of morning sunlight coming through the window in my patient’s room. It was then I knew I could make it to hour 30 (quitting time). It was grueling to keep going, but hitting the 30-hour mark only required me to keep my head down and do …

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3 reasons why we should care about the health care experience

Physician
November 21, 2018

The health care experience is so much more than a buzzword to be talked about in administrative circles. Some physicians I encounter (a minority, but still enough) really scoff when they hear this term. Responses I’ve heard from doctors include: “Hospitals are not hotels!” or “If that means giving our patients as much Dilaudid as they want, then count me out!”

Aside from these sweeping statements being entirely silly, they are …

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Why do we still use CD-ROMs for radiology images?

Physician
November 21, 2018

In the United States, any person who has tried getting their own (or their patient’s) radiology images from another hospital or practice will find the practice painful.

Here are several obvious reasons why the CD-ROM — briefly the darling of large data transfer — is a truly terrible way to share radiology images in 2018:

They require physical transfer. Remember the term “snail mail”? Do people still say that?

They are slow. When you bring a …

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Make sure your decision to leave medicine is not based on an emotional response

Physician
November 18, 2018

We know the statistics. More than 50 percent of physicians are experiencing burnout at the hands of EMRs, a nonexistent work-life balance and regulatory constraints to name a few. This is causing physicians to leave clinical medicine and find other work. Some are opting for nonclinical administrative roles, and others are leaving altogether for careers outside of medicine. This is adding to the shortage of physicians that we were already …

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The stories of rural physicians

Physician
November 17, 2018

This article is sponsored by Careers by KevinMD.com.

When George W. “Billy” Campbell, MD, walks down the street, he never knows who — or what — he’s going to encounter. Anything can happen when you’re the doctor at Foothills Family Medicine of Westminster, South Carolina, a small town with a population of only 2,500.

“I’ve had someone pull …

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The spirit of Santa Claus in medicine

Physician
November 16, 2018

For longer than anyone could remember, he was the rural community’s pharmacist.  A skilled compounder of prescriptions, he was conversant in chocolates, greeting cards, and how to obviate a trip to the doctor’s office by using an over-the-counter remedy.

A devoted family man, he was involved in many civic and church activities. Most have forgotten all the roles he once played in the community, but no one will ever forget that …

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The evolution of the stethoscope

Physician
November 13, 2018

The stethoscope. Nothings says “I’m a doctor” more than the stethoscope in a pocket or draped around the neck. Forty-five years ago when I got my first one, a gift from my physician-father, the former was more common. Then we were more likely to wear coats — white coats or suit coats — and pockets were available. I had suit coats in which the lining was worn out from the …

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The risks of co-signing PA and NP charts

Physician
November 13, 2018

We all know that there’s a remarkable shortage of physicians in America and that it’s growing worse.  This is especially true in primary care but it’s present across all specialties.  This shortage alone is a significant stress on practicing physicians.  But when it is coupled with corporatization, the increasing complexity of medical care, unrelenting electronic charting requirements and the explosion of administrative tasks, physicians barely keep up each day.

This is one of the …

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Doctors overcorrect too often

Physician
November 12, 2018

Back when cholesterol target numbers ruled unopposed (before 2013), we all checked fasting lipids every three months. Before 2012, we also checked liver function quarterly in hapless riders on the cholesterol pill merry-go-round. That year the FDA announced there had not been enough reports of statin-induced liver problems to recommend routine monitoring.

I have many colleagues who still do this, and who also routinely monitor routine labs quarterly …

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