Physician

A case for nephrology

Physician

February 7, 2020

In recent times, physician burnout has rightfully surfaced as a social concern for the medical fraternity. Physician burnout is a thing, and lately, I was thinking about it related to nephrology.

Many national physician organizations and local hospital systems are developing strategies to reduce work-life stress and improve the engagement of the workforce. In November 2018, I represented the Renal Physician Association at the interim meeting of the American Medical Association …

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A case for nephrology

How to build trust and therapeutic relationships in 15-minute office visits

Hans Duvefelt, MD

Physician

February 5, 2020

It is well known by now that a physician’s demeanor influences the clinical response patients have to any prescribed treatment. We also know that even when nothing is prescribed, a physician’s careful listening, examination, and reassurance about the normalcy of common symptoms and experiences can decrease patients’ suffering in the broadest sense of the word.

This has been the bread and butter of counselors for years. People will faithfully attend and …

Stressed is desserts spelled backward

Jasmine Toor, MD

Physician

February 5, 2020

Tiramisu, chocolate mousse, red velvet cake, freshly baked cookies, and warm brownies topped with ice cream. These are some of my favorite desserts and the things I start thinking about when I am under intense stress. I often gaze at the bakery section at the grocery store just to take a look when I feel overwhelmed with stress at work or home. It is the classic description of what we …

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Stressed is desserts spelled backward

The doctor who avoids answering your questions

Christopher Johnson, MD

Physician

February 3, 2020

Most of us are, to some degree, procrastinators. We avoid or postpone doing unpleasant things. In this sense, physicians who are avoiders are no different from anyone else. For a doctor, however, avoiding things often leads to poor, or at least less than frank, communication with parents.

One kind of avoidance behavior is when the doctor avoids answering your questions. These doctors do not behave this way because they are poor …

Black Man Syndrome: in memory of Bryce Gowdy

Earl Stewart, Jr., MD

Physician

February 1, 2020

He came to the office in search of help as many patients do, but the circumstances that compelled him to seek medical attention were all too similar to me. I’ve seen it time and again. He said that he couldn’t sleep at one visit. At another, his blood pressure was high.

At a visit after that, he’d share more information, and his wife would attend with him. He wasn’t making enough …

There is no such thing as medical swag

Nina Shapiro, MD

Physician

January 30, 2020

A recent excellent piece by Dr. Karen Sibert, an experienced anesthesiologist at my institution, raised some critical issues regarding how physicians are thought of by non-physicians, and how misguided that thought process is. Indeed, our stress levels associated with the moves we make and the decisions we contemplate, some of which are made and done in milliseconds, do not come with a price tag, but do …

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There is no such thing as medical swag

Here are the common ways that doctors can practice medicine

Smart Money, MD

Physician

January 29, 2020

When I finished my training, I wish that I had known all of the options I could practice medicine. Most of us categorized our options as either “academic” practice or “private practice,” but in reality, these two options only cover the tip of the iceberg. Was my limited understanding a shortcoming of my medical training? Perhaps. I doubt that many medical schools back then actually had seminars on practicing medicine. …

Are you happy with your decision to go into medicine?

Erin O'Laughlin, DO

Physician

January 28, 2020

On a rare Sunday morning, I woke and had the time to make breakfast for my kids and their cousin, who’d stayed the night. My nephew said, “Thanks, Aunt Erin, I feel like I never see you.”

To which my oldest (10) stated very matter-of-factly, with no ill-intent: “That’s because she’s never home.”

Being a full time, private practice physician and mom to 5 kids, with a healthy social life, it’s extremely …

Physicians are not incentivzed to talk with patients on the phone

Hans Duvefelt, MD

Physician

January 25, 2020

Talking to patients on the phone can be very efficient and quite rewarding, like when I called a worried patient today and told her that her chest CT showed an improving pneumonia and almost certainly no cancer, but a repeat scan some months down the road would still be a good idea. She told me she was feeling better, but still quite weak and that her sputum was still dark …

24 reasons to not vaccinate your kid

Rada Jones, MD

Physician

January 25, 2020

An excerpt from Stay Away From My ER, and other fun bits of wisdom.

1. You don’t like to be told what to do. Especially not by arrogant doctors, who act as if they know better, just because they’ve been through a few decades of training!

2. Your …

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24 reasons to not vaccinate your kid

Making humanism in medicine more humanistic

Ajay Khilanani, MD

Physician

January 23, 2020

Kahlil Gibran writes, “In friendship or in love, the two side by side raise hands together to find what one cannot reach alone.” What types of outcomes can physicians and patients achieve in healing, living, and life when Gibran’s message is incorporated into the physician-patient relationship? Can humanism in medicine become even more humanistic?

“Humanism in medicine” is characterized by the Arnold P. Gold Foundation as respectful …

A quick CT scan for the frail and elderly

Mary Braun, MD

Physician

January 22, 2020

First, you have to call up your daughter to pick you up and take you to the lab. It’s hard for the nurse to find your vein. The pain from his fishing around in your arm is not nearly as bad as the pain you always have in your hip, and back, and shoulders, but it’s the straw that breaks the camel’s back, and you cry a little bit. The …

This is a real problem in our ER. This is a real problem nationwide.

StorytellERdoc, MD

Physician

January 21, 2020

One of the largest problems in our ER, it seems, is that there is a subset of patients who visit us on a routine basis. Commonly known as “the regulars,” these familiar faces are sprinkled throughout our day between all our other patient visits. Whether it be for chronic pain, for chronic illness, for companionship, simply to have a place to hang out for a few hours, or to get …

Is obesity self-inflicted?

Anonymous

Physician

January 21, 2020

“Aren’t you happy for me?” asks the patient smiling from the exam chair in my office. I say yes, but that’s not entirely true.

Happiness isn’t the right word. Conflicted might be it. How do I reconcile my feelings when this patient, who I am not sure is deserving, reports that he was awarded Social Security disability?

Sure, he has severe arthritis, wildly uncontrolled diabetes, and a massive skin breakdown of his …

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Is obesity self-inflicted?

What to do if your doctor is excessively egotistical

Christopher Johnson, MD

Physician

January 20, 2020

Egotism is a common trait among doctors, although most of us keep it under adequate control when dealing with patients. The ideal doctor-parent encounter has been described as a collaboration among equals, each of which brings expertise to the exchange; the doctor knows medicine, the parent knows the child. This is the ideal, although sometimes the reality falls short of it. The way our medical system is now structured gives …

Stop the war on PAs and NPs

Brent Lacey, MD

Physician

January 18, 2020

I think it’s time for physicians to end the assault on the clinical practices of PAs and NPs.

Are you worried about PAs and NPs taking your job? If you’re a good doctor, you should stop worrying. Great PAs and NPs are everywhere, and I think it’s time physicians embraced them.

PAs and NPs have excellent skills

My first rotation as a third-year medical student was in the emergency department. There was a …

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Stop the war on PAs and NPs

Keep insulting doctors, and good luck finding a physician in 10 years

Karen S. Sibert, MD

Physician

January 17, 2020

If physicians are “muggers” and co-conspirators in “taking money away from the rest of us,” then journalists and economists are pontificating parasites who produce no goods or services of any real value.

I don’t think either is true, but the recent attacks on physicians by economists Anne Case and Angus Deaton, and “media professional” Cynthia Weber Cascio, deserve to be called out. You …

Can the physician credentialing process be saved?

Tom Clifford, MD

Physician

January 14, 2020

The physician burnout crisis and a national provider shortage have fueled a growing trend in health technology focused on better utilizing physicians and reducing administrative burdens. I became a surgeon because I wanted to help people, not because I had a strong desire to push paper. The high volume of administrative tasks increasingly consumes a physician’s time that could be better spent with patients. For example, primary care physicians Read more…

Can the physician credentialing process be saved?

When primary care handles the consequences of psychiatric medication prescribing

Hans Duvefelt, MD

Physician

January 13, 2020

If my hypertensive patient develops orthostatism and falls and breaks her hip, I fully expect the orthopedic surgeon on call to treat her. I may kick myself that this happened, but I’m not qualified to treat a broken hip.

If my anticoagulated patient hits his head and suffers a subdural hematoma, I expect the local neurosurgeon to graciously treat him even though it was my decision and not his to start …

After child sexual abuse, being “physically intact” doesn’t tell the whole story

Dr. Nkeiruka U. Orajiaka

Physician

January 13, 2020

The recent pardon of a convicted child rapist by the ex-Kentucky Governor has sparked a lot of controversies. The basis of the pardon was- “the victim’s hymen was noted to be physically intact.” Evolving studies have continuously shown that the hymen is not a reliable or accurate means to conclude sexual assault.

But if physical damage is the only criterion used to assess …