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 …
There’s no room for ego in health care
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 …
You must make a good first impression with patients
This article is sponsored by Careers by KevinMD.com.
As rewarding as working in emergency medicine can be, it also comes with some significant potential downsides. According to some recent studies, stress and burnout rates in the emergency room are some of the worst in the medical field. But don’t let that dampen your enthusiasm. Managing the proper …
How to reduce burnout in emergency medicine
A couple of years ago, I read an article by Dr. Profeta at LinkedIn called “These four words that may offend you … may also just save you.” He was invited to talk about burnout in medicine and did not get a warm reception.
“It’s just a job.”
The “it” in this case is medicine. Medicine, just like any other, is just a job. Let that sink in. Everything …
This article is sponsored by Careers by KevinMD.com.
Working in the emergency department or emergency room is not for health care practitioners who want to just chill. Although television’s portrayal of the ER on dramas like “ER” or “Chicago Med” is admittedly high on drama, life and work in the ER really are high pressure.
In 2016, the Read more…
Make peace with stress in the ER
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 …
The evolution of residents’ hours
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 …
3 reasons why we should care about the health care experience
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 …
Why do we still use CD-ROMs for radiology images?
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 …
Make sure your decision to leave medicine is not based on an emotional response
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 …
The stories of rural physicians
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 …
The spirit of Santa Claus in medicine
I was moved when a family entrusted me to give a eulogy for their beloved. This great privilege highlighted a hallmark of a physician’s service to humanity: “to cure sometimes, alleviate often, but comfort always.” But I was horrified to learn that his death at the hospital may have been the result of a preventable error — one that was withheld from the family.
Sadly, that patient …
Silence in health care is a crisis
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 …
The evolution of the stethoscope
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 …
The risks of co-signing PA and NP charts
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 …
Figuring out what’s actually true is far harder than most people realize. Our brains are both hypothesis-generating machines and incredibly credulous. As a result, most of the things we believe to be true turn out to be false. We don’t just mistakenly believe that vaccines cause autism, that the flu shot can give us the flu, and that astrology can predict our future. We also mistakenly believe that the salad …
The main difference between functional medicine and evidence-based medicine
Health care policy has been a hotly debated political topic for many years now. In recent years, new laws passed the halls of Congress while others failed to gain any traction. Despite the rules that have rolled out, health insurance companies have been in the driver’s seat for decades.
While spokespersons for the health insurance industry will tell you that they do not make medical decisions. As a doctor, I can …
How do health insurance companies harm patients?
A guest column by the American College of Physicians, exclusive to KevinMD.com.
Those of us who provide clinical care inevitably have patients who simply don’t do what we tell them. And this isn’t limited to only primary care but is encountered in all specialties and by subspecialists and consultants alike.
Not only can this be frustrating …
Why patients don’t do what physicians tell them
This article is sponsored by Careers by KevinMD.com.
When searching for a new job, building strong relationships is an important part of the process, especially when you’re working with a physician recruiter. The relationship you create with your recruiter will set the tone for your job search and ultimately have an effect on whether or not you …
6 ways to better work with physician recruiters
I swiped this editorial cartoon by Steve Sack from the redoubtable Dr. David Gorski’s blog, who goes by the nom-de-web of Orac. Recent epidemiology shows reducing the fraction of vaccinated children in the population rather promptly leads to a resurgence of the diseases vaccines protect against. This is the concept of community or herd immunity. …
Why demanding a randomized controlled trial for vaccines is disingenuous
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