Even though we have probably 20 years of work remaining as physicians, like a lot of you, I like to think about how we will spend our retirement years. After all, in twenty years we will still only be in our early fifties, hopefully with no dependents and a lot of financial security. Of course, my wife and I are interested in traveling, spending time with grandchildren (hopefully), gardening and …
Do physicians make the best politicians?
I just got off the phone with Paul, a highly-sought-after plastic surgeon in New York.
“I don’t want to be a doctor anymore,” Paul says. “What else can I do? I have lots of restaurant experience. I’ve worked in 15 restaurants during my life. It’s not easy, but I could do it. I did research on chains and franchises, and I chose Chick-fil-A. …
Plastic surgeon quits and couldn’t get a job at Chick-fil-A
From the notes I read, it seems that other medical specialties limit “social history” to whether or not someone uses tobacco, drinks alcohol, or uses drugs.
“Social history” is meant to get a sense of the context in which people live. Where do they live? Who do they live with? How did they come to live there? Where did they grow up? What sort of work do they do? How much …
Why the social history is important
Sometimes there are no words. Not even a eulogy.
Then one courageous family writes this obituary. (This obituary was written by Rachel Dawson, his wife, with the blessing of his parents.) In it, they share how their son lost his battle with severe depression. How he adored his children. How he sacrificed fun, free time, and relaxation to receive his medical …
Surgeon suicide-homicide: What happened to Dr. Chris Dawson?
When you tell anyone in health care that “sedation” to the point of coma is given in dentists’ and oral surgeons’ offices every day, without a separate anesthesia professional present to give the medications and monitor the patient, the response often is disbelief.
“But they can’t do that,” I’ve been told more than once.
Yes, they can. Physicians are not allowed to do a procedure and provide sedation or general anesthesia at the …
Safe pediatric dental anesthesia is the right of every child
If you’re thinking about a career in medicine, there’s a piece of technology you’ll come to know intimately. It’s small and sleek, with excellent battery life and remarkable durability. It’s not an iPhone; it’s not a Pixel. It’s a beeper. You will come to know, and to respect, this tiny black rectangular prism. It will govern your life. You will be at its mercy, yes, but it also offers you a chance at salvation. …
The physician’s relationship with the beeper
Let’s talk about the cycle of abuse. No, I am not referring to the very serious issue of domestic violence. Instead, I am talking about the graduate medical education system. No one is a resident forever: the duration of each residency is predetermined with a wide range of three to nine years. The self-limited nature of this experience decreases the incentive for participants to advocate for changes. And the attitude …
End the resident physician abuse now
What would medical education that is relevant for the here and now — for America in the early 21st century — address? It is impossible to teach the content relevant for an entire career. It is important to educate practitioners able to adapt to the changing landscape of medicine. We must consider what the future might hold.
Watching science fiction may serve to prompt future physicians to practice preventive medicine for …
Are post-apocalyptic disaster films inspiration for doctors?
I have good days and bad. Some days I am content, connected, focused, and motivated. On those days I enjoy my job, I enjoy the people I’m with, I am willing to be inconvenienced by interruptions.
On other days, not so much. I wake up as grumpy Rob and (despite multiple cups of coffee) the old codger doesn’t leave me alone. I keep score of all the ways in which life …
A doctor saved a patient’s life. Twice.
In a recent episode of the television series, The Good Doctor, a patient played as Robbie Ato does not tell his doctors he has a history of cancer. You can see his surgeons stare in disbelief as one consulting surgeon recognizes the patient’s name and then alerts the team leader that she treated him three years ago for cancer.
This is one of the very most troubling and dangerous acts of …
The Good Doctor shows us the value of time
A guest column by the American College of Physicians, exclusive to KevinMD.com.
It was actually a great diagnosis that led me to become an internist.
I distinctly recall a patient admitted to my service during my third-year internal medicine clerkship inpatient rotation. He was extremely sick and what was wrong with him had eluded multiple other …
Getting it right: the challenge and reward of clinical diagnosis
Primary care doctors don’t usually have scheduled blocks of time to read incoming reports, refill prescriptions, answer messages or, what we are told the future will entail, manage their chronic disease populations. Instead, we are generally expected to do all those things “between patients.”
This involves doing a little bit of all those things in the invisible space between each fifteen-minute visit, provided we can complete those visits, their documentation and …
The myth of multitasking in primary care
A recent post about a physician using her maiden name professionally generated major controversy on a physicians’ group. Hundreds of comments later, it became evident that female physicians who chose to use their maiden names are subjected to negative judgment.
I am a physician married to a supportive man who understands my choice to keep my last name. I am not unique in my circle. Most of my female physician friends …
What’s in a woman physician’s last name? A lot.
I was nearing the end of my pediatrics rotation as a third-year medical student when the senior resident asked me to admit a patient to the general pediatrics floor. The only information I had as I headed down to the intensive care unit was that she was a ten-year-old girl who had survived an extensive resuscitation at home.
By this point in my education, I was certain that I wanted to …
The moment I became a passionate doctor
Go to college, go to medical school, start and finish residency and fellowship, get married, settle down and have children …
There is a certain expectation of what a “successful life” would look like for a physician mom. Some may even choose to stop work and become a full-time stay-at-home mom.
Even when my spouse, who works part-time for most of our marriage, took a year off work to be the stay …
Here’s how to be a good mom and good doctor
I often see patients for follow-up and learn they are not taking the medications either I or another health care provider prescribed. Sometimes the reason is obvious, and other times the patient is reluctant to give up the information. Patients have the right to take or not take medication that was prescribed. But, sometimes by not doing so, they are putting their health at risk.
As a doctor, I want my …
4 reasons why patients don’t take their medications
Editor’s note: This article contains a racial slur crucial to the writer’s story.
It took only 57 hours of working as a new attending physician in Charlottesville, Virginia for a patient to call me the N-word.
Fifty-seven hours. In fact, a racial slur found me before I found the shortcut to the hospital cafeteria. So, when torch-bearing White supremacists gathered downtown earlier this year, I saw more confirmation of my conclusion that …
A patient called me the N-word
Recently, a Leonardo Da Vinci painting, Salvator Mundi (Savior of the World), was sold for $450 million, making it the largest fee for a painting ever sold. Was it a good investment? The painting was sold by Leonardo’s heir to King Francis I of France for 4000 gold ducats in 1519, which according to the American Numismatic Society would be equivalent to $575,000 at today’s price of gold at $1277 …
Leonardo Da Vinci and health care: a matter of perspective
Despite the fact that most people will have had the misfortune of visiting the emergency department (ED) at some point in their life, I find that many folks do not really understand what happens in the ED.
1. Emergency medicine is a specialty. Yes, we actually did residency training to learn how to work in the ED. This training lasted three to four years after medical school and is sometimes followed …
10 surprising things you need to know about the emergency department
When is the right time to have a baby? This question plagues professional women across industries. It takes on more significant importance for women training as physicians. Medical training is long and coincides with a woman’s late 20s, often stretching into her 30s. Waiting to have children until completing training is not always biologically feasible.
Medical schools and residency training programs still lag behind in developing formal parental leave policies. Outside …
Is there ever a right time for a doctor to have a baby?
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