“I can do that?”
During a recent morning practice session, a resident was presenting a patient who had had several episodes of syncope which culminated in a trip to the emergency room. She had a brief stay there, and on the discharge plan was written “follow-up with PCP and with cardiology.”
We went through her history and physical examination, we talked about how to further …
Are primary care doctors referring too much?
I am not God.
Nor do I want to be, but I feel sometimes that my patients and their families do.
When I entered the ICU early that overcast morning I knew judging from the throng of anxious people waiting outside that things were not right. He came to me straight away, his eyes haunting and sunken as if he hadn’t slept for the whole night. His body barely able to support …
Doctors are not God. Even if some patients want them to be.
In August of 1991, I became a family practitioner in the United States Air Force and was sent to Clark Air Force Base in the Philippines. During my time there, I was asked to go on a medical mission. This experience struck me with the missionary bug to provide my talents and to care for others in another country. With medications that were near expiration date in USAF stock and …
What this physician learned from a medical mission
To my beloved patients and your families,
Over the years, it has been an incredible experience and honor to be allowed to enter into your world. It is a world that I know few people are privy to, and it is an intimate world where the deepest questions about life tend to arise. I know that when you are confronted with sickness that leads you into this world, it can be …
A letter from a grateful physician to his patients
Leaving your career in medicine is like breaking up in a long term relationship. It may have all started out with lofty expectations, excitement about the future, and becoming your best self. However, somewhere along the way, things got messy and twisted and not what you signed up for.
There were hiccups along the way, signs that maybe it wasn’t good for you. There was the time you fell asleep at …
Retired at 37: Breaking up with a career in medicine
Among surgeons, it’s pretty common knowledge that residents and other providers may perform non-critical parts of a patient’s procedure. This not only helps residents and other trainees gain valuable surgical experience, it also gives patients better and faster access to high-demand surgical expertise.
The question is this: How well are surgeons explaining these facts to their patients?
Recent guideline updates by the American College of Surgeons (ACS) underscore the need …
4 scenarios surgeons need to explain to their patients
Medicine, what a noble profession. As the keepers of human health and longevity, we are entrusted with a huge but solemn responsibility. It’s an ancient artwork, passed through the generations from pre-antiquity, hand in hand from physician to physician. The Hippocratic oath ensuring that we first “do no harm” and commit ourselves to the honorable calling. We often hear “see one, teach one, do one” and so propagates the training …
All good doctors listen to nurses
The onset of the new millennium has brought about a shift in not only the technological aspect of our industry, but also the mindset of physicians who are entering the field. Gone are the days of “work 40 years at the same practice, retire and live the good life.” Physicians are finding more creative ways to be doctors including entering non-clinical careers, being entrepreneurs on the side, and moving into …
Life coaching for physicians is an underused physician burnout tool
I’m humbled by the honor to practice medicine. We have the opportunity to be frontline participants in an ever evolving cascade of events in the lives of others. Our decisions, directions, and split second actions have the ability to unite families, sustain breath or literally a beating heart. Although biased, I can’t think of many professions more fulfilling and honorable. There are issues and concerns, but they pale in comparison …
Compartmentalization failed me, and I’m forever grateful
I’m probably crazy. I ride my motor scooter to and from work at the hospital. Some consider it unsafe. Perhaps it is, but feeling the wind and rain, those unfiltered elements. And after 12 hours inside a controlled environment, it’s too refreshing to pass up. So at 2 a.m. Friday night, I’m zooming (you always “zoom” on a scooter) through the industrial district after a tiring admitting shift. I see …
We must remember to humanize our patients
It is no secret that physicians are disenchanted with the changes in medicine and can be overheard saying that they do not want their children to go into the profession. Has the practice of medicine deteriorated to the extent we say it has, and are there more appealing options?
According to a Doctors Company survey of 5,000 physicians, 9 out of 10 physician respondents indicated an unwillingness to recommend health care …
The medical profession has a bad reputation. Here’s why.
Most health care professionals went into the field because of a calling. For many of us, it is not just a career but a sense of mission. While the system drives hoards to the brink and over the edge of burn-out, a sense of purpose remains. The goals are not the same for all, but it is a good time to re-examine our life goals.
Being a doctor, or any professional …
Doctors serve the people not the system
I am a new mom to a beautiful 8-month-old girl, and I am breastfeeding. I am also a doctor at a large, well-known academic institution. The hospital where I work delivers several thousand babies a year, and highly encourages their new moms to breastfeed. They offer a postpartum consultation with a lactation consultant, keep the baby in the mom’s room 24/7 while in the hospital, and provide several other pro-breastfeeding …
Is breastfeeding as a working doctor an impossible task?
It was around 2 p.m. when a 380-pound woman came into the ED. She was in her late 30s. The physician went to see her and then ordered IV fluids, some basic blood tests, and a urine sample.
At a hospital, everyone’s job is made harder when a patient is obese. Getting the patient on the bed requires more personnel. Inserting an IV — an intravenous catheter to infuse fluids or …
Obese patients are among our most vulnerable
One of the most memorable times from my family medicine training days was the annual residency my intern year. It was the year of the World Cup, and a bonding experience that would later save my life. Being able to be with not only my residency class, but also the faculty in a relaxed and empowering environment brought a sense of safety that allowed me to reach out to one …
Physician coaching and retreats are innovative ways to fight burnout
Health behavior was my emphasis in my MPH. Add a faculty development fellowship, time as residency faculty, work in a private practice, and increasing interaction with medical students now as faculty at a medical school; the outcome is not just an emphasis, but a mindset. A mindset of health behavior that is not just for patients, but for physicians, as well.
I must have company in this concept as ten invitations …
How journaling can help physician wellness
With all this talk about medical student, resident, and fellow burnout, I thought we might take a break to discuss the small delights that sprinkle throughout medical training. This is not a “You should publish as a trainee” manifesto. It’s more of a DIY guide for those who are interested but can’t find the time or the mentor. And after a decade of rejected manuscripts, unfortunately, I’ve …
How to publish as a medical trainee
In this podcast, I share insights from a doc who barely survived his suicide attempt plus simple ways to prevent the next suicide. Listen in. You may save a life.
Dear Pamela,
I’ve never been so happy to fail at something in my life. Four weeks ago today I died. Cardiopulmonary arrest in jail. Why was I in jail? My wife alerted …
Doctor revived after suicide tells all
Gather round kids! Let Grandpa Doctor Leap tell you a few things about the old days of doctoring in the emergency room:
Back in the good old days, medicine was what we liked to call “fun.” Not because it was fun to see people get sick or hurt or die, but because we were supposed to do our best and people didn’t wring their hands all the time about rules and …
Once upon a time, being a doctor was great. Not anymore.
Knowledge is power. Increasingly, patients are demanding and receiving access to levers in the medical machine that would have been unthinkable a generation ago. The informed consent process, which I support, can overwhelm ordinary patients and families with conflicting and bewildering options.
Television and the airwaves routinely advertise prescription drugs directly to the public. Consider the strategy of direct-to-consumer drug marketing when millions of dollars are spent advertising a drug that …
Should patients order their own lab tests?
Get free updates delivered free to your inbox.
