As you look at the above image, please let me ask you a simple question: “What do you see?”
Do you see a sick man lying on a bed with a friendly looking doctor standing by his bedside?
Do you see only men in the picture and wonder, “Why not women?”
Do you see a clinical setting of an engaging sketch of a doctor and …
We look at the same picture but see different things
“He is the best physician who is the most ingenious inspirer of hope.”
– Samuel Taylor Coleridge
I was a third-year medical student on a Sunday morning when the reality of what I had chosen as my life career truly hit me in the gut. At that moment, I realized how intimate the practice of medicine was and that I would have to bring not only my brain and skills to work …
Doctors: Don’t emotionally detach
Hate your job? You may be in the right profession, but the wrong position for your personality. Want to love your life and career? Step one: discover whether you are an employee, a business owner or an entrepreneur.
Here’s how to figure it out:
Employees are risk averse and like to know the rules. They thrive on structure and predictability. They need clear instructions …
Doctors: Are you employees, business owners or entrepreneurs?
We in the medical community believe wholeheartedly in the prevention of all illness, especially by vaccination. Science and history continue to show that vaccination dramatically decreases both the mortality (death rate) and morbidity (severity of illness) of infectious diseases. And, more than 98 to 99 percent of the general population (non-medical) agrees with those statements as well.
Yes, it is absolutely frustrating when parents refuse to follow our advice and protect …
Why pediatricians should not kick out unvaccinated children
To me, five years ago:
Right now you are 28, seated at the top of everything: chief resident of the entire pediatric department. You are in charge of 19 other interns and residents. You are resilient, kind, funny and determined. You seem to have the solution for everything, yet you don’t actually have the answer to anything. At least that’s how you’ll feel on most days in your new leadership role. …
As a physician, you will fail at your job in these different ways. Learn from them.
Antibiotics save lives, but antibiotics can have negative effects. When patients have bacterial infections, we want to treat them to prevent complications of the bacterial infection, but not treat them for an excessive duration. So we have a Goldilocks problem — we want antibiotic duration to be just right — neither too short or too long.
Some clinical conditions have adequate research to define the Goldilocks duration. Community acquired pneumonia only …
How long should I take antibiotics? Exploring the Goldilocks problem.
“OK, one more patient to go,” I said to myself with my eyes quickly scanning the patient list in my hands. I was in the elevator, going up the spanking new glass tower in the giant tertiary care hospital I call my workplace. Today was turning out to be a better Monday than usual. I had worked over the weekend, so I knew the patients. And there were no major …
Inappropriate patient behavior is not OK
Recently, the Los Angeles Times broke a story that Dr. Puliafito, former Dean of the Keck School of Medicine of USC, had been abusing drugs and keeping company with a group of younger individuals who engaged in drug use and illicit activity. Much of this activity occurred while he was dean, and it is a shocking story: A 66 year-old titan of the field of ophthalmology, renowned for inventing …
Does the public shaming of Carmen Puliafito go too far?
June 30 is a date that those in the medical world know well; it’s the official end of the medical training calendar year. July 1 represents new beginnings: beginning of the academic year, an internship, a residency, or a fellowship. This year was our tenth and final passing through the medical new year. Looking back, I realize that we never would have predicted what we were going to learn and …
Here’s what it’s really like when your spouse is a doctor
In the U.S., approximately 30 percent of physicians work in practices that they own. This number has been dwindling down over recent years. Perhaps more surprising, the number of women doctors who are self-employed are a mere 18 percent.
Many hospitals and other corporate entities are actively looking to purchase the remaining practices. It is not just to make money from that practice; it’s to make money from services that are …
Why are doctors leaving private practice?
To a runner, numbers are everything. It’s data. It’s workouts. It’s goals. It’s pace. It’s winning or losing. To a physician, numbers are everything as well. Before you get into medical school, numbers are your schedule, your GPA and your MCAT. In medical school, numbers are your grades, your board scores and your rank in the class. It goes on and on. …
Being Latina, a physician, a mother and a runner: by the numbers
It wasn’t until I was six months into my second depressive episode that I discovered depression existed. I didn’t know it was a real disease. I didn’t know that my grandmother got electroconvulsive “shock” therapy in the 1950s. I only knew something was terribly wrong when I sat crying for 20 minutes in front of a pile of laundry one morning because the thought of choosing clothes and going through …
We need to talk about mental illness in the medical field
There has been much publicity recently surrounding the issue of doctor mental health after a spat of doctor suicides, and sadly not a new thing in the history of medical training. I think the crux of this issue is the idea that doctors are somehow above the concept of humanity. We are held to standards above human abilities, yet we bleed the same blood, cry the same tears and feel …
Doctors: Don’t lose your humanity
“For what it’s worth: it’s never too late or, in my case, too early to be whoever you want to be. There’s no time limit, stop whenever you want. You can change or stay the same, there are no rules to this thing. We can make the best or the worst of it. I hope you make the best of it. And I hope you see things that startle you. …
Goodbye to all that paperwork: An orthopedic surgeon leaves practice
I came into work last night for the last time. Though I was on a service full of sick patients, I was not nervous. After three years of this, three years of people trying to die in creative ways, and my friends and I trying to stop them — I have no nervousness left. There is just nothing left for the hospital to throw at me.
“Dan,” I asked my intern, …
3 steps to be a better medical professional. Even if it seems impossible.
“Dr. Fraser, the pharmacy is on the phone for you. Line one.”
I answer the call, pressing the gray, rectangular button with one hand while writing in a patient’s chart with the other.
“Sarah Fraser speaking.”
“Oh, hi, Doctor, we just got in a prescription of yours, but we are not quite sure what it says.” The pharmacist is gentle in her words.
It was the first time this had happened. I’d promised myself …
Doctor, we can’t read your writing
My smile freezes on my face as my patient says to me, “I’m so glad you’re back – that I get to see Mrs. Lycette today!”
He has been my patient for several years, and I am perplexed to hear him address me as “Mrs.” rather than “Doctor.” At the same time, I really do not think he means an intentional insult, so I keep my face neutral and continue with …
Don’t call me “Mrs.” Call me “Doctor.”
Margaret Edson’s 1999 Pulitzer Prize winning play, Wit, tells the story of the final hours of Vivian Bearing, PhD, an English professor dying of cancer. Early in the course of her disease, one of her doctors sees the value of her case from a research point of view and asks her to enroll in a clinical trial of an investigational therapy. In the film version of the play, which stars …
The decline and fall of informed consent
My husband, the anesthesiologist, came home one evening, he was solemn, affected, not himself. His patient died in the recovery room. It was sudden and unexpected for my husband. Despite the team’s swift efforts and perfectly executed code, the patient died anyway. It’s relevant to note that his patient was an almost 90-year-old man with significant congestive heart failure, probably chronic kidney disease, and complete occlusion of one of his …
5 ways to make dealing with death easier
1973, as we prepare to start our clinical rotations, the chief medical residents taught us the new concept of SOAP notes.
Larry Weed developed the concepts of the problem-oriented medical record and notes that included subjective, objective, assessment and plans for each problem. We wrote our notes each day using his system.
I have wondered in many conversations what he would think of the unreadable computer printout notes of …
Remembering Larry Weed, founder of the SOAP note
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