Physician

Better care: Private practice or academic center?

Physician

June 12, 2017

Throughout training, I had an idea. And that idea was — I would be a great academic physician. I had the right training. I had done research from college through fellowship. I had received research grants from medical school through fellowship, published numerous papers and started defining a niche. Everything was going great.

Academia — here I come!

Then attending-hood arrived. I looked for positions in academic centers. I was limited by …

This is what it’s like to be a military physician

Demis N. Lipe, MD

Physician

June 7, 2017

After another long shift of patients with colds, bug bites, ankle sprains and sore throats I eagerly looked through the wine selection at the local grocery store. It was my wedding anniversary and nearing 9 p.m. at the beginning of a holiday weekend. While at the checkout line, an elderly woman in front of me thanked me for my service. At that moment, I realized that I was wearing my …

MD vs. DNP: 20,000 hours make a difference

Niran S. Al-Agba, MD

Physician

June 6, 2017

As Southern states entertain legislation granting nurse practitioners independent practice rights, there are some finer details which deserve careful deliberation. While nurse practitioners are intelligent, capable, and contribute much to our healthcare system, they are not physicians and lack the same training and knowledge base. They should not identify themselves as “doctors” despite having a doctor of nursing practice (DNP) degree. It is misleading to patients, as most do not …

How can relationships survive medical school applications?

Sarah Epstein

Physician

June 4, 2017

Medical school applications can raise big hairy questions about the long-term potential and trajectory of your relationship as well as the question of whether you get a say in where the applicant applies and attends medical school. For some, the timing of these questions arises in synchrony with the relationship’s natural progression that is at a time when you and your partner are beginning to discuss your long-term prospects. Other …

Here’s the place where burned out physicians go

Sarah Kwon

Physician

June 2, 2017

Burned out cardiac surgeon seeks opportunities or empathy,” one message reads. “I feel stuck,” another confides. A third says simply, “I don’t want to be a doctor anymore!”

The posts come in from across the globe, each generating its own thread of commiseration and advice. “I just wanted to reach out and let you know I feel your pain,” a doctor-turned-MBA replies to one surgeon. “Your story is so similar to …

A retired physician asks: Am I still a doctor?

Robert Baker, MD

Physician

June 1, 2017

Monday morning and no place to go. After 35 years of practicing medicine and GI, including a year of eager anticipation, the day had arrived when there were no patients in my schedule. Nor would there be tomorrow. Nor the next day.

I was happily accustomed to a scheduled life. For me it had been decades of awakening early, working out, assembling a breakfast to inhale in the car, kissing the …

Seeing your gynecologist is not just for a Pap smear

Andrea Eisenberg, MD

Physician

May 29, 2017

Some days, I get so frustrated at work. Yes, we all have our frustrations. Maybe traffic is slow, and you get to work late. Maybe you spill your coffee on your work clothes as you walk into your office. Maybe someone calls in sick, and you are short help at work. But this is big! Like so big, it can impact the trajectory of someone’s life. They, in turn, are forced …

To help patients, doctors should consider going on strike

Matthew Hahn, MD

Physician

May 28, 2017

Last fall I was witness to a miraculous event. I rarely take off from work, but did so on a Friday to go to Baltimore to lend moral support to my family doctor friend, Cathy Maslen. She and her workmates at Chase Brexton Health Care (a community health clinic in the Baltimore area with a focus on the gay and transgender community and the inner-city poor) were doing something that …

This is what practicing medicine in rural America is really like

Edwin Leap, MD

Physician

May 27, 2017

“So tell me why you think you you’re having a stroke?”

The nice lady, mid 40s, sat on the ER exam table in work-clothes, an anxious look on her face. “Well, I was working the cattle up in the timber, and when I got back to my 4-wheeler my heart was racing, and I was short of breath. My arms were tingling, and so was my face. I’m concerned it might …

Residents performing surgery: Why can’t we reach a middle ground?

Skeptical Scalpel, MD

Physician

May 25, 2017

A comparison of appendectomy outcomes for senior general surgeons and general surgery residents revealed no significant differences in early and late complication rates, use of diagnostic imaging, time from emergency department to operating room, incidence of complicated appendicitis, postop length of stay, and duration of post-op antibiotic treatment.

The only parameter in which a significant difference was seen was that attending surgeons completed the procedure significantly faster by 9 minutes — …

How the $8 bottle of water in Las Vegas is a health care issue

Suneel Dhand, MD

Physician

May 23, 2017

I recently attended the annual Society of Hospital Medicine conference in Las Vegas.

As a proud hospital medicine doctor, this organization has grown exponentially over the last decade, and thousands of hospital physicians from across the nation descended on the city for a few days of great learning and networking opportunities. However, away from the conference, this being Vegas, there had to be some time for fun as well.

On Saturday evening, …

When science ceases to be value-neutral, science ceases to be science

Dr. Saurabh Jha

Physician

May 22, 2017

Recently, the Harvard Chan School of Public Health reported on the effect of surgical checklists in South Carolina. The press release was titled, “South Carolina hospitals see major drop in post-surgical deaths with nation’s first proven statewide Surgical Safety Checklist Program.”

The Health News Review, for which I review, grades coverage of research in the media. Based on their objective criteria, the Harvard press release would not score highly.

The title exudes …

A medical student fails USMLE Step 1. Can he ever be a surgeon?

Skeptical Scalpel, MD

Physician

May 20, 2017

I received these emails recently. The writer gave me permission to publish them. They have been edited for length, and some details have been changed to protect his anonymity.

I’m a third-year medical student at an allopathic state medical school. I’ve always wanted to do surgery. My problem is I failed USMLE Step 1 the first time and got a 207 on my second attempt. I hadn’t failed anything else throughout first …

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A medical student fails USMLE Step 1. Can he ever be a surgeon?

This physician won’t tell his alcoholic patients to stop drinking. Here’s why.

Michael Kirsch, MD

Physician

May 19, 2017

When I am facing an alcoholic in the office, I do not advise him to stop drinking.

Other physicians may advocate a different approach. We live in a free society and individuals are free to make their own choices. I have decided, for example, not to own a firearm, ride a motorcycle or bungee jump as these activities are not only beyond my risk tolerance threshold, but are also activities that …

Let’s get rid of the review of systems

Shabbir Hossain, MD

Physician

May 19, 2017

When it comes to the review of systems, I’ve been a natural, a savant — a prodigy you might say.

During my first few weeks of medical school, I remember doing mock interviews with fake patients. This was long before I learned anything about “HPI,” “ROS,” physical exams, billing or anything medically relevant for that matter. As other students stuttered, trying to figure out what to ask a lady pretending to …

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Let’s get rid of the review of systems

The hands tell us the most about a cadaver

Karen Yeter, MD

Physician

May 18, 2017

“OK, it is time to move on,” my professor claps his hands together and yells above the chatter. We all look up from our Netter’s anatomy books and our cadavers. The smell of formaldehyde burns my nose as the fluorescent lights flicker above.

“We have explored the chest cavity and the abdominal cavity. It is now time to move onto the extremities, starting with the arms. I want you to unwrap …

What surgeons do is a violent act

Bruce Campbell, MD

Physician

May 18, 2017

“I like good strong words that mean something.”
– Louisa May Alcott

My resident and I are removing a large, recurrent cancer from the neck. Dense scar tissue is everywhere from prior surgery and radiation therapy. The going is slow. Each move is arduous, and bleeding obscures the view of the anatomy.

“Watch out,” I tell her. “The jugular vein is nearby, probably buried in that scar.”

“Yeah,” she responds. “Look at this nerve! …

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What surgeons do is a violent act

No, I’m not settling for family medicine

Lauren Abdul-Majeed

Physician

May 16, 2017

During a recent internal medicine rotation, a senior resident expressed disappointment that I’ve chosen a career in family medicine. He was concerned that my talents would be wasted, because — in his words — I wouldn’t get to care for the “more complex patients” he sees in internal medicine. Although I appreciated his confidence in my abilities, I felt my heart sink, as it does each time I am faced …

Why medical professionals have potty mouths

Kristin Prentiss Ott, MD

Physician

May 15, 2017

While Muzak plays (think Kenny G covering John Mayer) and courteous expressions like “excuse me” and “thank you” are exchanged in hospital waiting rooms, behind the front desk, angry patients are firing curse words into the hallway like their mouths are assault rifles with an endless supply of ammunition. Nurses are being cussed out by patients who sound like characters in “Platoon.” And medical professionals are dropping f-bombs. All of …

8 traits of excellent hospital doctors

Sanjay Saint, MD and Molly Harrod, PhD

Physician

May 11, 2017

A good relationship between a patient and his or her physician is the cornerstone of superb medical care. That relationship is important when you know the doctor well. It may be even more important when you don’t, say when you are in the hospital.