Today, I’m thinking about the end of residency. But first, let me tell you about the beginning of residency. My first day of clinic, my very first week of residency, I had a grand total of one patient scheduled. A seasoned, outgoing resident had given me sign-out on this person, along with some big, knowledgeable shoes to fill. I did my most thorough pre-rounding the evening before. I prepped my note and …
Crossing the threshold when residency begins
How can we possibly get to standardization in medicine? And is that a good thing?
Standardized checklists save lives; rigid procedures for sterilization of equipment saves lives; universal compliance with recommended beneficial treatments saves lives. And while it’s sometimes a wonderful thing to let a surgeon solve a problem creatively or to allow a patient visit to go overtime in order …
Why electronic medical records should be standardized
I’m an ER doc, and proud of it. But I never mention it when I meet new people. Unless someone’s fixing to die, I avoid it like the plague. “I work in a hospital,” I say. “Where in the hospital?” “The ER. How about you?” That’s a topic changer, since most people would rather talk about themselves.
Why not own it, you ask? There’s no shame in being a doctor. It’s not like …
Why this physician never tells anyone she’s a doctor
You cannot work in medicine today without being inundated with burnout statistics and commentary on your feed, coming to your inbox, or spoken from stages about the state of medicine we are in. The data is dire: we are disengaged, we are making mistakes, we are not heard, and we are not empowered to make decisions.
There’s passionate debate on whether it’s individual versus institutional changes that will save medicine from …
We need physician leaders who understand our problems
A guest column by the American College of Physicians, exclusive to KevinMD.com.
Of all medical specialties, perhaps the most difficult to understand is internal medicine.
While the name suggests that those who practice internal medicine focus primarily on non-dermatologic diseases of “Internal” organ systems (which in many ways is true), unlike other medical fields whose names …
How internal medicine got its name
During the 25 years I’ve been a transplant doctor, I’ve cared for hundreds of patients who received lung transplants. I’m now worried about the growing number of people who will need this lifesaving procedure in the future but who won’t have enough transplant physicians to do it.
At any given time in the U.S., about Read more…
Why we need more transplant physicians
Addressed to Dr. Lynes, the note sat menacingly in my inbox like a distress signal ominously blinking on a battered ocean coast.
“Mr. Smith wants you to read the note before his preop, the nurse said harmlessly.” A premonition that day, just one more irrational fear in my downward spiral into darkness.
I am a physician, practicing a noble profession of merit. Sepsis, from a visit to Mexico, began a sad journey …
Quitting medicine: a disgraced survivor of a bloody suicide attempt
There are limited studies regarding pediatric malpractice claims, especially for the emergency department (ED). A recent study of malpractice claims involving children highlights the role of communication and systems issues. This 10-year study is important because it focuses exclusively on children and provides data on the top specialties named as defendants, including emergency medicine. The study found communication breakdowns between patients/families, and providers contributed to 15 to …
When treating kids, learn communication lessons from the emergency department
In journalism, the lede is the first part of a news story. A good lede will entice the reader to read more. It contains the key points and gives the general idea of the article. Ledes are also crucial in the field of medicine. As a graduate student in journalism and a general practitioner, I can appreciate the value of ledes in both fields.
When health care professionals communicate with each …
In medicine, use a strong lede
For most of us, going to the doctor is not at the top of our favorite things-to-do list, but it may be one of the most important. Whether the visit is for a scheduled check-up or to deal with a new problem, there are ways you can make the visit less stressful and more useful.
You must remember that things have changed. In the “good old days,” when I started in …
How to make the most out of your doctor’s visit
“When you start seeing your worth, you will find it harder to stay around people who don’t.”
– Unknown
After graduating from my residency a few years ago, I accepted a job within my organization as a staff psychiatrist and a medical director.
The idea of familiarity was a big driver in my ambivalence towards pursuing alternate opportunities, even when they came knocking on my door. As the job started and progressed through …
Get rid of the guilt. You matter as a physician.
Working in both the inpatient and outpatient setting, I have to frequently recommend my patients follow-up as soon as possible with their primary care doctors. I work in a couple of different locations, urban and rural, and I must say I have noticed a rather disturbing trend over the last few years. When I ask my patients who their primary care doctor is, I often get the reply:
“My primary care …
Primary care should be one of the highest-paid specialties
Tuesday, getting ready for work. Standing in the shower, it hit me. I couldn’t remember the last time I wanted a drink.
I almost got a blob of conditioner in my mouth as I snorted out loud.
“Mom, you OK?”
“Yeah, baby, I’m great.”
Incredible, actually.
Like so many, my habit of using external things to feel better was well ingrained. As a kid, I’d sneak ziplock bags of homemade cookies. In residency, stress eating …
Changing the habit of physician drinking
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As I lay there awaiting my shock, the doctors milled in and out of my room over the course of several hours. It was a normal but hectic morning in the emergency department with ambulances and code blues pulling my doctor away.
Before pushing the Propofol and completing my cardioversion, the doctor flatly stated something I’d heard many times before. With a certain look in her eyes, she shared a personal …
5 hidden symptoms of physician burnout
It may seem odd that a gastroenterologist patronizes fast food establishments several times each week. I’m in one right now as I write this. I eschew the food items –though French fries will forever tempt me – and opt for a large-sized beverage. In truth, I am not primarily there for a thirst-quenching experience, but more to ‘rent a table’ so I can bury myself in some reading. Indeed, many …
Should health care come with a money-back guarantee?
I’m fascinated by the human body — the intricacies of it, the poetry of it. I am intrigued that a cell can come together with other cells to form tissues, those tissues, organs, and systems.
The body is a powerful metaphor for unity: what happens when the one becomes the many, and the many, even more. It is a lesson in both individuality and community; how one sets out to create …
How do you determine that the dream of medicine is worth it?
On Twitter recently, I saw a tweet that commented on the fact that there were too few black men who became doctors. I readily confess that I don’t know the reason why. I asked whether it is due to implicit bias or outright racism. Another doctor answered that both play a role. Although I have witnessed acts of racism and bias in the past, I can’t say I understand it …
Too few minorities become physicians. Why is that?
At a certain point, we’ve all got to go home.
Whether it’s the end of the shift when the factory whistle blows and the assembly line stops rolling for a brief period while new people take our place, or late in the day after the last patient has been seen and our notes are all written and our portal messages have …
Can answers to after hours calls be automated?
This past August, I attended the American College of Obstetricians and Gynecologists (ACOG) District VI meeting in Wisconsin. The theme of this year’s meeting was “Bringing it Back Home,” with a keynote presentation focused on developing the emotional habits to influence others and “embody the inner attitude of a leader.”
After a day of much self-reflection, I decided to stop by the poster presentations during a break between the major talks. …
The medical illiteracy epidemic
It’s hard to describe the feelings I had when I received my first letter of intent to sue. I think I went through the Kubler-Ross stages of grief — denial at first, of course. This denial didn’t last long since the letter was clearly addressed to me — first, middle, and last name.
Anger was almost immediate … I was immediately upset at the deceased patient’s family who were bringing the …
The stages of grief when a physician is sued
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