Over the past few summers, I’ve noticed that I’m fearful of swimming in the deep end of the pool. Gone is the fearlessness of my youth, when I’d venture out, take risks, and somehow just know I’d make it back to the shallow end, where I could firmly stand on a solid foundation.
Somewhere along the way, I had replaced my fearlessness with what-ifs.
What if I get a cramp in my …
3 lessons learned from the deep end of the pool
When a patient comes to see me for a migraine headache, I know that they will leave feeling 100 percent better. They will finally be rid of that pounding, nauseating pain in their head, and they will be happy. And that makes me happy.
Doctors derive great joy from helping their patients. In addition to a strong sense of accomplishment, the ability to reach out and make another life brighter appeals …
It is wrong to exploit physicians’ compassion
Early into my career as an emergency physician, I was seated in the department with a colleague when I inquired about one of our co-workers I had not seen in a while. “Oh, she’s on the mommy track,” my colleague said and picked up another chart. To me, selecting a career path that sacrificed traditional professional advancement for more time to raise children was legitimate. My colleague’s pejorative “mommy track” …
Why physicians should have golden parachutes
It was a simple chief complaint: sore throat and fever. As expected, the little girl’s rapid Strep was positive. Instructions given. Antibiotics sent. This was Peds 101. But for some reason, before mom walked out the door, she made mention of their stay at the shelter.
Although I had seen this child many times before, somehow, I never knew that she was homeless. Nothing in my detailed history and exam had …
Improving health outcomes for children requires us to look at the big picture
What has the medical community, once thought of as the “ultimate team,” finally come down to in 2019? The “back in my day” sigh I often hear from more senior physicians has inspired me to read several books about the history of medicine. As I devoured them from cover to cover, the excitement of medical discovery, the anticipation of the near-miracles that were about to be revealed, and most importantly, …
Should physicians yearn for the nostalgic ideals of their predecessors?
While “trust” sounds like it would be an inherently good thing to have between two people or in a team, that is not always the case. Depending on what “trust” means to you, it can also be harmful at times.
While it may not at first seem pertinent, driving in traffic can be a helpful metaphor for understanding different definitions of trust in the workplace.
A couple of years ago, I was …
Beware of the potential harms of trust: 5 safeguards
This year, I learned that to have success and fulfillment, you don’t just do, sometimes you have to undo.
What do I mean by that? The process of undoing — or editing — it a key part of different areas of our lives. For example, we edit in medicine all the time. Think about the medical student’s SOAP note: the subjective story, the objective findings, the assessment, and the plan. Imagine …
To have success and fulfillment, sometimes you have to edit your life
“I just don’t know what to do, how to help.” My patient’s wife was slumped in the plastic chair by her husband’s side, fatigued and beleaguered. She had been there for hours, days, as we waited for antibiotics to start fighting back against the infection that had overwhelmed his body.
“What sort of music does he like to listen to?”
“Depends on what he’s doing. Zeppelin to work on the car. Jazz …
The changes that have occurred in health care over the last few years represent a sea change from the autonomy and clout that physicians once had. It’s no great secret to anybody working in medicine that most of these changes to practice — including the push towards employment instead of private practice, and the need to now spend the majority of the day clicking boxes on a computer screen — have …
Physicians need to stop being so nice
I just did my first telemedicine video visit.
The concept seems so strange, the idea of carrying out an “office visit” without the patient actually being in the office.
Right now we have it structured so that when a patient calls up requesting to see me on a day when I am already fully booked (or, as is usually the case, overbooked), …
A physician’s first telemedicine video visit
This summer, not unlike many families across the country, we were fortunate enough to visit a theme park while celebrating our break from another challenging school year. Being a mother and a pediatrician, I must admit how concerned I was to witness the number of children with obesity attending the park.
While we waited in line for the various rides, I couldn’t help considering how best to advise families on making …
Tell your patients these family health tips when they’re headed to a theme park
A debate highlighting gender discrimination in medicine currently rages within the pediatric hospitalist medicine community.
The debate centers on the board certification process for “grandfathering” for the new pediatric hospitalist subspecialty which effectively excludes women on the basis of motherhood.
For those not familiar with “grandfathering in,” this is the process by which a new subspecialty may grant board certification to physicians who have been practicing in the specialty. The alternative option …
Don’t make me choose between motherhood and my career
A book was recommended to me recently by a resident of mine. It is written by Simon Sinek and called Leaders Eat Last. I already knew that I agreed with a lot of what Sinek says because I’ve seen You Tube Videos by Sinek that feel like he has reached inside my head and ripped my ideas directly from my mind.
Today, I don’t want to deliver a …
Do hospital administrators eat last?
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The emergency room is an interesting place to work. It’s controlled chaos. Walk through the hallways, and you’ll hear people screaming, see others crying, and others wincing in pain.
Over time, you get a unique perspective on the human condition. In my years of training and practice, I’ve seen so much. People experiencing their worst days. Others receiving news that will change everything. Some lives ending. Others returning from the brink.
Certainly, …
5 lessons from an emergency physician
The only times I stood in Emily’s room without fear were the day I met her, and the day she died. These days were two long years apart, years of unhealthy snacking and spending most weekends away from my husband and son. When Emily’s name first appeared next to mine as an overnight admission, the resident physician providing the hand-off gave me a clear warning: “Good luck. She is the …
Anonymous acts of kindness: How this physician connects with every patient
While my forty-year parts warranty expired some time ago, leaving me with a snapped fibular styloid process not long after, the ensuing twenty-five years have not resulted in any serious medical encounters until last week. Following a very pleasant early evening session with our Congresswoman and a sweet snack at home, abrupt abdominal pain progressed in under two hours to a clinical acute abdomen. As I got dizzy and dependent …
The medical record often doesn’t capture the care of the clinician team
I meet doctors in different arenas: clinical settings, conferences, and referrals. I am noticing a trend. We are keenly aware of what we do not want in medicine. We talk about physician burnout and its impact on doctors’ lives. We know firsthand the effect the EMR has on the doctor-patient relationship as doctors spend less and less time in direct patient care activities. And we are learning how to navigate …
It’s time for physicians to bring clarity to their lives
On the face of it, this seems like a fairly simple business arrangement. My patients or their employers pay money to a health insurance corporation so they, in turn, have sufficient funds available to pay medical claims for services I render. That simple system seems to work for auto, home, and life insurance.
First of all, a little background about me. I am a board-certified otolaryngologist who did my residency through …
Health insurers and physicians are not partners
During my training to become a primary care physician, the importance of preventive cancer screening was ingrained in me. The idea of catching cancer at an early stage so we can better treat it made intuitive sense. But as I’ve learned over the years, the simplicity of this concept can obscure its limitations and make it difficult …
Convincing patients to stop cancer screening isn’t always easy
Doctors and policy wonks hear a lot these days about “low-value care.” What exactly is that, and should you care?
The term refers to tests, medications, and procedures that add little to a patient’s health or well-being but which cost them or the system more money than any benefit warranted. Some of the earliest research that looked at this was done at Dartmouth, where they found enormous variations in the cost …
What is low-value care, and why does it matter?
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