Recently, I heard from a student in her third year of medical school. To date, she has borrowed more than $100,000 to fund her education. She is in the top 10% of her class, with honors in all of her subjects and high scores on her national exams. She would be a valued resident in the most competitive specialty training programs. Her goal is to become a primary care physician …
Why physicians are anxious today
The toddler was a curious, rambunctious, talkative three-year-old who loved to explore.
Every week, he’d wait for Sunday to come, because Sunday was he and his dad’s special day. Mikey and his father adored each other.
Whether Mikey and his dad were doing “horseback rides,” playing basketball, or just sitting on the rocking chair for story time, whenever they were together there was fun, love and a forever bond.
Mom called them “the …
A toddler, his dad, and the unthinkable
One of the nurses knocked on my door on a quiet Monday morning.
“Hey, can you see this patient? I guess it’s not urgent but he’s here now, and I think what the doctor told him just threw him for a loop.”
Of course I had time. In my role as clinical nurse specialist in a busy uro-oncology unit, I see men who …
What patients want isn’t always what they need
So there I was — in deep denial. Maybe you’ve been there: Ignoring the symptoms. Hoping and praying that it would just “go away.”
A little knowledge is a dangerous thing. And as a doctor, I like to think I can Google with the best of them.
So when I had a persistent scary symptom (full disclosure: it was bloody discharge from my left breast. Not subtle. Not intermittent. Not OK, even …
A cancer scare changed my life in 7 seconds
There is an interesting article from ProPublica called “When Evidence Says No, but Doctors say Yes” making the rounds. It’s about the number of doctors who disbelieve, don’t know or don’t care about medical evidence to the detriment of patients. I do not find any fault with the article. I rail against this daily. I have my whole professional life. It is actually a big reason …
Providers and patients must listen to the evidence
Cardiac neuroses are often iatrogenic in origin. A well-meaning but careless comment by a physician can change a person’s sense of well-being in an instant. The effect can be permanent and devastating. Many clinicians who complain about overly anxious patients don’t appreciate their personal role in the genesis of this problem. Our words matter. They can reverse the good we do with our medications and procedures.
If you are a heart …
Watch what you say to patients
In the not-to-distant past, American health care was the gold standard. It offered job satisfaction and autonomy, was financially rewarding and was considered by many to be the most honorable profession. But as we all know, over the last two decades, increasing health care costs and demands and increasing competition for insurance contracts have changed the face of medicine. Metrics ranging from quality and safety (which are needed and were …
Physicians ceded control of health care. It’s time to take it back.
From a young age, I knew I wanted to be a physician. There were no physicians in my family, but I had interacted frequently with doctors as a child and felt a strong desire to similarly help others as I grew older.
To this end, I focused on academics. In choosing a university, I chose the one I felt was academically best, despite being a private school in an expensive city …
The far-reaching consequences of medical school debt
I am a bioethics researcher who studies physician misconduct. I am also a former gymnast.
I haven’t really kept up with gymnastics since I quit when I was 17. With the exception of the most recent Olympic Games, I avoid watching it on TV. The taciturn criticism from the commentators is too much for me to bear. I think, of course, she didn’t stick the landing. She just flew through the …
Larry Nassar and physician misconduct: No more code of silence
“Daddy, time to wake up! It is morning time!”
I open my eyes to our four-year-old daughter at the foot of the bed smiling, her hair meticulously braided. I get up and wake her younger brother from his crib and carry him downstairs. The baby is still sleeping. Soon come shouts of “coffee!” as we enter the kitchen — they know my routine well. After breakfast, we all get dressed, I …
This physician delayed residency to take paternity leave
A few weeks ago, I had the opportunity to interview a faculty physician at a large academic medical center. We spoke about burnout in students and faculty in general terms. He was aware of the problem yet did not seem affected himself.
I asked him how he managed to avoid burnout. He talked about remembering his purpose in entering medicine — that the profession is a calling, not just the daily …
Physician leaders’ role in preventing burnout
Am I the only emergency physician who sometimes wonders who left me in charge of an ED? I should be confident in managing whatever comes through those ED doors after more than ten years of single-coverage night shifts, but each night I hear a little voice in my amygdala questioning whether tonight will be the night I won’t be able to handle something. Sometimes I feel afraid of the unknown …
An emergency physician frozen by fear, and what she learned from it
And if they can, should they?
In recently post, I wrote about some unresolved issues with driverless cars and ended by saying “So are you ready to have an autonomous robot perform your gallbladder surgery? I’m not.”
But the robots are coming. A recent paper in Science Robotics proposed six different levels of autonomy for surgical robots.
The …
Will robots ever be able to perform surgery independently?
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Most of you know me — if you know me at all — as a pediatrician.
But I’m a parent, too, just like you. I have three fantastic girls that I love dearly. Let’s talk.
My first daughter was born before I knew anything about medicine. She has taught me more than I could have imagined. I’ve watched as she has grown from a tiny and helpless infant into the child she …
My kids are vaccinated because I love them
The return from a vacation weighed on me physically. This had been a true vacation — an entire week away from clinic and spent with my family. I even managed to unplug to the point of only checking email on my phone twice per day — really!
The tension that years ago took up permanent residence in my shoulders had faded away without my noticing, so that when I awoke to …
The burden of the medical profession. Is it worth it?
The emergency room is packed. I interject another question to further clarify when exactly Mrs. Smith’s chest pain started, cutting off a story about her daughter — a tactic I would have found unthinkably rude only years before but has now become a necessary technique. After leaving the room, I try to put in orders, but the electronic medical record resets itself, I’m informed an X-ray won’t upload unless I …
This doctor takes pride in being inefficient. Here’s why.
It’s no secret that health care is an unbelievably complex subject. One of the most complex issues facing the health care system is that of surprise medical bills. Surprise medical bills happen when:
The fundamental cause of surprise medical bills and how to fix it
Recently, another local family buried their young adult child due to a drug overdose. Sadly, this same story is playing out daily across the nation.
Upon reading the headline, I paused to think about an encounter leaving work one Friday evening. As I was walking in the dimly lit street to my car, I found a small group of shadows huddled over something lying in the adjacent alley. Once closer, I saw that …
Heroin is a public health emergency. The time to act is now.
And I don’t love it.
When I gained acceptance into medical school, I thought I would one day have one amazing job, or at least one job title where I might get to wear several meaningful hats.
I’m a physician anesthesiologist. It’s my duty to play a role in improving the health and the lives of my patients. I studied and trained for many years to have the privilege of understanding the …
I’m equal parts doctor, scribe, and mouse jockey
During breakfast with my father over the holidays, a friend of his asked me what kind of doctor I am. “I’m a radiologist,” I answered.
I was met with a puzzled expression and a reply of “Oh, I thought you were a doctor doctor.” I smiled and returned to my banana.
Most radiologists, especially those like me who are not physician offspring, are faced with this sort of discourse at least once. …
Isolation threatens the practice of diagnostic radiology
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