Recently I’ve seen a number of reports of women who are denied the ability to help in a plane emergency because they are not believed to be doctors. While most of the denied women are of color, since this became public a large number of women of all races have come forward because of similar racial and gender discrimination.
I am an emergency physician, and I was once called to duty …
Patients forming an opinion of your practice are doing so in a matter of seconds. And some of the latest research on first impressions, suggest that it may even be within the blink of an eye. Regardless of the length of time, first impressions are powerful and very difficult to reverse. So, if a patient has formed a bad opinion of you and your staff, during the first point of …
Make a good impression on your patients. Here’s how.
I have a mentor who is quite gifted at getting me to break a sweat in the OR. No matter how well an operation is going, she’ll have me set my instruments down. “If this doesn’t work, what’s your plan B?” We discuss how variations in anatomy, damage to critical structures, or unanticipated pathology could change our operative plan. She challenges me to not only consider plan B, but plans …
The most skilled surgeons are confident and humble
Several years ago, I was sitting at the gate in a Washington, DC, airport when I got a call on my cell. A close friend of one of my patients wanted to let me know that Lara (not her real name) had died after a long and difficult course of throat cancer.
Lara was relatively young, a kind, brilliant and incredibly thoughtful woman, and I’d had a deep patient-physician relationship with her, given all that she’d been through …
Nearly a month before our national presidential election, a video surfaced online capturing a conversation between Presidential candidate Donald Trump and reporter Billy Bush. During this 2005 “private” conversation between the two, Trump lewdly brags to Bush about kissing and groping women without their consent. He is even heard boasting he can “get away” with this behavior because of his celebrity status. Trump has been heavily criticized for his words …
The unacceptable cost of silence
Even though I don’t have an outpatient practice, I like to keep in touch with some of my patients after they’ve been discharged from the rehab hospital. Jack is one of my very favorite success stories.
I met Jack in a small regional hospital in rural America. He had been admitted with sudden-onset weakness, and during the intake process, he mentioned enjoying occasional evening cocktails when out for dinner. Unfortunately, this …
She didn’t save my life. She saved my lifestyle.
She had come to see me in consultation. A professor at a local university, she was well until four years earlier when she developed abdominal bloating and pain — telltale signs of ovarian cancer. Surgery followed, then adjuvant chemotherapy with intraperitoneal treatments. (“Terrible regimen,” she said.) She was fine for two years, until the bloating recurred heralding …
What’s the one word cancer patients never want to hear?
Four years ago, I was having a conversation with a friend of mine. We had graduated residency the same year and our careers had taken us to different parts of the country. It was ACEP 2012. We’d been mingling with old friends and current colleagues, and the conversation turned to kids.
I told him my wife and I were getting ready to start having children. He said he and his wife …
Physicians need to take a broader approach in their first job search
What is one of the rules that medical people comply with the least?
My vote goes to “translation.” The rule is that you must use a qualified medical interpreter for any interview or discussion with a patient who does not understand English.
How is “lack of understanding” defined? It is usually fairly obvious. If you aren’t sure whether the patient gets it, he probably doesn’t.
Why can’t family members act as translators?
There is …
What’s the big rule that medical professionals don’t follow?
As with most everyone else, I am watching the presidential race with something akin to amusement and horror alike. And as with many people, I feel that the U.S., as a nation, failed to find a suitable candidate for this presidential election. While there does need to be some test for fitness for office, I remain aghast at the medical speculations and facts being leaked about the presidential candidates. Reading this …
Medical speculation of Trump and Clinton leaves this doctor aghast
Classic rock music lovers who think they don’t like poetry, and literary purists who think they don’t like popular music, may have been equally baffled to hear that Bob Dylan is a winner of the Nobel Prize in Literature. As an unrepentant English major, I’m delighted.
I can’t remember a time when Dylan’s music wasn’t a part of my growing up, from the rebelliousness of the anti-Vietnam era …
Poetry and music tell stories of universal experiences
A recent issue of the New England Journal of Medicine once again questions two practices that used to be almost the backbone of primary care.
One article is about the low likelihood that prostate cancer detected through PSA screening will shorten a man’s life, even if he chooses just to keep an eye on it.
The other article is about how repeated mammography screening mostly leads to the diagnosis of small and …
Why physicians face a serious credibility problem
I recently spent an evening with a group of medical oncology fellows as part of a small panel discussing career alternatives. There were doctors who worked for pharma, academic medical centers, hospitals and a couple of us representing private practice. The questions and comments taught me more than I could contribute. I was surprised to learn not just about jobs and personal futures, but about something basic: the difficulty in …
Quality doesn’t always equal success for doctors
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I answer every phone call from every patient myself. I have no staff to respond to issues that come up during the day. There are no colleagues that take my calls after hours. This was my choice in response to what everyone knows: Health care is broken. I needed a radical change from the bureaucratic system that I experienced daily as a physician however I had no idea how to …
A physician quits and practices medicine her way
A few months ago I wrote an article about a 28-year-old MBA who attempted to tell an experienced physician where to round first. The article was widely circulated and went a bit viral. Clearly, the scenario resonated with thousands of physicians across the country.
It was interesting that afterward, I received many messages from various people who had read it. The majority of these were messages of support …
The day when MBAs no longer have to answer to physicians
I am constantly in awe of the patients I want to treat. I cannot fathom their strength to embrace their identity while overcoming prejudice and discrimination. I do not know what it must be like to fear being your true self everyday.
But I do know what it’s like to be told to keep my career interests quiet. When I was interviewing for residency, my goals of serving transgender …
It’s time we embrace the known benefits of gender-confirming surgery
“Good morning, Sandy. How was work?”
How do I answer that in a normal way? Any given shift in any given ED is comprised of the gamut of emotions playing out behind the calm facade of physicians and nurses. Afterward, we often don’t articulate or even process the roller coaster of feelings. The story of a recent Monday overnight illustrates the wild ride of emotions most people don’t realize that emergency …
This was my night in the ER. How was yours?
One very late spring evening during my last year of residency, I was driving home and got stopped at a police DUI checkpoint. I was exhausted from being up all night from being on call the night before and having been very busy had no time to shower, shave or change into my street clothes. I also got called in at 4 a.m. the previous day and had not showered or shaved that …
The night this physician was profiled. And he was OK with it.
This has not been an uncommon occurrence over the past 2 1/2 years. In my bed with my laptop when I should be asleep, looking at blogs, taking quizzes, checking out stats on different specialties to find my place in this crazy world we call medicine. This wouldn’t occur all the time but enough that it was noticeable and something I clearly wanted resolved.
On these nights my thinking started out …
A medical student realizes how he could change the system
As a primary care pediatrician, I am often on the front line of mental health care. Since child psychiatric referral services are sparse and overloaded, I often have to initiate counseling for anxiety in many of my patients. One thing that I have learned is that you can help someone with anxiety in a tremendous way by getting them to recognize a simple fact: It is counterproductive to worry about …
The precarious peril of pay-for-performance
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