This cartoon is based on data from the 2015 Medscape Physician Compensation Report. Dermatology is on one end, internal medicine on the other. The other specialties in between. Doesn’t seem to be a trend between the cognitive and procedural specialities, which is a bit surprising. You’d think the latter would skew towards the “happiness” side.
Do you …
Where are you on the physician pain scale?
If I’m to take fashion advice from Maureen Dowd’s March 3 column, “Stroke of Fate,” a take-down of emergency medicine disguised as a recovery narrative of her niece, then I should exchange my white coat for grease-stained overalls.
In her column, a Harvard neurology professor who specializes in stroke describes the brain as the Rolls-Royce of the human body. When it …
Defining the narrative of emergency care: The danger of Maureen Dowd
1. Due to intermittent monitoring versus continuous fetal monitoring which is standard in the hospital, the patient has increased mobility and a wider range of laboring positions/options: sitting, standing, walking, water, birthing balls. The American Congress of Obstetricians and Gynecologists (ACOG) has agreed that there is not a medical benefit to continuous fetal monitoring compared to intermittent monitoring in low-risk women.
2. …
10 reasons to have your baby at a birth center
The room hung silent when he was done speaking. It was Monday afternoon and I had just barely woken up from sleeping off my overnight shift in the ICU. A few days prior the poet laureate of Rhode Island, Rick Benjamin, asked me to join a poetry seminar he hosts weekly at a local assisted living community. Despite the ache as I lay my head down that morning, I set …
After residency: There is so much more to learn
He sat there holding his wife’s hands and hugging her as tightly as he possibly could. Tears were streaming down her face, and she was vulnerable to the diagnosis I had just bestowed upon her. Cancer, the “C” letter word nobody wanted to hear, suddenly invaded the lives of this newly married couple.
Multiple thoughts were running through my mind before bestowing …
It is OK for the doctor to cry
Often I hear comments from people who have been treated for cancer and other illnesses talking about the things they wish they knew, or things they wish their doctors would have shared with them about their treatments or conditions.
I don’t have to remind anyone there is a tremendous amount of anxiety and fear when you are diagnosed with cancer or any other perceived or potentially life-threatening illness.
Our health care system has …
This is the key quality for any health care provider
I work in a place where nobody calls me by my name.
They all address me by a moniker of their choosing that I have asked them not to use. I have asked them to use my name. Aside from a few who respect my wish, most of my co-workers just call me by the impersonal-sounding phrase they’ve selected instead. It creates …
I’m a physician. But please don’t call me doctor.
Recent events in Baltimore sparked by the tragic death of Freddie Gray in police custody have thrust our city into the national and international spotlight.
As others have observed, the anger, violence and grief that erupted in Baltimore following Gray’s death have roots that run much deeper — and much wider — than the highly publicized clashes between law enforcement and minority …
What 3 pediatricians think about the civil unrest in Baltimore
While examining a newborn baby for the first time, a mother happened to ask me, “Doc, what was your name?” “Dr. Bailony,” I replied. “Wow, that was the name of my pediatrician as a kid,” she said with a surprised tone in her voice. It turned out that her pediatrician as a young girl was my father, and by random chance …
This pediatrician realizes the power of families
Life is all about beginnings and endings. One of the biggest draws of obstetrics as a medical specialty is the fascination with the birth process as the beginning of life. The other extreme … well, let’s say in this particular place and time in history, it’s still something that catches people unaware. Too often filled with dread and loathing, we approach the death of patients as a foreshadowing of our …
The extremes of primary care can be equally rewarding
Loitering in the hallway of my son’s school awaiting his parent-teacher conference, I completely forgot that the woman introducing herself and shaking my hand was an alcoholic. I forgot that she had visited me in the office a decade prior for a consultation. I forgot all of it.
What I remembered is that we had gone to high school together. We had grown up in the same city, in the same …
A primary care success story: Sometimes our words hit the mark
A chief resident about to graduate wrote the following to me:
I just read — twice — the New Yorker’s review of Henry Marsh’s memoir you tweeted about. Wow.
It seems like he is grappling with so many of the things I’m feeling now, as I’m trying to sort out if I’m trained “enough” to head out into the world. Of …
The self-doubt that every new surgeon faces
In Bill’s room were his doctor, a medical scribe, a physician assistant, and a medical student. Not an imposing group, but in that moment each of them knew more about what was happening to Bill than he did. They were strangers who held keys to his fate.
The doctor first instructed the scribe to generate an electronic note. Then, he turned his …
Shared decisions are important. This example shows you why.
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I tossed and turned during many sleepless nights as a cancer patient. Some nights from nausea, some from pain. Some from sadness, some even from being cold without hair. There were nights where I feared my next surgery or next treatment. Nights fretting about the scan or blood work — had it spread? Would I see my graduation in 3 months? …
Medicine is not only about disease: It’s also about debilitating debt
At my institution, we have a decades-old tradition known as Girls’ Night Out. Once a year, the female surgical attendings treat the female general surgery residents to a night out at a fancy North End restaurant. At its infancy, in the late 1970s, the dinner consisted of the only two female members of the department of general surgery. It has since …
Why are women so underrepresented in surgery leadership?
As someone who has practiced hospital medicine up and down the East Coast for the last several years, I’ve had the fortune of working with some absolutely terrific colleagues. The hospital environment is by its very nature a busy and hectic one — where we all put our heads down and work tirelessly at the coalface for hours on end. Doctors …
Doctors: Be sure to thank the case managers
There was once a woman whom I met for the first time when she came to the ER, on death’s door, metaphorically. I told her and her family just how seriously ill she was, and how slim the chances of survival. We all agreed on that day to take a shot at it — at survival, that is — despite lousy …
We all have the ability to touch other people’s lives every day
There is much to learn as a new physician, but some patients teach you things you never meant to learn. This happened to me a few months ago.
I was taking care of a 26 year old who had an end-stage, inoperable brain tumor that was causing progressive seizure activity. He was admitted with a headache. He had just been discharged about one week ago with similar symptoms. We treated his …
Preserving patient autonomy is the ultimate respect
Physician, heal thyself.
That’s the unwritten rule, sadly, for us. I am a physician. I am therefore invincible and inhuman and all the things my patients cannot be. To seek help is a sign of weakness, and our profession has no place for the weak of body, mind or spirit. We work through illness because our patients deserve that and disease and …
Physician, heal thyself. But is it even possible today?
One of the core components in transforming a practice is team-based care, and this concept consistently is a focus of many conversations among physicians across the country.
My employer, the Quillen College of Medicine at East Tennessee State University (ETSU), also has embraced this concept. And the outstanding group of interprofessional educators with whom I work are constantly looking for ways to enhance not only the way we provide team-based care, …
Team-based training is key to providing team-based care
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