Our specialty of hospital medicine has grown exponentially over the last decade and now finds itself at the forefront of American medicine. I’m proud to be part of such a growing movement and must say that I find the job just as rewarding as when I first became an attending physician when the specialty was still in its fledgling stage.
As the number of us soars towards the 50,000 mark, the …
Hospitalists: It’s time to be more exclusive
“You have the nurse hand you the equipment, that way she doesn’t just stand and stare like a chaperone,” my doctoring mentor explained to me before we entered the room to do a pap smear on a young, 35-year-old woman. My doctoring mentor is a middle-aged, 6-foot-5, exceptionally hairy, broad-shouldered man that carries a warm, jovial presence. Yet the reality of the fallen world is that no matter how sweet, happily …
As a doctor, I need to understand power, trust, and pain
Like most of my age cohort, I was brought up to believe that the great Satan threatening to undermine the bloated American health care system was our broken-down, antiquated, self-interested model of reimbursement for care provided called “fee-for-service.” Being a professional who, to the best of my ability, tries to maximize the value of the care I provide to my patients, I subscribed wholly to the notion that the cause …
Is there a role for doctors in the brave new health care world?
Recently, I had the opportunity to sit at the table with some of the nation’s top thought leaders. We convened at the Newseum in Washington, DC, for the Healthcare Leadership Council’s National Dialogue for Healthcare Innovation; it was like a health policy nerd red carpet. Center for Medicare Director Sean Cavanaugh was there. Leapfrog Group CEO Leah Binder was there. America’s favorite bioethicist–oncologist–
What exactly is value in health care?
It’s hard enough to sustain a good relationship when neither partner is facing a health challenge. Illness ranks high on the list of life’s stressful events, so it’s no surprise that it can have a negative impact on a close relationship. Couples may benefit from counseling, one of the principal reasons being that the presence of a neutral party in the room can facilitate more calm and constructive communication.
What follows …
Tips for resolving conflicts when a partner is chronically ill
3-D printing has been documented as an innovation that’s being rapidly deployed in the medical field. Doctors and researchers have been creating intrinsically realistic models of organs, bones, appendages and sometimes, implanting them into patients. In 2012, University of Michigan doctors implanted a splint to hold open a 3-month-old child’s airway tube. They published their results in the New England Journal of Medicine and opened the gates for others to …
Are 3-D printing and the gamification of medicine good for patients?
Perhaps we thought we could get away with ignoring the relationship between doctors and patients. The Kaiser Health News article, “Efforts to Instill Empathy Among Doctors is Paying Dividends,” explains why we can’t.
Patient satisfaction scores and reimbursements aside, this relationship was once considered the cornerstone of quality care.
Doctors are healers but in recent years many have been reduced to diagnosticians, electronic medical records (EMR) data entry clerks, and health …
The doctor-patient relationship with dying patients
1. Be yourself and learn to be flexible. Don’t ever change who you are as a person. It’s OK to have a personality of your own. If you secretly listen to Taylor Swift’s Shake it Off on the way to work, it’s OK. As a junior member of the team it’s very unlikely your iPhone playlist will make the cut for the operating room …
10 secrets to success as an academic surgeon
Experiment 1. Stop five random people on your way to work and ask them to name the top public advocates of health and wellness that come to mind.
Do I dare speculate that more than a few would mention Dr. Oz. Or Jenny McCarthy?
Experiment 2. Stop five medical colleagues and ask them to list their top physician writers and journalists.
Do I dare speculate that more than a few would only have …
Older physicians should write. Here’s why.
If it weren’t for the coming together of people from all over the globe, the influenza pandemic of 1918, also known as the Spanish Flu, would not have had the devastating effect that it did. It is estimated that at one point this deadly strain infected one out of every five people on earth and ended up claiming the lives of approximately fifty million people (in comparison, nine million combatants …
Drinking diarrhea to save lives
I’m in a room full of doctors at my mom’s 50th medical school reunion when I announce, “It’s almost March 30th!” I pause. “Doesn’t anyone know what March 30th is?” Nobody has a clue.
March 30th is National Doctors’ Day! Who knew? I never heard of it — until a friend told me last week.
Veterans know about Veterans Day. Mothers know about …
It’s March 30th. Have you hugged your doctor?
Recently, I was asked to fill a questionnaire during check-out at a hotel in India. I was very pleased with my stay, so I agreed to provide feedback. It is worth pointing out that if I was only mildly satisfied I would not have agreed. If I was disappointed with my stay, I would have filled the form more enthusiastically.
When I …
Awesome is the new average: The problem with patient satisfaction
At age 37, after a nearly 2-year battle with stage IV lung cancer, a talented neurosurgeon lost his battle. My oncology-related newsfeed is filled with stories this week about this brave and clever man’s recent passing. In a field where the recent tweets tout results of the latest clinical trials (overall survival prolonged from 2 months to 4 months!), it is sobering to be reminded of what truly matters to …
Paul Kalanithi: A neurosurgeon leaves his mark on our hearts
ADVERTISEMENT
An excerpt from The Real Doctor Will See You Shortly. Warning: Contains explicit language.
It started with a banana peel.
After years of quiet study in the libraries, laboratories, and lecture halls of Harvard Medical School, I finally made the tectonic shift to hospital life in the summer of 2006. The third year of medical school marks a …
Ground rules for the aspiring surgeon
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 55-year-old man is evaluated for a 6-year history of typical gastroesophageal reflux symptoms treated on an as-needed basis with a proton pump inhibitor. However, the frequency of his reflux symptoms has recently increased and his episodes do not respond to treatment as completely as in the past. An upper endoscopy is …
MKSAP: 55-year-old man with gastroesophageal reflux symptoms
The July Effect is a relatively well-known reference to the influx of new trainees entering hospital systems annually on the first of the month. Researchers have attempted to investigate the impact of the new trainees on patient outcomes with divergent conclusions. Despite the ongoing debate, educators in medicine recognized the need to prepare medical students for day 1 of residency training, by establishing core competencies to evaluate the preparedness of students. One such example …
The medical student catch-22: Preparedness for residency vs. patient safety
The girl seizes.
Her body torques and twists and jerks about like a snake trapped on an electric fence. She flops back and forth on the gurney before us, her pale forehead glistening with sweat, her brown hair wetted black from the effort of muscle contractions that threaten to tear apart her tiny frame.
Trauma room two is silent save for the gluck-gluck-gluck of her …
Break seizure break. I repeat it in my mind. Again. And again.
One of the most revolting pleasures in life is to read learned opinions and in-depth analyses of consumers’ behavior written by beautiful people clad in designer clothing, dining at eclectic chic trattorias or enjoying the occasional canapé under crystal candelabra at their favorite charity gala. These wondrous creatures, having pored over a few disjointed numbers selectively allowed to escape from our struggle with health care, are informing us that there …
Health care consumer products need not contain real doctors
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 44-year-old man is evaluated during a routine examination. He is concerned about his general health and risk of diabetes mellitus. He has no medical problems. Both parents and his sister have type 2 diabetes mellitus.
On physical examination, temperature is normal, blood pressure is 130/79 mm Hg, pulse rate is 66/min, and …
MKSAP: 44-year-old man with a family history of diabetes
Does the profession of medicine favor certain personality types over others?
When I was younger, it seemed like all of my doctors were gregarious, self-confident, and humorous, leaving me to wonder if one can “make it” in medicine without being outgoing. This seemed a natural consequence of the fact that so much of medicine is team-based and demands constant interpersonal interaction with colleagues and patients. For many introverts, a career in …
Can introverts survive in medicine?
Get free updates delivered free to your inbox.
