The immediate impact of the transition to a pass/fail Step 1 exam

Education
December 1, 2022

Historically, students’ three-digit scores on the United States Medical Licensing Exam (USMLE) Step 1 were a main factor in determining competitiveness for residency programs. In February 2020, the world of medical education shifted drastically when it was announced that the USMLE Step 1 would transition to a pass/fail scoring system. One of the main factors driving this change was that medical students and residency programs were attributing too much …

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Why even doctors need regular doctor visits

Physician
December 1, 2022

After a great game of doubles tennis, a good friend brought up a recent visit with his primary care physician while sitting with friends, trying to cool down. He expressed appreciation for his position but complained about the need to see his doctor every three or six months, all the while acknowledging various medical problems being addressed.

This led to general comments by several non-physician friends about how they feel that …

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Effective doctors need to be challenged [PODCAST]

Podcast
November 30, 2022
YouTube video

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“Empathy, intelligence, and commitment are crucial traits every doctor must have to succeed. However, there is one trait that stands above the rest. One of the most important aspects of an effective doctor is the desire to …

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Prudence and promise in psychedelic-assisted therapy

Meds
November 30, 2022

Psychedelic-assisted therapy (PAT) represents one of the most promising developments in psychiatry in decades. The treatment typically involves the infusion of a compound such as LSD, psilocybin, or MDMA during an extended therapy session with licensed professionals.

Although it lacks widespread regulatory approval or clinical use, significant advances have been made in the study of PAT in the past decade, with a pronounced increase in recent years. Recently, a Read more…

A doctor’s grief

Physician
November 30, 2022

Last evening I crumbled in the arms of my patient and wept. This was unknown territory to me, an unexpected role reversal. For three weeks after my Mom’s death, I maintained a stoic distance as patients offered their condolences, as they asked about my mother, and empathized. We doctors have been trained to do this, to face death, to keep our emotions at arm’s length. But this patient, who has …

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When your letter to the editor is rejected or ignored

Physician
November 30, 2022

Dear Dr. El-Dalati,

I am sorry that we will not be able to publish your recent letter to the editor regarding the Chowdhury article of 16-Sep-2021.  The space available for correspondence is very limited, and we must use our judgment to present a representative selection of the material received.  Many worthwhile communications must be declined for lack of space.

The response from The New England Journal of Medicine (NEJM) seemed simple and …

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Let doctors in recovery be able to recover their careers [PODCAST]

Podcast
November 29, 2022
YouTube video

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“During addiction, the brain becomes ‘hijacked,’ which then ‘exaggerates the need for the drug and minimizes the dangers associated with the use of the drug.’ This is so affirming because the chemicals in my brain told me …

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What is cognitive load? How can we help clinicians manage it?

Sponsored
November 29, 2022

This article is sponsored by the Nuance Dragon Ambient eXperience. AI-driven ambient clinical intelligence (ACI) promises to help by revolutionizing patient and provider experiences with clinical documentation that writes itself.

What is cognitive load?

Cognitive load is a psychological theory that deals with how the human brain uses its working memory, how …

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5 tips for treating seasonal depression during the holidays

Conditions
November 29, 2022

Although the holidays are typically associated with feelings of joy and thankfulness, it is imperative that people should not automatically assume these emotions are commonly shared. Three percent of all individuals are impacted by seasonal affective disorder (SAD) during the holidays – a statistic many people are unaware of. The media promotes an unrealistic expectation that everybody should be happy during this time, but this is not the case …

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The most valuable health care companies of tomorrow will be technology companies

Tech
November 29, 2022

I’ve always been curious about the top 0.1 percent.

Their mindsets, backgrounds, upbringing, perceptions, skills, and behavioral traits that got them there.

After living through the Dot-com bubble, 9/11, Enron-WorldCom, the 2008 financial crisis, the meteoric rise of technology (search, e-commerce, social media, sharing economy), and the rise of a new class of billionaires, I intuitively sensed that there was a disconnect between what was going on in the real world, and …

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A physician’s remedy for stress, anxiety, depression, and burnout [PODCAST]

Podcast
November 28, 2022
YouTube video

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“My own burnout episode forced me into some heavy-duty soul-searching and serious reflection. I got lost in the world of seeing as many patients as possible, battling for more operating room time, and keeping up procedure volumes, …

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The transformative power of EMDR

Conditions
November 28, 2022

I became a self-involved status and achievement “junkie” in order to tune out unbearable inner voices that repeated, “You are worthless … you’re a fraud … you’re a failure.” I was obsessed with grandiosity: I owned a penthouse apartment with a landscaped terrace, a closet full of Brooks Brothers suits, a family crest ring, engraved stationery from Tiffany & Co., monogrammed dress shirts from Charvet in Paris, and towels from …

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Stop calling it the good cancer

Conditions
November 28, 2022

“You have the good cancer.”

These are the most common words that spill out of providers’ mouths to patients just being diagnosed with papillary thyroid cancer. However, this statement does not make this diagnosis any easier to comprehend and digest the life-altering news that has been received by the patient. The survivability rate for this cancer is a high percentage; that is good news, but not good cancer. An issue at …

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For me, COVID has a face

Conditions
November 28, 2022

I’ve moved recently, and in the process of moving, invariably, one discovers old items. This had gotten shelved in the fracas of those years, work changed overnight, changing employers, moving. However, in a discussion with a close friend today, this resurfaced as she’s grappling with patients and family who are not seeing what she’s seeing.

Summer 2020

It’s another Sunday night family dinner. Conversation centers around catching up on the latest family …

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What anticipatory grief feels like [PODCAST]

Podcast
November 27, 2022
YouTube video

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“I experienced many deaths when I was a nurse, from babies, kids, young adults, the elderly, and my own family. It was always heartbreaking, but I found that staying with the dying and the family and supporting …

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Has medicine lost its why?

Physician
November 27, 2022

From the halls of ancient Greece to the heights of television screens, the myth that the physician is more god than mortal has stood the test of time. As such, we are held to moral and superhuman standards no matter how tough things get. And thanks to our friend Hippocrates, we are oath-bound in our virtues to help anyone in need; while putting OUR personal needs aside, of course. Many …

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It’s called crying and it’s normal

Physician
November 27, 2022

Doctors treat people in all types of situations. Life or death. Sometimes both. Babies die, children die, and teenagers die. Women die. Men die. Sometimes you even have the misfortune of delivering a stillborn. Everyone experiences death, but for doctors, it’s part of our daily norm. Day after day, for decades throughout their career, we have to experience death and the pain of others. Beyond being knowledgeable and competent in …

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Don’t lie about medical errors. Apologize.

Conditions
November 27, 2022

Time of death: unknown.

It was around 6 p.m. on April 21, 2013.

My mom saw my grandfather dying slowly in the hospital bed.

She had pressed the nurse call button frantically over the last 20 minutes.

She rushed to the nurse station only to find out nobody was there.

She went back to my grandfather and spent the last three minutes with him.

She was the one who saw my grandfather’s bpm (beats per minute) …

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Opioid-free orthopedic surgery [PODCAST]

Podcast
November 26, 2022
YouTube video

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“How do we manage this? All patients meet with the physical therapist before surgery and within two days after surgery. They use transcutaneous electrical nerve stimulation (TENS) before and after surgery. They get a regional anesthetic block …

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The impact of hand surgery on human identity and expression

Conditions
November 26, 2022

One weekend, while taking hand trauma call, we received a pre-arrival page about an incoming patient, a plastic surgeon, who had injured himself while moving a glass table. The information we received was devastating — a wrist laceration through the median nerve of his dominant hand. After his arrival in the ED and the formulaic introductions at the beginning of any encounter, he frankly asked, “So, honestly, do I need …

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