When a mnemonic becomes dangerous

Conditions
April 9, 2020

Fat.

One tiny word. One voluptuous, full-figured concept.

Several weeks ago, amidst a conversation regarding the risk factors for cholelithiasis (i.e., gallstones) during a chief concern small group session for preclinical students, my preceptor ushered in an aurally convenient yet unsettling mnemonic utilizing alliteration that has apparently been in the works among medical education for a while now, known as “the 4 Fs”: female, fertile, forty, and … fat.

Yes, you read that …

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Support your local private practice physician. They’re a small business.

Conditions
April 8, 2020

Small businesses are a vital part of our economy. They are ubiquitous and take on numerous forms, including traditional brick and mortar spaces, kiosks, and online enterprises. They enhance our most basic capitalist principles, such as innovation, entrepreneurship, and competition. Many small business owners give of their hearts and souls, viewing their employees and customers as family. When the COVID-19 pandemic hit and with it the necessary sweeping measures of …

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I am a hospitalist and I love my job

Physician
April 7, 2020

About a year ago, I had an interesting encounter on my way back home to Texas after visiting my parents. I was casually chatting with an older female acquaintance as I got situated on the plane. She asked me what kind of medicine I practice. This woman is in medicine, not a physician, but knowledgeable about the varying specialties. I told her that I was an internist working as a …

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Quotes and songs to help you survive COVID-19

Conditions
April 7, 2020

I’m a cardiology fellow on the frontlines of the COVID-19 pandemic. Like many, I know suffering. In 2017, I lost my father to rapidly progressive dementia. I was postpartum at the time, and he did not even know I was ever pregnant. My stepfather — my father since I was eight years old — the only man who appreciated me and celebrated all my uniqueness and success, passed away …

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Hold on to humanity while we still can

Conditions
April 7, 2020

Washington State has benefited from an early response to COVID-19; organized and isolated, the curve seems to have flattened. Within our hospitals, we continue to prepare for the worst. This includes addressing the reality of limited resources and an insurmountable number of patients, a “crisis” standard-of-care.

For many health care workers, fatigue and fear of exposure pale compared to the emotional toll of countless COVID-19 tragedies. At the forefront of our …

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What does sacrifice in medicine really mean?

Education
April 6, 2020

Just another day as you work into the depths of the night. Medicine engulfs your life as your focus is centered on your responsibilities for tomorrow. You may or may not have time to sit down and enjoy a meal in silence. You may or may not have the opportunity to say good-bye or hello to a loved one. I hope we all had the foresight to realize what we …

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COVID-19 and the Hippocratic Oath

Conditions
April 4, 2020

On a sticky summer day four years ago, a class of eager medical students and I harmoniously chimed the Hippocratic oath, binding us to the highest standards and code of medical ethics.

As newly accepted and unassuming medical students, how could we understand the sacred nature of this rehearsed and recited ‘covenant?’

While pledging the words embedded in this sacred vow, we were completely unaware that the culmination of our medical education …

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My uncle’s battle against COVID-19

Conditions
April 4, 2020

I just lost my uncle to COVID-19. I am writing this to honor him because I cannot leave the country to travel to Canada to see him, I could not visit him in the hospital when he needed us the most, I cannot attend his funeral, and I could not tell him in person how much I love him and appreciate everything he has done for me.

He was …

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The fragile economics of America’s emergency departments

Conditions
April 2, 2020

On the front lines, America’s emergency departments (ED) are currently in at the center of a crisis treating patients with COVID-19.  Emergency physicians and other clinicians are placing themselves and their families at risk. Yet, there is also another important crisis facing hospital-based EDs: surprise billing legislation. Certain forms of surprise billing legislation have the potential have a substantial and negative impact on how America’s EDs are supported, and our …

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The doctor’s budget — remastered

Finance
April 2, 2020

About a decade ago, I had my first doctor-client. And part of what they wanted to discuss was budgeting in order to save more. They just got new jobs and wanted some general planning for the sake of making good decisions.

Software for budgeting and spending history didn’t exist the way it does now. I wanted to provide the best help I could on this topic, and I knew about budgeting, …

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Being a doctor is not what it used to be

Conditions
March 31, 2020

All my life, I’ve been told that I will have job security. No matter what, as a doctor, I will always have a job despite whatever may come. I have chosen one of the most stable and secure jobs that exist. But did I?

Coming from a family of clinicians — seven physicians, two nurses, and one LPN — one would assume that we are safe and secure, for …

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The world is a scary place right now, and that’s OK

Conditions
March 30, 2020

As a society, we are faced with levels of uncertainty that are unprecedented for our times. This tension and fear doesn’t discriminate and permeates every corner of the globe.

People might compare the magnitude of this pandemic to events like 9/11 or Hurricane Katrina, but that misses a key element. The disasters we have lived through in our lifetimes up until now were, of course, tragic and devastating in their own …

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The ethics of being a doctor on board

Physician
March 30, 2020

It was Christmas Eve, and where most people are home with their families, residents are all too familiar with spending holidays inside the hospital. As such, I was traveling back to Austin for an early morning shift on hospital service, when I encountered an ethical dilemma that has stuck with me since.

A mere 20 minutes after the plane took off, I heard the dreaded words: “A passenger requires medical attention. …

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Choose not what’s easy, but what is right

Conditions
March 28, 2020

“Dark times lie ahead of us, and there will be a time when we must choose between what is easy and what is right.”
– Albus Dumbledore

After Voldemort’s return in Harry Potter and The Goblet of Fire, the students of Hogwarts are faced with much fear and uncertainty. Suddenly a future that many had envisioned – progress through school, graduate, find a job – was no longer as straightforward as it …

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Relax documentation requirements during the COVID-19 pandemic

Conditions
March 27, 2020

The Centers for Medicare & Medicaid Services announced several measures guiding the care of patients during the current COVID-19 pandemic. Another important action that will immensely help the health care workers at the forefront is to reduce the documentation requirements for all patients. Health care workers should be unshackled from endless documentation, freeing up their time and resources to take care of the increasing number of …

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In the midst of COVID-19, triage is a four-letter word

Conditions
March 27, 2020

In my career as an outpatient family physician, triage is not something that I commonly do. But now, with the COVID-19 pandemic in full swing, it seems the large percentage of my day is spent in triaging patients. And I have to say, I don’t really care for it. (This is an understatement. I’m trying really hard not to use other four-letter words in describing how I truly feel.)

In my …

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COVID-19 is rattling the nerves of preemie parents everywhere

Conditions
March 27, 2020

As I write this, hand sanitizers, disinfecting wipes, gloves, and masks are sold out everywhere in the panic over COVID-19. People are writing about increased anxiety, and mental health professionals cite a massive surge in requests for help.  Go anywhere, and it is not unusual to see people wearing personal protective equipment. Welcome to my world 16 years ago when my daughter was born prematurely at 30 weeks’ gestation …

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