A case for nephrology

Physician
February 7, 2020

In recent times, physician burnout has rightfully surfaced as a social concern for the medical fraternity. Physician burnout is a thing, and lately, I was thinking about it related to nephrology.

Many national physician organizations and local hospital systems are developing strategies to reduce work-life stress and improve the engagement of the workforce. In November 2018, I represented the Renal Physician Association at the interim meeting of the American Medical Association …

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Reconciling consent culture and bodily autonomy with pediatric care

Conditions
February 6, 2020

Every day, children are cared for in clinics and hospitals. And every day, some of them are unhappy about it; some of them deeply unhappy about it.

The contemporary practice of nursing and medical care includes health care providers having to touch their patients. This may include an abdominal exam, listening to their lungs with a stethoscope, or even slightly invasive maneuvers, such as having to put an otoscope into their …

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How to build trust and therapeutic relationships in 15-minute office visits

Physician
February 5, 2020

It is well known by now that a physician’s demeanor influences the clinical response patients have to any prescribed treatment. We also know that even when nothing is prescribed, a physician’s careful listening, examination, and reassurance about the normalcy of common symptoms and experiences can decrease patients’ suffering in the broadest sense of the word.

This has been the bread and butter of counselors for years. People will faithfully attend and …

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Stressed is desserts spelled backward

Physician
February 5, 2020

Tiramisu, chocolate mousse, red velvet cake, freshly baked cookies, and warm brownies topped with ice cream. These are some of my favorite desserts and the things I start thinking about when I am under intense stress. I often gaze at the bakery section at the grocery store just to take a look when I feel overwhelmed with stress at work or home. It is the classic description of what we …

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The doctor who avoids answering your questions

Physician
February 3, 2020

Most of us are, to some degree, procrastinators. We avoid or postpone doing unpleasant things. In this sense, physicians who are avoiders are no different from anyone else. For a doctor, however, avoiding things often leads to poor, or at least less than frank, communication with parents.

One kind of avoidance behavior is when the doctor avoids answering your questions. These doctors do not behave this way because they are poor …

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The questions people ask medical students

Education
February 3, 2020

Wow, you’re in medical school? So you are going to be a doctor? What year are you? When are you going to finish? What are you going to go into?

You should become a skin doctor, what do they call them again? It doesn’t matter, but they do good. But they are not real doctors, so maybe it’s not worth it.

You should become a doctor that gives vaccines. Are vaccines real? …

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A medical student’s advice for clinical rotations

Education
February 2, 2020

As a rising fourth-year med student, these are my words of wisdom for all students who are on their clinical rotations.

Your mental health is paramount; do not neglect how you are feeling!

There is not one med student that I know of who hasn’t felt anxiety, paranoia, or depression. Some of your peers may even be diagnosed with psychiatric disorders and take medications. And that is OK! As a mentor of …

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Black Man Syndrome: in memory of Bryce Gowdy

Physician
February 1, 2020

He came to the office in search of help as many patients do, but the circumstances that compelled him to seek medical attention were all too similar to me. I’ve seen it time and again. He said that he couldn’t sleep at one visit. At another, his blood pressure was high.

At a visit after that, he’d share more information, and his wife would attend with him. He wasn’t making enough …

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Black boxes: health warning or profit warning?

Meds
February 1, 2020

“Boxed warnings” or “black boxes” are the strictest FDA label warnings. They appear on cigarettes, fluoroquinolones (for tendon rupture), Lamictal (for SJS and TEN), Accutane (birth defects), and other products with well-known risks.

The industry obviously dislikes black boxes since they reduce sales (though their lobbyists charge the boxes “confuse” and “unnecessarily alarm” patients).

So it was no surprise that when the Read more…

Doctors, a tech revolution is coming

Tech
January 31, 2020

What if I told you just a few years ago that Amazon — a budding e-commerce startup — would come to disrupt the multi-billion dollar retail industry.

I seriously doubt that anyone could have given it a serious thought. At least not in the magnitude that will force a slew of big-box retailers to shut their doors for good.

I am sure the same response would have been elicited about Uber and …

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Nurses are sick of being treated like hotel workers

Conditions
January 31, 2020

“Compassion fatigue” is a phrase thrown around easily when talking about the health care professions. It is often spoken in the same breath as “burnout” and “turnover” while discussing the crisis of a diminishing workforce and increasing demand in health care.

The phrase brings to mind the burnt-out nurse who doesn’t have the emotional energy to care anymore. I can see her: deep frown lines, flat facial expression, dimmed eyes.

The light …

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Why every physician should be on YouTube

Social media
January 30, 2020

If you talk to anyone you know, it’s very likely they will tell you that they are on some form of social media. Whether this is Facebook, Twitter, Instagram, Snapchat, TikTok, or YouTube, most people are on at least 1 to 2 forms of social media these days.

Video is one of the most powerful tools in marketing. According to Google, 64 percent of consumers use video to research health care …

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There is no such thing as medical swag

Physician
January 30, 2020

A recent excellent piece by Dr. Karen Sibert, an experienced anesthesiologist at my institution, raised some critical issues regarding how physicians are thought of by non-physicians, and how misguided that thought process is. Indeed, our stress levels associated with the moves we make and the decisions we contemplate, some of which are made and done in milliseconds, do not come with a price tag, but do …

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Here are the common ways that doctors can practice medicine

Physician
January 29, 2020

When I finished my training, I wish that I had known all of the options I could practice medicine.  Most of us categorized our options as either “academic” practice or “private practice,” but in reality, these two options only cover the tip of the iceberg.  Was my limited understanding a shortcoming of my medical training?  Perhaps.  I doubt that many medical schools back then actually had seminars on practicing medicine. …

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Are you happy with your decision to go into medicine?

Physician
January 28, 2020

On a rare Sunday morning, I woke and had the time to make breakfast for my kids and their cousin, who’d stayed the night. My nephew said, “Thanks, Aunt Erin, I feel like I never see you.”

To which my oldest (10) stated very matter-of-factly, with no ill-intent: “That’s because she’s never home.”

Being a full time, private practice physician and mom to 5 kids, with a healthy social life, it’s extremely …

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How do you know if you have hypertension and need medication?

Conditions
January 27, 2020

High blood pressure is the silent killer. It puts people at risk for heart attacks, strokes, vascular disease, kidney failure. It is basically really bad to have longstanding, undertreated high blood pressure.

But it is also harmful to be told you have high blood pressure when you don’t, and to be treated for high blood pressure when that treatment won’t benefit you. So when your doctor diagnoses you with high blood …

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Physicians are not incentivzed to talk with patients on the phone

Physician
January 25, 2020

Talking to patients on the phone can be very efficient and quite rewarding, like when I called a worried patient today and told her that her chest CT showed an improving pneumonia and almost certainly no cancer, but a repeat scan some months down the road would still be a good idea. She told me she was feeling better, but still quite weak and that her sputum was still dark …

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Making humanism in medicine more humanistic

Physician
January 23, 2020

Kahlil Gibran writes, “In friendship or in love, the two side by side raise hands together to find what one cannot reach alone.” What types of outcomes can physicians and patients achieve in healing, living, and life when Gibran’s message is incorporated into the physician-patient relationship? Can humanism in medicine become even more humanistic?

“Humanism in medicine” is characterized by the Arnold P. Gold Foundation as respectful …

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Beyond red flags: Beware of black butterfly warnings

Conditions
January 23, 2020

I’ve just discharged a kid with a cough, and there are no patients waiting to be seen. “I’ll be back,” I tell the nurse, as I slip away to the hospital kitchen and unlock the door. I steal two frozen grilled cheese sandwiches from the freezer and throw them into the microwave. Minutes later, I’m in the call room.

I take a couple of bites and can already feel acid rising …

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