Patients are used to seeing physicians who are not their doctors

Physician
October 27, 2019

Nowadays, patients are used to seeing physicians who are not their doctors. Often, patients may be seeing a nurse practitioner, a highly trained professional for their medical care, instead of a physician. A generation ago, patients nearly always saw their own physician, including if a patient was hospitalized. Imagine that: Your own primary care doctor sees you in the hospital, an event that occurred when dinosaurs roamed freely.

The medical universe …

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When we walk into a patient’s room, we are entering a story

Physician
October 27, 2019

The doctor opened the door after a gentle knock. He was greeted with warmth, offered a seat by Mary, and promptly sat down on the end of the hospital bed. As he sat, the family stood to greet him. They discussed the grandkids, the trips taken since they last saw each other. The room felt peaceful. Time slowed down.

Walking in behind my attending, I had been ruminating about the lengthy patient list, the work to be done. Then …

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Don’t use stimulants to cram for exams. It ruins sleep and doesn’t help test scores.

Meds
October 26, 2019

Along with a steeper financial burden and an increasingly competitive academic environment, this year’s incoming freshman university class will likely be confronted with the pressure to take a little pill that some popular culture references say will make you “awesome at everything.” Or they may eschew the temptation and rely on the standard practice of study, sleep, repeat.

Welcome to #GenerationAdderall, the …

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How best to support, honor, and show gratitude for your mentors

Physician
October 26, 2019

I recently had the amazing opportunity to both witness and participate in an event where my Children’s Hospital of Philadelphia (CHOP) pediatric mentor received a lifetime achievement award for her many years of exemplary service to the pediatric community of Southern New Jersey.

My mentor’s leadership, compassion, and dedication to serving the Latino community have set an example — not only for patients and their families but for generations of pediatricians …

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What does cable news do to your brain? A neurosurgeon explains.

Conditions
October 25, 2019

The availability of up to the minute information, presented 24/7/365, could assist a democratic society in making the best choices in determining its future. That was the promise of cable news. Unfortunately, cable news has fallen short of its potential and has led to the further polarization of America. More than that, it has changed the way your brain works. Not for the better!

The various cable …

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Can CRP testing guide antibiotic decisions?

Conditions
October 25, 2019

In response to concerns about the unnecessary use of antibiotics, researchers have sought to identify simple, non-specific tests to help clinicians determine which patients require antibiotics and which do not. Indeed, such tests could facilitate challenging management decisions, which currently rely predominately upon a thorough clinical assessment. To compound the challenge, patients often have pre-conceived ideas about whether or not …

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A framework for understanding health care systems

Policy
October 25, 2019

First in a series.

Way back as a business strategy undergrad and then as a medical student, I developed a framework for understanding health care systems. I call it the Healthcare Incentives Framework, and I believe it clarifies the big-picture components of health care systems that people need to grasp to be able to understand the sources of problems, which then leads to appropriate solutions. The whole thing cannot be explained …

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The Resident and Fellow Bill of Rights

Education
October 24, 2019

Last June, I became a freshly-minted young doctor, bright-eyed, and enthusiastic about heading off to my dream residency program. By August, I found myself crossing the street on my way home, wondering if I had made a horrible mistake that could have harmed a patient. The most painful thing was, I hardly had the energy to care.

This is not why I chose to dedicate myself to medicine.

Like many medical trainees, …

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Why electronic medical records should be standardized

Physician
October 22, 2019

How can we possibly get to standardization in medicine? And is that a good thing?

Standardized checklists save lives; rigid procedures for sterilization of equipment saves lives; universal compliance with recommended beneficial treatments saves lives. And while it’s sometimes a wonderful thing to let a surgeon solve a problem creatively or to allow a patient visit to go overtime in order …

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Why this physician never tells anyone she’s a doctor

Physician
October 22, 2019

I’m an ER doc, and proud of it. But I never mention it when I meet new people. Unless someone’s fixing to die, I avoid it like the plague. “I work in a hospital,” I say. “Where in the hospital?” “The ER. How about you?” That’s a topic changer, since most people would rather talk about themselves.

Why not own it, you ask? There’s no shame in being a doctor. It’s not like …

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4 significant misconceptions about universal health care systems

Policy
October 21, 2019

Recent polls show a majority of Americans support Medicare for all, but few seem to realize that no other system in the world operates like the current single-payer proposals in Congress.  I addressed the concept of single-payer health care, with Cuba’s system as an example.  Today I’m writing more about the ideas being discussed now in our country and how those compare to other nations that provide …

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When you’re a physician, you’re a detective

Education
October 21, 2019

A professor recently romanticized my idea of clinical reasoning as he began our session by saying, “When you’re a physician, you’re a detective.” He elaborated: “Every fact you have, every piece of evidence you have, must be consistent with your leading diagnosis.” As he said this, my eyes narrowed, and I sat up a little taller.

My fellow first-year medical students and I have begun our official training in clinical reasoning, …

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A father-physician tests if a little peanut a day keeps allergy away

Conditions
October 20, 2019

No one I knew had food allergy, let alone peanut allergy, when I was a child. I grew up at a time when peanuts were given freely on airplanes, and there was no such thing as a peanut-free table at school. Fast forward to today and the world has changed, with food allergies taking on almost epidemic-like proportions.

I am an allergist and became interested in food allergies …

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Why this medical student chose to pursue medicine

Education
October 20, 2019

Pain and suffering together is a universal language. It is unspoken, one that a person of any age feels when they see a loved one die, or when someone sees another human being suffer when nothing more medically can be done.

I once saw a Vietnam War veteran who, within a few years of returning home, suffered from a hemorrhagic stroke. He was robbed of his ability to walk, to talk, …

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How “Joker” gets mental illness wrong

Conditions
October 20, 2019

Spoiler alert: Plot points of the movie “Joker” are revealed.

“Joker” opened to a mix of rave reviews and criticism on October 2, 2019, amid fears of mass-shootings at theaters in the U.S.

This left law enforcement agencies scrambling to beef up security at movie theaters to prevent any untoward incidents. Quite ironically, October  2, is also the 150th birthday of Mahatma Gandhi — the crusader and champion of non-violence.

Warner Brothers even …

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Why the flu shot cannot give you the flu (and why you should get one now)

Conditions
October 19, 2019

Flu vaccination prevents millions of flu-related illnesses and deaths annually, but vaccination rates are low for many reasons.

During the 2018-2019 flu season, the Centers for Disease Control and Prevention reported that about 45% of U.S. adults received the flu vaccine. While this is an increase of 8% from 2017-2018, it falls way below the national goal of 70% of American adults …

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Get rid of the guilt. You matter as a physician.

Physician
October 17, 2019

“When you start seeing your worth, you will find it harder to stay around people who don’t.”
– Unknown

After graduating from my residency a few years ago, I accepted a job within my organization as a staff psychiatrist and a medical director.

The idea of familiarity was a big driver in my ambivalence towards pursuing alternate opportunities, even when they came knocking on my door. As the job started and progressed through …

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