The questions surgeons need to ask their seniors before surgery

Conditions
August 13, 2019

The decision seemed straightforward. Bob McHenry’s heart was failing, and doctors recommended two high-risk surgeries to restore blood flow. Without the procedures, McHenry, 82, would die.

The surgeon at a Boston teaching hospital ticked off the possible complications. Karen McHenry, the patient’s daughter, remembers feeling there was no choice but to say “go ahead.”

It’s a scene she’s replayed in her mind hundreds of times since, with regret.

On the operating table, Bob …

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How to save money when moving for residency

Finance
August 13, 2019

Here are some specific ways for medical trainees to save on their move.

Timing is everything

When is the exact timing of your move? Are you flexible? Think about your situation: you graduate medical school, pack up, and then move for residency. Right?

Most moving companies are busiest (read: most expensive) between May and September when they know you are likely to move. With Match Day in mid-to-late March, getting an early start …

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The doctor trap: What it is and how to escape it

Physician
August 12, 2019

There is a trap used to capture monkeys that uses a tree with a hollowed-out trunk. The opening is just large enough for the monkey to put its hand inside. While the monkey can easily pull its empty hand out at any time, inside the hole is a larger space containing delicious nuts that the monkey craves. When the monkey grabs a large handful of nuts, it is unable to …

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Becoming a doctor in India can be life-threatening

Education
August 12, 2019

Recently, my niece gingerly confided that she was going to study engineering rather than medicine. I was certain she’d become a doctor – so deep was her love for biology and her deference to our family tradition. But she calculated, as would anyone with common sense, that with an engineering degree and an MBA, she’d be working for a multinational company making a comfortable income by twenty-eight. If she stuck …

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Doctors: Step boldly into your calling

Physician
August 12, 2019

We often associate our calling with our career. That’s what I did from the very moment I decided to become a doctor. That’s all I focused on. I studied for it. I invested time and money into it. Like many doctors, my identity was intimately woven into what it means to be a doctor. It’s who I became to the exclusion of everything else.

From the outside looking in, I was …

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Stop nickel and diming doctors

Physician
August 11, 2019

So, who doesn’t want a better health care system?

We are barraged with stories in the medical literature and in the public press about the terrible state of our health care system, what poor outcomes we have, the inefficiencies in care, complaints about the electronic medical record, inflated costs, lives ruined by medical bankruptcy, and massive social inequities in terms of access …

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A doctor survived a day without a computer. Here’s how he did it.

Physician
August 9, 2019

It wasn’t even nine o’clock when the screen on my laptop suddenly froze. From that moment until my last patient left the building, my clinic had no internet.

For my part, the day went pretty smoothly, mostly because of some of my own work habits. It also helped that it was a warm, sunny day, and my schedule was on the light side. Others have frowned at my old-fashioned work habits, …

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Why doctors make bad patients

Physician
August 8, 2019

I’m a doctor. And, like most medical professionals, I’m a bad patient.

Two years after my last appointment, I got a CTJ, “Come to Jesus” from my doctor.

I called his office for a form. I needed proof that I don’t have tertiary syphilis. For my Thai visa.

Why tertiary syphilis, as opposed to HIV, cholera, lepers or bubonic plague? I don’t know. That’s the power of bureaucracies. They don’t have to make sense. …

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Elon Musk’s girlfriend had eye surgery for depression. Is there science behind that?

Conditions
August 7, 2019

Claire Elise Boucher, 31, known professionally as Grimes, is a Canadian singer, songwriter, record producer, and visual artist. Her music incorporates elements of varied styles, including dream pop, R&B, electronic music, and hip hop. Since 2018, Boucher has been in a relationship with technology entrepreneur Elon Musk.

Grimes recently became the star of a new Adidas advertising campaign. In announcing this new …

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Pro tips for residency or fellowship relocation

Finance
August 7, 2019

Each spring, thousands of students and residents will relocate for their next career stages facing the same question: How am I supposed to move my stuff? The answer is varied and can be surprisingly complex.

Relocation is part of any industry, but medical trainees, in particular, relocate during a narrow time frame often without any employer reimbursement.

How does your move fit in with other major life events such as a wedding …

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How to make $5 million from investing in real estate

Finance
August 6, 2019

When I first started working on this blog post, the working title was “Different Ways to Make $1 Million in Real Estate.”

However, I realized that if you’re reading this, you’re likely looking for a similar type of life that I’m interested in: a life of financial freedom where I’m also able to make huge contributions to society as well.

Unfortunately, $1 million may not be enough these days to make that …

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White coats should no longer be worn by physicians

Physician
August 6, 2019

Did you know that the traditional doctor’s white coat that you probably associate with your physician actually was a look that doctors “borrowed” from another profession? Back in the early days of doctoring, to add some perceived legitimacy to the title physician, the white coat look was adopted from our colleagues in the hard sciences who did actual experiments in the lab. If you recall, what we doctors call a “white …

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Who are the best educators for medical students?

Education
August 6, 2019

I shared my assessment and plan with the preceptor as she walked into the room. She cut me off, “You think this patient needs surgery?” she smirked. “He has no idea what he is talking about, don’t mind him,” she whispered loudly to the patient. I kept quiet until the patient left, and my preceptor began writing her note. I pulled up a recent research article I had found prior …

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The importance of patient education before surgery

Conditions
August 6, 2019

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

For years, research and common belief have supported the concept that patient education alters patient behavior and improves patient outcomes. For instance, lifestyle changes, implemented after improved physician-patient engagement and education, have demonstrated clinical benefits in a wide range of chronic illnesses, …

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A critical discussion is needed about planned death

Conditions
August 4, 2019

“Planned death.”

When you put it like that, this can only mean one of two things: suicide or murder. For most of us in medicine, the very idea of “planned death” seems safely outside our purview. After all, the bulk of medicine is concerned with staving off death. And the very nature of death’s uncertain timing enables practitioners of everyday medicine to take refuge in its mystery.

When necessary, we prognosticate. But …

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Physicians need better PR

Physician
August 3, 2019

On July 8, 2019, the American Academy of Emergency Medicine wrote a letter to the American Medical Association, asking the organization to create a public campaign to support physician-led care.

Noting concerns over the recent media crusade to promote nurse practitioner care to patients, including the American Association of Nurse Practitioners “We Choose NPs” campaign, the letter asks the American Medical Association to combat the …

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What The Big Sick says about our profession

Physician
August 3, 2019

“The Big Sick” is an intimidating name for a movie. I never know what to think when “sick” is used as a noun. Does it mean vomit? Are we referring to ailing people? Just as the name doesn’t give you much insight, neither does the beginning of the film. It has nothing to do with illness. It’s about a Pakistani standup comedian/Uber driver who starts dating a white girl, but …

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Roundsmanship: the skill you didn’t know you needed

Physician
August 3, 2019

“What’s the most common missed fracture?” my supervising PA asked during my clinical rotation in the emergency department. “The second one,” I answered confidently. It was the right answer, and I surprised him by knowing it. He had previously given a lecture to my class and had emphasized this clinical pearl in such a way that I knew it was one of his favorite trick questions.

Unfortunately, I didn’t always know …

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When should physicians read the House of God?

Physician
August 2, 2019

Many consider the novel the House of God, written by Samuel Shem (pen name for Stephen Bergman), to be a must-read for any physician or soon-to-be physician. A fictionalized account of his internship year, the book details how the accumulated stress, fatigue, and powerlessness of being a first-year doctor inexorably accumulates during that year — with sometimes hilarious, and but also disastrous, results.

The survival strategies of the interns in …

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