Practicing medicine full-time in America is very difficult. It’s time to think outside the box.

Physician
July 4, 2019

Talk about physician burnout and job dissatisfaction is everywhere right now. If you are a doctor, you cannot escape the news. Within the last couple of weeks, organizations in Massachusetts (a mecca of healthcare and hospitals) declared physician burnout a “major public health crisis.” This all sounds rather dramatic. On the surface, physicians are reasonably well paid, still enjoy a good degree of autonomy (certainly compared with many other …

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Why is it so difficult for Americans to make doctors’ appointments?

Policy
July 3, 2019

Jill Ladkin was already having a terrible autumn. It began with a seizure that put her in the hospital with what seemed like scores of unfamiliar physicians attending to her state of health. The brain scan revealed a mass in the lining of her brain, a location usually signifying a benign tumor; but, given her seizure, the tumor was hardly what you would call a harmless growth. The surgeon had a theory of what …

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You’re lucky to have a medical student in the family

Education
July 2, 2019

One of the most common experiences faced by a medical student is being asked for health care advice from a friend or family member. My initial reaction to these questions is usually something along the lines of, “Are you sure you want to be asking me that? I’m not even a doctor yet!” This is especially true when the question is about something that I’m not particularly experienced in (which, …

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A key strategy to use for difficult conversations: Ask questions

Physician
July 2, 2019

No matter what profession you are in, having uncomfortable and difficult conversations is something you have to get used to. Tim Ferris said in his bestselling book, The 4-Hour Workweek (which I’d highly recommend), “A person’s success in life can usually be measured by the number of uncomfortable conversations he or she is willing to have.”

It could be with another colleague, a client or customer. Even in your personal …

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Physicians are problem solvers and artists

Physician
July 1, 2019

I keep thinking about the dichotomy between covering a lot of ground and getting to the point.

The other day I saw my bosses at one of my clinics stop in their tracks when I suggested that a lot of the things we are measured on as physicians could be turned into standing orders and simply get shifted off my plate. I have just created a letter that anybody can send …

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What to do with physicians who don’t explain

Physician
June 29, 2019

How doctors treat patients’ need for information has changed significantly over the past decades. Sixty years ago medical practice was much more paternalistic than it is now, although some would say it continues to be so in important ways. Still, not too long ago it was common for doctors to tell patients or their families next to nothing about what was going on. The presumption always was: the doctor knows …

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A diagnosis of pneumonia in a rehab facility: We can do better

Physician
June 28, 2019

I’ve known Pat McCann (identifying information changed) for many years. He carries a diagnosis of COPD and has a preventative and a rescue inhaler, but he has never really had any serious flare-ups.

He fell and broke his hip. Then he went to skilled rehab, one of a half dozen near Cityside Hospital. His stay turned longer than expected because he fell, luckily didn’t break anything, but had to go back …

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10 tips for success after you finish residency

Physician
June 28, 2019

If you’re done with your residency or fellowship, you’ve paid your dues. And I am excited for you. Life is about to get better. A lot better.

If you read my prior article about going unmatched, you know that things have not always gone smoothly for me. But now, after a reasonably good first year out of training, I feel compelled to reflect on why things are going well, and also—to offer any …

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Physicians: Do not be intimidated by administrators

Physician
June 28, 2019

A piece of advice I would give to any younger physician, especially one who is just graduating residency, would be to expect a whirlwind ride into the realities of frontline medical practice. It’s something that you are totally not prepared for in the controlled environment of education and residency training. A steep learning curve awaits you once you start practicing medicine. And one of the biggest things you will have …

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How climate change affects your skin

Conditions
June 27, 2019

Global climate change is reaching a critical mass.

Since the advent of the industrial revolution, we have seen the global mean temperatures increase by 1°C (1.8°F), and significant steps must be taken by 2030 to mitigate an even larger global temperature increase of 1.5 to 3C as predicted by 2030. In other words, we are in dire need of change.

This change is not only reliant on governmental policy change but is …

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5 confessions of a medical student

Education
June 27, 2019

I’ve finally stopped thinking about the process of getting into medical school. But with friends going through the application cycle, waiting on and making decisions, I’ve been reflecting on my process and remembering just how terrible the whole thing felt. To offer some support to those going through it, I wanted to confess a few things. These confessions feel silly and small in retrospect, but I hope they’ll help at least one …

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A physician volunteers with migrants. Here’s what she saw.

Physician
June 26, 2019

“At least seven children are known to have died in immigration custody since last year,” according to a NBC News report last month.

I recently spent a Saturday working with amnesty-seekers that had been detained at California detention centers in the desert. They were dropped off at bus and train stations in the desert in Southern California, most with no money and no ability to …

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How becoming a doctor can help and hurt the ability to build wealth

Finance
June 26, 2019

I recently graduated from medical school and will soon start residency. Yay! Although I’m happy with my decision to become a doctor, I can’t help but notice that there are several ways that going to medical school and becoming a physician helped — and hurt — my ability to build wealth.

Ways it helped me build wealth:

1. I will have a high income. Most of us doctors will make at least …

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Travel during residency: perspective of a resident’s spouse

Physician
June 26, 2019

My husband and I are nearing the completion of a fifth and final year of residency. I say “we” because, as all residents know, the training years involve the entire family. As I reflect on the struggles and successes over the past five years, there are a few things that I know have helped us cope with the challenges, and one of those things has been travel.

We made significant life …

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Concussion treatment centers: 5 red flags to watch for

Conditions
June 25, 2019

The incidence of brain trauma has been rising in recent years. According to the Centers for Disease Control and Prevention (CDC), emergency department visits related to traumatic brain injury (TBI) increased by 53 percent in the U.S. from 2006 to 2014. For 2014 alone, the CDC reported about 2.87 million TBI-related visits, hospitalizations, and deaths. Reports of concussions in high school athletes have also increased in recent …

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How to have an exciting death: 5 tips from a palliative care physician

Conditions
June 25, 2019

We’re all gonna die.

It’s a simple truth that an astounding number of people neglect to acknowledge or accept. Some people die sudden, unexpected deaths, but most eventually fall victim to chronic or terminal conditions like COPD, heart failure or cancer. As a palliative care physician, I often meet patients who have had conversations with their families about their end of life wishes and have completed supporting legal documents.

While I appreciate …

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What should a cure for cancer look like?

Conditions
June 23, 2019

Words have meaning. And when it comes to cancer, especially advanced cancer, there aren’t many words that have more meaning than the word “cure.” It is that very word and concept that is top of mind for some of us these days.

We clinicians are guilty as charged when it comes to reluctance declaring those who have had a remarkable response to treatments for advanced cancer “cured.” Experience has taught us …

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