What happens when doctors discriminate against patients?

Physician
June 19, 2019

Physicians have a long history of discriminating against patients, and racial discrimination only scratches the surface of current problems facing patients who seek access to care. The Tuskegee Syphilis trials demonstrated how the medical community exploited and compromised the trust of African American patients. Recent research indicates that out of a study of 222 residents and medical students, about half demonstrated false beliefs concerning biological differences between white and black …

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Should we change resident duty hours?

Physician
June 19, 2019

As I listened to my attending explain how during her residency training she was on call every third night, I realized how the definition of “call” had significantly changed since that time. For her, it meant her shift started at 6 a.m. and ended at 8 p.m. the next day, totaling the shift to upwards of 36 hours. My call, on the other hand, was a mere 6 a.m. to …

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Maximize locum tenens income: 4 tips to make more and work less

Physician
June 17, 2019

Every hospitalist heard that locum tenens work pays better than permanent. Of course, I did, too, when I first started practicing. This was one of the reasons why I switched to the full-time locum tenens years ago.

Now, things have changed since then, and employed hospitalist salaries have been rising steadily over the years. It became obvious, then, that $150 per hour for locum tenens work doesn’t cut it …

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Career or the egg? Is it time to put pregnancy first?

Physician
June 17, 2019

Whether to have a child before becoming an attending physician is a personal choice, but as a fertility specialist, I’m concerned that many people — including physicians — overestimate the effectiveness of today’s fertility treatments.

In the U.S., the average age at which women have their first child went from 21.4 years in 1970 to 26.6 in 2016. Experts attribute that in part to more people seeking advanced education and taking …

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The inflammatory myopathies rap video you didn’t know you needed

Video
June 17, 2019
YouTube video

Learn about the differences between polymyositis and dermatomyositis the Medcomic way.

Illustrated by Jorge Muniz and music by Neil Bobenhouse.

Image credit: Medcomic.com

Working in the ER taught this doctor what evil really means

Physician
June 17, 2019

If you ask people if there is evil in the world, a lot of them will smile politely at such an obviously Medieval (or Neanderthal) view of the world.  Which, of course, is a bit of an insult to both groups who were from all evidence quite intelligent folks.

Some might rattle off some examples of evil.  Things like intolerance, racism, sexism, homophobia, transphobia, Islamophobia, and assorted others.  Disregard for the imminent …

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How a patient saved this physician from losing her passion for medicine

Physician
June 16, 2019

I left a full-time academic position five years ago because I was literally, “check-all-the-boxes,” burned out. In looking back during that time prior to my decision to leave, I recall months of feeling overwhelmed, emotionally exhausted, depressed, and in a sense grieved for the loss of what I envisioned my career path to be until retirement. It was not until one of my favorite patients, Mr. Young, who knew me …

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MKSAP: 63-year-old woman after right hemicolectomy for colon cancer

Conditions
June 15, 2019

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 63-year-old woman is evaluated at a follow-up appointment after undergoing right hemicolectomy for colon cancer 1 year earlier. Her paternal grandfather had colon cancer diagnosed at age 75 years. She reports that she has been feeling well and takes no medication.

All physical examination findings, including vital signs, are …

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A trauma surgeon reflects on the Yale System, 20 years later

Education
June 14, 2019

The best lens for reflection is to be immersed in the places and people that spawned those memories. Why else would reunions matter? Twenty years after we graduated the Yale School of Medicine, I found myself on campus embracing my classmates again. But it didn’t take long before I felt something creeping up behind the celebratory mood. Amid storytelling and laughter, I couldn’t help reflecting on some of the more …

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The ethics behind the world’s most expensive medication

Meds
June 14, 2019

With the recent FDA approval, Zolgensma became the world’s most expensive medication. Priced at $2.125 million per patient, the one-dose gene therapy is a potential life-saver for children with spinal muscular atrophy (SMA). Now, the treatment is at the center of an intensifying debate over the rising price of medications.

Industry watchdogs are outraged. They say Zolgensma is merely the …

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How failing Step 1 helped me pass the boards. Twice.

Physician
June 13, 2019

I remember the day well. The dean of my medical school called me directly. As soon as she announced herself on the other end of the line, I knew it was bad news. Deans don’t tend to make social calls, and I was right. She was calling to tell me that I had failed the USMLE Step 1, the first in a long series of standardized national exams to complete …

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OB/GYNs are getting old and tired. Who’s going to be left to deliver your children?  

Physician
June 13, 2019

I’m a 46-year-old OB/GYN. I’ve been on call at least as often as every fourth night for my entire career.

Let that sink in for a minute.

How many people get up and answer phone calls, remove ectopic pregnancies, deliver babies, and do C-sections every fourth night for an entire career?  Probably not many.

It’s 4:15 a.m. I just got a call from the hospital about a patient of mine who is term, …

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My caffeine-free residency

Physician
June 12, 2019

A kind resident or attending asks me, “I’m going for a coffee run. Can I get you anything?” I politely decline. “You sure?” “Yeah, I’m actually doing a caffeine-free residency.” A mix of utter disbelief and disgust crosses their faces, probably yours too. With skepticism, people ask: “Why?” I actually hate the taste of coffee. (That is absurd in Seattle, where I’m doing my residency training.) Whenever I try a …

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Speaking out about practicing medicine in Ethiopia

Physician
June 11, 2019

I am a young physician practicing medicine in the “motherland” of God-gifted Ethiopia, which is located in eastern Africa, south of the Sahara Desert. I want to share my personal story, as well as to expose some of the serious problems facing physicians and patients in my country.

I started medical school, which requires the highest academic performance of any career path when I was 18 after completing secondary school. Despite …

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To struggling medical students: Meet the physician who conquered the “no’s”

Education
June 11, 2019

I know what kinds of things I’m supposed to tell you. I know that your other would be advisors will usually stick to the same basic messages: “Keep reaching for your dreams” or “your hard work is all worth it in the end” or “your education will lay the world at your feet.” These platitudes are all well and good, but honestly, they’re forgettable. And pretty words don’t always translate …

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Bottle-feeding grandmothers vs. breastfeeding daughters: advice from a pediatrician

Conditions
June 10, 2019

Recently, a friend’s mother asked me how to best support her daughter’s decision to breastfeed her first grandchild.  The new grandmother questioned her ability to encourage her daughter’s decision because she had not breastfed her own child, and this lack of experience made her feel unqualified to provide support.  With mixed emotions and a lingering sense of guilt, this new grandmother wanted to learn, from a pediatrician friend, how best …

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If you won the lottery, would you quit being a doctor?

Physician
June 10, 2019

On October 23, 2018, the Mega Millions lottery jackpot was 1.6 billion dollars, making it one of the largest lottery jackpots in history.

The hospital was abuzz with chatter in the week leading up to the drawing. Discussions about the possibility of becoming an instant billionaire were just too good to resist.

During that week, I found myself sitting at the nurse’s station in one of the ICUs at midnight. A nurse …

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The inspiring story of a female orthopaedic surgeon

Physician
June 10, 2019

As a female orthopaedic surgeon, I am often asked how I ended up in this field. Although seeing women in orthopaedic surgery is becoming more common, we are still makeup only 6 percent of the orthopaedic surgeons in the U.S.

I actually had no idea what orthopedic surgery was before medical school. In fact, I started medical school thinking I would be an internist, but it really didn’t take me very …

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