How to spot a narcissistic doctor

Physician
May 3, 2019

How is it possible that endemic bullying persists in medicine despite myriad initiatives to improve awareness, mutual respect and medical culture?

In some cases, we can blame health systems issues, such as medical workforce shortages, lack of funding and unsafe hours. But in other cases, we must take collective responsibility for failing to hold individual doctors to account for their damaging behaviors.

Most doctors readily change after being counseled about poor social …

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Stop the anti-doctor media bias

Physician
May 2, 2019

The April 18, 2019 CNN headline was a prime example of clickbait: “Feds charge doctors in 8 states in opioid bust, including ‘Rock Doc’ accused of trading pills for sex.”

The only problem with this headline? Of the 60 individuals charged, half were not physicians. More importantly, Jeffrey Young, the so-called “Rock Doc” who prescribed nearly 1.5 million pills of opioids and benzos often in exchange for …

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We need a Hippocratic Oath for administrators

Policy
May 2, 2019

The biggest change in medical practice that has occurred during my 25 years as a physician is the open acceptance of physician employment. Compared to this change, the ACA, EMRs, “Gorillacillins,” and the latest sepsis protocol, combined, aren’t even worth mentioning.

Physician employment was, and is, obviously an intrinsically flawed structure that was considered absolutely unacceptable for obvious reasons for the entire history of medical practice! Now, suddenly physician employment is …

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When physicians are cyberbullied: an interview with ZDoggMD

Social media
May 2, 2019

Pseudoscience hate groups of all kinds are targeting physicians who openly advocate for public health issues. This is a favorite intimidation tactic used by anti-vaccine activists: When pediatrician colleague Jen Trachtenberg posted a video for National Immunization Awareness Month 2018, she was blasted with thousands of horrible comments and fake online reviews. I wrote a blog post in her defense, and immediately, I was similarly targeted, …

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New medical students: Here are 10 tips for success

Education
May 2, 2019

1. Stop comparing yourself to others. You got into medical school, that is an extraordinary achievement. Whatever you have done so far has worked,  you already have proven your intelligence and study habits. You need to trust that you are capable of succeeding in medical school. Every student has different study habits, and different things work for everyone. Just because your classmate is pulling an all-nighter before an exam doesn’t …

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“I earned it. I’m proud of it. I am a doctor.”

Physician
May 2, 2019

I follow a Facebook group of physician moms.  We share and offer feedback on everything from a clinical puzzle to a frustrating patient encounter, and we offer our tricks for how to find balance in a crazy medical life.  I’ve seen several recent posts about women being called Mrs. even when it is known they are a physician.  Most recently there was a long post where a female physician at …

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How often did doctors treat you with courtesy and respect? 

Physician
April 29, 2019

During this hospital stay, how often did doctors treat you with courtesy and respect?   Seriously?  Why is this question even necessary?  Obviously, because it doesn’t always happen.  Well, that’s interesting.  Maybe interesting isn’t the word.  Maybe the word is, “shocking.”  I can’t fathom treating any patient with anything less than courtesy and respect.   I just don’t get it.

I’m not accusing anyone of being rude to patients.

Remember, HCAHPS are not necessarily …

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Pause before writing your personal statement

Education
April 28, 2019

Trust me: The time you spend thinking about your personal statement before you start writing will make the actual writing process much, much easier.

Before you even start writing a word, spend some time reading personal statement examples. Read good ones, read bad ones, read strange ones. The reason for this is to give you an intrinsic idea of what you personally liked and didn’t like. Moreover, you will begin to …

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4 reasons why this physician specialized in infectious disease

Physician
April 27, 2019

The last sunlight of the day was slanting through Joseph’s hospital window. As the sun descended, it burned the sky crimson, and the mists rolled away, disappearing into Rwanda’s seemingly endless hills. I had just arrived in Kigali for global health work with a goal of medical education and, as I looked out, I felt at peace with my recent decision to apply to an infectious disease (ID) fellowship.

Earlier, while …

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How diabetes education programs can help busy primary care physicians

Conditions
April 26, 2019

Busy primary care physicians have a lot on their plates. But when it comes to helping people with diabetes learn how to improve their health, they don’t have to do it all themselves. Diabetes self-management education and support (DSMES) programs, led by a diabetes educator, can provide vital assistance by helping people with diabetes maintain a healthy weight, quit smoking, begin an exercise routine and integrate other self-management behaviors into …

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What are the best student loan repayment plans for medical students and residents?

Finance
April 26, 2019

If you’ve ever tried to learn about student loan repayment plans, you might have felt overwhelmed and confused. Instead of spending days researching information — as I did — here’s a summary of the different repayment plans to help you choose the right one.

1. What is the standard repayment plan?

With the standard repayment plan, you will pay off your student loans in 10 years by making “fixed” monthly payments. The …

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The truth and challenges of being a doctor mom

Physician
April 25, 2019

Being a doctor mom is a beautiful paradox of feeling like a badass one moment and a frazzled I-don’t-know-what-the-heck-I-am-doing mess of a person. Being a female physician, the majority of us feel there is a societal and cultural pressure to be perfect all the time in every sphere of our life: as a professional, parent, and person. Obviously, expecting perfection is a bit unrealistic.

Among doctor moms, there are some common …

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Every doctor needs to monitor their online reviews

Physician
April 25, 2019

We’ve had several articles from various sources over the years on grooming your social media. Most of them advise paying attention to your physician ratings, but not acting on anything specifically. “Don’t engage” is the mantra. Let’s take a fresh look at this.

Like probably everyone in medicine, I have my share of physician rating site reviews. Most are good, some are bad, but all of them I pay attention to. …

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The obscene price of insulin: This is what happens when health care is for profit

Meds
April 25, 2019

I recently had a patient whose blood sugar was well controlled until he lost his health insurance. He purchased his diabetes pills because they’re cheap, but he couldn’t afford the insulin. His diabetes had been well controlled. Now, almost a year later, his hemoglobin A1C was 14, or double what it should be. The HbA1C measures sugar control over the last three months.

The bee sting kit or EpiPen cost hike …

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Medical workplace bullying: We just want it to stop

Physician
April 25, 2019

Health care is increasingly complex. Objective peer review, constructive feedback, and robust debate are essential to continually improve the quality of patient care.

But doctors don’t always disagree well. One of the contributing factors to bullying in medicine is the complex interplay of different personality types in very stressful situations. Some doctors have personality traits that predispose them to have interpersonal conflict and being unable to see the view from the …

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Why didn’t your doctors tell you the truth?

Conditions
April 24, 2019

Here’s what they should have told you: “We found cancer in your lymph nodes, your liver, your lungs, and your brain. It explains your weight loss, your difficulty breathing and your loss of appetite. This wasn’t just your depression like you thought. It started in your lungs, and now it’s everywhere. This cancer has been growing for quite some time. You cannot, even with the strongest medications and the longest …

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A patient that reminded me of the first man I ever witnessed dying

Conditions
April 24, 2019

He struggled to breathe, progressing from deep breaths with wet sounds reverberating in his lungs, to guppy breathing — opening the mouth like a fish, contorting the entire face. His heart rate slowly decreased, from 150 beats a minute — a pace attempting to keep up with the oxygen demands of the body — to 50 beats, to 40 beats, to that which is incompatible with life. The nurse pushed …

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USMLE Step 1 tips that may surprise you

Education
April 21, 2019

To reach my current position as a general cardiologist, I have taken nine board exams. I have also been teaching medical students for over ten years with several colleagues who write questions for the USMLE Step 1 exam. Through this experience, I have observed a number of themes about what works and does not work for board preparation. I share these with you now in the hopes they may help …

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A nurse’s downfall was telling the truth

Conditions
April 21, 2019

These events happened over 18 years ago. Some content has been changed to protect the innocent and the guilty. Searching for positive changes in the health care industry. We are not a number, and the patients are not a number.

I’m not good at lying. My eyes go to the left or look downward, and I start to stutter and pause. There is no eye contact, and I fall deep into …

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