A Xanax prescription that should have been rejected

Meds
February 27, 2019

In hindsight, I should have never accepted a Xanax prescription from my doctor. What followed was catastrophic — rapidly developing tolerance and physical dependence on the drug and a prolonged illness. Three-and-a-half years later, I am still slowly tapering off Valium (having transitioned to a longer-acting benzodiazepine to aid in tapering) and experiencing debilitating symptoms daily.

I was unprepared for what happened to me by my medical …

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Physician negotiating: Go get what you’re worth

Finance
February 27, 2019

Nearly five years into practice, I have negotiated my first contract, multiple pay increases, call compensation and independent contractor status. I prepared by researching my market value and reading about negotiation strategy. The following are some points I have learned along the way.

If you negotiate in medicine, you may feel like the only one.

Over the years, my mid-career colleagues confided that they have not received a single pay increase, only …

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Every physician will kill a patient

Physician
February 26, 2019

How did I miss his hypokalemia? Two weeks into my intern year and my patient’s potassium returned at 2.9. Minutes later, he coded. And I felt responsible. As I explained to my partner how my patient had become pulseless after diuresis of his heart failure, she looked at me and said, “Physicians kill patients, it’s inevitable. Has no one told you it’s part of the job?”

There is truth to this …

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Medical schools need to cut their cutthroat culture

Education
February 26, 2019

The United States will be short 120,000 doctors by the end of next decade, according to the latest research from the Association of American Medical Colleges.

That shortage will become permanent unless medical schools make the path to becoming a doctor a bit less arduous.

Some medical schools seem to take pride in imposing a heavy emotional and physical toll on their students. Toughen up aspiring doctors early on, the thinking goes, …

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How a medical student can help the team during clinical rotations

Education
February 23, 2019

Based on my clinical experiences, there are ten pieces of advice I would give to any medical student starting their rotations that will maximize productivity and lead to a robust and thriving work environment (your interns will thank you).

1. Do as complete of a workup on your assigned patients as you can. Be thorough with your admission H&P. Think of all the tests, labs and imaging studies you want ordered. …

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8 ways to go broke as a doctor

Finance
February 22, 2019

So much of personal finance and investing isn’t about winning; it’s about not losing. That’s because investing is a single-player game; it’s you against your goals, not you against your neighbor or your partner or some yahoo on an internet forum. However, there are precious few whose ultimate financial goal is to be broke and if you can avoid doing that, well, that’s one mark of success. There aren’t that …

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How can doctors address patients’ expectations?

Physician
February 20, 2019

No one wants to be sick, especially when no one can tell them what is wrong. In the U.S., we live in a culture where we want instant results; we want easy answers for complex problems. However, in medicine, there are often no easy fixes. Adverse medical events happen, despite our best efforts. For example, a young child was recently diagnosed with Type 1 diabetes mellitus. While he and his …

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An emergency physician with no friends

Physician
February 20, 2019

Every time I call a friend, all I have for them is more work. I’ve never yet called to say: “I hope you’re having a great day. Why don’t you take a break and have some fun? You’ve worked enough.”

Nope. I only call to give them extra work. Whether it’s 2 a.m. or 2 p.m., I need you to get away from your bed/lover/high horse and come take my patient. …

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Physicians: Don’t make these mistakes when looking for your first job

Physician
February 19, 2019

We all have either experienced the fears of starting our first job or will eventually do so at some point in our careers.  It only happens once for everyone.  Those of us who are in the market for a job change will end up reliving some of the challenges in job hunting; hopefully, we all have learned from our past mistakes. As I am advising upcoming graduates during their job …

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Physicians should stop being afraid of getting audited by the IRS

Finance
February 17, 2019

Not only is an audit unlikely to happen — if it does, it’s rarely a huge deal.

Few words inspire such fear in the hearts of Americans as “IRS audit.” But one of the biggest mistakes that taxpayers make is letting fear of the IRS stop them from taking advantage of tax savings they deserve. Especially for locums tenens docs and other 1099 income earners since the 67,000-page tax code favors …

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When depersonalization is necessary in medicine

Physician
February 17, 2019

I could hear the scream from across the room. It was shrill and filled with panic. Any parent can identify the difference between the cries of normal toddler discomforts and a true emergency.

I dropped what I was doing in the kitchen and found my three year old lying motionless on the ground, unable to move his left arm. My five year old was looking sheepishly down at the carpet, afraid …

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A physician defends Ayurveda: Is it the original personalized medicine?

Conditions
February 16, 2019

As more patients and clinicians are searching for holistic approaches to health care, Ayurveda, or the traditional medical system of India, has been gaining popularity in the Western world.  Unfortunately, many allopathic physicians still view this system as “quackery” because of its focus on the “intangibles” of health.  However, Ayurveda has contributed immensely to the foundations of modern medicine, which many may not know.  Sushruta was an Indian scholar and …

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When you identify your Lyft driver as potentially having bipolar disorder

Conditions
February 15, 2019

I remember September 27, 2018 like it was yesterday. When Ashley* picked me up from my apartment Thursday morning, I thought it would be like the 138 past Lyft rides I’ve taken since 2017. I was wrong.

After I waived to Ashley from the curb, I got settled into the right back seat. The doors locked, and she asked me the usual question.

“You from here?”

“Yes, I’m a local.”

“That’s great! I’m from …

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The clinical and financial life of a pediatrician

Physician
February 14, 2019

Most doctors well into their tenure of medical already have a general idea about how other specialists spend their days (except for radiation oncologists, where no one else knows what they do).  However, as a medical student, I had incredibly limited insight into the variety of means to practice medicine. Even as an attending physician, I am still discovering how creative some medical specialties allow one to be.  For instance, …

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She was dead: How shame almost ruined a physician’s life

Physician
February 14, 2019

Dear friends— especially my colleagues,

I recently failed a class (I have been working on a PhD in psychology) and found myself immobilized and disengaged from life, personal happiness and joy. I actually didn’t even tell my husband, who is my true confidant of my feeling and thoughts, until the following day. I found myself in that familiar place of guilt and shame. I thought I had transformed a lot of …

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The hidden curriculum of medicine

Education
February 13, 2019

Think all the way back to your grade school years. Did you know that your personality traits were starting to be honed for the work you do today? Let me give you some examples about myself and see if you can relate.

I remember the praise and exhilaration of being the only kid in the class to get a 100 percent on an extremely difficult second-grade spelling test.  My teacher told …

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Wonder why your hospital is full?

Physician
February 11, 2019

Why is your hospital always full? Actually, it’s more than full.  You have twenty boarders in the ED. You turned your postop recovery unit into an overnight surge center.  Every day administrators beg you to please, please discharge patients, if possible before 11 a.m.  You’ve hired an army of case managers, dissected the discharge process, and held countless capacity management meetings, but you’re still bursting at the seams.

It wasn’t always …

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My battle against the nurse’s cap

Policy
February 10, 2019

Florence Nightingale was among the first nurses who started wearing a nurse’s cap.

The cap was derived by nuns and represented those caring for the sick. Hair was neatly tightened into a bun and covered by the cap.
Back then becoming a nurse was typically seen as a female profession, but men were allowed to become nurses too. In 1930, only one percent of RNs nationwide were male.

Growing up in the 1950s …

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How many beers is too many?

Conditions
February 10, 2019

“I drank beer with my friends. Almost everyone did.”

Alcohol has become constitutional to American culture: “grabbing a drink” after work, happy hour, cheers before meals, on New Year’s, or just because. Our society’s normalization of drinking creates a slippery slope toward excessive alcohol use. Unhealthy alcohol use is rampant: one in six Americans drinks excessively four times a month, according to the Centers for Disease Control (CDC). Almost thirty percent …

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5 things emergency physicians should consider when looking for jobs

Physician
February 9, 2019

This article is sponsored by Careers by KevinMD.com.

Whether you recently completed your residency as an emergency medicine (EM) physician or are ready to move on from your current position, potential locations for work are undoubtedly a big factor in determining which emergency physician jobs you’re willing to consider.

If you have children, location is especially important, because you want …

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