The breakthroughs and failures of medicine

Meds
June 2, 2019

There is a pervasive tendency to turn to medicine looking for magic. Patients and health care professionals alike generally expect medicine to be able to cure diseases, alleviate symptoms, and relieve suffering. Historically, medicine has met and exceeded these expectations in a variety of ways.

However, in some cases, these expectations can cause a blurring of the lines between hope and reality, resulting in false “promises” and preventable disappointment.

You may be …

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MKSAP: 48-year-old woman with elevated liver chemistry tests

Conditions
June 1, 2019

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

A 48-year-old woman is evaluated at a follow-up appointment for elevated liver chemistry tests over the preceding 6 months. She reports no symptoms. She has type 2 diabetes mellitus and hypertension. Her family history is unremarkable. She drinks two glasses of wine one or two times per month. Her …

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It’s time to rethink what it means to be a DO

Education
May 30, 2019

The future of our profession lies in our ability to come together with a unified voice. We must also recognize that the practice of osteopathic medicine, and the training of osteopathic physicians, has evolved significantly since A.T. Still, MD, DO, created osteopathy.

The AOA recognized this when its Board of Trustees announced that the AOA will start providing two pathways for board certification. DOs will be able to …

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3 ways to change your mindset in continuing medical education

Education
May 30, 2019

The seeds of emotional turmoil inherent in medical education are planted early in the pursuit of becoming a doctor. It is the unspoken fear that medical students and residents experience each day on attending rounds.  It is the worry of missing a vital piece of information from the history and physical exam of a patient. It’s the concern that despite reading and preparing for the cases, emerging physicians may find …

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How this physician fought imposter syndrome

Physician
May 29, 2019

It took me a long time to put a name to what I was feeling. Only recently had I started to read about imposter syndrome. I’ve had this feeling multiple times throughout my life, and it always had the potential to pull me backward instead of allowing me to propel forward towards my goals.

I had this feeling when I made it into college, then again in medical school. Even when …

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Home buying tips for physicians

Finance
May 29, 2019

Financial planning is comprised of the six decisions people make with their money. Physicians need to make decisions as to how you earn, spend, save, borrow, give, and protect yours. Home buying typically touches on all of the six money decisions.

Home buying often begins with a mortgage, so you will have to make decisions about borrowing money. You also must earn money or at least have the potential to earn …

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Physicians and the risk of a plateauing net worth

Finance
May 28, 2019

Wealth accumulation can follow many trajectories, depending on discipline and external factors like stock market health or economic fluctuations.  With a proper financial plan, doctors can stick to a game plan that should allow them to reach financial milestones rather predictably.  The adage that wealth begets wealth certainly does hold true most of the time, but it doesn’t necessarily guarantee financial victory.  One of the issues with wealth accumulation is …

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A physician’s journey to working from home

Physician
May 27, 2019

Raise your glasses (of juice, water, champagne, or whatever you fancy) and join me in celebrating a dream come true: I’m officially a physician who practices medicine from home. To think that it was only four years ago that I was burnt out. It took having that eye-opening experience to take myself off the grid and begin practicing medicine on my own terms. I left nephrology to practice as a …

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The journey from a low GPA to an orthopaedic surgeon

Physician
May 27, 2019

I’m an orthopaedic surgeon, but if you told me I’d be here when I graduated from college, I’d be laughing at you. When I got started in college, I thought I was going to be pre-med and apply to medical school. It was not a well-thought-out decision. I thought that this was what good Chinese-American children do: Grow up to become doctors. It became clear that this goal was parent-driven …

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A patient’s tale of type 2 diabetes

Conditions
May 26, 2019

Samuel was an English gentleman hailing from London. Close to 10 percent of the U.S. population, over 30 million people, lives with diabetes. Five years ago, Samuel was diagnosed with type 2 diabetes. Taking lisinopril and glipizide, he also goes on hour-long walks every morning at 6:30 a.m. to keep his A1c at his comfort number of 5.5. It has not always been this way for Samuel as he was …

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Why you should see your doctor in the morning

Physician
May 25, 2019

A recent New York Times piece had the catchy title, “Don’t visit your doctor in the afternoon.” It was prompted by a study published in JAMA Network Open that had the much less catchy title “Association of Primary Care Clinic Appointment Time with Clinician Ordering and Patient Completion of Breast and Colorectal Cancer Screening.” The study found that the frequency of appropriate ordering of …

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It’s time for physicians to be less “productive”

Policy
May 25, 2019

Physician compensation in most employed positions is based on how much a physician “produces.” I work as a psychiatrist, and this amounts to how many patients you see per hour. The more patients you see, the more “productive” you are, the more money you generate, the more valued you are by your organization and the more RVUs you churn out for a larger paycheck. But, in human terms, what exactly …

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Endocrinologists are needed more than ever. Why are they being devalued?

Physician
May 24, 2019

I chose endocrinology to be my lifelong profession out of love for the complex interactions of endocrine glands and intricate feedback loops. I take pride in preventing medical complications, prolonging life expectancy, and providing complex care to type 1 and type 2 diabetics. At times, this field of work requires spending hours — either with the patient or before or after patient visits — counseling, examining blood glucose data and …

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How a disability changed this medical student

Education
May 23, 2019

As a college freshman in 2012, my life seemed perfect. I was attending Rhodes College in Memphis, TN, with the dream of becoming a pediatric oncologist. To that end, I was serving as a volunteer, researcher, and clinical intern at the world-renowned St. Jude Children’s Research Hospital. I was thriving in my classes and building incredible relationships with my peers and professors. I had never been happier.

Everything changed when I …

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A medical student’s biggest fear

Education
May 22, 2019

It was the last week of my EMS elective. I was incredibly lucky to ride with one of the EMS captains who was eager to take me to any call that sounded interesting. We were called to a possible stroke. An 82-year-old woman with sudden-onset unilateral weakness and expressive aphasia. The paramedic and EMT on scene were two I had met before. We actually talked earlier that day about the …

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Don’t forget this common trigger of cyclic vomiting syndrome

Conditions
May 21, 2019

There is a condition known as cyclic vomiting syndrome which causes people to develop episodes or “attacks” of frequent vomiting lasting for a few days at a time without an apparent cause. Sufferers of cyclic vomiting are totally fine between episodes … it’s kind of like a migraine of the upper gastrointestinal tract! Just like treating migraine headaches, treatment of cyclic vomiting syndrome is aimed at identifying and removing triggers, and using …

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Celebrities are bringing a myriad of health conditions into the public consciousness

Physician
May 21, 2019

It seems now as if every day and every month is associated with a “national day” or an “awareness month.”  Some such as “national taco day” may be less important than others, well depending on one’s priorities.  Although many illnesses now also have a dedicated day or month, many of these diseases will go unnoticed.  They will rarely be discussed — that is until a celebrity or someone in the …

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The financial disadvantages of being a doctor in California

Finance
May 20, 2019

Geographical arbitrage is a huge component to being able to build wealth in a timely manner.  For doctors, the formula for rapid wealth accumulation calls for geographical arbitrage even more strongly as our salaries do not have wide ranges across the country.  A doctor in Texas will probably command a similar salary in Arizona (maybe slightly less).  A doctor in the midwest might earn more, spend less, and work less …

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