You must make a good first impression with patients

Physician
December 4, 2018

First impressions are critical. We are taught early in our careers that first impressions truly matter. Whether interviewing for medical school or a residency program, our goal is to make a positive first impression in hopes of making the cut at each checkpoint in our early careers.

These processes in our academic lives and careers are exhausting. As residencies and medical schools are becoming more competitive, the importance of first impressions …

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A physician’s letter to his wife

Finance
December 3, 2018

To my wife,

Let’s just start at the beginning.

When we first met, you thought I was arrogant and prideful.  For two and a half years we would rarely talk while we walked past each other in our small college town.  At the time, we never could have imagined that one day we would get married.  In a twist of irony, two weeks before we started dating you still didn’t know as …

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A surgeon mistakes a kidney for a tumor. How can this happen?

Conditions
December 3, 2018

A number of media outlets recently featured a story about a Florida general surgeon who removed a normal kidney from a woman who was undergoing spine surgery. How could this have occurred?

The 51-year-old patient who had been injured in a car crash was scheduled for an anterior lumbar interbody fusion (ALIF) of the fifth lumbar to the first sacral vertebra. The general surgeon’s role was to provide …

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Here’s what the corporatization of medicine is doing

Policy
December 2, 2018

Have you ever been to a doctor’s office and felt that your evaluation was rushed? Have you been seen in the emergency room and felt that you were just a number in a long series of patients? Have you ever seen the same doctor for years and felt like the doctor just met you for the first time each visit?

Chances are we’ve all experienced this as patients. If we’re honest, …

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Physicians who pursue financial independence and early retirement are not wrong. It may save them.

Finance
November 30, 2018

When Jason Kilar graduated from college he experienced tremendous personal and professional adversity.  Three days after graduation, Kilar’s father ended his own life after battling bipolar disorder.

Kilar also battled professional valleys. In the months after graduation,  the work-life he had long envisioned couldn’t have seemed further from the reality he faced.

After building shelves at a local store and hustling to find a job that he actually loved, this is what …

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The problem with mental health funding and prisons

Policy
November 29, 2018

Moving to the Bay Area from the Midwest was a culture shock in many ways. I was amazed by the diversity, the food, the openness of opinions. And I was struck by the traffic, the stark differences driving from one community to another and the homelessness — you could see signs of it everywhere. As time went on, I acclimated to these changes. Working in the hospital, I got used …

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Nurses aren’t commodities

Policy
November 28, 2018

Corporate health care mentality set up nurses up to be inhuman while holding us to superhuman expectations. We’re told to be caring — but not allowed to do it. It’s time to demand that we stop being abandoned and dismissed by dysfunctional leadership.

Early in my nursing career, I was assigned to the pediatric area for one shift in a busy emergency department (ED). Our team received notification of an incoming …

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Don’t miss this adverse drug reaction when tapering benzodiazepines

Meds
November 27, 2018

“Alice Woods” is dying of metastatic breast cancer, but she cares little for awareness efforts like pink ribbons and catchy hashtags like #stage4needsmore. You see, Alice has akathisia due to an adverse effect from discontinuing Klonopin — a condition that has caused her far more suffering than her terminal cancer. It has also prevented her from receiving adequate cancer treatment and is, therefore, ending her …

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How sickle cell anemia influences a medical school journey

Education
November 25, 2018

“Where there is no struggle, there is no compassion.”
-Frederick Douglass

Growing up with sickle cell anemia exposed me to the field of medicine. As I go through the pain and complications, it humbles me to the point that motivates me to work harder to be the doctor I want for myself. I want to be a physician-scientist that conducts clinical research targeted toward patients like me. I believe that as a …

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Medicine: noble profession or big business?

Policy
November 24, 2018

In 1976 I graduated from medical school and proudly joined the medical profession. Thirty-seven years later, I retired as an employee of the biggest business in the country. In 2016 the medical industry was responsible for 3.3 trillion dollars of expenditure, comprising 18 percent of the United States GDP. For perspective, there are only four countries with a GDP more than the amount spent on health care in the United …

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The evolution of residents’ hours

Physician
November 23, 2018

It was the 24th hour of my call shift, and I was running on fumes. Despite my weariness, I could see the first rays of morning sunlight coming through the window in my patient’s room. It was then I knew I could make it to hour 30 (quitting time). It was grueling to keep going, but hitting the 30-hour mark only required me to keep my head down and do …

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Is your smartphone leading to burnout?

Tech
November 22, 2018

Burnout and dealing with its symptoms has become a hot topic in the last decade. It’s a problem that has multiple contributing factors. Some of those factors are thrust upon us and are beyond our control, such as government regulations. Other factors are self-imposed, and thus under our control, such as volunteering for extra call shifts. One self-imposed factor is a little thing we use to improve our lives, our …

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3 reasons why we should care about the health care experience

Physician
November 21, 2018

The health care experience is so much more than a buzzword to be talked about in administrative circles. Some physicians I encounter (a minority, but still enough) really scoff when they hear this term. Responses I’ve heard from doctors include: “Hospitals are not hotels!” or “If that means giving our patients as much Dilaudid as they want, then count me out!”

Aside from these sweeping statements being entirely silly, they are …

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Why do we still use CD-ROMs for radiology images?

Physician
November 21, 2018

In the United States, any person who has tried getting their own (or their patient’s) radiology images from another hospital or practice will find the practice painful.

Here are several obvious reasons why the CD-ROM — briefly the darling of large data transfer — is a truly terrible way to share radiology images in 2018:

They require physical transfer. Remember the term “snail mail”? Do people still say that?

They are slow. When you bring a …

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Is it still worth it to go to medical school?

Finance
November 21, 2018

Medicine has changed immensely over the past 40 years. Not only has the drugs, surgeries, and procedures changed, but the culture and economics of medicine have changed as well.

Radiologist and blogger Xrayvsn enlisted physician finance bloggers young and experienced to write posts on the common topic of generational perspectives of the past, present, and future of medicine:

  1. Doctor of Finance MD: A Late-Career Perspective On Medicine
  2. Xrayvsn: Medicine …

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Lewy body dementia and a farewell to a physician’s father

Conditions
November 20, 2018

When I finished my training, I was taught that the vast majority of dementia was Alzheimer’s disease, with occasional cases of multi-infarct dementia as well as odd syndromes such as Kreutzfeld-Jacob disease and genetic, traumatic, toxic and tumor-related syndromes. Parkinson’s disease, we were taught, caused a tremor and freezing up of a person’s movements and only very rarely was associated with any kind of memory loss.

These teachings helped us modern …

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