The hidden benefits of your health insurance plan can save your life

Policy
January 1, 2020

At kitchen tables everywhere, ordinary Americans have been grappling with the arcane language of deductibles and co-pays as they’ve struggled to select a health insurance plan during open enrollment season.

Unfortunately, critical information that could literally spell the difference between life and death is conspicuously absent from the glossy brochures and eye-catching websites.

Which plan will arrange a consultation with top-tier oncologists if I’m diagnosed with a complex …

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The difference between shallow and deep work in medicine

Physician
December 31, 2019

“Let me order some labs, and then we’ll discuss where we go from there once I have the results.”

I walk out of the patient’s room and right into one of my nurses. “Zoe, can we start that lady on pressors like we talked about? Her blood pressure is still low after the fluids. I need you to put the order in so the pharmacy can send it up.”

I smile my …

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Stand up and be heard. But don’t hate your doctor.

Physician
December 29, 2019

“I don’t know.”

That is an answer patients hate to hear. It is also an answer doctors hate to utter, and in truth, many of us fail to say those words when it would be proper to say them. Doctors spent long hours over many years of training, sacrificing personal time and family life. Most of us are perfectionists, and not knowing a medical diagnosis often feels like failure. Perhaps, the …

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The continuing battle between the emergency department and radiology

Physician
December 28, 2019

I overheard a disappointing phone call while supervising a radiology resident recently. I could tell that the resident was struggling in a conversation with an emergency department physician, so I asked him to switch over to speakerphone. Eventually, I heard the emergency physician say, “Listen. This is how it works. A patient points to what hurts. Then I have that part scanned, and you tell me what is wrong.”

Disheartening as …

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How setting healthy boundaries can help you regain control in a demanding world

Physician
December 28, 2019

Advancements in technology have blurred the lines between work and home life. This is because modern technology, such as the smartphone has made it easier for others to reach us. Time and location no longer serve as barriers. It is not uncommon for work-related matters to reach us via email or text after hours. People are continuing their work from home rather than enjoying precious time with loved ones.

Physicians are …

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The excitement of clinical rotations: Not just learning medicine but doing medicine

Education
December 27, 2019

The first time a woman went into the final stage of labor, I watched from a corner of the room. As a third-year medical student, I was on my six-week clinical rotation in obstetrics and gynecology, and it was day one of the two-week portion on the labor and delivery floor. As a loudspeaker announcement projected over the woman’s screams, and nurses and doctors rushed in response, I instinctively clasped …

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For students with test stress, medical schools leave a void  

Education
December 27, 2019

I’m writing this for my tribe of worriers and self-doubters, people for whom ever-present test stress is inextricable to the med school experience.  Sure, every medical student becomes preoccupied fretting over exams to some degree.  That’s part of what you sign up for.  But our preoccupation is something greater than that—it towers over us and bullies us.  It makes us cower in the corner, begging to be spared from harm.

We’re …

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10 things you need to know about strangulation and domestic violence

Conditions
December 27, 2019

Having recently testified in several legal cases involving strangulation, here are some facts we all need to know about this extreme form of domestic violence (DV). I invite other subject matter experts to share their personal opinions on what is important.

1. Strangulation is assault with a deadly weapon – an act with known potential lethal consequences. Formally defined, strangulation is an external force applied to the neck cutting off blood …

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Why this primary care physician still rounds at the hospital

Physician
December 26, 2019

I have been fortunate in that I have not had to hospitalize any patients in the past four weeks.  This means I have an extra 60 minutes or more to prepare for the workday in my office. The streak ended this weekend when my associate, taking his rotation of being on call, hospitalized one of my patients with pneumonia.

In many cases, pneumonia is treated as an outpatient. You receive an …

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Alexithymia: patient satisfaction, doctor burnout and health care costs

Physician
December 26, 2019

My next patient was a healthy man in his early 20s following up for eczema.  His case had not been severe, so I had anticipated that the prescription strength steroid cream I had given him would have addressed his symptoms faster than I had promised.  His chief complaint had been itch—a symptom—something that he was experiencing.  He hadn’t even noticed the rash.  It was what one would call “bread and …

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Your medical career won’t last forever

Physician
December 25, 2019

“Slowly comes the hour, it’s passing speed how great.”
– Samuel Cowper

Our careers will end someday.

Of course, we know this deep down, but I think we lose sight of it amid our training and the day-to-day grind of our jobs.

But just this past week, I was given a little reminder.

At our Christmas party, we took some time to honor one of our colleagues on his journey to retirement. He had spent …

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When physicians are so emotionally drained, they have nothing left for their families

Physician
December 25, 2019

The other night, while I was getting out of my car, my oldest son, standing on the porch, excitedly yelled out, “Mom, look at this lego structure I made!”

I couldn’t see it, but I could tell how happy he was to show it to me. “It looks neat from here. Let me get closer.”

My husband appeared, knowing how tired I was, “Mom worked a long day. Why don’t you let …

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This doctor has no regrets to becoming a physician. Here are 3 reasons why.

Physician
December 24, 2019

There’s so much negativity out there when it comes to health care, it must be a concern to any young person thinking about entering the field. I certainly spend a lot of time writing about all the challenges we face, and have to hold my hands up to (occasionally) spreading some of that negativity as well! Guilty as charged. That’s why it’s important for anyone outside of health care (or …

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Waking up to the sexual violence in America’s psychiatric units

Physician
December 24, 2019

It wasn’t until I first had to manage the aftermath of a sexual assault on a psychiatric unit one night during my residency that I realized psychiatry might have a problem with sexual safety.

My fellow residents and I had never been informed of a management policy for inpatient sexual assaults, and my program’s curriculum was silent on how to handle the issue.

Because the assault involved a psychotic patient who was …

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A psychiatrist can’t help patients anymore

Physician
December 22, 2019

I bid farewell to four people this month who I’ve been caring for in my outpatient psychiatry practice — all under sensitive circumstances but ultimately moving in positive directions. As I write formal discharge letters, the unique role psychiatrists and other mental health clinicians play in the lives and minds of the people we care for is on my mind.

It is the nature of our healing practice to build trust …

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Let’s do better for patients with limited English proficiency

Physician
December 21, 2019

I’ve noticed a theme in my clinic since I started practicing medicine: when a patient understands what is being said about their care, treatment, and services, they’re more likely to fulfill critical health care responsibilities. No one should be surprised by this, but as our nation and hospitals increase in diversity, the issue of health care equality for LEP (limited English proficiency) patients is becoming more pronounced.

Today, this population of …

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Doctors: Always be prepared to suture wounds

Physician
December 20, 2019

Ninety minutes before my Sunday night shift, my two-year-old, Titan, comes screaming up the stairs looking like a scene out of a slasher horror movie. His older sister sheepishly admitted to chasing him into the edge of a door frame. We created an ED bed on our kitchen counter and slipped a pillowcase up his arms, behind him, with him laying …

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An orthopedic surgeon goes to a bar. Here’s what happened next.

Physician
December 19, 2019

I went to a bar last night — and I looked good: red coat, black dress, knee-high suede boots.  I was feeling pretty good.

I met my best friend at this bar — he lives elsewhere now — but this is his favorite spot in the world.  Like Norm in Cheers, he is also their favorite customer.

We ordered dinner, and my best friend stepped away to talk to the bartender.  I …

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