The myth of multitasking in primary care

Physician
December 15, 2017

Primary care doctors don’t usually have scheduled blocks of time to read incoming reports, refill prescriptions, answer messages or, what we are told the future will entail, manage their chronic disease populations. Instead, we are generally expected to do all those things “between patients.”

This involves doing a little bit of all those things in the invisible space between each fifteen-minute visit, provided we can complete those visits, their documentation and …

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The first rule of medical school interviews: Don’t talk about cost

Finance
December 14, 2017

The fall is over, and winter has come, which means I have just wrapped up a busy season of medical school interviews. Most interviews are conducted in a similar fashion with an hour of introduction, speeches by the dean, presentations of facts I already knew from the website, and finally the interviews.

Within the first hour, I understand the reason: “We are the best medical school at (fill in the blank).” …

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What’s in a woman physician’s last name? A lot.

Physician
December 13, 2017

A recent post about a physician using her maiden name professionally generated major controversy on a physicians’ group. Hundreds of comments later, it became evident that female physicians who chose to use their maiden names are subjected to negative judgment.

I am a physician married to a supportive man who understands my choice to keep my last name. I am not unique in my circle. Most of my female physician friends …

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Insurance and the destruction of our health care system

Policy
December 11, 2017

When interviewing for my book, I asked about insurance, but the topic came up even when I didn’t specifically ask about it. It was never positive in relation to practice.

A doctor said, “I expected to be around tough and hard cases. I expected it to be hard. I did not expect to have to think if the insurance company will not pay for it.”Another one said, “This completely changes the …

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The moment I became a passionate doctor

Physician
December 9, 2017

I was nearing the end of my pediatrics rotation as a third-year medical student when the senior resident asked me to admit a patient to the general pediatrics floor. The only information I had as I headed down to the intensive care unit was that she was a ten-year-old girl who had survived an extensive resuscitation at home.

By this point in my education, I was certain that I wanted to …

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Here’s how to be a good mom and good doctor

Physician
December 8, 2017

Go to college, go to medical school, start and finish residency and fellowship, get married, settle down and have children …

There is a certain expectation of what a “successful life” would look like for a physician mom. Some may even choose to stop work and become a full-time stay-at-home mom.

Even when my spouse, who works part-time for most of our marriage, took a year off work to be the stay …

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An eye-opening rotation at the Indian Health Service

Education
December 8, 2017

For the month of September, I embarked on the experience of a lifetime, living and working on the largest Native American reservation in the United States. Sprawled across the four corners region of Utah, Arizona, New Mexico and Colorado, the Navajo Reservation in Chinle, Arizona, encompasses an area as large as the entire state of West Virginia. Its population, however, is only about 300,000, making it extremely rural. To leave …

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4 reasons why patients don’t take their medications

Physician
December 7, 2017

I often see patients for follow-up and learn they are not taking the medications either I or another health care provider prescribed. Sometimes the reason is obvious, and other times the patient is reluctant to give up the information. Patients have the right to take or not take medication that was prescribed. But, sometimes by not doing so, they are putting their health at risk.

As a doctor, I want my …

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A patient called me the N-word

Physician
December 7, 2017

Editor’s note: This article contains a racial slur crucial to the writer’s story.

It took only 57 hours of working as a new attending physician in Charlottesville, Virginia for a patient to call me the N-word.

Fifty-seven hours. In fact, a racial slur found me before I found the shortcut to the hospital cafeteria. So, when torch-bearing White supremacists gathered downtown earlier this year, I saw more confirmation of my conclusion that …

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Leonardo Da Vinci and health care: a matter of perspective

Physician
December 6, 2017

Recently, a Leonardo Da Vinci painting, Salvator Mundi (Savior of the World), was sold for $450 million, making it the largest fee for a painting ever sold.  Was it a good investment?  The painting was sold by Leonardo’s heir to King Francis I of France for 4000 gold ducats in 1519, which according to the American Numismatic Society would be equivalent to $575,000 at today’s price of gold at $1277 …

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5 challenges of working in a county hospital

Policy
December 6, 2017

As a trainee at a large private health system (residency) followed by a NCI-designed comprehensive cancer (fellowship) in two large metropolitan areas in the United States, I was not prepared to face the challenges of working at a university setting affiliated with a county (public) hospital in more rural west-Texas.  After one and a half years of experience as a practicing urologic oncologist, these are the five challenges I have …

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10 surprising things you need to know about the emergency department

Physician
December 5, 2017

Despite the fact that most people will have had the misfortune of visiting the emergency department (ED) at some point in their life, I find that many folks do not really understand what happens in the ED.

1. Emergency medicine is a specialty. Yes, we actually did residency training to learn how to work in the ED. This training lasted three to four years after medical school and is sometimes followed …

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Is MRI contrast a dangerous threat?

Conditions
December 5, 2017

In early November, Chuck Norris filed a lawsuit against medical device manufacturers involving gadolinium-based contrast media, a chemical used in MRI imaging scans. The lawsuit stated that the gadolinium that doctors injected into his wife Gena to improve the clarity of her MRIs have left her “weak and tired and with debilitating bouts of pain and a burning sensation.”

As with any adverse effects involving medical procedures in the news, it …

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Can universal health care and capitalism coexist? Yes, here’s how.

Policy
December 4, 2017

Eat what you kill.

Sounds like a mantra from a survival reality show, right? Akin to “eat or be eaten,” “kill or be killed.” It’s also a common reference to the prevailing business model in our American scarcity-minded, competition-driven, fee-for-service health care culture. How ironic, the application of these words to this profession. It was explained to me essentially as: “Every man for himself, and you’re a minion. You are expected …

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Is there ever a right time for a doctor to have a baby?

Physician
December 4, 2017

When is the right time to have a baby? This question plagues professional women across industries. It takes on more significant importance for women training as physicians. Medical training is long and coincides with a woman’s late 20s, often stretching into her 30s. Waiting to have children until completing training is not always biologically feasible.

Medical schools and residency training programs still lag behind in developing formal parental leave policies. Outside …

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How being an immigrant shaped the way I treat patients

Education
November 30, 2017

I was born in Shanghai, China. In September 2000, my parents and I left behind our family and friends, a language and culture dear to our hearts and social and financial stability to immigrate to the United States. I was six at the time. Although I don’t claim to have fully understood the weight of their decision to start a new life, I knew that my parents were making a …

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Make more than your spouse? Here’s how to save money on taxes.

Finance
November 30, 2017

The only time my husband outearned me was during our first three years of marriage when I was still in residency and working 80-plus hours per week earning less than minimum wage per hour. Since then, despite graduating in a professional degree, we have made relocation moves that primarily help with my career growth, to the detriment of his.

In 2015, an NPR article quoted statistics showing that 38 percent of …

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5 shifts to move health care in the right direction

Policy
November 29, 2017

The truth about change in health care was never more perfectly captured than in an episode of Sex and the City, when Carrie Bradshaw lamented that we keep “should-ing all over ourselves.”

In the past decade, those of us on the front lines of health care have seen the passage of nine major pieces of federal legislation that, combined, have profoundly affected how they work. We’ve seen the number of people …

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How to inspire medical students to pursue primary care

Education
November 29, 2017

I distinctly remember the excitement I felt during my first year of medical school when exposed to the breadth of general and specialty fields that seemed all so equally rewarding and medically influential.  I envisioned myself holistically understanding my patient, seeing the problem in the context of her other medical issues, her personality, her family and her environment — an approach I considered at the heart of the oath we …

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