Take back our practices with physician cooperatives

Physician
September 14, 2017

One of the biggest points of contention in the ongoing discussion of burnout is that the system of health care is flawed.  The endless bureaucracy, decreasing physician pay, and increasing meaningful use requirements that spawn endless clicking on an already inefficient electronic medical record platform have become unbearable by most practicing physicians today.

Furthermore, all the talk about mindfulness only riles up more anger in physicians as they feel they are …

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A resident deals with being a wife, mother, and doctor

Physician
September 14, 2017

As a second-year family medicine resident, wife of a nurse and mother of an almost-two-year-old, the feeling of just not being enough has a suffocating hold on me some days. Non satis. Sounds like a pretty good gig when I talk with others outside the medical profession and friends from home. Training to be a doctor? Great. Happily married to an amazing man who’s taking time off work to raise …

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Stop exploiting medical students and residents

Physician
September 13, 2017

Approximately 300-400 physicians commit suicide annually. Given that a typical doctor has about 2,300 patients under his or her care, that means more than a million Americans will lose a physician to suicide this year.

In a study of six medical schools, almost seven percent of students said they had thought of ending their lives in the last two weeks. In another recent study, 29 percent of residents …

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Health care reform: A free-market solution works in other countries

Policy
September 13, 2017

Repealing and replacing the Affordable Care Act is on indefinite life support. The political consensus was that President Trump needed to pass health care reform to be able to move forward with his legislative agenda. While this may be true, the passing of any repeal and replacement bill without fundamental reforms has little chance of long-term success, likely defining Trump’s presidency as a failure no matter how successful he is …

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When we talk about quality, what exactly do we mean?

Policy
September 12, 2017

It’s a health care buzzword for sure, but when we talk about quality, what do we mean? We can compare the quality of similar things and focus on its absence, but otherwise, putting the idea into words becomes complicated. Context is important. And so is perspective: One’s position within the health care system influences how he defines quality to a larger degree than it does at a restaurant, or in …

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Let’s not be petty about affirmative action in medical school

Education
September 11, 2017

Just a year after the Supreme Court rejected a challenge to race-conscious admissions in Fisher v. University of Texas, this issue is being pushed back to the front of the room by none other than the Trump administration’s Justice Department hauling out hoary tropes about “reverse discrimination.” They are preparing cases against Harvard and the University of Pennsylvania, charging to the rescue of the multitudes of …

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A love letter to patients

Education
September 9, 2017

This is a letter to everyone who has ever smiled, shrugged their shoulders, or nodded while either hesitantly or enthusiastically uttering the words, “Yes,” “Sure,” “OK,” “I guess so,” or, “Of course,” when a medical student has asked if he or she can talk to and examine you before your doctor comes in. We know that you are busy and that your time has value. We know that you have …

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I vow not to call my patients “difficult.” Here’s why.

Education
September 9, 2017

I am not a doctor.  (Yet.)  I am a novice third-year medical student, somewhat able to perform and document a physical exam on a sleeping child, to dial the correct number to call a consult and to make wild guesses about chest X-rays (“I see a consolidation?”). I write about medicine not from a position of experience, but of malleability.  I want to become like the best doctors I see.

Towards …

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A reminder that physicians are artists

Physician
September 8, 2017

Anyone entering medical training is taught that medicine is an art, one that combines scientific knowledge, discovery and application with its practice. It is both art and applied science. It should never become nor has it ever been only all one or the other.

To be medicine at all, the noble vocation that so many brilliant minds sacrifice to pursue in service to their fellow humans, the practice must balance art …

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A cancer survivor embraces the light of going to medical school

Education
September 8, 2017

This article was originally presented as student remarks at the 2015 Harvard Medical School commencement. 

At the end of medical school, I always return to a musing, a zen koan of sorts from Dean Jeffrey Flier. At my white coat ceremony, a close friend and current resident, Dr. Nina Gold was chatting with the dean about the heft of our newly bestowed bright white coats. He asked her, in one beautiful …

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7 ways for doctors to stay safe at work

Physician
September 7, 2017

Being a health care provider has always come with personal risk. We care for all patients, which includes patients agitated due to psychiatric issues, dementia, acute medical illness, alcohol or drug intoxication or just anger. Patients can be extremely volatile and lash out unexpectedly causing physical injury to their doctor, nurse or another provider. Besides the physical risk, patients can be emotionally and verbally abusive as well- and both types …

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For a long, happy career, be more than just a doctor

Finance
September 7, 2017

“You’re a doctor; focus on being a doctor.”

This piece of advice was recently given to me by my own father, in regards to my multiple ambitions outside of the medical field. He himself only recently retired from a long career as a surgeon, so his opinion is the result of years of experience.

His advice got me thinking.

What makes for career longevity in our field? Statistics show that more than half …

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Are CTE headlines overblown? A radiologist investigates.

Conditions
September 6, 2017

A study published in JAMA looking at the brains of former football players donated to a brain bank, a highly selective sample, found signs of chronic traumatic encephalopathy (CTE) — a degenerative neurological disease — in nearly all deceased players examined.

The mainstream media converged towards numerical consensus.

  • Fox News reported players in a study had CTE.”
  • CNN reframed the headline, “CTE found …

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Your patient is angry. Here are 5 things physicians can do.

Physician
September 5, 2017

It’s a scenario that every doctor is familiar with. You are having a busy day and working full steam to get everyone better. You suddenly receive that unexpected message: “Mr. Johnson and his family are very upset and would like to speak with you now.”

Most of the time, any physician’s initial reaction will be one of irritation, disappointment or frustration: “My goodness, I’m working so hard here, and we have …

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Gamification of medical education: Choose Your Own Medventure

Education
September 5, 2017

More and more health care practitioners are turning to social media for their medical education. Fellows are learning ultrasound from Snapchat, nurses are learning how to insert NG tubes from watching YouTube, and learners are learning pathophysiology from blogs and podcasts. To reach this audience with credible and reliable content, it is important for medical educators to be present where the learners are, and that means social media.

Users are also …

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Patients and doctors should give each other the benefit of the doubt

Physician
September 1, 2017

In my first year in the hospital, as a third-year medical student, there was one refrain I often heard from physicians and staff alike: This is a hospital, not a hotel. It was an expression of the frustration engendered by “needy patients,” those who were upset that their breakfast was late or that the room was too hot or that they couldn’t speak with the physician just this second. Often, …

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“You’re making a huge mistake because you’re threatening a nurse.”

Policy
September 1, 2017
YouTube video

Alex Wubbels, the head nurse at the University of Utah Hospital’s burn unit, was arrested for refusing to draw blood from an unconscious patient.   She was absolutely correct, since it was against hospital policy, and constitutional law, to do so.

ZDoggMD dedicated an episode of his Facebook Live show, Incident Report, highlighting the travesty:

“Sir, you’re making a huge mistake because you’re threatening a …

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The parable of the pizza shop

Physician
September 1, 2017

One day a man decided to open a pizza shop. The first week he sold pizzas and collected money from his customers; the happy customers ate hot pizza, and the man made some money.

The next week many of his customers who came in had pizza insurance, and had already paid Blue Wall Insurance for their pizzas. Since so many of his customers had purchased pizza insurance, the man signed a …

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Dear insurance doctor: You are not my peer

Physician
September 1, 2017

I am a gynecologic-oncologist. I work in the high-stakes realm of cancer care. I strategize complex treatment plans involving surgery, radiation, chemotherapy and the newer biological agents to treat the myriad of disease that we call collectively “cancer.” Cure — or at least control — requires urgent and timely administration of these modalities along with various imaging or blood work to assure that the treatment prescribed is effective. I love …

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5 keys to a successful long-distance relationship during medical school

Education
August 31, 2017

When my husband Brian started first-year of medical school at the University of Miami Miller School of Medicine, I jettisoned off to Thailand to spend a year teaching English and traveling.  We figured if we were going to date long-distance, why not go all in? Why not ensure that we were a full 12 hours apart, on literal opposite sides of the world. What can I say? We like a …

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