What do you do when you know someone is going to die? I’m not talking about death when it comes at the end of a long protracted illness or a terminal diagnosis. Or the final act at the end of a “good” life, when the body and mind have ultimately given way. I’m talking about when you realize the twenty-five-year-old woman in front of you, who you met five minutes ago, …
So it’s a Wednesday night, and I just got home after completing a shift. I’m beat. My beautiful sofa beckons to me, and my TV seduces me with brainless images and sound. I succumb to the temptation. I turn on Netflix. Too many movies, too many decisions. Screw this; I didn’t just finish up a shift to have to sit and make more decisions. I go to the suggested for …
As graduation nears, I recall an away rotation that concerns me for the future of medicine. I remember eagerly boarding my plane, ready to work hard, learn as much as possible, and explore the unknown. My first day in clinic, I was excited to befriend the student I would rotate with. After seeing our first patient together, she asked me to share my clinical reasoning for the case. I happily …
I’ve known since I was very young that I just experienced life differently than did my extroverted family members and friends. During parties, they seemed to truly enjoy the loudness and chaos of get togethers and the seemingly endless small talk, while I would secretly yearn to return home so that I could read my latest novel in peace. An older family member once told me that I would eventually …
What can I tell you? It started out innocently. College exams were over. And that meant one thing — party time! Bubbly, shots, beer, cocaine and Percocet. Everyone was happy. It was a celebration.
Pam came from a pretty strict religious family: no alcohol, no premarital sex and no crazy music in her house growing up. It was church every Wednesday and Sunday. And if you missed a Sunday, you were …
I was sitting on hold in the resident room gearing up to beg the IT person that would soon come on the other line for enough authorization to be able to view the residents’ patient problem list, and I found myself thinking about what some of the old docs must think of us third-year students now. Talk to some of these older physicians and they’ll tell you their stories of …
Like many of my peers, I started medical school with idealistic dreams of providing compassionate care for poor patients. I thought being a physician was a noble profession and even discussing money, much less changing my career choices based on it seemed antithetical to that. A visit to the financial aid office quickly cured me of my naiveté. I was facing over $300,000 in debt and would be forgoing millions of …
Eating meat has been linked to cancer, high blood pressure, heart disease, diabetes, stroke, dementia and many other diseases. Nearly every modern lifestyle disease has been associated with meat. With so much emerging evidence against meat, it begs the question: Did we …
As the repeal of Obamacare is debated in the halls of Congress and on cable TV, one common theme is: “What will happen to patients?” Questions loom about what might change with coverage, about cost, about whether you’ll still be able to keep your doctor, and if medications will still be covered
But what about doctors? What about how they’re doing?
There are things doctors want to tell their patients, not only about …
I recently reported on a doctor-turned-dog-walker who says with her career switch she’ll enjoy more happiness — and income! In her own words:
Dear Pamela, Today I realized that if I become a dog walker and charge $25/hour and walk five dogs per day, I would make my equivalent salary with fewer hassles. I’m seriously considering this as a career move. I could …
Match Day results were announced recently and a record high 35,969 medical students learned the location and specialty of their first job. As these newly indoctrinated physicians chart their next steps, the majority will opt out of academia, creating a potential crisis in medicine and healthcare innovation.
Although 45 percent of graduating medical students aspire to work in an academic setting, only about 16 percent will do so. Of those who do …
On July 1st, 2017, the updated Accreditation Council for Graduate Medical Education (ACGME) Common Program Requirements will take effect. The increase in the maximum continuous work hour shift from 16 to 24 hours has surely received the most attention, and will likely continue to do so.
However, the ACGME did make some significant improvements in this latest guideline update worth noting. Among them was a slight conjunctional switch from an “and/or” …
Medical school didn’t teach me about the intricacies of health insurance. My family medicine residency program took pride in caring for all patients regardless of insurance status. When I worked in New Zealand and Canada it was a relief to not worry about which diabetic test strips were on formulary or whether a patient’s insurance would cover their birth control.
In my current position as a primary care physician at an …
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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 52-year-old man is evaluated for the sudden onset of erectile dysfunction that has persisted for 6 months. He reports having erections that are inadequate for vaginal penetration. He feels guilty about not being able to satisfy his wife’s requests for sexual intercourse, although he still has sexual desires. He has been sleeping poorly …
I’m not here to tattle. No siree, Bob. I’ll save that for my kids. But what I am here to do is spell out a story in which I ended up down in the dumps.
A medical mistake happened. To me. On me.
I’ll never forget it. I can’t because I carry it with me forever.
Here’s the short of the long:
My obstetrician messed up. She took care of my pregnancy during one of the most …
You graduate from medical school and get your MD degree. At first, when someone calls you “doctor,” you look around and wonder who they’re talking to, but after years of hard work and sleepless nights, you realize you really are a card-carrying “doctor.”
If you’re a woman, however, you start to realize that a lot fewer people call you “doctor” than your male colleagues. At first, it’s subtle. And you shrug it …
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I am always fascinated by my colleagues’ stories about why they became physicians and when they knew medicine was the path for them. Some describe a longing to heal, some a love of science, and others a desire for respect. For me, medicine was a calling that revealed itself in my sophomore year of undergraduate studies and was the perfect culmination …
He was referred to me by a colleague with a large geriatric practice for evaluation and treatment for HIV. He was 76 years old and lived in an assisted living facility. He was, however, very independent and only required limited assistance. When asked what he expected from the visit he responded that he had been sent to me by his PCP. Review of his records suggested that in addition to …
Heroin abuse in the United States is reaching epidemic proportions. According to SAMHSA, between 2007 and 2012, the number of Heroin users has doubled from an estimated 375,000 to over 665,000. Additionally, in 2010, the number of deaths as a direct result of overdose surpassed auto accident deaths.
It is impossible to avoid the facts about heroin. We are bombarded daily by the national and local media and extensive online resources. …
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As a first-year oral and maxillofacial (OMF) surgery intern, I was the first responder to any facial trauma at a hospital in Queens, NY. Therefore in the past 12 months, I was a primary care provider for numerous facial lacerations of women due to domestic violence. And was a 1st assistant in providing care to patients (both men and women) with orbital floor fractures and mandible fractures due to domestic …
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