A surprising amount of thought goes into the radiology report

Physician
March 3, 2016

“‘Normal’ is one of the most powerful words a radiologist can use.”
– Curtis P. Langlotz, professor of radiology, Stanford University

After I used “clinically correlate” thrice in a row in my report, the attending radiologist asked, “How would you feel if the referring clinician said on the requisition for the study ‘correlate with images’? When you ask them to clinically correlate, you’re reminding them to do their job.”

I had been a …

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A star medical student feels like he made a terrible decision

Education
March 3, 2016

It is February of our last few months of clinical rotations. I am a rising fourth-year medical student at a well-known East Coast institution with a not-so-bad track record, I guess you could say. I scored in the top percentile for the USMLE Step 1, honored my third-year rotations, and have comments from attendings about how I am destined to succeed in this career. One might think that at this point …

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5 reasons why physicians fail as leaders

Physician
February 28, 2016

Most physicians are smart and very talented. They’re skilled clinicians and technically superb. But despite such abilities, they fail to get others to follow them, once they take on the role of leader. As a consequence, they’re unable to get physicians to change or improve performance.

Jay Conger, a professor of business at Claremont McKenna College who has devoted his career to the study of leadership, has helped me understand why …

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A doctor shares the secrets of cancer survivors

Conditions
February 26, 2016

Disclaimer: I have never had cancer. Therefore, at the most basic level, I do not have the right to pontificate about dealing with the dread disease. Rather, I have been the servant and support of those that struggle with cancer. I thought it might be of some assistance to share my observations from the other side of the bed rail. Perhaps, their secrets of survival may help you.

Cancer is a …

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Why are mental health questions still allowed on physician job applications?

Physician
February 24, 2016

DearPamela

Dear Pamela,

Question for you in regards to disclosure about mental illness. In every job that I have applied for, as part of the credentialing process, there are questions about felonies, treatment for drug/alcohol abuse and mental illness. Why are mental health questions still allowed to be on there? I have had postpartum anxiety/depression three times now, and I feel like it is …

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Should you have a precolonoscopy visit? The answers may surprise you.

Conditions
February 23, 2016

Your primary care doctor has been nagging you for years. Your wife and brother seem to be in on the scheme too. Every once and a while one of your coworkers even says (with a chuckle) “C’mon Bob, you’re fifty-seven, you really need to get it done!”

“OK, enough,” you finally say, “I’ll go for a colonoscopy!” So at your next visit you ask your primary doctor how to set it …

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Why daughters need their fathers

Physician
February 23, 2016

Men, we need you.

We — mothers, daughters, and sisters — need your help in raising healthy young women. We need every ounce of masculine courage and wit you own because a father, more than anyone else, sets the course for a daughter’s life.

After more than 20 years of listening to daughters — and doling out antibiotics, antidepressants, and stimulants to girls who have gone without a father’s love — I …

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Tips to rank your match list. Here’s how this medical student did it.

Education
February 22, 2016

As an early third year medical student, I had a few attending physicians tell me that MD stands for “make decisions.” I find myself subject to these sorts of pep talks when I answer their clinical questions with a response influenced by a high pitched vocal inflection that suggests that I’m uncertain.

For example, while being pimped on the next step in managing a patient, I might have responded with a …

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A physician aces his USMLE and ABIM board exams. Here are his tips for success.

Education
February 21, 2016

In this article, I’ll discuss a medicine-specific strategy that many of my physician colleagues and I have used over the years to learn dense, complicated information quickly and effectively, and to do well on board exams.

These are the two most important tenets of studying for a medical board examination:

1. Find the highest-yield information and memorize it cold.  With active methods such as mnemonics, teaching others, lecturing “to the wall,” writing notes …

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The questionable competency of today’s medical and surgical residents

Education
February 21, 2016

What does it mean to be competent at something? Competency may be defined as the ability to do something successfully or efficiently. When it comes to determining if a physician is competent in his profession, no one, board, no organization, no government, no residency training program or hospital actually will state that an individual is competent. There are significant legal ramifications to declaring someone as competent to practice medicine, and …

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Who is responsible for OR delays? And what can we do about them?

Physician
February 17, 2016

Every two or three years, someone, usually a hospital administrator, decides that delays in operating room turnover time need to be looked into. A committee of 20 or 30 stakeholders (love that term) is appointed and assigns someone the job of measuring the time between cases and identifying reasons for delays. In years when turnover time is not being studied, first case starting delays are on the agenda.

In my nearly …

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This is what I’m wearing instead of a white coat

Physician
February 16, 2016

Hospitals are places of long-standing hierarchies where some people are made to feel important and others … not so much. A long time ago, I was told nurses used to stand when a white coat walked into a room. (Imagine that now. Laugh. Snort. Choke. Cough.) In those days, in the patient care setting, white coats were synonymous with importance.

These days, non-clinical hospital administrators, various technicians, and Clinique make-up counter …

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Dr. Mona Hanna-Attisha is a hero. Here’s why.

Physician
February 16, 2016

I have a new hero. Her name is Mona Hanna-Attisha, MD, MPH.

Dr. Hanna-Attisha is a pediatrician in Flint, Michigan. She grew up in a suburb of Detroit. She graduated from the University of Michigan before attending medical school at Michigan State University. During her clinical years (the 3rd and 4th years of medical school), she spent many months at Hurley Medical Center in Flint, which serves as a clinical training site …

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We want access to safe and effective Avastin. Here’s a solution.

Conditions
February 15, 2016

Recently, two states in India halted all use of Avastin for the treatment of eye disease following the report of 15 patients who underwent emergency surgery for potentially blinding infections at the C.H. Nagri Municipal Eye Hospital in Ahmedabad.  Though further investigations are ongoing, there is worry that the cluster of infections centered around a tainted lot of compounded Avastin. This most recent event serves as a reminder of …

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Maybe God made teenagers difficult so we can let them go

Physician
February 15, 2016

It happens each time one of my children enters the teenage years (sometimes a little bit before). I go from having a lovely child and feeling like a reasonably pleasant parent to having a moody houseguest and becoming a shrew.

You’d think, having gone through this now four times, that I’d figure out how to avoid it. Or that I’d expect it. Or not let it bother me so much. Nope. …

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The games drug companies play can dramatically raise costs for patients

Physician
February 14, 2016

I had a patient last week who was a real pain in the ass.  Wait.  No.  He was actually a really nice guy.  He wasn’t a pain in the ass; he had a real pain in the ass.  Literally.

I was initially concerned about a pilonidal cyst, given the unfortunate fact that he was previously afflicted with this condition (which I consider to be incontrovertible proof of Satan).  But, fortunately to …

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A psychiatrist shares her 5 secrets to love

Conditions
February 14, 2016

As a mother of three daughters, I frequently find myself singing along to the catchy tunes of Taylor Swift.  Singer, songwriter, and overall superstar Taylor Swift is famous for penning undeniably captivating love songs. She is popular not only because she has the voice of an angel, a cutting edge look, and a fierce attitude, but also because she is honest and real. Taylor has an uncanny ability to put …

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I left medical school for a startup. Here’s why I went back.

Education
February 13, 2016

Last May, I reflected on my path from medical school to starting a health tech company in San Francisco. In an environment which fetishizes the “dropout founder,” I always met perplexment when I said I planned on returning to medical school. Now that graduation day is around the corner, I thought I’d shed light on my choice for clinical practice and what I learned on the other side.

Medical …

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Can we truly heal another if we can’t heal ourselves?

Physician
February 12, 2016

“Liver Transplant Surgeon Addicted to Alcohol” — reads like a headline from a tabloid paper selling sensationalism.

How could it be?

How could a liver transplant surgeon, someone who sees up close and personal the devastating effects of alcohol on the body, be addicted to alcohol? Surely the diseased, fibrosed, hard, shrunken cirrhotic livers with dilated and engorged veins that can rupture and bleed catastrophically; the yellow eyes and skin of the …

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