Why don’t patients pick up their prescriptions?

Physician
March 16, 2016

As emergency physicians, we write prescriptions for patients that we discharge home for all manner of presenting complaints. I used to believe that the overwhelming majority of these prescriptions would be filled by the patient after discharge.

It turns out I was wrong.

Research estimates that patients discharged from emergency departments (EDs) fail to pick up their high urgency prescriptions, like antibiotics, nearly 35 percent of the time.

This is problematic because failure …

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Are essential oils safe for children?

Meds
March 13, 2016

On January 5, 2016, emergency crews were called to Our Kids Daycare and Learning Center in Middleton, Idaho. The reason: concern for carbon monoxide poisoning. The daycare center’s director Robin Hagaman noted that some of the 12 toddlers in the classroom were acting strangely when they awakened from their naps and were also noted to have dilated pupils. In addition, two of the teachers were simultaneously experiencing headaches and …

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A routine heart exam. An unexpected problem.

Education
March 13, 2016

Every fall, medical schools welcome nearly 20,000 college graduates. They arrive anticipating endless hours of lectures, too much coffee, and infinite facts to memorize. There is one thing they do not expect, however. I know. Forty-nine years ago, I was one of them.

The first day I walked onto the wards was in spring of 1967. I was in St. Louis, doing my second year of medical school. Previously my presence …

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How to do a no hands-on physical in 3 minutes (or less)

Physician
March 12, 2016

Pamela-Wible-Big-Box-Medicine2

Step 1: Greet patient.

Step 2: While chatting, check all boxes in electronic medical record for a complete review of systems and physical exam. Copy and paste parts of previous chart note while looking at patient every once in a while. Smile if possible.

Step 3: Tell patient to do yoga.

Step 4: Bill insurance company for complete physical exam.

Welcome to big box assembly line medicine.

Ever wonder what …

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This doctor quit medicine. It saved her life.

Physician
March 11, 2016

I quit medicine. I was five months out of residency, and I was leaving medicine. I had dedicated my heart, soul, several years of my life along with weekends, holidays, special events, and my children’s first words to this honorable profession. Medicine was never suppose to “just be” my job. It was suppose to be my calling, and it had betrayed me.

I was finally a full fledged physician, and I …

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From burnout to balance: How this medical student did it

Education
March 11, 2016

I burned out for the first time in my life about three months after starting medical school. The surprising thing was that nothing out of the ordinary happened, I was doing exactly what they told me to do, pre-reading from lecture notes and recommended textbooks, going to lectures and labs, and trying to study and review what I learned that day in the library.

The problem was, that after a 45-minute …

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A gastroenterologist shares practical advice on probiotics

Meds
March 10, 2016

The microbiome is among the hottest topics in medical and scientific research. The National Institutes of Health and private foundations have invested hundreds of millions of dollars in research to define and characterize the human microbiome. In the next decade, billions more will be devoted to deciphering how microbes influence human health in a positive manner. The White House even issued a national call to action for …

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What you don’t know about anal sex. A gastroenterologist explains.

Conditions
March 10, 2016

Although it is still early, 2016 is already shaping up to be a year to remember in science: Long-postulated gravitational waves were finally discovered, the CDC scrambles to battle Zika virus on multiple continents, and long-awaited clinical testing begins for a new HIV vaccine.

But these accomplishments all pale in comparison to the monumental study published in the American Journal of Gastroenterology titled “Read more…

How palm reading helps this physician today

Physician
March 9, 2016

I grew up in a house of spirituality, homeopathy, palmistry, astrology, art, and science alike. My father, with a masters degree in statistics, is a computer systems architect. He also fancies himself an amateur palm reader. The irritation with which I reluctantly used to give my hands over to my father, before the SATs, college decisions, medical school admissions, and my residency match results was real, but I was always …

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Should doctors marry doctors? Here are the challenges they face.

Physician
March 9, 2016

Fifty years ago, it was very uncommon to find doctors married to other doctors. Why? To answer that question, we need to explore the sociology of the time. Fewer women went to college, which meant fewer female doctors. Many couples married early, right out of high school or right after college. If the wife had career aspirations herself, these were often put aside in order to help her husband get …

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The heartbreak of dating an exhausted medical resident

Physician
March 8, 2016

When I was finishing my fifth year of studies as clinical psychology doctoral student, I fell in love with a second-year medical resident; a wanderer at heart with the softest smile and a way of listening that made me feel like the whole world stopped when I spoke. Whenever possible, we found ourselves in the forest exploring the world on foot or, if the weather was bad, on long drives …

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The problem with cultural competency in medical education

Education
March 8, 2016

“Let’s say a Chinese patient comes into labor and delivery … simply logs onto the CultureVision website. Next, click on the Chinese section and finally click ‘Labor, Birth and Aftercare.’ Just that quickly you have the information you are looking for.”

CultureVision boasts that it is the “first comprehensive, user-friendly database that gives health care professionals access to culturally competent care.” The website’s automatic slideshow, entitled “Did you Know?” shifts …

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A resident’s guide to being a medical student

Education
March 5, 2016

Though I am two years into my residency, I still experience flashbacks to my time as a medical student on the wards. The adrenaline of arriving at the hospital 2 hours before rounds, scrambling to see my patients, constructing a note that no one would ever look at, and preparing a hastily-constructed presentation to deliver in a half-performance, half-examination outside of our patient’s room.

I remember being the object of a …

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10 truths of physician parents

Physician
March 5, 2016

1. You either over or under-react to everything related to your child’s health. Your kid chokes?  You perform the Heimlich and are back to dinner conversation 2 minutes later.  Your infant spits up a little more than usual after their introduction to rice cereal?  You decide they may have FPIES and stay up all night worried they may require tube feeds.  True story.

2. You can’t go to …

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We are human beings before we are doctors

Physician
March 4, 2016

Mental illness has long been associated with shame and stigma. Although progress has been made through the efforts of global celebrities like Stephen Fry and many others to de-stigmatize mental illness — many are still ashamed to admit to it, and the stigma is far from being annihilated.

Nowhere is this stigma more entrenched than within the medical profession itself. A fact that should shock us out of our judgmental slumbers …

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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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