Noise pollution is an epic problem in hospitals

Physician
February 5, 2016

Me: Hello Mrs. Smith, my name is [BEEP!] Dr. Gandolfo and I am a [BEEP!] gastroenterologist. [BEEP!] Your doctor wanted me to [BEEP!] talk to you about something that showed up on [BEEP!] your CT scan.

Mrs. Smith: Who are you? I [BEEP!] didn’t hear your name?

Me (louder): It’s Fred Gandolfo, I am the [BEEP!] stomach doctor. [BEEP!] I need to talk to you about [BEEP!] that CT scan you had.  You see, there was … [BEEP!] [BEEP!] [BEEP!] Can you straighten your …

Read more…

How do surgeons deal with their mistakes?

Physician
February 5, 2016

As surgeons we are privileged to have our hands work inside someone’s body with the intention of alleviating suffering, removing sources of pain, excising diseased organs, fixing this or that, ultimately to improve someone’s quality of life, prolong it or at times even save it.

Yet we also know that people can suffer complications from surgery, that in some cases are fatal, and where our good intentions seemingly backfire. Patient deaths …

Read more…

The truth about fevers in infants

Conditions
February 4, 2016

Fever phobia is common among parents. The vast majority of the time, these fears are unfounded, because a fever is very rarely a cause for significant concern. One important exception is in newborns under 2 months of age. Compared to older children, these very young infants are at high risk for serious infections, so any fever in this age group requires urgent medical evaluation. Here’s what parents needs to know …

Read more…

Doctors: Feel like a fraud? You’re not alone.

Physician
February 2, 2016

Imposter syndrome (n.): Term coined in 1970 by psychologists and researchers to informally describe people who are unable to internalize their accomplishments despite external evidence of their competence.

When I was in medical school, I remember walking outside the library and trying not to glance inside to see how many of my classmates appeared to be meticulously studying for final exams. I remember trying to ignore their off-hand, and occasionally self-congratulating, …

Read more…

Customer service in health care: Does AIDET really work?

Physician
February 1, 2016

Mnemonics can be incredibly cool. When I was in medical school, there was just too much stuff to remember and memory aids were so very helpful. Most specifically I refer to the vile and inappropriate one that helped me remember the cranial nerves which I remember to this day and will not share in print.

In ancient times orators used memory palaces to memorize long speeches or poems, associating words with …

Read more…

Doctors need to learn to say no. Here’s how to do it.

Physician
January 30, 2016

If you have a life where you never, ever say yes when you mean no, then you can stop reading right now.

But I guess that you’re a lot like me. Now and then, you get caught off guard.

And before you know it, you’re staying late to see that emergency patient. Bringing cupcakes for the second-grade class. Volunteering for the coffee meet-and-greet at church next Sunday.

What’s up with that? We’re smart. …

Read more…

The shocking confessions of a naturopathic doctor

Physician
January 29, 2016

I was a licensed naturopathic doctor in two states. I quit practicing naturopathic medicine after discovering my former boss, also a licensed ND, had been importing and administering an illegal cancer drug. I trusted my boss, as did his patients, because he was well respected in the naturopathic community and his credentials included “FABNO” (Fellow of the American Board of Naturopathic Oncology). This FABNO treated any kind of cancer, even …

Read more…

The benefits of trauma-informed care in the NICU

Conditions
January 29, 2016

When my twin sons were born prematurely at 26 weeks’ gestation, my family’s lives were thrust into the whirlwind of the NICU and living daily with the reality of the babies (William and Elliott) being on life support. Having had no prior intense and prolonged experiences with the hospital, and watching helplessly and fretfully as my tiny two-pounders fought for their lives, it’s almost impossible to put into language what …

Read more…

Will the real doctor please stand up?

Physician
January 26, 2016

comicfinal

In 2006, graduate nursing programs started granting doctorates of nursing practice (DNP degrees). In a media fact sheet, the American Association of Colleges of Nursing (AACN) explains the thrust for the change this way:

Some of the many factors building momentum for change in nursing education at the graduate level include: the rapid expansion of knowledge underlying practice; increased complexity of …

Read more…

Gastroenterologists are the tattoo artists of medicine

Conditions
January 25, 2016

Everywhere you go, you can see people from all walks of life sporting some pretty cool tattoos. Tattoos are so popular nowadays that they’re almost conformist. I consider myself really hip since I don’t have any tattoos; how avant-garde! However, that doesn’t mean I don’t appreciate good ink when I see it. As a matter of fact, I even dabble as a tattooist sometimes.

It is common practice to leave a permanent tattoo at …

Read more…

Your vagina doesn’t need a herbal cleanse. Here’s why.

Conditions
January 25, 2016

I woke up to someone forwarding this tweet.

Yes, some company is selling tiny bags of herbs (they call them pearls) to stuff in the vagina for three days to cleanse your uterus or shrink your fibroids or treat bacterial vaginosis or tighten your vagina.

This is not only pointless it could be very dangerous. Here’s why.

Your uterus and vagina want you to leave them alone.

Your uterus isn’t tired …

Read more…

The unintended consequences of the night float rotation

Education
January 24, 2016

This past month has been a particularly difficult one for me because I’ve been on our float rotation. I have worked only night and swing shifts throughout our hospitals; this means my work hours are primarily from 8 p.m. to 10 a.m.

There are certainly other rotations during which I worked longer hours and had more emotionally draining conversations, but I have never felt as burned out as I have this …

Read more…

Physicians should invest time in work-life balance: It’s priceless

Physician
January 19, 2016

“As a mom and a doctor, what advice would you give a third-year medical student trying to choose a specialty?” the bright-eyed med student asked me.

Her smile was ear to ear, and I didn’t want to burst her bubble. This is a complicated question to ask and the answers change as life changes. I chose OB/GYN because it was the only specialty I truly fell in love with. For me, …

Read more…

ADVERTISEMENT

A daily decision to prioritize my patients over my notes

Physician
January 16, 2016

It’s been a long day in the psychiatry clinic.

Seeing patients is never dull, and each interaction is meaningful in its own way. From the moment they walk into my office to the moment they leave, I try my best to be fully present with the patients sitting in front of me. That means listening to every word, watching every nuance of body language, hearing every concern — both spoken and …

Read more…

A letter to myself as a first-year oncology resident

Physician
January 15, 2016

I’m writing to you from the future — approximately ten years from where you are now. You’re a few months into your medical oncology residency, just beginning to assimilate to the flow of your daily responsibilities as a doctor committed to the diagnosis and treatment of cancer.

You hate living in upstate New York, and are dreading the upcoming winter and the associated endless piles of snow and sub-zero temperature nights …

Read more…

ADVERTISEMENT

Doctors grieve too: A lesson I did not learn in medical school

Education
January 14, 2016

“She is not yours to grieve.”

That statement, from another physician, hours after Ava died and as pent up tears rolled down my face, left me embarrassed and ashamed.

The message: She was my patient, not my child.

Never mind the amount of time and tenderness I had poured into her care during the month she spent in the pediatric ICU. I had no right to mourn her death. I am a doctor.

As …

Read more…

10 rules every primary care doctor should read

Physician
January 13, 2016

Primary care medicine is intense and chaotic, a constantly mutating kaleidoscope of data, emotions, goals and obstacles. It is designed to confuse and distract, and will find and magnify any tendencies towards ADD in even the most organized clinician.

During my 30+ years as a family physician, I’ve come to depend on some core principles and concepts to stay grounded and maintain focus. Here are ten rules I have found useful, …

Read more…

The story of how this doctor lost his first patient

Physician
January 13, 2016

During medical school, we are taught the physiology, anatomy, and pathophysiology of hundreds of disease processes. One thing medical schools don’t teach well is how to cope with losing a patient. Some physicians will go many years as a physician before having their first patient die on them. Others will lose a patient earlier on during their career. I was the latter. I hadn’t even graduated from medical school yet …

Read more…

ADVERTISEMENT

The struggle of mommy-guilt in physician-mothers is real

Physician
January 11, 2016

What does a 3 year old know?

If you don’t like our toddler’s opinion, just wait; she’ll change her mind in a few seconds.  The ever-changing mind of a 3-year-old is what makes the fact that I decided to be a  doctor at that age all the more amazing.  But, that’s how old I was when my parents took me on a mission trip to Haiti, and I decided I wanted to …

Read more…

542
pages