How should salespeople sell to doctors?

Physician
January 21, 2019

Two device salesmen recently came unannounced to our small private gastroenterology practice. They were hawking a product that could quickly and non-invasively determine how much scar tissue had formed in a patient’s liver, a useful tool for assessing patients with hepatitis and many other liver conditions.

We are physicians, not entrepreneurs. We do not regard the colonoscope as a capitalist tool. Yet, these two salesmen were barraging us with facts and …

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A reflection on the last day of residency

Physician
January 20, 2019

I entered residency self-assured, if not in my scholarly achievements, at least in who I am as a person.

I left slightly broken.

Something happens to you in residency, and you don’t realize the transformation as it occurs. It may be the loss of a patient who died on your watch, or the realization that you have not changed the world. It could be the constant fear of failure or punishment by …

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An orthopedic surgeon’s bone broth journey

Physician
January 19, 2019

Many cooks traditionally use broth derived from simmered bones of fish, fowl, or four-footed critters to flavor soups and sauces. Recently, bone-broth bars have popped up around the country and serve a non-caffeinated, nutritious alternative to tea or coffee. In some of these health-conscious establishments, the owners claim that these drinks also have filling, cleansing, and detoxing capabilities.

I decided to see if a daily cup of bone broth should be …

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Don’t judge when trainees use dating apps in the hospital

Social media
January 17, 2019

During rounds, in between seeing patients, the medical student pulls out his phone and scans a dating app for new matches. In the team room, a resident opens Facebook before responding to a non-urgent page. Each of these instances may seem trivial enough, but I’ve seen both lead to poor evaluations, reprimands, or others whispering terms like “unprofessional.”

In the medical world, there’s an implicit understanding that while you’re at work, …

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The old days of medicine are gone

Physician
January 17, 2019

In the last decade, specifically in the last five to six years, we have seen the gradual disempowerment of America’s physicians as well as their unfortunate patients.

Starting with health management organizations, managed care, all the way to the insurance exchange, doctoring has been forcefully wrestled away from physicians only to be placed into the hands of large insurers, administrators and the United States government.

The common denominator was never about improving …

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For residents unsure about their choice of specialty

Physician
January 16, 2019

About halfway through the internal medicine residency, there comes a time when a resident must decide on what he or she plans to do after three years of training. We may come across a second-year resident saying: What should I do next? Should I become a hospitalist or plan for a fellowship? But in what? Cardiology and gastroenterology are fascinating careers, but is my resume ready for a competitive match? …

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10 tips for non-traditional medical school applicants

Education
January 16, 2019

I would like to offer some words of encouragement to what many call the “non-traditional” students pursuing medicine.

The term encompasses people in different aspects in their lives. It may be someone in a different line of work looking at medicine as a second career or another just getting started that didn’t take the traditional path in undergrad.

My own journey

I started medical school at 28 after spending six years as a …

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Why is Medicaid reimbursement below sustainability?

Policy
January 15, 2019

Recently, a child was on a waitlist for five months to get into my practice. For this article, I will call him Tiny Tim.

Tiny Tim, now five years old, has a skin condition known as eczema or atopic dermatitis. When we first met, virtuously every area of his body was covered with wounds from constant scratching. Skin that breaks easily and heals poorly can give bacteria access to other parts …

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A divided house always falls: Why doctors lost control of health care

Physician
January 15, 2019

I recently met an old friend of mine for the evening in New York City. He’s a talented young orthopedic surgeon, who has already, in the short amount of time since finishing residency, experienced so many of the problems our health care system faces.

The topic of conversation quickly turned to the current state of medical practice, the dramatic swing to corporate medicine, and the consequential loss of autonomy suffered by …

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A call for the end of routine opioid use after wisdom tooth removal

Meds
January 15, 2019

We are writing as a parent and a dentist to spread a message to parents and dental health care providers across Canada: there are alternatives to prescribing opioids after wisdom tooth removal.

Removing wisdom teeth is considered by many as a rite of passage for teenagers. It is one of the most common surgical procedures done in young people aged 16 to 24.

Amy’s 16-year-old son, Felix recently had his wisdom teeth …

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The fallacy of work-life balance in medicine

Physician
January 15, 2019

Physician well-being, burnout, and “work-life balance” are pretty common topics in training.  We start at intern orientation, discussing how to work 80 hours a week, eat, sleep, exercise, and still have some semblance of social life.  It’s like we’ve forgotten the origins of our job title: “resident” or “house staff” — implying that, until recently (and even now, in places outside of North America), we, the physicians-in-training, lived at the hospital.  …

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Peanut allergies: What is the best policy for schools?

Conditions
January 14, 2019

Peanut allergies can be a serious problem, and many exposures happen when our kids are at school. On average, there are probably about 5 peanut-allergic children in each of our nation’s 100,000 school buildings. What’s the best policy for schools to use to help protect these kids from potentially fatal reactions?

Different schools have taken different approaches, and as far as I can tell there is no authoritative national guideline …

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How physicians can successfully wind down their practice

Finance
January 14, 2019

A retirement plan isn’t usually a top priority for fresh doctors looking for their first jobs, whether that final date is in five years or thirty. Perhaps knowing when to hang up your hat is immaterial so early in your career since most doctors will end up leaving their first job within the first five years anyway.  However, I do wish that I had some inkling about the career paths …

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How carefully do most patients or doctors read medical forms?

Physician
January 14, 2019

Does any living, breathing human believe that there is not enough paperwork in our lives? While we are all burdened, I believe that the medical profession is uniquely deluged with an absurd volume of documentation requirements, most of which should be filed under “N” for nonsense. Ask any physician or nurse about this and have antacids on hand as you will soon see some sizzling smoke emerging from the medical …

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Investing in the stock market is like playing that game of rock-paper-scissors

Finance
January 11, 2019

Rock-paper-scissors is a game that nearly all of us played as children.

It is a game with incredible opportunities to play mind games with your opponent.

There is no luck in rock-paper-scissors as with card games.

The game does not have complex rules like chess.

You simply have to figure out the patterns of your opponent (or induce patterns into them) and take advantage accordingly.

Can you beat the New York Times computer bot?

Back in …

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A financial checklist for the pregnant woman physician

Finance
January 11, 2019

Women physicians are disheartened when they discover the financial implications of having children. Most of us will not get paid leave. Many of us are the breadwinning partner. And most of us will not become stay at home moms so we will need to pay for high-quality childcare or have a stay at home spouse.

Certain things should be in place prior to becoming pregnant. So even if you’re single, I …

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10 surprising things you need to know about the hospital

Physician
January 11, 2019

1. Very little revolves around the patient. For a place dedicated to healing, the hospital does a poor job accommodating patients. Labs are drawn in the middle of the night, so the doctor has them early in the morning. There is no standard rounding time, so the patient is constantly awakened throughout the day. Vitals must be measured every few hours. Patients often comment about being happy to be discharged …

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Treating sleep apnea without CPAP

Conditions
January 11, 2019

It was 4:00 a.m. when I made it to my parents’ home. My mother called me to say that my father was having a hard time breathing. I could hear him struggling in the background. I ran inside to see my mother cradling my father on the floor — not breathing. I performed CPR on the man that gave me life! CPR on the person who just three months earlier …

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