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The sad demise of an idealistic family physician

Physician

January 6, 2020

Graduation from my residency program was a bittersweet experience. At the time, my specialty was suffering from a crippling job shortage, so our futures were uncertain, and a dark mood had come to permeate my radiology residency. We were disgruntled with the specialty, with the system, and with medicine in general. I attended my graduation without any guests and only stayed long enough to receive my certificate.

I was, however, honored …

What’s the hardest part of a physician’s job?

Rada Jones, MD

Physician

January 5, 2020

I work in the ER. It’s not an easy job. Not glamorous either. At least not as glamorous as my mother-in-law used to think.

Years ago, when I declared I was going into emergency, she looked at me askance. She didn’t ask why. She looked at me with her wise old eyes. “Let me tell you about ER,” she said. “I know all about it. I watch every show.”

She was politely dismissive …

My dream as a physician

Kamala Tamirisa, MD

Physician

January 5, 2020

Everything in life starts as a dream. Big or small. My dream was to become a physician since I was quite young — the first one in my family to walk the path. I wanted to understand the science of the human body and help the sick. Heal with my skills, knowledge, and empathy. Hold my patients’ hands with care and confidence. My work was to be like none other. …

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My dream as a physician

What doctors can (and should) learn from patients

Philip A. Masters, MD

Physician

January 5, 2020

A guest column by the American College of Physicians, exclusive to KevinMD.com.

In many ways, the patient-physician relationship is seen as being mostly one-sided, with doctors possessing medical knowledge and wisdom, and patients with less medical information being in a position where they need a physician’s help and guidance in managing their health issues. Consequently, …

Most medical offices are hopelessly old fashioned

Hans Duvefelt, MD

Physician

January 4, 2020

Imagine if your bank handled all your online transactions for free but charged you only when you visited your local branch — and then kept pestering you to come in, pay money and chat with them every three months or at least once a year if you wanted to keep your accounts active.

Of course, that’s not how banks operate. There are small ongoing charges (or margins off the interest they …

How your mind can turn against you

Kyle Bradford Jones, MD

Conditions

January 4, 2020

An excerpt from Fallible: A Memoir of a Young Physician’s Struggle with Mental Illness.

Jason had an entire group of voices in his head that he called “the committee.” They talked nearly constantly, sometimes in a flat roar but often escalating to shouting. He described it as …

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How your mind can turn against you

5 tips on choosing the right medical specialty for you

Ara Feinstein, MD, MPH

Physician

January 4, 2020

As a practicing surgeon that has one foot in the world of teaching and the other in corporate health care delivery, I enjoy speaking to students and residents about the future. We often discuss topics like the shift from volume to value, consolidation, insurance models, and specialization.

Often this information is new to them, and overwhelmingly they ask some form of the question: “How will this affect my career?” The following …

8 things to do as a new attending that I didn’t learn as a resident

Cory Fawcett, MD

Finance

January 3, 2020

Here are eight things to do as a new attending that I didn’t learn as a resident (and wish I had).

Establish a budget

There are two times when a budget is a very important tool: when you are struggling financially and when you have a large income or expense change. Now that you have graduated to your new attending income, it’s important to intentionally decide how you will invest, save, pay …

The intern who knows everything

Jason Lizalek, MD

Conditions

January 3, 2020

What seems like a tidal wave of pages washes over you. Drowning in a torrential sea of order clarification, bowel regimens, and vital sign deviations — you struggle to stay afloat. Medical school did not prepare you for this. Patients and nurses are calling you, “doctor,” you wish to return to that minimal responsibility role as a medical student.

Welcome to your first on-call weekend.

These first few days, weeks, and months …

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The intern who knows everything

What makes the perfect doctor?

Rada Jones, MD

Physician

January 3, 2020

I’m an ER doc, and I spent my last two decades in the house of medicine. First, training to become a doctor. Then, trying to be a better doctor. No matter how hard I tried, I’ve never been the “perfect doctor.” I started wondering: what makes one a “perfect doctor”?

The perfect doctor lives in the moment, focusing on the here and now: This patient. This case. This encounter. They devote …

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What makes the perfect doctor?

Stop cutting patients off their prescribed benzodiazepines

Christy Huff, MD

Meds

January 2, 2020

In the wake of the opioid epidemic, benzodiazepines have been called “our other prescription drug problem” and “the next U.S. drug crisis.” Prescriptions are on the rise, with over 30 million Americans reporting benzodiazepine use in the previous year. This is alarming, as benzodiazepines are implicated in at least 30% …

Is health care just legal human trafficking?

Debra Blaine, MD

Policy

January 2, 2020

The standard business model around which our world revolves has no place in the “business” of human life, which is what the commercialized industry of health care has become. To be the most successful, businesses work to optimize profits by minimizing their operating costs, which include material resources and all the steps involved in distributing their product. This business model, in some form, is applied universally from the manufacturing and …

The hidden benefits of your health insurance plan can save your life

Michael L. Millenson

Policy

January 1, 2020

At kitchen tables everywhere, ordinary Americans have been grappling with the arcane language of deductibles and co-pays as they’ve struggled to select a health insurance plan during open enrollment season.

Unfortunately, critical information that could literally spell the difference between life and death is conspicuously absent from the glossy brochures and eye-catching websites.

Which plan will arrange a consultation with top-tier oncologists if I’m diagnosed with a complex …

The difference between shallow and deep work in medicine

Zoe Smothermon, DO

Physician

December 31, 2019

“Let me order some labs, and then we’ll discuss where we go from there once I have the results.”

I walk out of the patient’s room and right into one of my nurses. “Zoe, can we start that lady on pressors like we talked about? Her blood pressure is still low after the fluids. I need you to put the order in so the pharmacy can send it up.”

I smile my …

Stand up and be heard. But don’t hate your doctor.

Linda Girgis, MD

Physician

December 29, 2019

“I don’t know.”

That is an answer patients hate to hear. It is also an answer doctors hate to utter, and in truth, many of us fail to say those words when it would be proper to say them. Doctors spent long hours over many years of training, sacrificing personal time and family life. Most of us are perfectionists, and not knowing a medical diagnosis often feels like failure. Perhaps, the …

There is a global anesthesia crisis

Berend Mets, MD

Physician

December 29, 2019

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

There is a global anesthesia crisis: too few people trained to give anesthetics for surgery and obstetrics worldwide. The Lancet launched a commission to look at the needs for global surgery, which identified the issues starkly. While international disease control efforts have …

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There is a global anesthesia crisis

The continuing battle between the emergency department and radiology

Cory Michael, MD

Physician

December 28, 2019

I overheard a disappointing phone call while supervising a radiology resident recently. I could tell that the resident was struggling in a conversation with an emergency department physician, so I asked him to switch over to speakerphone. Eventually, I heard the emergency physician say, “Listen. This is how it works. A patient points to what hurts. Then I have that part scanned, and you tell me what is wrong.”

Disheartening as …

How setting healthy boundaries can help you regain control in a demanding world

Dimitrios Tsatiris, MD

Physician

December 28, 2019

Advancements in technology have blurred the lines between work and home life. This is because modern technology, such as the smartphone has made it easier for others to reach us. Time and location no longer serve as barriers. It is not uncommon for work-related matters to reach us via email or text after hours. People are continuing their work from home rather than enjoying precious time with loved ones.

Physicians are …

The excitement of clinical rotations: Not just learning medicine but doing medicine

Orly Farber

Education

December 27, 2019

The first time a woman went into the final stage of labor, I watched from a corner of the room. As a third-year medical student, I was on my six-week clinical rotation in obstetrics and gynecology, and it was day one of the two-week portion on the labor and delivery floor. As a loudspeaker announcement projected over the woman’s screams, and nurses and doctors rushed in response, I instinctively clasped …

For students with test stress, medical schools leave a void

Steve Blatt, MD

Education

December 27, 2019

I’m writing this for my tribe of worriers and self-doubters, people for whom ever-present test stress is inextricable to the med school experience. Sure, every medical student becomes preoccupied fretting over exams to some degree. That’s part of what you sign up for. But our preoccupation is something greater than that—it towers over us and bullies us. It makes us cower in the corner, begging to be spared from harm.

We’re …

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