What happens when abortion services aren’t available

Conditions
February 17, 2020

In my very first job as a doctor — working in a London hospital in the 1980s. I always took a ridiculously detailed past medical history for every patient I saw. I started to notice how many elderly women had had septicemia, a life-threatening infection in which enormous amounts of bacteria enter the bloodstream.

The neighborhood surrounding the hospital had once been the worst slum in London. And it didn’t take …

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What happens when abortion services aren’t available

What do hospital discounts really mean?

Policy
February 16, 2020

Our local newspaper recently ran an article on the top of its front page, stating that our monopoly health system is now “expanding health care cost discounts.”  The article was actually a press release – free advertising on the front page. As a primary care physician who refers patients to this health system, I wanted to know what these discounts really meant.

So, I asked the newspaper in an editorial, “what …

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What do hospital discounts really mean?

The Hufflepuff of medicine

Physician
February 16, 2020

Recently, my mother waited for over an hour for what turned out to be a 5-minute visit with her primary care doctor. Her doctor seemed rushed and stressed, her questions perfunctory, the management plan hurried. And then she was gone. “It’s like she didn’t even know I was there,” my mom relayed to me.

This is a physician who is thoughtful, intelligent, and kind, with excellent clinical instincts. After this visit, …

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The Hufflepuff of medicine

Numb: How I survived as a physician

Physician
February 14, 2020

On my final day of work before beginning my self-imposed  burnout sabbatical, a colleague asked, “Why don’t you just get on medication?” I remember thinking, “What am I medicating?  I feel nothing.” I was in the vice grip of burnout, overwhelmed, and physically and emotionally exhausted.  But mostly, I was numb.

But in reality, I have always self-medicated – with work.  As a professional ballet dancer turned doctor, my life has …

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Numb: How I survived as a physician

Heart of a doctor. Mind of a doctor. Soul of a giver.

Physician
February 14, 2020

Calling.

I am awakened by the loud, screeching sound of my pager. I feel my heart race. I look at the clock.

It is 3:07 a.m. It’s cold in the room. I am shivering. I stand up quickly, instinctively. I feel the soreness of my feet for a brief moment, but push that thought aside and look quickly at my pager. It reads, “room 2309, death pronouncement”.

My heart sinks. She is mine—my …

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Heart of a doctor. Mind of a doctor. Soul of a giver.

USMLE Step 1 pass/fail winners and losers

Education
February 13, 2020

On February 12, 2020, the National Board of Medical Examiners (NBME) announced that the USMLE Step 1 will transition to a pass/fail exam in January 2022 at the earliest. This move comes amidst increasing pressure on the NBME regarding its financial conflicts of interest, as well as the tangible sense among medical school deans that students were neglecting …

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USMLE Step 1 pass/fail winners and losers

The simple step that helped this physician lose 10 pounds

Conditions
February 13, 2020

By the time I turned 40, I had gained and lost 40 pounds at least ten times. It started with the “freshman fifteen” plus another twenty-five in college. In medical school, I was introduced to sweetened coffee beverages, and I snacked on pretzels and candy to stay awake while studying. I got through overnight call during residency by using my meal tickets to buy chocolate-covered ice cream bars. And once …

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The simple step that helped this physician lose 10 pounds

As I become a better baker, I hope that I will continue to become a better doctor

Education
February 12, 2020

Growing up in a Korean household meant that I had very little experience with the type of baking that most Americans are used to; My grandma made rice cakes, not birthday cakes.

But during my third year of medical school, an intern recommended a show called The Great British Bake Off. After watching a few episodes and seeing what devoted home bakers could do, I was smitten and resolved to bake a …

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As I become a better baker, I hope that I will continue to become a better doctor

Cervical cancer guidelines leaves women confused about annual pelvic exams

Conditions
February 11, 2020

There is good news and bad news in the world of women’s health.

The good news is that women do not need annual Pap smears. The bad news is that, upon hearing the good news, many women incorrectly assume they no longer need annual pelvic exams, either.

Historically, Pap smears were performed annually, and during the same time as pelvic exams, so it is understandable why women would conflate the two. But …

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Cervical cancer guidelines leaves women confused about annual pelvic exams

Why doctors need life skills

Physician
February 11, 2020

Medical school prepares doctors for patient care: perform a history and physical, and based on the findings, consider the next diagnostic tests to order, review all data, and develop a treatment plan. By graduating from medical school, you are skilled to perform those duties with a certain level of competency and confidence.

Success in the next phase of this journey and the rest of your life depends on honing those skills …

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Why doctors need life skills

Medical residents need parental leave

Physician
February 10, 2020

My wife and I had a baby a few months ago. Or, more accurately, she birthed a child while I sat in the corner, contemplating the miracle of reproductive physiology in a vasovagal fugue. In the months leading up to and following that wondrous moment, we found ourselves navigating the labyrinthine complexity of parental leave in graduate medical education.

To start with the positive, we are both residents in the same …

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Medical residents need parental leave

Health care is like lions for lambs

Physician
February 9, 2020

I just watched the movie 1917 at the theatre. Shot in a unique way giving an immersive experience, showing the frontline reality of war through an unforgettable human story, it has to be one of the greatest war movies ever made. I’d encourage everyone to go watch it. I learned a fair bit about the First World while I was in high school in the United Kingdom. Its stories are …

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Health care is like lions for lambs

How you can show patients you are listening

Physician
February 8, 2020

Being a physician is an important role. It’s easy to forget the impact that you have on a patient just by being at their bedside.

It’s huge.

Have you ever been a patient? It’s an incredibly vulnerable experience.

You’re not really sure what’s happening and what is going to happen next.

People are really putting their faith in you to understand their needs and to ease their suffering. It’s a powerful thing to ease …

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How you can show patients you are listening

MKSAP: 32-year-old woman with loose stools, bloating, and weight loss

Conditions
February 8, 2020

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 32-year-old woman is evaluated for a 6-month history of loose stools, bloating, and a 3.2-kg (7-lb) weight loss. Her medical history is otherwise unremarkable. Her brother has type 1 diabetes mellitus, and her mother has autoimmune thyroid disease. She reports no other symptoms and takes no …

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MKSAP: 32-year-old woman with loose stools, bloating, and weight loss

Goodbye, Benadryl: It is time for you to retire

Meds
February 7, 2020

Sometimes, old ideas and time-tested treatments remain the best. Newer doesn’t always mean better. Except in the case of one of our oldest antihistamines, tried-and-true Benadryl. It is time for that old drug to be retired, sent off to pasture, and never used again. Goodbye, Benadryl. Fare thee well, adieu, and don’t let the door hit you on the way out.

Benadryl (diphenhydramine) was introduced in 1946. The top single that …

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Goodbye, Benadryl: It is time for you to retire

A case for nephrology

Physician
February 7, 2020

In recent times, physician burnout has rightfully surfaced as a social concern for the medical fraternity. Physician burnout is a thing, and lately, I was thinking about it related to nephrology.

Many national physician organizations and local hospital systems are developing strategies to reduce work-life stress and improve the engagement of the workforce. In November 2018, I represented the Renal Physician Association at the interim meeting of the American Medical Association …

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A case for nephrology

Reconciling consent culture and bodily autonomy with pediatric care

Conditions
February 6, 2020

Every day, children are cared for in clinics and hospitals. And every day, some of them are unhappy about it; some of them deeply unhappy about it.

The contemporary practice of nursing and medical care includes health care providers having to touch their patients. This may include an abdominal exam, listening to their lungs with a stethoscope, or even slightly invasive maneuvers, such as having to put an otoscope into their …

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Reconciling consent culture and bodily autonomy with pediatric care

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