The changes that have occurred in health care over the last few years represent a sea change from the autonomy and clout that physicians once had. It’s no great secret to anybody working in medicine that most of these changes to practice — including the push towards employment instead of private practice, and the need to now spend the majority of the day clicking boxes on a computer screen — have …
Physicians need to stop being so nice
I just did my first telemedicine video visit.
The concept seems so strange, the idea of carrying out an “office visit” without the patient actually being in the office.
Right now we have it structured so that when a patient calls up requesting to see me on a day when I am already fully booked (or, as is usually the case, overbooked), …
A physician’s first telemedicine video visit
A debate highlighting gender discrimination in medicine currently rages within the pediatric hospitalist medicine community.
The debate centers on the board certification process for “grandfathering” for the new pediatric hospitalist subspecialty which effectively excludes women on the basis of motherhood.
For those not familiar with “grandfathering in,” this is the process by which a new subspecialty may grant board certification to physicians who have been practicing in the specialty. The alternative option …
Don’t make me choose between motherhood and my career
The emergency room is an interesting place to work. It’s controlled chaos. Walk through the hallways, and you’ll hear people screaming, see others crying, and others wincing in pain.
Over time, you get a unique perspective on the human condition. In my years of training and practice, I’ve seen so much. People experiencing their worst days. Others receiving news that will change everything. Some lives ending. Others returning from the brink.
Certainly, …
5 lessons from an emergency physician
I made my 10:20 a.m. patient wait while I told my support staff about my day off.
“I was getting an ice cream when I saw a car accident. By the time I got there, it was clear that there were no serious injuries and all I did was to distract the passenger so she wouldn’t panic while we waited for EMS. Her husband hit a tree with their van, and …
Asking patients the right questions isn’t as easy as you think
Some radiologists perceive teleradiology as the “dark side” of our profession. I may have counted myself among those skeptics, but I now see the light and am happy to share a place among the converts.
Most of my career has been in traditional private practice, but there’s not a great deal of difference in how they operate versus a teleradiology practice. Both organizations exist to provide clinicians and patients with diagnostic …
4 reasons why this radiologist loves practicing teleradiology
The one thing doctors want to avoid like the plague is a lawsuit — a medical malpractice lawsuit.
To be sued means the doctor loses precious time from work, endures emotional personal and family distress and is unable to fully invest oneself in providing the very best medical care possible. It is a dark cloud that hovers over the majority of physicians at least once in their lives. Some medical specialties, …
10 reasons why doctors get sued
People often compare internship to drinking from a fire hose. Overwhelmed by new information and workflow, interns (especially international) usually do not have a clear direction about how to optimize their working/learning experience. Here are some tips for interns to smooth their transition from a newbie into a high-functioning intern in the setting of medicine inpatient wards.
Success leaves clues
Don’t explore yourself, specifically ask your upper-level resident about the most productive …
4 actionable tips for new medical interns
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 25-year-old woman is evaluated in the emergency department for chest pain after a belted motor vehicle accident. She is pregnant at approximately 23 weeks’ gestation. She reports no additional symptoms and is otherwise well. Her only medication is a prenatal vitamin.
On physical examination, the patient is afebrile, blood …
MKSAP: 25-year-old woman with chest pain after a motor vehicle accident
Jeffrey Epstein’s apparent suicide while in custody at a Manhattan detention facility has focused intense media scrutiny into jail suicide prevention procedures. Suicide is the biggest cause of death in jails in the U.S. — by far. Because of this, all jails (including the facility where Epstein was housed) have a suicide prevention policy. Since the process was an epic …
I’m a jail physician. Here’s what likely happened to Jeffrey Epstein.
According to a recent Harvard report, physician burnout is “a public health crisis that urgently demands action.”
Half of all doctors report troubling symptoms: depression, exhaustion, dissatisfaction, and a sense of failure. These physicians are twice as likely to commit a serious medical error, research finds. Experts predict that if left unaddressed, burnout will further erode the mental health of doctors and radically undermine …
Clinical performance data: a physician’s friend or foe?
Every year, there’s this rite of passage, the passing of the baton, as our graduating senior residents move on to fellowships, or into spots as hospitalists, or to practice jobs here in New York City or other cities, and a fresh new group of newly-minted physicians arrives ready to take up the gauntlet of training as Internal Medicine doctors under our …
New doctors are prioritizing the wrong things
“It is high time for us to recognize that the physicians who spend so much of their lives caring for us are often suffering in silence, and effective interventions would be good medicine for all of us.”
– Joan M. Anzia, MD
On February 4, 2007, I attempted to take my own life.
It was Super Bowl Sunday, and the Colts were playing the Bears. My wife Charlene and I were home, and …
The deadly silence of physician depression and suicide
Many years ago, it was called the emergency room. Now we call it the emergency department. However, unlike so many departments in the world, the emergency department has almost too many purposes, duties, and mandates to number.
However, in the process of being the under-funded safety net for American health care, it has also become a place of remarkable danger where medical and nursing staff, support personnel and even patients face …
ER staff deserve a safe place to do their jobs
On March 11th and 12th, representatives from the NBME, AMA, AAMC, Federation of State Medical Boards and the Educational Commission for Foreign Medical Graduates gathered in Philadelphia for InCUS — the Invitational Conference on USMLE Scoring — to discuss potential changes regarding how Step 1 is scored. InCUS came about as a result of a wave of student frustrations over the pressure from the increasing importance of this exam in …
Should USMLE Step 1 be pass-fail?
The decision seemed straightforward. Bob McHenry’s heart was failing, and doctors recommended two high-risk surgeries to restore blood flow. Without the procedures, McHenry, 82, would die.
The surgeon at a Boston teaching hospital ticked off the possible complications. Karen McHenry, the patient’s daughter, remembers feeling there was no choice but to say “go ahead.”
It’s a scene she’s replayed in her mind hundreds of times since, with regret.
On the operating table, Bob …
The questions surgeons need to ask their seniors before surgery
Here are some specific ways for medical trainees to save on their move.
Timing is everything
When is the exact timing of your move? Are you flexible? Think about your situation: you graduate medical school, pack up, and then move for residency. Right?
Most moving companies are busiest (read: most expensive) between May and September when they know you are likely to move. With Match Day in mid-to-late March, getting an early start …
How to save money when moving for residency
There is a trap used to capture monkeys that uses a tree with a hollowed-out trunk. The opening is just large enough for the monkey to put its hand inside. While the monkey can easily pull its empty hand out at any time, inside the hole is a larger space containing delicious nuts that the monkey craves. When the monkey grabs a large handful of nuts, it is unable to …
The doctor trap: What it is and how to escape it
Recently, my niece gingerly confided that she was going to study engineering rather than medicine. I was certain she’d become a doctor – so deep was her love for biology and her deference to our family tradition. But she calculated, as would anyone with common sense, that with an engineering degree and an MBA, she’d be working for a multinational company making a comfortable income by twenty-eight. If she stuck …
Becoming a doctor in India can be life-threatening
We often associate our calling with our career. That’s what I did from the very moment I decided to become a doctor. That’s all I focused on. I studied for it. I invested time and money into it. Like many doctors, my identity was intimately woven into what it means to be a doctor. It’s who I became to the exclusion of everything else.
From the outside looking in, I was …
Doctors: Step boldly into your calling
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