I was recently working in clinic on a Friday afternoon. I was on my last patient of the day, and it had been a particularly long clinic. I had big plans for the weekend and should have already finished. The gentleman entered the room, sat down, and we began the consultation. Because I was so behind, I went through everything a little quicker than I usually would, but still covering …
Never let your patients know you’re in a hurry
It’s 10 p.m.
Seven days before Christmas.
I’m sitting at work “finishing” up some charts.
I am suddenly overcome with anger.
What am I doing here right now at this minute? I am helping no one.
This work I’m typing away at — trying so hard not to scream — it’s hoops. Fucki*g hoops … for insurance companies. So I can beg them to pay me. Pay me pennies for the hard, good, compassionate, humanitarian …
“90 percent of what you will learn over the next four years will be wrong in a couple of decades from now.”
Speaking to a lecture hall of 120 first-year medical students, our professor’s prophecy seemed to fall on deaf ears. Looking around, I saw no concerned students, no diminishment of our collective enthusiasm. For me, however, his words of caution struck a chord on that first day of medical school.
As …
Most of what you learned in medical school is wrong. And that’s OK.
Students’ time in medical school should help them grow and become insightful, caring doctors. Instead, medical education is somehow turning smart, gifted, enthusiastic applicants into exhausted and unhappy students who become interns, residents, and physicians at increased risk of depression and burnout.
I’m no stranger to the demands of medical school. My father and father-in-law were both …
Medical schools cause burnout. Here’s how to fix that.
As media coverage of the 50th anniversary of Woodstock shifted into high gear earlier this month, two articles in the “Arts and Medicine” section of JAMA called attention to another anniversary that transported me back in time.
It has been 40 years since the publication of The House of God — an unabashedly irreverent (some would say “borderline pathological”) fictionalized account of author Stephen Bergman’s …
Does the House of God stand the test of time?
“Jeff, turn my headphones up.”
There is a peace and tranquility to the recording booth before the beat drops. A heavy bass and drum kick in, signaling me to bark gravelly lyrics into a state-of-the-art microphone with hopes that it sounds passable. Over the past year, my rhymes have gone from clunky to less clunky, and for a few moments, they weave between melodic insightfulness and relatable humor. Embedded within these …
Meet the orthopedic surgeon who became a rapper
A guest column by the American College of Physicians, exclusive to KevinMD.com.
Because I work for a medical specialty society, I’m frequently asked by non-members why I believe they should belong to a medical professional society. This is a particularly relevant question these days given the rapidly changing landscape of medicine and with physicians becoming …
Why should you belong to a medical professional society?
As we’ve seen, the lives of those working in the health care system has become overwhelmingly challenging, burdened by all of the excess nonmedical stuff that has been added into our lives as we try to take care of patients.
From prior authorizations, to clicking in the electronic medical record, to endless streams of regulatory requirements, to the continuous onslaught created by …
How can we address retention in the era of physician burnout?
What is coaching? It’s a conscious effort to notice and evaluate how our thinking impacts our experiences, how perspective shows up in the results of our life.
Coaching has been integral to fields other than medicine for many years. Yet, many physicians don’t know much about it — much less anything about its potential to radically transform the culture of medical training and our experiences in health care.
It’s time we caught …
Physician coaching: the new normal?
An interesting article in the journal Pediatrics is both intriguing and sobering. It is intriguing because it lays bare something we don’t talk much about or teach our students about; it is sobering because it describes the potential harm that can come from it, harm I have personally witnessed. The issue is overdiagnosis, and it’s related to our relentless quest to explain everything.
Overdiagnosis is the term the authors use to describe …
The problem of overdiagnosis: What can patients do?
Earlier this year, I asked a group of nurses what gifts doctors could give that would help them know they are appreciated. There were hundreds of comments that included many I expected: Food (pizza, chocolate, cake, tacos, bourbon, Starbucks, healthy snacks), pens, cash, and/or gift cards for all shifts.
There were some interesting “high end” ideas: Massages or a massage chair. Trips. Cars. Stethoscopes.
Some still make me shake my head and …
A thank you from doctors to nurses
Ever feel like you are always on the go, not feeling comfortable slowing down? All through school, college, medical school, residency, and then practicing medicine, the one thing that I got really good at was staying busy. Planning projects, test-taking, solving cases, treating patients, emails, meetings, joining boards, organizations, getting more certifications, a world of task lists, and checkboxes. What was often sacrificed was being a mom, wife, domestic duties, …
Is overachieving a sign of past trauma?
Susanna Harris was sitting in her lab class for her graduate program at the University of North Carolina at Chapel Hill when she received an email that told her she had failed what she describes as “the most important exam in grad school,” the doctoral qualifying exam. She took the rest of the day off, went home, and baked cookies.
Harris continued with her regular schedule: lab, work, home, repeat. Everything …
Sharing mental health issues on social media
Interleveling strategy
Want to crush USMLE Step 1? Here are some evidence-based study tips.
For what seemed like an hour, I stood staring at the flat lines scrolling endlessly across my monitor in the OR. The once pulsatile waves, rendered useless and flat due to the absence of a beating heart. After a frenzied six hours of pouring blood into the patient while it poured back out of her just as fast, the surgeons drowning in blood in their attempt to sew the new …
If a doctor has a bad day, someone dies. Remember that.
Actor Peter Fonda, son of Henry Fonda and younger brother of Jane Fonda, passed away August 16 at his Los Angeles home. Fonda, who was 79, is probably best known for his role as Wyatt in Easy Rider, a movie he co-wrote, produced, and starred in. Fonda was nominated for the Academy Award for Best Original Screenplay for that film as …
Explaining Peter Fonda’s lung cancer
I am a cardiac anesthesiologist. I want to explain what anesthesiologists do, who we are, and why it is important for the public to know.
Anesthesiologists are physicians.
Anesthesiologists are the guardians of the operating room.
Anesthesiologists are leaders.
If you get in a car accident, we are there.
If you develop an infection and can’t breathe, we are there.
If you are having a heart attack, we are there.
If you need a new knee or …
We are anesthesiologists. We got you.
The definition of pimping in the medical field is different than the colloquial usage by artists like Jay-Z, Snoop, and Kendrick Lamar. Although most people are aware of pimping in the vernacular language (which will not be discussed further, I would suggest avoiding most rappers terminology if you desire to research), the medical use of the word is a little more nuanced and opinions on the practice are split.
Pimping in …
In defense of pimping in medical education
The first two years of medical school are geared towards learning enough so you can pass your first round of boards. All the sleepless nights and the tears can be overwhelming, but to finally get to the finish line is an incredible achievement. It reinforces that these first two years were worth it and that you learned some things along the way.
However, some students don’t receive the same good news. …
An interview with a medical student who failed the boards
Dear hospital,
The last three years, I have had the pleasure of working in our state’s renowned emergency department and level-1 trauma center. My departure closes out a decade of my nursing career as an emergency room and flight nurse. This department — the staff, in particular — will forever hold a very special place in my heart. I leave with a great amount of respect and thanks for this exceptional …
A nurse’s powerful ER exit letter
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