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Roundsmanship: the skill you didn’t know you needed

Physician

August 3, 2019

“What’s the most common missed fracture?” my supervising PA asked during my clinical rotation in the emergency department. “The second one,” I answered confidently. It was the right answer, and I surprised him by knowing it. He had previously given a lecture to my class and had emphasized this clinical pearl in such a way that I knew it was one of his favorite trick questions.

Unfortunately, I didn’t always know …

When should physicians read the House of God?

Paul Sax, MD

Physician

August 2, 2019

Many consider the novel the House of God, written by Samuel Shem (pen name for Stephen Bergman), to be a must-read for any physician or soon-to-be physician. A fictionalized account of his internship year, the book details how the accumulated stress, fatigue, and powerlessness of being a first-year doctor inexorably accumulates during that year — with sometimes hilarious, and but also disastrous, results.

The survival strategies of the interns in …

Work hard now, enjoy later. Is it time to rethink that?

Passive Income, MD

Finance

August 2, 2019

Something I’ve been thinking about lately is the path that we’ve all been somewhat conditioned to take. And that is working really hard now so we can reap the rewards later. If you don’t work really hard now, you risk not being able to enjoy life when “later” finally comes.

Does that sound familiar to you? Well, it should, because that’s the exact path we took to become successful in our careers. …

The physician who became a chronic pain patient in seconds

Linda Girgis, MD

Physician

August 2, 2019

It took me decades of studying, training, hard work, and sleepless nights to become a doctor. In approximately five years, I became a successful writer, editor, columnist, and a whole array of other titles assigned to that type of work. In under 3 seconds, I became a chronic pain patient for the rest of my life.

Around this time last year, I was taking my two dogs outdoors when they spotted …

I’m sorry: Why I lost my love for medicine

Anonymous

Physician

July 31, 2019

I’m sorry you are sick. I’m sorry you had to wait a long time in the waiting room. I’m sorry you haven’t gotten your pain medications. I’m sorry I don’t have an answer. I’m sorry the department is busy. I’m sorry it’s loud. I’m sorry I don’t know why it smells in here. I’m sorry your neighbor is screaming. I’m sorry you are in pain. I’m sorry you are uncomfortable. …

Beware the hidden agenda of free hernia screenings

Mary Chris Jaklevic

Conditions

July 31, 2019

Some hospitals are trying a curious new tactic to attract patients: free hernia screenings.

One Illinois hospital raffled off tickets for a smart speaker to entice people to get their abdomens checked by a surgeon, while an Indiana hospital offered a chance to win dinner at a chophouse.

Announcements for screening events in Colorado and Maryland warned about “life-threatening” complications that could arise if hernias are left untreated. And hospitals in Read more…

Beware the hidden agenda of free hernia screenings

Off-label use of gabapentin and pregabalin for anxiety

Wallace B. Mendelson, MD

Meds

July 31, 2019

An excerpt from Understanding Medicines for Anxiety.

In addition to medicines with FDA indications for anxiety, such as benzodiazepines and some antidepressants, a number of drugs are frequently prescribed off-label. Among these are gabapentin and the related compound pregabalin, collectively known as gabapentinoids. Their popularity is remarkable: gabapentin has been …

Which retirement account is best for physicians?

Altelisha Taylor, MD, MPH

Finance

July 30, 2019

Whether you are starting a new job, like me, or extending the contract at your current one, part of the process may involve signing up for retirement accounts. Most people have heard of a 401(k), but you may have other options available to you such as a 403(b) and Roth IRA. Let me breakdown the pros and cons of each account, so you can better determine which one is best …

How physicians become medical narcissists

Shannon Casey, PA-C

Physician

July 30, 2019

It is no secret that health care providers shoulder a lot of responsibility. As a whole, they take this on with both competence and kindness. Sacrificially, they go above and beyond in order to provide patients with the highest of quality care. They juggle a multitude of professional and personal responsibilities in creative and admirable ways. Meanwhile, each health care provider learns to adopt a unique combination of coping mechanisms …

Are pediatric hospitals ready to embrace value-based payment models?

Johanna Vidal Phelan, MD, MBA

Policy

July 30, 2019

Although pediatric (children’s) hospitals are not yet mandated (as are their general population counterparts) to participate in value-based contracts (VBCs), as competitive medical institutions they are very cognizant of the market changes toward value-based payment models while tirelessly seeking to increase value in pediatric health care delivery.

The push towards better alignment of payers and hospital systems continues to change the landscape of competitive health care. Children’s hospitals “are the backbone …

When physicians focus more on screens than patients

Carmen Heredia Rodriguez

Tech

July 29, 2019

As Wei Wei Lee sat with her doctor to discuss starting a family, she felt a “distance” between them. The physician was busy on the computer and focused on the screen.

“It just didn’t feel very personal,” Lee said. “I didn’t feel heard.”

It seemed as though keeping a record of the conversation was more important to the doctor than making a connection with Lee.

It wasn’t the experience she wanted, but she …

What to do when physicians get subpoenaed as witnesses

Judy Melinek, MD

Physician

July 29, 2019

You’re a clinician. You had a patient die under your care, and now your hospital is being sued. You are not named in the lawsuit, but you are being asked to give a deposition. How much of your time is this going to take? If some lawyer sends you thousands of pages to review before scheduling multiple phone calls …

Physicians are overwhelmed by alarms and alerts

Fred N. Pelzman, MD

Physician

July 29, 2019

Yesterday, I got just about the strangest version of “MD aware” I have ever had.

We all know what this is, the person who is relaying some critical clinical information (positive blood cultures, Mr. Smith in Room 402 is having chest pain, etc.), and then they ask for your name so they can write it down somewhere in the chart.

In this case, …

5 powerful words you can say to patients

Suneel Dhand, MD

Physician

July 28, 2019

Our job as health care professionals is not just to diagnose our patients by applying our scientific knowledge and clinical skills, but also to be the “communicator-in-chief,” “listener-in-chief,” and “reassurer-in-chief.”

Any doctor who doesn’t fully grasp this, is not doing the best job they can or being the best doctor they can be. I truly believe that over 90 percent of our everyday job as a physician involves being a good …

A medical student reviews Eric Topol’s Deep Medicine

John Paul Mikhaiel, MD

Tech

July 28, 2019

Following on the heels of The Creative Destruction of Medicine and The Patient Will See You Now, Dr. Eric Topol has published his newest book, Deep Medicine, earlier this year. While the first two books highlight how technological disruption will first digitize and then democratize medicine, his newest is about deep learning, and how artificial intelligence (AI) has the potential to ultimately deepen the patient-physician bond. It …

Paltering: When the truth is used to deceive

Shannon Casey, PA-C

Conditions

July 28, 2019

One evening in the clinic’s bullpen provider office, a colleague of mine wondered aloud how to respond to a difficult question a patient asked via patient portal message. A physician within earshot responded, “Just because someone asks you a question doesn’t mean you have to answer that question.”

I tried to empathize with where the physician was coming from. Surely after decades of practicing medicine, one might become weary of spending …

The disaster at Hahnemann University Hospital

Karen S. Sibert, MD

Physician

July 26, 2019

Though the news at first stayed local in Philadelphia and the northeast, it’s gaining traction nationwide. ZDoggMD is on it. Bernie Sanders held a rally.

What happened? The venerable Hahnemann University Hospital, the main teaching hospital for Drexel University College of Medicine in Philadelphia, is bankrupt and will soon close its doors after more than 170 years as a safety-net hospital serving inner-city patients.

Why should we care? After all, there …

The experiences in medicine shape your future

Stephanie Wellington, MD

Physician

July 26, 2019

Hitting a roadblock in your life and career? Don’t get frustrated. Use the resources that are readily available to you.

Not sure what they are? Think about it. You have had access to them all the time.

The moment you decided to become a doctor, you became unstoppable. You may have followed the traditional path and went from college into medical school and then residency. Maybe your path took a few turns before medical …

Think beyond benzodiazepines for anxiety

Wallace B. Mendelson, MD

Meds

July 25, 2019

An excerpt from Understanding Medicines for Anxiety.

Although the SSRIs (selective serotonin reuptake inhibitors) are among the most widely prescribed medicines for depression, they also have a useful role to play in treating anxiety disorders. In this article, we will look at their benefits and limitations when used in this …

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