A guest column by the American College of Physicians, exclusive to KevinMD.com.
When talking with patients – particularly those with multiple, complicated medical issues – it often doesn’t take very long to hear about their increasingly suboptimal and sometimes harrowing interactions with our health care system.
Examples include inpatient experiences in which care is provided by …
In our health system, who “owns” patients?
It was a beautiful day in southern California as I made my way along Interstate 5 en route to San Diego from Los Angeles. Seeking a venue near the ocean to get some work done on my computer and maybe a snack with my iced tea, I turned off the interstate in search of a restaurant I had heard about with a good local reputation and well-reviewed food.
Bringing hospitality back to the hospital: lessons from a bartender
One of the more common complaints that I hear from medical practitioners in jails and prisons (especially new practitioners) is, “These manipulative patients are driving me crazy!” Well, to be honest, I ran into a lot of manipulative patients when I worked in the ER, as well. But it is true that many of our patients in jails are especially …
The 9 types of manipulative patients
Residing in all of us, whether or not we feel it, is an innate zest for life. As a family medicine resident, I live with enthusiasm daily, because I am happy seeing patients, no matter my rotation. From the acute care wards to the family medicine clinic, I enjoy and relish the opportunities to sit with patients. Unfortunately, this zest for life was once lost on me, and at times …
How depression made this doctor a better physician
For a hospital that had once labored to break even, Wheeling Hospital displayed abnormally deep pockets when recruiting doctors.
To lure Dr. Adam Tune, an anesthesiologist from nearby Pittsburgh who specialized in pain management, the Catholic hospital built a clinic for him to run on its campus in Wheeling, W.Va. It paid Tune as much as $1.2 million a year — well above the salaries of 90% of pain management physicians …
When physician pay packages become hospital kickbacks
If you’re planning on applying for Public Service Loan Forgiveness (PSLF) and spending the first ten years of your career in academic medicine or working for 501c(3) employers, this scheme could mean paying off your loans six months sooner, saving you an average of $30,000.
Consolidate your loans with your loan servicer and begin one of the income-driven repayment plans (IBR, RE-PAYE, ICR, or PAYE) immediately, foregoing any deferment or grace …
How to save tens of thousands of dollars on your medical school loans
Being a medical student is tough, applying for a competitive residency spot is tough, and being a new mother is also very tough. I am one of the lucky women to do all three at the same time. I had my child early August of my fourth year of medical school. The fourth year of medical school is a great time to become a new mother. The schedule is more …
8 tips for having a baby while applying for residency
A gray-haired emergency medicine physician once provided the most succinct view of ED efficiency ever uttered. He said, “Sometimes they ask us to dig a ditch. Then they give us spoons with which to do the job.” Though cynical, it is the view of many. There really is only one problem and a single solution to ED efficiency. The problem is variation. The answer is scale.
Biologists understand variability best. Biologic …
Here’s the secret to emergency department efficiency
Most Saturdays, I join a therapy session down the hall from where I do my walk-in clinic. A patient of mine has a weekly session just before the Alcoholics Anonymous meeting at noon in our big conference room.
Last weekend he told my behavioral health colleague that the people in the AA group who have the most solid recovery seemed to be the ones who claimed to carry a lot of …
The role of hatred in medicine
If you read my curriculum vitae, you might assume that I must have a high opinion of the U.S. News & World Report higher education rankings. I earned my bachelor’s degree from Harvard University, #2 behind Princeton in the “Best National Universities” category. My Master of Public Health degree is from Johns Hopkins, the #1 public health school. And my medical degree is from NYU, tied with Cornell and the Mayo Clinic as …
Why you shouldn’t place too much importance in college and medical school rankings
In 1976, we couldn’t wait to be nurses. Our starched white dresses with the nurse caps and stripes symbolized our graduation status as we were called one by one to receive our diploma and a rose.
We took an oath to care for the sick, to be professional, to critically think, to respect doctors and to respect patients and family members.
And to respect each other.
It was the age before computers. We …
Nursing’s newest problem: The young eating the old
There is a pervasive tendency to turn to medicine looking for magic. Patients and health care professionals alike generally expect medicine to be able to cure diseases, alleviate symptoms, and relieve suffering. Historically, medicine has met and exceeded these expectations in a variety of ways.
However, in some cases, these expectations can cause a blurring of the lines between hope and reality, resulting in false “promises” and preventable disappointment.
You may be …
The breakthroughs and failures of medicine
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 48-year-old woman is evaluated at a follow-up appointment for elevated liver chemistry tests over the preceding 6 months. She reports no symptoms. She has type 2 diabetes mellitus and hypertension. Her family history is unremarkable. She drinks two glasses of wine one or two times per month. Her …
MKSAP: 48-year-old woman with elevated liver chemistry tests
An excerpt from Hindsight: Coming of age on the streets of Hollywood.
During my medical school clerkships, an attending recognized a truth within me that I’d hidden for many years. Just a few hours into my pediatrics rotation, the …
The story of how a homeless teen became a physician
The future of our profession lies in our ability to come together with a unified voice. We must also recognize that the practice of osteopathic medicine, and the training of osteopathic physicians, has evolved significantly since A.T. Still, MD, DO, created osteopathy.
The AOA recognized this when its Board of Trustees announced that the AOA will start providing two pathways for board certification. DOs will be able to …
It’s time to rethink what it means to be a DO
The seeds of emotional turmoil inherent in medical education are planted early in the pursuit of becoming a doctor. It is the unspoken fear that medical students and residents experience each day on attending rounds. It is the worry of missing a vital piece of information from the history and physical exam of a patient. It’s the concern that despite reading and preparing for the cases, emerging physicians may find …
3 ways to change your mindset in continuing medical education
It took me a long time to put a name to what I was feeling. Only recently had I started to read about imposter syndrome. I’ve had this feeling multiple times throughout my life, and it always had the potential to pull me backward instead of allowing me to propel forward towards my goals.
I had this feeling when I made it into college, then again in medical school. Even when …
How this physician fought imposter syndrome
Financial planning is comprised of the six decisions people make with their money. Physicians need to make decisions as to how you earn, spend, save, borrow, give, and protect yours. Home buying typically touches on all of the six money decisions.
Home buying often begins with a mortgage, so you will have to make decisions about borrowing money. You also must earn money or at least have the potential to earn …
Home buying tips for physicians
Wealth accumulation can follow many trajectories, depending on discipline and external factors like stock market health or economic fluctuations. With a proper financial plan, doctors can stick to a game plan that should allow them to reach financial milestones rather predictably. The adage that wealth begets wealth certainly does hold true most of the time, but it doesn’t necessarily guarantee financial victory. One of the issues with wealth accumulation is …
Physicians and the risk of a plateauing net worth
I recently wrote an article giving 3 reasons why any patient may not have liked their doctor. They included the physician being visibly in a hurry, appearing to brush off concerns, or giving a general sense of not caring. While no doctor deliberately sets out to do any of these things, complaints like these are all too common, unfortunately.
The degree to which the practice of good medicine is …
3 reasons why your patients love you
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