Raise your glasses (of juice, water, champagne, or whatever you fancy) and join me in celebrating a dream come true: I’m officially a physician who practices medicine from home. To think that it was only four years ago that I was burnt out. It took having that eye-opening experience to take myself off the grid and begin practicing medicine on my own terms. I left nephrology to practice as a …
A physician’s journey to working from home
I’m an orthopaedic surgeon, but if you told me I’d be here when I graduated from college, I’d be laughing at you. When I got started in college, I thought I was going to be pre-med and apply to medical school. It was not a well-thought-out decision. I thought that this was what good Chinese-American children do: Grow up to become doctors. It became clear that this goal was parent-driven …
The journey from a low GPA to an orthopaedic surgeon
Samuel was an English gentleman hailing from London. Close to 10 percent of the U.S. population, over 30 million people, lives with diabetes. Five years ago, Samuel was diagnosed with type 2 diabetes. Taking lisinopril and glipizide, he also goes on hour-long walks every morning at 6:30 a.m. to keep his A1c at his comfort number of 5.5. It has not always been this way for Samuel as he was …
A patient’s tale of type 2 diabetes
A recent New York Times piece had the catchy title, “Don’t visit your doctor in the afternoon.” It was prompted by a study published in JAMA Network Open that had the much less catchy title “Association of Primary Care Clinic Appointment Time with Clinician Ordering and Patient Completion of Breast and Colorectal Cancer Screening.” The study found that the frequency of appropriate ordering of …
Why you should see your doctor in the morning
Physician compensation in most employed positions is based on how much a physician “produces.” I work as a psychiatrist, and this amounts to how many patients you see per hour. The more patients you see, the more “productive” you are, the more money you generate, the more valued you are by your organization and the more RVUs you churn out for a larger paycheck. But, in human terms, what exactly …
It’s time for physicians to be less “productive”
I chose endocrinology to be my lifelong profession out of love for the complex interactions of endocrine glands and intricate feedback loops. I take pride in preventing medical complications, prolonging life expectancy, and providing complex care to type 1 and type 2 diabetics. At times, this field of work requires spending hours — either with the patient or before or after patient visits — counseling, examining blood glucose data and …
Endocrinologists are needed more than ever. Why are they being devalued?
As a college freshman in 2012, my life seemed perfect. I was attending Rhodes College in Memphis, TN, with the dream of becoming a pediatric oncologist. To that end, I was serving as a volunteer, researcher, and clinical intern at the world-renowned St. Jude Children’s Research Hospital. I was thriving in my classes and building incredible relationships with my peers and professors. I had never been happier.
Everything changed when I …
How a disability changed this medical student
It was the last week of my EMS elective. I was incredibly lucky to ride with one of the EMS captains who was eager to take me to any call that sounded interesting. We were called to a possible stroke. An 82-year-old woman with sudden-onset unilateral weakness and expressive aphasia. The paramedic and EMT on scene were two I had met before. We actually talked earlier that day about the …
A medical student’s biggest fear
There is a condition known as cyclic vomiting syndrome which causes people to develop episodes or “attacks” of frequent vomiting lasting for a few days at a time without an apparent cause. Sufferers of cyclic vomiting are totally fine between episodes … it’s kind of like a migraine of the upper gastrointestinal tract! Just like treating migraine headaches, treatment of cyclic vomiting syndrome is aimed at identifying and removing triggers, and using …
Don’t forget this common trigger of cyclic vomiting syndrome
It seems now as if every day and every month is associated with a “national day” or an “awareness month.” Some such as “national taco day” may be less important than others, well depending on one’s priorities. Although many illnesses now also have a dedicated day or month, many of these diseases will go unnoticed. They will rarely be discussed — that is until a celebrity or someone in the …
Celebrities are bringing a myriad of health conditions into the public consciousness
Geographical arbitrage is a huge component to being able to build wealth in a timely manner. For doctors, the formula for rapid wealth accumulation calls for geographical arbitrage even more strongly as our salaries do not have wide ranges across the country. A doctor in Texas will probably command a similar salary in Arizona (maybe slightly less). A doctor in the midwest might earn more, spend less, and work less …
The financial disadvantages of being a doctor in California
A lot of parents ask me about the HPV vaccine, “Isn’t that the optional one?” Well, let me walk you through why my answer to that question is a hard “no.”
Human papillomavirus (HPV) is a virus that causes warts and several types of cancer. There are over 200 different strains of HPV, some of which tend to cause warts on the hands, feet, or face. Other strains …
No, the HPV vaccine isn’t optional
In medical school, you’re not taught how to give stellar patient presentations. Yes, you’re shown the traditional order of things: “Give an effective one-liner first, then tell the HPI [history of present illness] but only give pertinent info, etc.” Just exactly how to deliver the punch that impresses your attending is an art. And it’s an art that takes some time to perfect.
My very first time presenting a patient was …
A medical student’s first patient presentation
An excerpt from Private Equity in Gastroenterology: Navigating the Next Wave.
A long time ago, gastroenterologists ran solo or small group practices. Despite the myriad challenges of running a medical business, doctors enjoyed the independence that private practices offered.
But over the years, everything got too complicated. From insurance reimbursements to …
Private equity in gastroenterology: Is it the future?
For as long as I remember, studying medicine has always been the goal I focused on the most. For years, I thought that I knew the path I was taking, and that I calculated the benefits and drawbacks. However, with time, I learned that no matter how much one assesses his decisions, one cannot have a full grasp of it, until he/she “begins” to experience it.
I wasn’t aware how much …
Medicine was consuming this medical student. Was it worth it?
When writing medical notes, some clinicians include an appreciation of their patient’s personality and disposition in their opening line (the “chief complaint”), or when they’re wrapping up (in the “assessment and plan”), or in both locations.
You know — it goes like this:
“CC: Ms. Smith is a very pleasant 62-year-old woman admitted with …”
or:
“A/P: To summarize, Mr. Jones is a delightful 89-year-old man presenting with …”
or:
“CC: This lovely 74-year-old retired school teacher was in her usual state of health …
Should we write that patients are “pleasant” in medical notes?
It was the first time the young woman had come to the health center in a suburb just north of Chicago. When the 26 year old walked into the exam room back in 2008. There was no paper chart or electronic health record (EHR) accompanying her, no background information — nothing to indicate anything but a routine annual gynecological exam.
She and her husband were about to try to have their …
The simplest and most important question to ask in the exam room
Let’s burn health insurance down. Greedy corporate bastards should burn. Big Pharma and big hospitals should probably burn too. You know who else is really, really, bad? Wall Street. Let’s burn the banks. And let’s burn Big Tech and the entire Silicon Valley cartel. Let’s also burn Big Agribusiness that’s making us fat and sick. And let’s burn the Oil companies that are destroying the planet, and let’s burn the …
The problem with burning health insurance down
“In a case that could have wide-reaching implications for medical practice in Minnesota, the Minnesota Supreme Court issued a ruling on April 17 in the case of Warren v. Dinter holding that the existence of a physician-patient relationship is not a prerequisite for a medical malpractice action. Rather, a person may sue a physician for malpractice – even if that person was not a patient of the physician – if the harm …
How a Minnesota Supreme Court decision could affect curbside consults
As physicians, we have embraced a calling where we help others. A commitment many of us fully relish. We are grateful for our patients and the families who put their trust in us as we diagnose and treat their sometimes incredibly complex illnesses. I have been genuinely inspired by the stories I have heard from patients and my colleagues on the work we do.
Yet, in spite of the incredible advancements …
Second victim syndrome: a doctor’s hidden struggle
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