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Here’s the secret to emergency department efficiency

Policy

June 5, 2019

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 …

The role of hatred in medicine

Hans Duvefelt, MD

Conditions

June 4, 2019

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 …

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The role of hatred in medicine

Why you shouldn’t place too much importance in college and medical school rankings

Kenneth Lin, MD

Education

June 4, 2019

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 …

Nursing’s newest problem: The young eating the old

Debbie Moore-Black, RN

Policy

June 3, 2019

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 …

The breakthroughs and failures of medicine

Shannon Casey, PA-C

Meds

June 2, 2019

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 …

MKSAP: 48-year-old woman with elevated liver chemistry tests

mksap

Conditions

June 1, 2019

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 …

The story of how a homeless teen became a physician

Sheryl Recinos, MD

Physician

May 31, 2019

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 …

It’s time to rethink what it means to be a DO

Seger Morris, DO, MBA

Education

May 30, 2019

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 …

3 ways to change your mindset in continuing medical education

Stephanie Wellington, MD

Education

May 30, 2019

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 …

How this physician fought imposter syndrome

Nancy Yen Shipley, MD

Physician

May 29, 2019

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 …

Home buying tips for physicians

John Dameron

Finance

May 29, 2019

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 …

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Home buying tips for physicians

Physicians and the risk of a plateauing net worth

Smart Money, MD

Finance

May 28, 2019

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 …

3 reasons why your patients love you

Suneel Dhand, MD

Physician

May 27, 2019

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 …

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3 reasons why your patients love you

A physician’s journey to working from home

Nana Korsah, MD

Physician

May 27, 2019

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 …

The journey from a low GPA to an orthopaedic surgeon

Nancy Yen Shipley, MD

Physician

May 27, 2019

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 …

A patient’s tale of type 2 diabetes

Ton La, Jr., MD, JD

Conditions

May 26, 2019

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 …

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A patient’s tale of type 2 diabetes

Why you should see your doctor in the morning

Edward Hoffer, MD

Physician

May 25, 2019

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 …

It’s time for physicians to be less “productive”

Anonymous

Policy

May 25, 2019

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 …

Endocrinologists are needed more than ever. Why are they being devalued?

Sameera Tallapureddy, MD

Physician

May 24, 2019

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 …

How a disability changed this medical student

Emily Hayward

Education

May 23, 2019

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 …

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