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OB/GYNs are getting old and tired. Who’s going to be left to deliver your children?

Physician

June 13, 2019

I’m a 46-year-old OB/GYN. I’ve been on call at least as often as every fourth night for my entire career.

Let that sink in for a minute.

How many people get up and answer phone calls, remove ectopic pregnancies, deliver babies, and do C-sections every fourth night for an entire career? Probably not many.

It’s 4:15 a.m. I just got a call from the hospital about a patient of mine who is term, …

My caffeine-free residency

Rebekah Fenton, MD

Physician

June 12, 2019

A kind resident or attending asks me, “I’m going for a coffee run. Can I get you anything?” I politely decline. “You sure?” “Yeah, I’m actually doing a caffeine-free residency.” A mix of utter disbelief and disgust crosses their faces, probably yours too. With skepticism, people ask: “Why?” I actually hate the taste of coffee. (That is absurd in Seattle, where I’m doing my residency training.) Whenever I try a …

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My caffeine-free residency

Speaking out about practicing medicine in Ethiopia

Dr. Yohannes Mengistu

Physician

June 11, 2019

I am a young physician practicing medicine in the “motherland” of God-gifted Ethiopia, which is located in eastern Africa, south of the Sahara Desert. I want to share my personal story, as well as to expose some of the serious problems facing physicians and patients in my country.

I started medical school, which requires the highest academic performance of any career path when I was 18 after completing secondary school. Despite …

To struggling medical students: Meet the physician who conquered the “no’s”

Diana Cejas, MD

Education

June 11, 2019

I know what kinds of things I’m supposed to tell you. I know that your other would be advisors will usually stick to the same basic messages: “Keep reaching for your dreams” or “your hard work is all worth it in the end” or “your education will lay the world at your feet.” These platitudes are all well and good, but honestly, they’re forgettable. And pretty words don’t always translate …

Bottle-feeding grandmothers vs. breastfeeding daughters: advice from a pediatrician

Johanna Vidal Phelan, MD, MBA

Conditions

June 10, 2019

Recently, a friend’s mother asked me how to best support her daughter’s decision to breastfeed her first grandchild. The new grandmother questioned her ability to encourage her daughter’s decision because she had not breastfed her own child, and this lack of experience made her feel unqualified to provide support. With mixed emotions and a lingering sense of guilt, this new grandmother wanted to learn, from a pediatrician friend, how best …

If you won the lottery, would you quit being a doctor?

Anonymous

Physician

June 10, 2019

On October 23, 2018, the Mega Millions lottery jackpot was 1.6 billion dollars, making it one of the largest lottery jackpots in history.

The hospital was abuzz with chatter in the week leading up to the drawing. Discussions about the possibility of becoming an instant billionaire were just too good to resist.

During that week, I found myself sitting at the nurse’s station in one of the ICUs at midnight. A nurse …

The inspiring story of a female orthopaedic surgeon

Nancy Yen Shipley, MD

Physician

June 10, 2019

As a female orthopaedic surgeon, I am often asked how I ended up in this field. Although seeing women in orthopaedic surgery is becoming more common, we are still makeup only 6 percent of the orthopaedic surgeons in the U.S.

I actually had no idea what orthopedic surgery was before medical school. In fact, I started medical school thinking I would be an internist, but it really didn’t take me very …

9 things I learned when purchasing disability insurance

Altelisha Taylor, MD, MPH

Finance

June 9, 2019

As an incoming resident physician, I need disability insurance. Although a group policy is offered through my employer, it doesn’t provide enough coverage to adequately cover my monthly expenses or insure my future income. Thus, I purchased an individual long-term disability insurance policy. This is what I discovered:

1. Disability insurance is expensive. A substantial number of people use disability insurance, so companies raise the price to cover the payouts and ensure …

When should you be tested for vitamin B12?

Edward Hoffer, MD

Conditions

June 8, 2019

Two recent patient experiences prompted this post. In the Wall Street Journal, Dana Hawkins-Simons described several years of being seen by specialist after specialist for her complaints of tiredness, dizziness, ringing in the ears, palpitations, shortness of breath and “brain fog.” She finally researched her symptoms and demanded that she be checked for vitamin B12 deficiency, which turned out to be the cause of her symptoms.

Recently, the …

The journey from hand surgeon to entrepreneur

Eric George, MD

Physician

June 7, 2019

An excerpt from We: Ditch the Me Mindset and Change the World.

We use them to greet friends, congratulate acquaintances, and embrace loved ones.

To lay bricks, perform surgeries, and sculpt artwork.

Everyone uses them thousands of times a day in a variety of different ways.

It took me years to recognize …

In our health system, who “owns” patients?

Philip A. Masters, MD

Policy

June 7, 2019

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 …

Bringing hospitality back to the hospital: lessons from a bartender

Cory Michael, MD

Physician

June 7, 2019

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.

The 9 types of manipulative patients

Jeffrey E. Keller, MD

Physician

June 7, 2019

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 …

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The 9 types of manipulative patients

How depression made this doctor a better physician

Alistair MacDonald, MD

Physician

June 6, 2019

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 …

When physician pay packages become hospital kickbacks

Jordan Rau

Policy

June 6, 2019

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 …

How to save tens of thousands of dollars on your medical school loans

Rishi Thaker, DO

Finance

June 5, 2019

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 …

8 tips for having a baby while applying for residency

Molly Johnson, MD

Physician

June 5, 2019

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 …

Here’s the secret to emergency department efficiency

Phillip Stephens, DHSc, PA-C

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 …

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