One of the things I am most grateful for, as a doctor who has worked in at least a dozen different hospitals over the last decade, is the broad range of experiences I’ve had and the variety of physicians I’ve met and gotten to know. I enjoy hearing experienced physicians’ perspectives on how the practice of medicine has changed from what it used to be in the 1970s to 1990s.
I …
Physicians: Don’t let administration intimidate you
As resident physicians with a tight budget, one of the last things on our mind is paying for added insurance. Trust me; I get it. However, as a [future] high-income earners, long-term disability insurance is essential. It may not be at the top of our priority list, but it should be.
What is it and who needs it?
Unless you are already financially independent or were lucky enough to have a trust …
Questions about physician disability insurance answered
I can vividly remember the day the phone call came. My cousin screaming over the phone, trying to make out words but unable to speak, disbelief, horror, the fear in her voice palpable even though she was thousands of miles away. It was barely 5:30 a.m., I was frantically rushing out to beat traffic, hoping to get a head start on pre rounding since I was on call. Confused, I …
The brutal emotional challenge of medical training
When I told my colleagues that I was going to try to create the first psychiatry review course at the University of Toronto, I received the same two responses: “It’s about time somebody did that!” and “What is wrong with you?” — sometimes from the same person!
The first reaction taps into the excellence of our department. With approximately 1,000 faculty with diverse expertise and the largest residency program in Canada, …
Want to create a review course? Here’s how this physician did it.
The U.S. health care “system” is completely and utterly broken. According to the World Health Organization (WHO), the U.S. system ranks 37th in the world, all while spending dramatically more on health care than other wealthy countries. Tens of millions remain without any health insurance coverage. For many, medical bills can mean economic ruin — some surveys show that up to Read more…
Nurses are striking. Where are the physicians?
“I have the CPAP machine. I’ve had it for a year, but I don’t have electricity in my house. I stayed with my aunt who has electricity but things didn’t work out,” said the young Navajo man, his massive belly protruding out from underneath the tray table.
The old Navajo man with Parkinson’s disease, unable to walk fast enough to make it to the outhouse in time, had started taking anti-diarrheal …
The systemic poverty in Navajo Nation is a national travesty
Dear colleagues, I know you have seen these questions:
Do you currently have any physical or mental impairment that could limit your clinical practice?
Are you currently taking any medication?
Have you ever been hospitalized for any reason?
Have you ever been hospitalized for, or diagnosed with, a psychiatric disorder to include substance abuse?
Ugh! I hate, hate, HATE these questions! “It is none of their business,” or at least that is what I told …
Should physicians lie when asked these questions?
Whenever I discuss matters of money and business with medical students and residents, I‘m surprised by the responses: “Zilch, nothing,” or “Are you kidding?” Sadly, our doctors-in-training still receive little to no education in this arena.
There’s a stigma surrounding physicians and money, based largely on fact, which has become a beacon for all sorts of disingenuous, exploitive people who view doctors as over-stuffed pinatas, belly-full of money, ready to be …
Avoid the stigma: money advice for young doctors
I sat across the table from my physician client and listened to her story. She asks, “How can it be that after four years of medical school and three years of residency training in my chosen field, I feel so disillusioned and disconnected?”
Instead of seeing the excitement of starting a new chapter in her career or even acknowledging some trepidation about becoming an attending with the increasing pressures of this …
Success in medicine does not equate to a successful life
Anyone can exhibit narcissism or narcissistic personality traits or types from time to time in different forms from mild to severe. When doctors are under stress, they can “act out,” or their behavior can worsen. Greater awareness of damaging behaviors is therefore important. The more we recognize the traits in ourselves and others, the less likely they become a problem. However, unfairly labeling or stereotyping doctors as narcissists is to …
How to manage narcissistic doctors
During college and medical school, my summer employment acquainted me with members of organized crime families. Now, reflecting on my full career as a primary care clinician, geriatrician, and researcher on health care delivery improvement, I have discovered that several insights from organized crime could guide medical professionals’ responses to our country’s health care crisis.
Organized crime and the U.S. health care industry have more in common than might be immediately …
What do organized crime and health care have in common?
One big life event for me was having my son Matthew during medical school. It has been a fulfilling and interesting journey.
I met my husband Andrew during college, and we were lucky to matriculate together at the University of Minnesota Medical School. I decided to do a dermatology research year between the third and fourth years of medical school, and Andrew did a neurology research year at the same time. …
The journey of being a parent in medical school
A swimming pool. Most of a Tesla. Not nearly enough to have your kid swapped out during their sham SAT test. Nor would an ICU bill for a stay that resulted in survival — $48,744 is the cost of that. What costs an alarming amount more is the bill the US Government pays annually on erectile dysfunction medications for servicemen — a whopping $8.7 million according to a 2016 Rand …
$34,000 to save mothers and their children from postpartum depression
A guest column by the American College of Physicians, exclusive to KevinMD.com.
We are just now beginning to recognize the impact of isolation and loneliness on the health of our patients. Recent cultural and societal changes have led to markedly increased levels of isolation of our patients with a dwindling size and activity of their …
The isolation and loneliness that physicians experience
If you have worked in the hospital setting for any length of time, you likely are aware of the physicians’ lounge. It’s the protected space where the hard-working medical staff can escape to catch a break or grab a hot beverage. The physicians’ lounge is absolutely necessary. Medical staff members need a space where they can refuel and exhale the stresses that caring for the sick and dying will often …
Growing up, I was discouraged from becoming a doctor; I was too emotional. My mother, a geriatrician, worried about my attachment to patients and the volatility of inpatient medicine. To some degree, I understood her concerns; I’m tearful during goodbyes and inconsolable at funerals. Yet my interest in medicine persisted, and I began medical school. In my third-year, I experienced the innumerable emotions associated with witnessing patients’ deaths. I was …
Death through the eyes of a medical student
My interest in understanding burnout among medical trainees started during my second year of medical school. With Step 1 nearing, I noticed a dynamic shift in my classmates. The growing tension, petty arguments, and constant worry surrounding our futures took over. This led to a research project assessing burnout risk factors that stood out like a red flag on my application for residency. I found most of my interviewers were …
If medical students are already experiencing burnout, how are they going to survive residency?
Physicians actually make good pilots. But, in 1966 they received a bad rap due to a report published by the FAA’s Chief of Aviation Medicine, Dr. Stanley Mohler. Mohler had a point. Physicians were crashing planes at a higher rate as opposed to the general aviation population. His report would be a cautionary tale for all of us. It would be three decades before we even began to understand why …
A wag once said: “There is no such thing as a healthy person, just one who has not had enough tests.”
As we make every minor deviation from the average into a disease, that jest is becoming uncomfortably close to the way our current medical system behaves.
Part of the problem is that many diseases represent an arbitrary cut-off of a number. Thus, hypertension is defined as a blood pressure above a …
Many diseases represent an arbitrary number
The following is something I wrote for our annual memorial service for children who have died at our Children’s Hospital. But these same thoughts are with me every day.
It’s an honor to be here with you to celebrate the lives of our patients. Thank you for being here. Thank you for sharing your children’s lives with all of us. Speaking for the staff of the children’s hospital, thank you for …
Thank you for letting us be a part of your child’s life. You truly are the heroes of medicine.
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