I’m usually a hugger. When I see people I haven’t seen for a while or want to acknowledge someone in an open-hearted way, I often will automatically reach for a hug. Physical acknowledgment is usually perceived as a sign of warmth. But not always. In the last few years, I have noticed that this automatic hug can actually cause harm or insult even though my intent is not to.
I learned …
We physicians stand witness to countless tragedies in our careers.
At some point, as we stand by the bedside of a dying patient, comfort a heartbroken relative or officially call a death. We learn that love and loss, sorrow and joy are intertwined. They depend upon each other. They are two sides of the same coin. Dealing with loss after loss, we learn to look for the beauty in all of …
When we think of a brand, we usually think of companies such as Apple or Coca-Cola with their recognizable logos and colors. We may also think about celebrities, such as Beyoncé and the Kardashians, who have large-scale exposure and garner massive attention.
But, what is a brand? A brand is a particular identity or image that’s regarded as useful or valuable. And, a brand’s identity is how a business wants to …
I was taught anatomy and physiology by a pediatrician-turned-professor who found in academia an opportunity to meld his love of medicine with a propensity for the performing arts. His lectures were scripted and theatrical, and he gifted a generation of students with an awe and understanding of the human body that would serve as the foundation for hundreds of medical careers. Because he was a physician, ours was one of …
I watched the young woman across from me wrap the soft stretch of fabric around her face. She folded a part of it that hung close to her ears and loosened it slightly, put her fingers slowly under the fabric and experimented with how much room there was. Would a stethoscope earpiece fit through each side easily? She unwrapped it again. Repeated the same finger test.
She had chosen a light …
Money is great. It provides security, options, and freedom. If you work hard, practice relative deprivation, and save enough money to become financially independent, you will have reached a commendable milestone.
However, financial independence means nothing if you don’t have your health. It doesn’t matter that you have $5 million if you aren’t around to enjoy it, or if your health is so poor you can’t travel, start a business, teach a class …
This week I had some particularly emotionally tough cases at work, and it got me thinking about life in general and how, in spite of having a tough job, I have learned so much from it.
When I think of childhood diseases, there are the ones that are chronic, the ones that let you process that your baby is sick and has a potential life-threatening condition. You have weeks and months to …
The final year of any residency is a time of accelerated independence, moonlighting, and an intense search for that first job as an attending. This decision is critical as one embarks on a life-long career in medicine, and it will undoubtedly blend a mix of analytics, emotion, and finance into the final analysis.
With a bit of candor, I want to share the mistakes I made when accepting my first contract …
There’s an interesting article in the Journal of Hospital Medicine on what to do when a patient wants to leave the hospital against medical advice. After reading and rereading it, I had to disagree with the conclusion, but it took me a bit to get there because the article, with its confusing use of terms, is a masterpiece of obfuscation. The most obvious example is the oxymoronic use of the term “AMA …
We’re going to address the most common question I see. Should you pay off debt or use your money to invest? Over and over again it is asked, always with slightly different details. 95% of the time, the answer is a simple “It depends.” So today, we’re going to talk about what it depends on. I’ve written about this topic before, but it has been six years. I …
As a private practice specialist in an affluent metropolitan area, I am often inundated with requests for consultation by local residents and primary physicians. That’s fine — it’s what I do, and it’s what I enjoy doing. Hey, it pays the bills, and I won’t complain about that.
Concierge medicine has taken a foothold locally, and this means more referrals directly from doctors who insist we take care of their patients …
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 75-year-old man is seen for routine follow-up for very severe COPD. He has constant dyspnea and air hunger and spends most of the day in a chair. He has had no change in baseline cough and sputum production. He has had multiple COPD exacerbations that required ICU admission and intubation. He …
I spent considerable time after college working in academic labs being indoctrinated with the theory that publication is the currency of academic value and that researchers should always want to have their work printed in the journal most cited by other journals. You are supposed to be impressed when somebody claims that he or she is from a highly ranked university or institution, as these well-regarded institutions are synonymous with high achievement.
That all changed for me during residency when I met …
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I feel the mountain in my bones. The methodical plodding of feet over uneven terrain, a meditation, the grace of a single forward path, with no decisions, no guilt or what-ifs, no fear. Just forward movement, forward momentum. I hear Mary Oliver’s words at my core: “I don’t know exactly what a prayer is. I do know how to pay attention … how to be idle and blessed.” It’s taken …
“Are you a left-sider or a right-sider?” my classmate asked with a puzzled look during an end-of-the-year dinner among first-year medical students. I was confused. He repeated himself then answered. “Do you sit on the left or the right side in class … that’s right; you sit on the right.” He then mentioned that everyone present was a “right-sider.” Nearly everyone was white.
For the past 18 months, we sat in …
Physician training is an extremely high stakes business, not only for the patients that will be under the care of the eventual independent, fully-trained, board-certified doctor, but for the trainee herself. The financial and time costs of the entire training process are enormous. To become derailed from the board certification path can have significant and permanent career consequences. With so much at stake, what does a resident do when she …
A few months ago, I hired a contractor for a home improvement project. He didn’t know that I was a physician at the time, and we came to a mutually agreeable price.
Fast forward a few weeks, when we realized that we needed an extra, seemingly small, addition to our project. By this point, we’d gotten to talking, and he’d learned that my husband and I were both physicians.
To my surprise, …
Have you ever come out of an interview feeling like you spent an hour (or more) talking about yourself but learning absolutely nothing about your potential employer? I certainly have.
Sure, interviews are a chance for potential employers to see if you are a good fit, but after way too many one-sided interviews, I came to a realization. Interviews are also the best way to find out if this medical institution …
I am pediatrician who has been practicing for almost twenty years. During my career, I have been employed by two different free-standing children’s hospitals, a non-profit community-based health center, and now I own my own practice. In every setting, I have had to generate coding and billing for my work even when my salary was independent of that billing.
There is no other profession that would dutifully learn the “rules” of …
Doctors at some of the largest U.S. hospital chains admit they went overboard with opioids to make people as pain-free as possible, and now they shoulder part of the blame for the nation’s opioid crisis. In an effort to be part of the cure, they’ve begun to issue an uncomfortable warning to patients: You’re going to feel some pain.
Even for people who’ve never struggled with drug abuse, studies …
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