A patient sues when a DNR is ignored

Physician
December 23, 2018

A New Mexico woman, suffering from Dercum’s disease (adiposis dolorosa) which causes painful fatty tumors, is suing a Santa Fe hospital and an emergency physician claiming she was the victim of two negligent acts in 2016.

One, according to the Albuquerque Journal, she told hospital personnel she was allergic to Dilaudid but went into cardiac arrest after receiving an injection of the drug.

Two, despite the presence of a lawfully …

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A patient sues when a DNR is ignored

A medical student after an OB/GYN rotation: Here’s what he learned

Education
December 23, 2018

On one of my first days on the labor and delivery ward, one of the attending obstetricians asked me what area of medicine I was interested in. When I said that I was applying into neurology this year, she said, “Ah! The other end of the body!” After a pause, she continued, “Well, this rotation will be … different.”

It wasn’t the first, or last, time I had heard a similar refrain during …

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A medical student after an OB/GYN rotation: Here’s what he learned

Electronic health records: Separating the signal from the noise

Physician
December 23, 2018

5,177.

That’s the current number of “cc’ed charts” as of this morning in my electronic health record in-basket.

While it might sound like a lot, this is not at all an unusual accumulation, partly due to the fact that I receive a notation every time a patient at our practice gets a flu shot, and also every time one of my patients or …

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Electronic health records: Separating the signal from the noise

What to know before moving for a health care job

Physician
December 22, 2018

This article is sponsored by Careers by KevinMD.com.

How satisfied are you in your current health care position? According to the Conference Board, a global, independent business membership and research organization, only 51 percent of employees report overall satisfaction with their current job. In the survey, conducted earlier this year, respondents reported that the job factors …

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What to know before moving for a health care job

The rewards of being a designated airman medical examiner

Physician
December 21, 2018

For the last 25 years, I have had the privilege of being a designated airman medical examiner by the Federal Aviation Administration. To earn that privilege, it required flying to FAA headquarters and taking a one-week training course followed by refresher training material every three years.

The FAA grades medical examiners annually by our judgment and decision-making. The nature of the questions we are required to ask the pilot candidates, and …

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The rewards of being a designated airman medical examiner

Diagnosed with prostate cancer? You must ask these 10 questions.

Conditions
December 20, 2018

Prostate cancer often presents unique challenges to patients and physicians alike. It can be indolent and non-aggressive — or life-threatening and everything in between. Unlike most cancers that have a dedicated roadmap for treatment for prostate cancer revolves around opinions and biases.

To help patients navigate the landmine of prostate cancer, I’ve compiled a list of 10 basic questions to ask when diagnosed with prostate cancer. Here they are:

1. “What is …

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Diagnosed with prostate cancer? You must ask these 10 questions.

How physicians can play the credit card reward game

Finance
December 19, 2018

We’ve all heard about credit card points and miles by now—put enough of your expenses on plastic and you’ll be flying first class airlines all the time, right? We are actually fortunate in American (sorry for those of you residing in, let’s say Japan, who still are stuck in a mostly cash-based society) to be able to have incredible amount of credit card options to squeeze out every penny.

While the …

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How physicians can play the credit card reward game

A clinician’s guide to microbiome testing

Conditions
December 17, 2018

The intestinal microbiota, also commonly known as the ‘‘gut microbiome’’ is integral to human physiology and has wide-ranging effects on the development and function of the immune system, energy metabolism and even nervous system activity. There is a lot of excitement around the potential of targeting the microbiome therapeutically to promote health and to prevent or treat medical conditions. Further, as DNA sequencing technologies and computational methods …

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A clinician’s guide to microbiome testing

How to foster and encourage genuine, curious learning in a medical student

Education
December 16, 2018

I just had a conversation with a physician and faculty member at my school. He started the conversation like this: “It’s alright if you disagree with me, and I can disagree with you too. Good academic discourse should allow people to disagree with each other.”

He then allowed me to question him and explain my perspectives for over an hour as he explained his answers, helped clarify some points, and gave …

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How to foster and encourage genuine, curious learning in a medical student

The key to successful rounding

Physician
December 15, 2018

A wonderful senior resident helped me understand the goal of rounding.  Rounds should focus primarily on understanding the key problems and the diagnostic and therapeutic approaches to those problems.  She suggested that some rounds spend too much time on “minutia” that the resident could handle, and not enough on understanding the big issues.  According to her, rounds work best when we spend our time addressing the problems that the patient …

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The key to successful rounding

6 ways to ensure you’re not accepting a terrible health care job

Physician
December 15, 2018

This article is sponsored by Careers by KevinMD.com.

What makes any particular job a “bad” one? Maybe the pay is too low. Perhaps the hours don’t work with your other commitments. It could be the commute is too long, or the opportunity for advancement is too little. A job might be bad because it has a poor …

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6 ways to ensure you’re not accepting a terrible health care job

The fight to save Howard University College of Medicine

Education
December 13, 2018

Our country is at risk of losing an iconic institution that has played a pivotal role in the history of medical education. A school, which has produced some of the boldest pioneers in medicine, could lose accreditation upon the opening of a new hospital that will shunt away 40 percent of their current patients. Scores of our brightest potential medical students will be ripped away from the communities that desperately …

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The fight to save Howard University College of Medicine

How social media leads to a loss of creativity

Social media
December 12, 2018

I use social media.  Specifically, I use Facebook, Twitter, and LinkedIn.  In the beginning, I did so for utilitarian purposes.  As a columnist and aspiring writer of books, these were (and indeed are) useful marketing tools.

I have, in the past, carried around a note-pad to jot down ideas.  I was never without my note-pad.  I always wanted a small legal-pad with a blue or black gel-ink pen.  It was my …

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How social media leads to a loss of creativity

The day when the white coat can be worn with no hesitation at all

Education
December 11, 2018

It was my first day of orientation at medical school. In a hallway stood a coat rack overflowing with white garments. I set down my accumulated papers, reached for a hanger and — for the first time ever — shrugged first one arm and then the other into a white coat.

It was too large, but I had no other options. The unisex coats ran from XXS to XXL, but the …

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The day when the white coat can be worn with no hesitation at all

The Wild West approach to PICU practice

Policy
December 10, 2018

I spent my early and mid-career years working in a pediatric intensive care unit (PICU) at a large academic center. We did almost everything except for a few things esoteric at the time — small bowel transplants, a few kinds of experimental surgery. I’m now in my late career (but have no plans to quit anytime soon!) and work in a smaller PICU. I am frequently confronted with the issue …

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The Wild West approach to PICU practice

Disability can be a devastating outcome to a doctor’s career. Here’s how handle it.

Finance
December 9, 2018

Disability can be a devastating outcome to a doctor’s career and self-image. Think about it: You busted your butt to learn how to do a Whipple procedure, end up getting into a skiing accident that ends your career right there. No worries, because you purchased the appropriate coverage of own-occupation disability insurance, right?

Having disability insurance certainly provides a protective cushion, especially you are the sole breadwinner. This is a no-brainer, …

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Disability can be a devastating outcome to a doctor’s career. Here’s how handle it.

Why mentors are so important in medicine

Physician
December 8, 2018

This article is sponsored by Careers by KevinMD.com.

After spending a decade in college and medical school, followed by internships and residency, seeking additional guidance at the beginning of your career may seem excessive. You’ve already taken direction from dozens of leaders; isn’t it time to cut your own path?

Yes and no. You’ll make plenty of your …

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Why mentors are so important in medicine

How physicians can get started with passive income

Finance
December 4, 2018

It’s been a little over two years since I started this journey of blogging about passive income, and I’ve learned so much along the way. The term “passive income” has come to mean something very different to me over these years.

I used to think that passive income was simply earning money in a way that isn’t proportional to the time you put in. And while this is …

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How physicians can get started with passive income

There’s no room for ego in health care

Physician
December 4, 2018

I was recently seeing a rather complicated medical patient in the hospital. We were treating both a heart and kidney condition, and things were not going so well. To spare anyone non-medical who is reading this the scientific details of the bodily processes involved, we were essentially balancing hydrating, with the need to get rid of excess fluid. After seeing the patient, I spoke with the nurse, went over the …

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There’s no room for ego in health care

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