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 …
MKSAP: 75-year-old man with very severe COPD
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 …
Let academic physicians recover more of their clinical revenue. Here’s why.
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 …
On mountains and miscarriage: a physician’s story of loss
“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 …
Segregation in the medical school classroom
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 …
It’s important to proactively manage your resident progress. Here’s how.
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, …
It’s time to debunk the myth that doctors’ dollars come easily
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 …
Top 5 questions doctors should ask during a job interview
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 …
Insurance companies manipulate the doctor-patient relationship for financial gain
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 …
Stop opioid addiction where it starts: in the hospital
Life insurance is one of the key foundations of a good financial plan. In this article, we will discuss the basics of life insurance.
Why life insurance?
While you might feel invincible and 100% healthy, as physicians we all know patients or colleagues who were diagnosed with terminal cancer or died suddenly because of an accident or health condition.
If someone is dependent on your income (usually your spouse or children), then life …
A physician’s guide to life insurance
Someone who I care about deeply messaged me today: “I think I’m done with surgery.”
This person, a surgeon, feels like his potential is elsewhere. There are more opportunities, different challenges, and fulfilling experiences in other places and he is ready to explore.
I told him that he inspires me.
But I am in medical school. So how could someone leaving the medical field be inspiring to me?
Because inspiration does not come from a job description or a fancy …
What inspires this medical student
College
I went to a fairly expensive college, George Washington University. I think at the time (1998) it actually was one of the, if not the most expensive schools. Why did I decide to go there? Well, my brother was attending the school and living in Washington, DC seemed amazing to a suburban boy from Tennessee. Sure, I had gotten into University of Tennessee with a scholarship, but adventure won over …
Is private college and medical school worth it? One physician’s story.
Walking up to the admissions desk I knew the routine. I stretched out my arm for my hospital band. A name, a number, and a doctor were what defined me during my many hospital stays. It was simple; my brain was too large for my skull. Brain surgery after brain surgery has occupied my life for many years, all while I have been studying to become a doctor.
I …
Studying to be a doctor, while living as a patient
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In my last post, I told my story of how I got out of medical school with only $18,000 of debt. By the time I left residency, I had that whittled down to $6,000 at 3% interest. Then during the next three years after starting my practice, I had accumulated almost $500,000 of new debt.
Initially, I didn’t think anything of this new large debt, after all, I …
How this doctor eliminated $500,000 in debt
It was a long December.
A few years ago, my husband of 37 years got his death sentence: recurrence of liver cancer with mets to his lungs and lymph nodes.
He had a “Whipple” — a surgical procedure for pancreatic cancer — on Dec 24, 2015, and the surgeon discovered liver cancer too. So it was a 16-hour surgery. We were told he might die on the table.
His eyes haunted me as …
My husband was dying. I was being ignored.
I am an emergency medicine physician.
I save lives.
As an ER physician, my job is frequently misunderstood. A common question that patients ask is, “What specialty are you hoping to go into?” The misconception is that emergency rooms are staffed by cardiologists, internists, etc., who are trying to make extra income. That’s likely not the case anymore. Some also believe that we can take the place of their family doctor. Or …
What exactly does an emergency physician do?
These are tumultuous times for practicing physicians. The health care landscape is changing at breathtaking pace and less and less of our time is spent doing what we were actually trained to do: taking care of patients. I absolutely love the patient care part of my job, do everything possible to always remember why I went to medical school in the first place, and maintain focus on the aspects of …
10 steps to keep physicians sane
The ad is compelling.
A surfer rides a blue wave, seen from below in crystal clear reflection. The Apple Watch on his left arm cuts through the surf, elegant, sparkling ripples trailing behind. Suddenly, it breaks the surface, and the screen lights up, announcing an incoming call.
Let’s face it, shall we? We are always connected. We are always wired in. We are always on.
We have become a world of interconnected people, …
The dangers of being always connected
“It is neither wealth nor splendor, but tranquility and occupation, which gives happiness.”
– Thomas Jefferson
If you are a practicing physician, you need rest.
Why do I say this? Because you have gone through an enculturation process which focuses on hyperactivity and super high-level achievement. In training programs and in practice, admitting that you are tired or needing a rest break is a sign of weakness and is discouraged, to say the …
If you are a practicing physician, you need rest
Another young doctor recently jumped to her death in New York City. She landed at the entrance of the building where she lived.
Within less than an hour, I received the following emails about her. All published with permission.
Hello Pamela, I am not a doctor, but a mother of 3 and a wife of a resident physician. Tonight I watched AGAIN the police …
A physician suicide: covered up with a tarp and silence
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