What inspires this medical student

Education
January 28, 2018

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 …

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Is private college and medical school worth it? One physician’s story.

Finance
January 27, 2018

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 …

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Studying to be a doctor, while living as a patient

Education
January 26, 2018
YouTube video

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 …

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My husband was dying. I was being ignored.

Conditions
January 25, 2018

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 …

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What exactly does an emergency physician do?

Physician
January 25, 2018

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 …

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10 steps to keep physicians sane

Physician
January 24, 2018

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 …

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The dangers of being always connected

Physician
January 23, 2018

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, …

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If you are a practicing physician, you need rest

Physician
January 23, 2018

“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 …

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A physician suicide: covered up with a tarp and silence

Physician
January 22, 2018

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 …

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You can’t separate mind and body in medicine

Physician
January 22, 2018

According to the American Psychological Association and the American Academy of Family Physicians, well over half of patient visits to primary care physicians are for mental health issues. So, as part of my book, I Have Been Talking with Your Doctor: Fifty doctors talk about the healthcare crisis and the doctor-patient relationship, I asked about mental health.

None of the doctor interviewees disagreed with the important role that …

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Should the SOAP note be changed?

Physician
January 22, 2018

Our hospital system’s IT department has recently encouraged us all to change our default encounter note template from the traditional “SOAP” format to the “APSO” format.

For those not familiar with those acronyms:

S: subjective — the patient’s story
O: objective — physical exam, labs, other data
A: assessment — the identified issues/diagnoses
P: plan — details of how to address issues/diagnoses in the assessment

The argument in favor of APSO, putting the assessment and plan …

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When should physicians retire?

Finance
January 22, 2018

The decision to retire is a difficult one for anyone, including physicians.

However, with everyone’s investment accounts so flush with money because of the bull market, a lot of physicians younger than the traditional retirement age of 65 have enough money to retire early. Some have chosen to do so; others have chosen to continue to work even though they are financially ready for retirement.

So what …

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13 things every doctor wants their patients to know

Physician
January 21, 2018

1. We worry. We lie awake worried sick about you more often than you’d think. The stakes are so high, and we know it.

2. We wonder. I ran into a friend who’d met a patient I’d had sixteen years earlier. She gave me some follow-up, and it made my day — maybe my month. It was a year ago, and I’m still thinking about it. She’d had blood cancer. I referred her …

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Young surgeons are learning robotic surgery in the shadows

Physician
January 19, 2018

Artificial intelligence and robotics spell massive changes to the world of work. These technologies can automate new tasks, and we are making more of them, faster, better and cheaper than ever before.

Surgery was early to the robotics party: Over a third of U.S. hospitals have at least one surgical robot. Such robots have been in widespread use by a growing variety of surgical disciplines, including urology and …

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The practice of emergency medicine is a team sport

Physician
January 18, 2018

“Same team!” bellowed all the frustrated parents from the sideline of a lacrosse game as we watched two teammates clash sticks while fighting to catch the same pass. Both players missed the ball, and the other team scooped it up and scored, perfectly illustrating to our kids what happens when they battle among themselves.

It’s easy to remind our kids that teammates shouldn’t fight, but it’s harder to remind each other …

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A patient accused this doctor of sexual harassment

Physician
January 17, 2018

It was a typical weekend on call. The usual number of surgeries, ER calls and consults. I was called to consult on 47-year-old female who had been admitted with four days of left shoulder pain. She had gone through a cardiac workup and was cleared by her internist. So now, a consult was called to see if there was an orthopedic cause for the patient’s pain — not an uncommon …

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18 ways for physicians to invest $25,000

Finance
January 17, 2018

So a new year is upon us! 2017 was a fantastic year for investors in general, so I hope it was a prosperous one for you. I believe that 2018 will be a great year as well and filled with multiple opportunities for everyone. A quick wish: May your 2018 be filled with much joy, great health, and hefty growth of your passive income streams.

Now back to the post – One …

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Top 10 lies doctors tell themselves

Physician
January 16, 2018

Pamela Wible: Today I’m sitting here with Sydney Ashland, an expert in physician mental health, who has worked with doctors for decades helping them overcome negative thinking patterns. And we’re going to dive into the top 10 lies that physician’s tell themselves. The number one thing that I hear over and over again from doctors is, “I’m stuck in assembly line medicine.”

Sydney Ashland: Yes. I …

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5 reasons to keep working after financial independence

Finance
January 16, 2018

I was browsing the Bogleheads forum last night, and my eyes naturally gravitated to the thread titled “What is FI if you love your job?”

The short answer is that FI is financial independence. Nothing more, nothing less, and it doesn’t look any different if you love, hate, or feel indifferent towards your job.

The long answer, after learning that the man asking the question is about ten …

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