A breakdown of your pathology report

Conditions
September 27, 2018

I’m a pathologist and the main way I communicate to the outside world — to your doctor and ultimately to you, the patient is via the pathology report. But the short missives I send from behind the microscope lack any excitement and can fall short of full communication.

Here’s the usual story:

Skin left scapula, biopsy

Nodular basal cell carcinoma

Negative for perineural invasion

Margin status: Positive

Doesn’t sound real interesting, does it?

How about a more …

Read more…

A breakdown of your pathology report

Here’s why you wait in the ER

Physician
September 26, 2018

All have to wait. As is normal with the busy ER, the ambient noises of machines, alarms ringing, painful moaning, and loud drunken outbursts permeate the department. It’s a controlled chaos.

But, a woman’s scream pierced my soul. Her baby eight-month-old boy laid limp in her arms. He’s already pale, lips blue, his chest not rising as it should with breathing — he is not responding at all. We wasted no …

Read more…

Here’s why you wait in the ER

Why historically black colleges and universities matter

Education
September 26, 2018

Every few months, there happens to be another breathless news story about racism in health care. Mass media seems shocked, progressives angrily tweet, while conservatives claim that somehow it was all President Obama’s fault.

Meanwhile, the four relatively unknown and certainly underappreciated historically black college or university (HBCU) medical schools in the United States (Howard University, Meharry Medical College, Morehouse School of …

Read more…

Why historically black colleges and universities matter

10 things wealthy doctors won’t tell you

Finance
September 25, 2018

Guess what? You’re surrounded by rich doctors. You probably didn’t even know it. You know why? Because doctors don’t talk about that filthy lucre known as money. So while you’re assuming that all the other doctors in your group, office building, and hospital are in the same position as you, you’re wrong. Some of them are rich. There are ten things they’re not telling you, but which …

Read more…

10 things wealthy doctors won’t tell you

The influence of a physician’s father

Physician
September 25, 2018

Because of my father

When you lose a parent during childhood, it effects just about everything you become.  Decisions about life naturally stem from enduring this trauma.  Some try to form families early and replace that which they feel has been lost.  Others spurn close connections and create a wall so firm that no one else can encroach.  An attempt to protect against pain.  Because of my father I …

Read more…

The influence of a physician’s father

When should insurance companies be held responsible for medical malpractice?

Physician
September 25, 2018

In July, 2009, the family of Massachusetts teenager Yarushka Rivera went to their local Walgreens to pick up Topomax, an anti-seizure drug that had been keeping her epilepsy in check for years. Rivera had insurance coverage through MassHealth, the state’s Medicaid insurance program for low-income children, and never ran into obstacles obtaining this life-saving medication.

But in July of 2009, she turned 19, and when, shortly after her birthday, her family …

Read more…

When should insurance companies be held responsible for medical malpractice?

It’s really hard to make money in the stock market

Finance
September 24, 2018

No, I’m not saying that the process of investing in index funds is difficult. In fact, it’s actually quite simple to build a diversified index portfolio, whether your money is invested at Vanguard, Fidelity, Schwab, or Etrade.

What makes investing in the stock market so difficult is tolerating its high volatility. Many investors are unable to stick with the stock market in the long run because of the ups and downs.

But those who stay invested …

Read more…

It’s really hard to make money in the stock market

10 financial tips for physician maternity leave

Finance
September 22, 2018

Let’s be real here. Women make babies. Women also kick butt working. Sometimes women need to make babies while kicking butt working. So, you know, the human race can survive … no big deal. But, all too often, families are unfairly burdened by our dismal maternity support system. Bleary-eyed and bloody, new mamas emerge from childbirth facing a mountain of medical bills and no income.

For my first pregnancy, my family …

Read more…

10 financial tips for physician maternity leave

Why doctors can’t take sick days

Physician
September 21, 2018

I learn all manner of interesting things from the information sheets posted on the walls of the employee bathrooms at my hospital. I learn, for example, about upcoming CME offerings for advance practice providers, how many seconds one has to scrub the hub of a central line, and what the new process is when nurses need to call in sick. They call a specific phone number and state that they …

Read more…

Why doctors can’t take sick days

A physician with congenital heart disease

Conditions
September 21, 2018

Everyone always jokes with doctors, “What happens if you get sick?” Some of us laugh off the question. The busy schedule of health care often means our own health comes last. However, what happens when it’s a chronic disease that requires treatment? Then the answer to this question is a little different.

I am a family medicine physician dealing with congenital heart disease (CHD). Saying that someone has congenital heart disease …

Read more…

A physician with congenital heart disease

Words can hurt those on benzodiazepines

Conditions
September 20, 2018

There exists a large, mostly-underground, growing community consisting of those iatrogenically harmed by benzodiazepines. Guilty only of following doctors orders, these patients are marginalized and misunderstood. This has been enabled, at least in part, by poor terminology.

Recently on Twitter, Michael P. Hengartner and Marnie Wedlake both posted critical questions in response to a benzodiazepine news story:

In response to …

Read more…

Words can hurt those on benzodiazepines

Shortening time in medical school is a bad idea. Or is it?

Education
September 20, 2018

Recently, there has been a number of articles on reducing the length of medical training to help ease the physician shortage. And our medical curriculum is due for a major overhaul. Its foundational document, the Flexner report, was released over 100 years ago, and our medical needs and knowledge have changed. Shortening medical education may provide a “bonus” in easing the anticipated shortage of physicians …

Read more…

Shortening time in medical school is a bad idea. Or is it?

Stop the money-shaming in medicine

Finance
September 18, 2018

There is a taboo in medicine. It is becoming less prominent, but it still exists. You’re not supposed to talk about money. Not how much something costs a patient, not how much you get paid, not how you invest, and certainly not about the freedom from medicine that financial independence can bring.

This first shows up as you are applying to medical school. You don’t want anyone writing a …

Read more…

Stop the money-shaming in medicine

10 things a pediatric oncologist wants you to know

Conditions
September 17, 2018

1. Cancer is not rare.  Technically, childhood cancer is rare compared to adult cancer, but it’s not as rare as you think.   Outside of my work, I can think of 3 people who I know personally that had a childhood cancer.  A teammate on my high school basketball team, my sister-in-law, and a high school debate teammate.   My guess is that you also know someone from church, a coworker’s …

Read more…

10 things a pediatric oncologist wants you to know

Burnout doesn’t start in medical school

Education
September 17, 2018

Burnout affects as many as 50 percent of physicians. Interventions have been proposed at virtually every stage of a physician’s life, from medical school to residency training to professional practice. While the rigors of medical training certainly contribute to the high levels of burnout in the profession, there are indications that the trouble begins at the undergraduate level.

I recently graduated from an undergraduate program geared toward students interested in medicine. …

Read more…

Burnout doesn’t start in medical school

It’s time to upgrade the outdated intake forms at health care clinics

Physician
September 16, 2018

The process of setting up a new pain management clinic has allowed me to critically consider the role of patient intake forms, an area that has traditionally been ignored by technological advances and institutional innovation.

Health care must empower patients to conveniently complete intake forms digitally — whether at home, en-route to our clinics, or in our waiting rooms.  When done correctly, the forms can greatly enhance the patient …

Read more…

It’s time to upgrade the outdated intake forms at health care clinics

12 tips to help you survive residency

Education
September 15, 2018

Each year, thousands of newly minted MDs are elevated from mere medical students to — drumroll, please — interns. If that’s you, congratulations and welcome to the world of residency.

Welcome to the world of motivation, inspiration and altruism — where you wake up every day knowing this was what you were meant to do.

And welcome to the world of the hungry, the tired, the poor. …

Read more…

12 tips to help you survive residency

Patients need an advocate at the bedside

Physician
September 14, 2018

Being a hospitalized patient is perhaps one of the most disempowering experiences an individual can face (besides being in war, or a prisoner). Patients face constant uncertainty; having no idea what time their physician will visit, when they will be taken for their tests, or who will suddenly interrupt them again with a demand – perhaps an early morning blood draw, or yet another round of interrogation and uncomfortable examination …

Read more…

Patients need an advocate at the bedside

The existential benefits of ginger ale

Conditions
September 14, 2018

On a curiously warm morning last February, the minister arrived at my childhood home to guide my father to the other side. When he approached the bedside where all of us were gathered around with the Eagles Pandora radio humming in the background, my dad emerged from a semi-conscious state and sat up as best as he could. “Listen. I am not dying,” he declared. As an early-career researcher focused …

Read more…

The existential benefits of ginger ale

649
pages