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How to fix bullying in health care

Policy

June 23, 2018

When we think of bullying, we’re usually worrying about our school-age kids or remembering bad experiences from high school.

We learn quickly in the health care field that bullies don’t change once they enter the clinical world. Health care, with its incredible differential in knowledge, authority and pay creates large power differentials and easily generates subordinate/superior relationship dynamics.

Bullying occurs within professions between trainees and trainers and faculty, and across clinical areas …

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How to fix bullying in health care

Welcome to your intern year breakdown

Diana Cejas, MD

Physician

June 21, 2018

Summer is upon us, and with it comes the end of the academic year, graduations and the arrival of the newest crop of interns. Soon these fresh-faced physicians will enter into one of the most remarkable educational experiences of their medical careers: residency. Many of these soon-to-be-interns are looking to attendings now for advice on how to excel during (or survive through) the arduous first year of training. Suggestions like …

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Welcome to your intern year breakdown

Life as a doctor is selfless and selfish at the same time

Farah Karipineni, MD, MPH

Physician

June 20, 2018

It was 5:45 in the morning on a Monday after a full weekend of call. Thoroughly exhausted, I shuffled into the elevator and was met by the stench of stale clothing mixed with cigarette smoke. A painfully thin teenager exited, looking lost. I allowed him to wander out, grateful to be spared his odor. I was apathetic, overtaken by a weariness I vowed as a medical student never to have.

Morning …

Becoming a doctor is the epitome of delayed gratification

Natasha Abadilla

Education

June 19, 2018

Recently, I had the honor of standing by one of my childhood best friends as she promised the love of her life that she’d stand by him forever. The wedding was beautiful, and at the reception, I played with another close friend’s 3-year-old daughter and talked with other friends about their work promotions and apartment searches. All I have to contribute to these conversations are anecdotes about medical school and …

Why do physicians publish in predatory journals?

Skeptical Scalpel, MD

Physician

June 19, 2018

A new study found several senior academic surgeons had published papers in what used to be termed “predatory journals.” The newer, gentler term is “solicited publishing,” but it defines the same pay-to-play, low-quality publications.

Surgeons from the University of California, San Diego examined 110 emails sent to the senior author from 29 publishers during a six-week period and early 2017. Nearly all were requesting manuscript submissions. The 29 publishers represented 113 …

5 ways assembly line medicine harms patients

Linda Girgis, MD

Physician

June 18, 2018

When we go to the deli, we expect to take a number and wait in line. Accomplishing any task at the department of motor vehicles can be an ordeal of waiting and then being herded out the door. This is part of life in American society. However, it should not be part of your health care.

Patients need personalized attention and they need a health care team that listens to them, …

A physician was fired for standing up for his beliefs

Jamie Katuna

Policy

June 17, 2018

Dr. Eugene Gu. He is — was — a surgical resident at Vanderbilt University. His resume exemplifies academic perfection: valedictorian in high school, undergraduate degree from Stanford, medical degree from Duke, surgical residency at Vanderbilt. He also founded his own research company. Not once throughout the span of his academic or professional career would one have any reason question his capability or competency. But several weeks ago Vanderbilt fired him, citing “performance” issues.

Why?

Because …

The Handmaid’s Tale and the state of medicine

Danielle J. Johnson, MD

Physician

June 15, 2018

Spoiler alert! I recently started watching Hulu’s The Handmaid’s Tale after continuing to hear rave reviews about the show. It is based on the dystopian novel by Margaret Atwood. I just started watching this weekend and am now caught up to season 2; it’s that good. It portrays a world in which fertility and birth rates have declined so drastically, that fertile women have been forced to serve as handmaids …

5 mistakes hospitalists should avoid when starting a locum tenens position

Geeta Arora, MD

Physician

June 15, 2018

For the last 8 years, I have worked as a locum tenens hospitalist. I began on this path when it was the least popular option upon graduation from residency.

I did countless hours of research trying to find accurate information about locum tenens companies, but never found anything written by physicians, only by the companies themselves. So, I stepped into this field blindfolded and learned the hard way. Since then, I have …

Medical students: You are more than your grades

Anonymous

Education

June 15, 2018

Recently, I entered an essay contest on advice you would give to future medical students. I sincerely believe that the best person to write an article offering advice to younger medical students should come from a person who didn’t match. Also known as me. Why, you say? Well, for everyone else, Match Day is a culmination of four years of mentally, physically, and emotionally taxing work. They might even forget …

The worst enemy of a doctor should never be another doctor

Edgardo Olvera Lopez, MD

Physician

June 14, 2018

“The worst enemy of a doctor is another doctor,” said one of my professors during rounds when I was doing my internal medicine clerkship as a third-year medical student.

I remained skeptical. That did not match the idea of becoming a doctor nor did it support what Dr. Pellegrini said: “Medicine is the most humane of the sciences.”

Nonetheless, my old professor explained that when it comes to patient care planning and …

Am I the cold and detached physician?

Michelle Ramirez, MD

Physician

June 13, 2018

It’s 9:30 a.m. on a Wednesday, I get on the elevator, and I hear a man in his 40s, having a conversation on his cell. He says: “He had a brain bleed yesterday, and they had to put a breathing tube in, they don’t know how much damage his brain has suffered at this point.” He gets off on the adult ICU floor. I quickly think “that sucks” and carry …

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Am I the cold and detached physician?

The U.S. is failing at mental health care

Linda Girgis, MD

Conditions

June 13, 2018

Where I practice, the process of referring a patient suffering a mental illness is quite infuriating. The wait to get in to see a psychiatrist or psychologist can be months all the while patients are suffering. Worse yet, with certain insurances, there are just no mental health providers available for any of their covered patients. The failure of treating mental health disease in the U.S. is glaring.

In the U.S., approximately …

7 habits of being on call

Angela Seabright, DO

Physician

June 11, 2018

1. You sleep when you can. Despite what medical television dramas portray, call room beds are for sleeping. Period. As you curl up into the bed you have no idea whether you are about to get a couple hours of sleep or a couple of minutes, but in that moment of sheer exhaustion, the drab hospital cot or bunk suddenly transforms into a luxurious sleeping pad. Bonus if you can …

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7 habits of being on call

Identifying social determinants of health is critical to the patient interview

David Velasquez

Policy

June 11, 2018

After a semester of medical school, I returned home to the Antelope Valley in California, an area CNN coined, “health care’s nowhere land” because of low health insurance rates and limited provider networks that force residents to travel far for care. I wanted to help my family and neighbors by using the physical exam skills I learned during my first few months as a medical student, but …

5 reasons why you can’t start passive income streams

Passive Income, MD

Finance

June 10, 2018

It seems like everywhere I look these days people are talking about passive income streams: why you should start them, which ones you could start, how they can change your life, and how much money you can make from them.

Doctors commonly look for ways to create passive income as a way of being able to work less while still maintaining the lifestyle they want or honestly to quit …

A better way to follow-up your office visit is needed

Fred N. Pelzman, MD

Physician

June 10, 2018

Actual conversation heard in the hallway outside an exam room earlier this week:

Doctor: “So, we’re going try this medicine for your blood pressure; you keep checking it at home as we discussed. If the numbers remain high, we can increase the dose or add another medicine.”

Patient: “Well, what do we do if the pressure stays high; if this medicine doesn’t work?”

My partner told me later that she had explained the …

Being idealistic is a necessary component in achieving your goals

Gaurav Jain

Education

June 10, 2018

I am a first-year medical student, and just like some of you once did, the primary reason I am becoming a physician is to really make a difference for my patients by [insert x, y or z].

“Wow, that’s really great, but we’ll see how you feel about it in a few years.”

“That’s not how it works once you’re actually out there.”

“Trust me, medicine isn’t what it used to be, get …

MKSAP: 78-year-old man with symptoms of dysphagia

mksap

Conditions

June 9, 2018

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 78-year-old man is evaluated for symptoms of dysphagia that began 2 weeks ago. When he eats, he starts coughing after the first bite of food and occasionally has nasal regurgitation.

On physical examination, blood pressure is 135/90 mm Hg, pulse rate is 78/min, and respiration rate is 12/min. Left-sided weakness is noted in both extremities, …

5 ways to live through medical malpractice lawsuits

Stacia Dearmin, MD

Physician

June 8, 2018

Nothing troubles physicians more than an unforeseen outcome and a malpractice lawsuit. It cracks open self-doubts and assumptions about medicine and may be life-changing.

It commonly fuels burnout, loss of confidence, PTSD and early retirement. And there are links to depression and physician suicide.

There’s another side to this story, though. Like all of life’s great challenges, a patient’s unexpected loss, and professional litigation present us with huge opportunities for growth.

I am …

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