So last week, I did the bravest thing I have done in a very long time — I quit my job. Yes, I put in my 60-day notice. This was my dream job post service in the U.S. Air Force. I had dreamed of working in this establishment for months before my service time was up. I could not have been happier when I joined their team, a group practice …
Why this physician quit her job
The upgraded responsibility and authority given to starting residents is both a blessing and a curse. Suddenly, the need for co-signatures vanishes. There is greater autonomy in clinical practice. Residents get paid. However, residency can also be a time of significant stress. Residents are forced to navigate the demands of preceptors, other residents, medical students, nurses, patients, family members, and administrators. Residents have very little control over what they do, …
10 ways to make residency less stressful
“It kind of strips you of any pride that you have. It was very humbling.”
As a care manager, Mary helps patients follow their care plans by coordinating medical visits and community resource referrals, but this was the first time Mary shadowed one of her patients out in the community. At the food bank, Mary watched her patient, who was living with diabetes, receive one box of macaroni along with other …
How to be aware of patients’ non-medical needs
Imagine spending days or even weeks in an emergency room without treatment for a broken leg or painful kidney stone.
Patients in psychological crisis across the country are living this exact scenario. Long waits in an ER, hospital room or prison for an inpatient psychiatric bed, otherwise known as psychiatric boarding, are their unfortunate reality.
Rewind to over 50 years ago — as institutionalized patients were gradually integrated into communities, the availability …
Let’s talk about the psychiatric boarding crisis
Dear first-year medical students,
Welcome to medical school — congratulations! You have worked, sacrificed, waited for this moment for many long years, have left blood, sweat, and tears along the tracks of your life marathon. This is the first checkpoint in your journey. You’ve made it. Your loved ones are right here cheering your accomplishments, there are many. That new, freshly-pressed, short white coat makes you look like an absolute stud(ent). …
Welcome to medical school. Welcome to the rest of your life.
I began practicing as an internist/nephrologist in the early 1960s. Having rented an office in Los Angeles, I introduced myself to the local medical community and set out to build a practice.
With a growing family, a mortgage and an office to support, I was hungry for patients. Hospital emergency rooms were good referral sources, so I took ER call at three different hospitals.
Late one Friday night, I got a call …
You can’t always expect a miracle, but you can always hope for one
Have you ever been the only customer in your local supermarket? Although the experience can be a bit unnerving, at first, you soon start to notice the advantages: No line at the deli, no pushy shoppers, no carts jamming up the produce section. As you breeze through checkout, you think to yourself, “Gee, I could get used to this.”
Now, imagine walking into an empty waiting area at your local emergency …
3 ways to decrease emergency department wait times
Recently, a respected allergist reassured his audience: the mortality rate for food allergy is very low. The risk of dying in a car crash is much greater than the risk of dying from food allergy. The implication seemed to be that the anxiety around food allergy is misplaced. Though any loss of life is too great; statistically, food allergy deaths are rare. To the food allergy community, it just doesn’t …
Food allergy: Death is not our only fear
A colleague recently sent me a link to the American College of Cathopathic Physicians a new organization whose mission “is to protect the professional autonomy and advocate for a full, broad scope of practice for DNPs as a ‘cathopathic physician’ completely equal in every way to our MD and DO counterparts.”
I was, I admit, so stunned by the statement that I thought the whole thing might be an elaborate joke. It was only …
Not all doctors are physicians
If somebody asks you how many bones there are in a human body, please do not blurt out, “206.” The correct answer is nuanced. To respond accurately to the query, you have to address five questions. Who? What? When? Where? Why?
Consider first that humans vary from one another in facial features, hair color, height, and shoe size. Unknown to nearly everybody except …
How many bones in the human body? It’s not what you think.
First of all, I am far from a financial genius. I am also not a natural saver. Thanks to scholarships and jobs, I made it out of college without loans. But, I took out a $191K for medical school. In the middle of med school, I took a year off to teach. During that year, I didn’t put anything towards student loans and lived it up. Unfortunately, in forbearance, those …
How this physician paid off $100,000 in debt in 6 months
Burnout has been a descriptive term for years, but lately, psychologists and others have assigned it specific characteristics with a view toward being able actually to study and measure it. One common definition of burnout is a state of chronic stress that leads to physical and emotional exhaustion, cynicism, detachment, and feelings of ineffectiveness. The PICU environment is often one of high stress, so it’s a place where this …
Burnout in pediatric intensive care physicians
Match Day is the culmination of a medical student’s education: the day all graduating seniors and non-traditional applicants find out where they will spend the next three to seven years to train in a desired specialty. I fell in love with obstetrics and gynecology (OB/GYN) as it was the perfect way to combine my passion for women’s health with medicine and surgery. I also liked that the patients were relatively …
What’s life like after not matching? A physician’s story.
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 25-year-old man is evaluated for dark-colored urine for 2 days, swelling of the face and hands for 1 day, and severe headaches this morning. He reports having an upper respiratory tract infection 1 week ago with fever, sore throat, and swollen glands, but had otherwise felt well. Medical history is otherwise unremarkable, …
MKSAP: 25-year-old man with dark-colored urine
We’ve all been through difficult times. It may be the death of someone we love or suffering abuse with no one to help. In life, many events fly at us that are hard to manage. Many of us just suffer silently through the pain, not allowing anyone in. And even while we do that, we also know that is not the healthiest response.
Many patients come to me struggling with anxiety …
How to deal with hardships in life
A natural part of life is emotionally growing (hopefully) with experience. If I was to look back at my own journey, when I was in medical school and just graduating, I would say that without doubt, one of the biggest things I would tell my younger self, would be to not take things too personally. This would be particularly true in professional situations.
I look back at how personally I used to …
Physicians can’t take things personally. Here are some tips.
One common question that doctors face in estate planning is whether to establish a trust. This topic gets brought up in the doctors’ lounges, especially after someone gets a pitch from their financial planner. Most doctors who bring up the topic are quite enthusiastic, and cite that doctors need a trust because “we make a lot of money.”
Fair enough.
Medical students and residents probably do not need a trust
I’ll get this …
What physicians need to know about living trusts
Death and dying — it is one of the first topics I was taught about in medical school. I was fortunate to attend a medical school that only made us spend half our time falling asleep in lectures. The other half we were in small group sessions, working our way through real patient scenarios, trying to learn to think like a physician.
As part of our first-year curriculum we had to spend time doing …
A physician explains the afterlife to his child
Vanguard, Fidelity, and Schwab have been engaging in a fierce competition to claim the mantle as the leading provider of low-cost index funds. As a result, each has aggressively lowered their fees for their index fund offerings over the past few years and advertised their low-cost offerings to investors.
After the latest round of fee reductions in mid-2017, I wrote a post speculating whether it was inevitable that Vanguard, Fidelity, …
What do the Fidelity ZERO mutual funds mean for physician investors?
Writing in Annals of Family Medicine a few years ago, Chicago obstetrician Benjamin P. Brown vividly described his mentor’s interaction with a patient who had just emigrated from Mexico and had no family support. “When he asked earnestly how she was doing, her hard-won defenses seemed to crumple, and all of a sudden she was sitting on the exam table, sobbing,” Brown wrote. “I watched, rapt, as Dr. Gonzales — …
A strong doctor-patient relationship: why it matters
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