“Why don’t you just get a shotgun and blow his brains out next time? Better yet, next time stay the hell away from my patient!”
I was frozen, and the ICU attending wasn’t even talking to me. My co-intern had barely started her presentation when she met damnation. Mind you — there was a senior resident, a pulmonary fellow, and a team of nurses caring for the patient also. Yet the …
How to deal with devastating criticism
I have spent a good part of my career investing time and energy towards side hustles. I generally categorize them into two distinct types of ventures. The lazy side hustle involves starting a business or consulting in a field tangential to ones main hustle. For example, an accountant who works normally as an auditor may do a few tax returns on the side during tax season. I call his …
The good, bad, and the ugly of being a medical expert witness
“Those emergency room residents are f**king retarded!” This was the comment that rang through the workroom. I had only been on this hospital service for three days, and I was having a discussion about a patient with my attending when the on-call resident had burst into the workroom and sat down next to me. He was fuming.
“Why the f*** would they think I need to be consulted for this? Only …
Don’t be mean: Treat your team members with respect
I recently needed to transfer my patient to a larger medical center for some urgent care. As I sat there in my relatively small hospital working out where they would be best served, a famous academic medical center that was not too far away, came to mind. I placed a call to the facility’s bed facilitator, who took the patient’s details from me, and was told to await a callback …
Why the battle against being called a provider is probably lost
The most common response when I introduce myself as a preventive medicine resident is an interjection, “You mean family medicine?” I have come to realize that the majority of the healthcare field has never heard of preventive medicine as a unique medical specialty. It’s a shame, because preventive medicine is truly the best medical specialty you’ve never heard of.
Preventive medicine practices at the intersection of public health and clinical medicine …
The best medical specialty you’ve never heard of
I met David on the internet. It was to become on of the closest, most intense relationships of my life. For you see, a few months before he crossed my path his daughter finished the same protocol for the same type of brain tumor that my daughter just had started. They had successfully traversed the waters that to me were completely unknown — and frankly terrifying. On the pediatric brain tumor listserv, …
Everyone needs someone to be a safe harbor
I recently received a call from a physician resident in the Northeast U.S. who had been notified that she would be terminated from her residency program for a “weak knowledge base.” There would be no contract offered to her for the coming academic year. She reports that her scores are no worse than several of her colleagues and that her accredited program has a history of arbitrarily dismissing residents. She …
Medical residents and academic due process: Know your rights
Want to hear a crazy story?
Typical medical school students can relate tales of a college experience that includes summer research or hours spent reviewing for the MCAT. I didn’t even take the MCAT. Read on for the oddest medical school acceptance story you’ve ever heard.
I was driven in high school. I’d heard for years about smart kids going off to the Ivy League, and I wanted that experience — to …
I was accidentally accepted to an Ivy League medical school at 17
I’m always intrigued by those who earn millions of dollars per year or even per month. Some manage to blow all that money and then some. Others, like a select few NFL players, choose to spend wisely and save prodigiously.
Today’s Saturday Selection highlights the habits of one athlete who was among the highest paid NBA stars for many years. The headlines sadly feature athletes with similar …
Personal finance lessons from Shaquille O’Neal
Just sign here.
How many times a day are we asked to do this? “Just sign here.” “Just put down your license number.” “We need a stamp with your doctor’s info on it.” “Give us your NPI.” “Initial here, here, and here.”
If we took the time to read all the things we’re signing, we wouldn’t have time to do any doctoring.
The other day I was asked to hand-write the date on …
Too many things need physicians’ signatures
I’m sitting in the waiting area across the endoscopy room of a major hospital. Mindless talk show TV runs in the background. Patients are waiting patiently. They anxiously look up every now and then from their phones towards the reception desk.
It’s a scene I’ve experienced for years while working in health care while waiting for doctors.
But there’s something different in the air now.
Patients, like those around me, will encounter a …
Why some physicians thrive and some struggle to survive
Growing up with a father who is a physician made for a natural draw to medicine. However, as young people are prone to do, I did my best to rebel. Early into my undergraduate career I proudly announced to my father that I had decided to go to law school. And perhaps to dig the needle a little deeper, I told him I planned on going into medical malpractice, on …
How this physician became a financial advisor
Once every couple of years I have medical students from the local medical school over for dinner. At some point, the conversation usually turns to finance, and I commiserate with them about their loan burdens. I typically toss them a few pearls of wisdom, wish them good luck, and we move on to something else. They always think it’s funny when I say, “If you can’t live on $200K, you …
10 reasons why doctors spend too much money
In 1994, Penguin Books published what would become a national bestseller titled, Listening to Prozac written by Dr. Peter Kramer, a Clinical Professor of Psychiatry at Brown University at the time. Throughout the book, he debates the ethics of “cosmetic pharmacology” a term associated with the transformation of personality traits through medication. Kramer describes several patients as becoming “better than well” on Prozac — more socially adept, less inhibited, and …
As we continue to attempt to restructure how health care is measured, reimbursed and organized, we must hold true to the idea that health care is simply not a service commodity.
“A commodity is any good or service (“products” or “activities”) produced by human labor and offered as a product for general sale on the market.” Our health care delivery model continues to evolve as we move away from the fee-for-service (FFS) model …
Health care is not a service commodity
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 35-year-old woman is evaluated for intermittent fever, sweats, fatigue, and dull midchest pain of 2 weeks’ duration. Medical history is significant for liver transplantation 6 months ago for primary biliary cirrhosis; she was seronegative for cytomegalovirus and Epstein-Barr virus, and her donor was positive for both. Results of pretransplant testing for tuberculosis …
MKSAP: 35-year-old woman is evaluated for intermittent fever
Change and health care are closely interconnected. Health care organizations are continually faced with the need to adapt to change, whether it be advances in medical care or technology, growing demand for care delivery, a patient population that is increasingly active and involved in their own health and well-being, or evolving reimbursement and cost models. By recognizing that change is inevitable in the health care sphere, organizations can focus on …
What makes you an effective change agent in health care?
Do you ever feel like time is always slipping away? Do you feel like you hardly get time to enjoy the things you love? For example, do you feel like you get enough time in your day to spend with your kids? If your answer is “no,” welcome to the club. You are not alone! I am a physician mom of young kids who used to feel like I never …
A physician’s guide to getting more time with family
May lay in a hospital bed, her wrinkled skin covered with sensors that monitored her every breath and heartbeat. Her husband sat at her bedside gently stroking her withering gray hair as her chest moved slowly up and down accompanied by the soft whoosh-whoosh of the ventilator that breathed for her.
He stared expectantly at her face as if at any moment she would rise and free herself from the multiple …
When someone is not dead but not alive
Whether to circumcise a newborn male child is not the simple, binary “yes/no” question it appears to be. Rather, the choice is affected by an astonishing array of issues: religion, culture, health and hygiene, sexually transmitted infections, expense, pain and medical recommendations. Some cite ethical concerns regarding usurpation of a child’s free choice. Others claim an equivalency between neonatal male circumcision and the practice of female genital mutilation.
As a practicing …
An emergency physician makes the case for circumcision
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