Which of these patients should get a liver transplant?

Conditions
July 7, 2018

People with liver failure and cirrhosis die every year because there are not enough livers available. Who should receive the treasured life-saving organ? There is an organ allocation system in place, which has evolved over time, which ranks patients who need liver transplants. Without such a system, there would be confusion and chaos. How can we fairly determine who should receive the next available liver? What criteria should move a …

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Which of these patients should get a liver transplant?

3 things patients really want from their doctors

Physician
July 5, 2018

The doctor-patient interaction is the absolute core of clinical medicine. Maybe I’ll go much further: it’s the core of health care in general. I always try to remember, whenever I’m ever feeling frustrated with the system, the crazy bureaucracy — and of course, the debacle of our clunky electronic medical records and their data entry requirements — to separate myself from all of that when I’m face-to-face with my patient …

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3 things patients really want from their doctors

Job security in medicine is a myth

Finance
July 5, 2018

Imagine, if you will, that you’re an anesthesiologist. You’ve been part of a successful practice for over 10 years. You can walk down your neighborhood street and run into mothers whose epidurals you’ve helped place. You’ve established a home, a community, and your children are in a great school system.

One uneventful day, say Wednesday, you get an email from the hospital administrators announcing that there’s going to be a meeting …

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Job security in medicine is a myth

Don’t tell patients they look great, except in these cases

Physician
July 4, 2018

One of my colleagues sat on a wheeled clinic stool at the end of the examination table and told the patient, which was in this case an actor, “Everything looks great.” After, he swiveled around to face the instructor and the small group of onlooking medical students behind him. Our instructor also turned to us and said, “Very good job. But can anyone tell me what he did wrong?” He …

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Don’t tell patients they look great, except in these cases

A doctor’s apology can go a long way

Physician
July 3, 2018

I came across a letter I wrote to a patient while rummaging through some old files on my computer. I flashbacked to what triggered this: a response to a letter she had sent me, one that was, shall we say, extremely unflattering and quite scathing in the way she described me and our last encounter. From the letter’s tone, I sensed she held back on using more profane language to …

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A doctor’s apology can go a long way

5 ways to show empathy in medicine

Physician
July 2, 2018

As medical professionals we often see people at their worst: battered and broken, bothered and in pain, no make-up, bad hair day, naked and too ill to even care about modesty. At those critical moments, in our patients’ hour of desperation, they hand over their lives to us … and the lives of their family. All that they are — they willingly place at our mercy. At times, burnout, and …

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5 ways to show empathy in medicine

The difference between care and service is significant

Physician
July 2, 2018

My father, recently retired, spent over 40 years in private practice. After dinner, he would sift through piles of paper charts and call patients with their lab results. As a grade schooler, what impressed me the most was that he knew many of his patient’s phone numbers by heart. Of course, this was in the days before HIPAA and caller ID, so scattered charts on the dining table and calling …

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The difference between care and service is significant

Attending time: That’s just a myth

Finance
July 1, 2018

One of the great myths amongst residents is that once they become attendings, they’ll have so much more free time. I’ll never work this much again, they think. This is the most time-intensive phase of life, and everything after residency is easy in comparison.

Unfortunately, they are usually wrong.

Statistically, working about the same number of hours in residency and as an attending is the norm. In one study, attendings work 59.2 …

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Attending time: That’s just a myth

Why more physicians should enter industry

Tech
June 30, 2018

Attend any biotech or health informatics conference and one thing becomes clear: the scarcity of physicians. Entrepreneurs, businessmen, angel investors, and software engineers swarm these conferences — and their encompassing companies — all the while the imperative persona in this realm remains tied up behind a dysfunctional EHR or in an overbooked operating room. Why?

Certainly, inculcating these dynamic players in the health care space is integral to the successful evolvement …

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Why more physicians should enter industry

10 tips every young physician should read

Physician
June 29, 2018

How do I balance my home life with physician life?

I really want to do a research study. How do I start?

How do I get involved in my specialties society?

I am overwhelmed with clinical duties. How do I negotiate for nonclinical time?

My manuscript was rejected. What should I do next?

I had a bad clinical outcome, and I can’t seem to recover. How do I move forward?

Joining this committee will be a …

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10 tips every young physician should read

A physician on timeshares: Who are they right for?

Finance
June 29, 2018

Timeshares, for those who might not know, are a way to own the right to use a vacation resort. It comes in two forms, owning points or owning a specific room in a complex for a specific week. It’s like a partial ownership of a condo at a resort. These units can be traded for other timeshares all over the world. If you own a week, it can be traded …

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A physician on timeshares: Who are they right for?

5 reasons to get involved in organized medicine

Policy
June 24, 2018

The following are intended to inspire to medical students and residents to learn more about organized medicine. Whether it be at the national, state, county, or specialty level, there are numerous societies with opportunities for contribution.

1. To pull back the curtain. Many physicians are innately curious and like to “see how the sausage is made,” so to speak. There is a great deal of policy behind the scenes of our …

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5 reasons to get involved in organized medicine

How to create an app as a physician

Tech
June 24, 2018

“There’s an app for that.”

The phrase became so popular with the advent of smartphones that Apple even trademarked it. There are currently 3.8 million apps available on Android devices and over 2 million available to Apple iPhone users.

Does that mean that we’ve reached a limit on new and useful apps that can be created? Absolutely not. Especially in the medical world, it seems as if there’s so much room to …

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How to create an app as a physician

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

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

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 …

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

Becoming a doctor is the epitome of delayed gratification

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 …

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Becoming a doctor is the epitome of delayed gratification

Why do physicians publish in predatory journals?

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 …

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Why do physicians publish in predatory journals?

5 ways assembly line medicine harms patients

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, …

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5 ways assembly line medicine harms patients

A physician was fired for standing up for his beliefs

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 …

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A physician was fired for standing up for his beliefs

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