Even though my own internship was a decade ago, I vividly remember the transition from student to resident. Residency was monumental in my path to becoming a physician. There were obvious changes: People now called me “doctor,” my misshapen short white coat was upgraded to a more comforting full length one, and I was often the first one paged to respond to patient problems. Coupled with the positive aspects though, …
How to thrive during your residency
A guest column by the American College of Physicians, exclusive to KevinMD.com.
Trust is the belief that another person or entity will act in your best interest, and it serves as the foundation upon which the doctor-patient relationship and our health care system are built.
But we have a significant trust paradox in American medicine. As …
Restoring the trust in the medical profession
My (sometimes solicited, but often unsolicited) advice for graduating medical students, residents, and fellows:
June is one of my favorite times of the year. One, because it’s summer, but also because it’s graduation season. I love seeing and hearing about everyone’s accomplishments, and seeing years of hard work come to fruition – although if I’m being honest, it’s bittersweet, because it’s also a reminder of how I’m getting older.
This year, I’ve …
6 pieces of advice for graduating medical students and residents
An excerpt from 7 Ways to Stop Drama in Your Healthcare Practice.
Although the ability to initiate difficult conversations is part of good leadership, I’ve never met a leader who enjoys it. Whether your conversation is about body odor, rude behavior, dress code, personal conduct or performance issues, difficult conversations are …
8 steps to have those difficult conversations
No news attracts attention like a physician who’s in trouble with DEA or their state medical board. So, how does it happen, what are the common issues and what can a physician do to safeguard themselves?
First, let’s look at what the numbers and the research tell us.
The Federation of State Medical Boards (FSMB) tells us that 4,091 physicians were disciplined during …
10 ways to stay out of the DEA’s crosshairs
An excerpt from the Docs Outside the Box podcast, episode 1: When the going gets tough… MOVE!
Dr. Nii: All right, well thank you very much for joining us on the Doc’s Outside-the-Box podcast. You are our first guest — first victim, I guess. It’s the inaugural episode, so I just wanted to thank you for joining us. I know you are in New Zealand, which is roughly 18 hours away.
Dr. Brown: It’s …
A conversation with a doctor who was tired of feeling burned out
Literature coming from business and human resource management suggests that women are over-mentored and under-sponsored. However, if you have been reading reports about women in medicine, then you likely have heard that women are both over-mentored and under-mentored. Where does the truth lie? That depends on various factors including the definitions of these terms.
What exactly do these words mean? In the business sector, mentorship is …
What’s better: mentorship or sponsorship?
The Centers for Disease Control and Prevention reports that 63,632 individuals died in 2016 as a result of drug overdose. Among these, 66 percent died from opioid overdose. The statistics are derived from in-depth research that was carried out by the research institute in 2016. The Centers for Disease Control and Prevention warns that cases of drug abuse are swiftly spreading geographically and increasing demographically. The …
Prescription drugs are killing students and the educational system
The keto diet has recently garnered much fame for its apparent ability to improve diabetes and obesity – results so impressive the Journal of the American Medical Association recently highlighted the diet and thereby christened it as something more than a low-carb craze. However, not all the evidence supports such a positive outlook, leading the diet to straddle the increasingly blurred lines between faddist snake …
A physician’s warning on the keto diet
In medicine, this is the time when one season ends and another begins. New doctors graduate from medical school. They are excited and, at the same time, scared as they enter into residency training. Interns become residents. Senior residents celebrate moving into attending positions or look forward to subspecialty training in fellowship programs. It’s the excitement of completion combined with the uncertainty of charting a new course in medicine. Each …
3 steps for doctors to move into the next level of career growth
Recently, a journalist with NPR asked her audience if sleeping with your baby is as dangerous as doctors say. In short, yes, it is very dangerous.
In the article, Michaeleen Doucleff repeatedly trivializes the danger of parents co-sleeping with their baby. She uses anthropological evidence to reassure parents that sleeping with their infant is safe if parents don’t drink, smoke, or use illicit drugs. She makes light …
Sleeping with your baby: Mainstream media gets it wrong
Over the last month, a dermatologist practicing in Georgia known as the “dancing doctor” was suspended by the Georgia Medical Board, which said she posed a “threat to public health, safety, and welfare.” At least ten patients have sued this physician with complications including disfigurement and brain damage, and reportedly there are another 100 former patients who …
The hidden issues of the “dancing doctor”
I sometimes get messages from people who have lost physician colleagues and loved ones to suicide. It’s the specifics of these stories that wound me: a note left for an unexpected person; an insignificant fight at sign-out that in retrospect is full of meaning; the white coat that a woman wore when she jumped to her death. Each of these lives is complex, and each of these deaths …
What I wish my family had known about medical residency
On May 15, President Trump attempted to kill not just two, but three birds with one tweet, simultaneously denouncing the Media and the Mueller investigation, and crowing about his approval ratings. “Can you believe that with all of the made up, unsourced stories I get from the Fake News Media, together with the $10,000,000 Russian Witch Hunt (there is no Collusion), I now have my best …
Political polarization is harming America’s health
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 …
Which of these patients should get a liver transplant?
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 …
3 things patients really want from their doctors
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 …
Job security in medicine is a myth
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 …
Don’t tell patients they look great, except in these cases
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 …
A doctor’s apology can go a long way
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 …
5 ways to show empathy in medicine
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