Perhaps one of the hardest things about medicine is cross-coverage, that is, to be the covering doctor for your partners, whether for the occasional night, weekend, or longer. It’s not something done only in oncology. All specialties in medicine have this system, which allows us to have lives outside of our hospitals and clinics. What’s …
Cross-coverage has made me aware of the art in medicine
Martha (not her real name) was not an overly complex case in my field of geriatric psychology. But the case was complex enough to require multiple approaches and reliable follow up. And in rural Mississippi, follow up can be elusive. Soon it occurred to me that Martha’s case is emblematic of how caring for this vulnerable population often runs up against a huge problem — the Medicare merry-go-round.
A 78-eight-year-old with …
The Medicare merry-go-round in geriatric psychiatry
When I was in fourth grade, I won our school’s spelling bee. This meant that I went on to the next tier of the local spelling world — the sort of prestigious competition that takes place in a gymnasium somewhere with a makeshift stage and a bunch of flags.
I was the first kid disqualified. I misspelled veterinarian “veterenarian” and battlement “battlemint.” I remember feeling, in the moment the announcer said, …
We are sorry, you did not match to any position
You extend a firm handshake and get ready to sit down at the table across from your mentor for the first time.
Woah, wait. Let’s back up to the legwork that should have happened prior to this meeting. First step, you found the mentor (see this post for practical ideas on how to find a mentor). Neither you nor the mentor have a lot of time — a frequent obstacle often …
Your first meeting with a mentor
Strong letters of recommendation are essential for supporting your residency application and matching well. This article details how to ensure you get great letters of recommendation.
Knowing what constitutes a great letter of recommendation is crucial to obtaining outstanding letters. A strong letter of recommendation clearly conveys knowledge of the medical student, how that student performed and qualities that predict excellent performance in residency. Strong letters of recommendation include the following:
How to ask for a great letter of recommendation for residency
In 2013 I began searching for ways I could change my career to reduce my workload, but not give up medicine altogether. During that time I took a cruise and looked at various jobs I could do on a cruise ship. One of the jobs I was qualified for, I thought, was to be a Cruise Ship Doctor.
After talking with the ship’s doctor to find out what it was like …
What to do if you want to be a cruise ship doctor
The Affordable Care Act (ACA), widely known as “Obamacare,” has survived several repeal attempts by Congress. Storm clouds, however, are still on the horizon.
The ACA’s individual mandate obligates every American to be covered by comprehensive health insurance. This requirement has been the most unpopular feature of the law. That’s because healthy people, especially those who are self-employed or between jobs, have found the ACA premiums too expensive.
They are not alone. Health …
The skinny on skinny health insurance
“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
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