I do some of my best thinking while exercising.
A few years ago, I was swimming laps in the still-dark early morning.
Swimming is one of my favorite activities. But in a pool, it gets boring staring at the bottom, so my mind often wanders off to tackle difficult problems.
That morning, like many of you, I was wrestling with the question of how to turn my passion into a successful side gig …
How this physician started his consulting business
We are a product of our upbringing. For many of us, this means we develop values and beliefs about money and work from our parents. Our communities, however, also play a role. It is in these communities that we learn a joint value system, a blueprint for how to approach and interact with the world. It’s easy to underestimate the profundity of this effect.
I grew up in vastly different cities. One …
We are a product of our upbringing: a tale of 2 cities
Performance appraisals are an integral part of an organization’s assessment of employee and trainee standing. Management and human resource literature is full of analysis and debate regarding how to best rate subordinates. Regardless of evaluation system utilized, some of the common goals of individual appraisals are to monitor progress, identify areas for growth, set goals, guide development, provide and elicit feedback through open communication, and document issues that may require …
Influencing your resident evaluations for success
“Where is Saipan?” I typed into Google to search for this little U.S. territory island in the Western Pacific when I was told about a need for an OB/GYN in 2016.
Next, I inquired to the private physician looking to expand his practice, “Do you really have a significant volume to support another doctor?” My vision of island medicine was that there were a smaller number of births due to a …
A physician’s life as an FBI informant
Opioids are an essential class of drugs used in pain management. In recent years, complex mechanisms pertaining to their abusive use have prompted a deadly crisis which is unfolding in the United States. The U.S. Centers for Disease Control and Prevention stated that 91 Americans lose their lives daily due to an overdose of opioid drugs. This public health crisis has inspired much apprehension even among Haitian …
The miscalculated fear of an opioid crisis in Haiti
For millennia, blood-letting was the standard of care for many diseases; today it is a joke, evoked only to mock our predecessors. But it is time to dismount our high horse and realize that there is at least one infection that we still primitively try to drain from the body, not from the bloodstream, but from the colon. This is our friend Clostridium difficile.
According to the CDC, there are about …
It’s time to treat C. diff diarrhea
Anyone who has ever tried to buy health insurance in the open marketplace knows how difficult and expensive it can be. I spent years working at jobs that did not provide health insurance, and I remember the annual feeling of dread when I received notice of the new premium increase. The only way I could keep the cost affordable was by continually raising the deductible until eventually, I was paying …
Here’s why health insurance is different from other insurance
Many physicians don’t want to think too hard about investing. There are a lot more fun things to do in life than worry about the minutiae of index funds.
One of the best investments for beginner investors are target-date funds. It’s a great way to get started with investing, while you learn more about the principles of asset allocation.
But there are literally hundreds of target-date funds available. How do you pick …
Pick the right target-date mutual fund. Here’s how.
As a medical student, I have big shoes to fill. I feel that void in my foot-space at all times. These shoes are expensive, and they are monstrously huge. We’re talking circus-clown, Shaquille O’Neal, Andre the Giant shoes. I feel awkward in these size 24s. I’m stumbling and scuffing them, but I’m not even close to calling it quits. These shoes are staying on. I am trying as hard as …
In medical school, everything is a zebra
After a complicated stay in the hospital, my patient was finally ready to be discharged. After all he had been through, I was excited to tell him the good news.
“You will be leaving this afternoon,” I said, heartened by the smile I saw spreading across his face. He thanked me, and then said something that made me cringe.
“Finally! I thought you guys were going to keep sticking me with needles …
Are all of those morning labs really necessary?
“I can’t do this anymore,” Mary* said to me after morning rounds.
As third-year medical students, this could have been in reference to a number of things: 5 a.m. rounds, practice sutures, 14-hour days, the list goes on. Though I later learned Mary was simply referring to living.
An article recently published by JAMA showed depression or depressive symptoms among medical students was as high as 27.2 …
Why do medical students kill themselves?
As women in the medical workforce increase, women physicians are faced with the unique position of training the hardest they ever had in their lifetime cutting into precious childbearing years. Many women physicians seek time off or engage in part-time jobs to address the dilemma of fulfilling the obligations of their careers while enjoying the tender years of their babies. Others pursue non-clinical routes such as medical chart reviews or …
How to get back into the medical workforce if you’re a mom
The third year of medical school is when a student experiences the frustrations of medicine firsthand. Once, my team admitted a transfer patient from another hospital to treat a condition that was ravaging the patient’s lungs. But before we could act, we needed to rule out a dormant infection; if our patient was unknowingly infected with tuberculosis (TB), giving our first-line therapies could lead to a disseminated infection — even …
Poor communication between EHRs is unacceptable. Let’s fix it.
Why are there vending machines in hospitals? This seems like an odd question to ponder, and it certainly would seem to have nothing to do with the current state of medicine and health care in our country. But it is a question that I am having a hard time wrapping my brain around. Certainly, most hospitals do have vending machines that sell snacks and soda, and they are by no …
Why are there vending machines in hospitals?
A guest column by the American College of Physicians, exclusive to KevinMD.com.
I recently saw a 35-year-old patient of mine who came into clinic requesting brain imaging. Although she had no specific symptoms, she had a friend who was diagnosed with a brain tumor several months ago and is concerned about the possibility that she …
The challenge of the worried well
As a boy growing up in a small town in Pennsylvania, I never gave much thought to the concept of a kiss. My family gave and received kisses without hesitation. I continue to give and receive kisses from my wife and kids in the same nonchalant manner.
Until one night — on shift.
I work in the ER of a medium-sized town in southern Oregon. It was late into my shift. The …
A kiss changed this doctor’s life
I am a physician in recovery and just celebrated my fifth-year anniversary on October 11, 2017.
While in active addiction, my drugs of choice were benzodiazepines and opioids that I washed down with top-shelf alcohol. Near the end of my usage, I was diverting scheduled drugs in order to feed my addiction. After an unsuccessful suicide attempt, I finally admitted myself for treatment.
As part of the treatment process, I enrolled with …
What’s the cost of being a doctor in recovery?
Early this month, Joanna Gaines, co-host of HGTV’s popular Fixer Upper, shared her pregnancy news with the world via a baby bump photo and an ultrasound, both posted to Instagram. The congratulations began pouring in from excited fans. But the conversation took a dark turn when a physician commented that the ultrasound appeared to …
An ultrasound posted on Instagram. Does a physician have a duty to warn?
Doctors are intelligent people, but are we good thinkers? And how should we think?
There are two basic kinds of thinking: analytic and intuitive. (And maybe good and bad, so that’s four.) Within medicine, analytic thinking can perhaps be best exemplified in the evidence-based movement, which began in the early 1990’s. It was a gilded age, full of promise, and bolstered by the reality that computers would give physicians instant access to the …
How doctors should think: Heuristic thinking isn’t heretical
We all know that life is unpredictable. In fact, the only thing that’s certain is that things will be uncertain. Despite this, or perhaps because of it, I think the majority of people are risk-averse. We’re concerned about future and its potential for unfortunate circumstances. If we weren’t, there would be no such thing as insurance–and there’s insurance for just about everything.
While it’s important to think optimistically, knowing you have …
Have you set up the safety nets in your life?
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