Is there any hope for physician-only anesthesia groups?

Physician
February 12, 2016

Today is a remarkable day for me. I’m officially leaving private practice after almost 18 years, to return to academic medicine with a faculty position in a highly regarded California department of anesthesiology.

Why would I do that?

There are many positive reasons. I believe in the teaching mission of academic medicine:  to train the anesthesiologists of the future, and the scientists who will advance medical care. I enjoy teaching. The years …

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Vaginal marijuana for menstrual cramps. Does it really work?

Meds
February 11, 2016

Foria wants you to know they are selling vaginal suppositories of THC (tetrahydrocannabinol) and CBD (cannabidiol) called Fiora Relief for menstrual cramps. Each suppository contains 60 mg of THC and 10 mg of CBD.

Foria claims they can treat the pain of menstrual cramps and endometriosis. Is this possible?

THC and cannabidiol (CBD) are compounds found in marijuana. The psychoactive (i.e., high) from marijuana is believed to be due to …

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A quantitative analysis of the first year of internal medicine residency

Education
February 11, 2016

In a few weeks, thousands of medical students find out where they have matched for residency. I still remember the excitement and anxiety of peeling back that envelope and hoping I would see my top choice. My medical school had a tradition of putting each 4th year’s name in an old doctor’s bag. One by one, our dean would pull out a name, the student would contribute $1 to the …

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Listen to this doctor’s advice to medical students

Education
February 9, 2016

It’s been six years since I graduated from internal medicine residency. Enough time to give me some perspective, but short enough to still remember the highs and lows vividly. I recently had the opportunity to talk with a bright and energetic group of medical students. (Really, though, is there any other kind?)

The conversation turned to any advice that I had or maybe I felt obligated to give some as part …

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10 ways to become a physician entrepreneur

Physician
February 9, 2016

I find myself standing in front of six first-year medical students. They’re waiting for me to tell them something about how to become a physician entrepreneur.

These students are now elite amongst their peers. They’re the ones who’ve had the courage to sign up for my course. And, perhaps unbeknownst to themselves, they’re also among the 1 percent of early adopters to lead the way for health care change.

How do I …

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The end can be sudden in advanced cancer

Conditions
February 8, 2016

It was after shoveling winter snow that Brett began to cough. It was a dry cough, a morning cough, a “smoker’s cough.” It persisted, grew deeper. Several weeks later, there was a particularly harsh cough and in the sink was a crimson blob. Frightened, he called his doctor.

For 71 years old, Brett looked healthy. His lung exam was clear and the cough was gone. A case of bronchitis?   The chest …

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Surgery for your child is scary. This pediatric anesthesiologist is here to help.

Physician
February 8, 2016

The parental drive to protect your child is passionate, and learning that your child needs surgery is jarring at best and terrifying at worst.  As her guardian and provider, your instinct is to prevent harm to her at all costs, and even if you know that surgery is ultimately in your child’s best interest, the thought of her going through an invasive procedure, combined with the presence of illness or …

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5 simple strategies to get the residency you want

Education
February 7, 2016

All medical students start out as the best of the best: You had to be to get into medical school.  So now that you’re in, what are some of the things you can do to attain the specialty you really want? How do you set yourself apart from your peers?

1. Get out of your head. Telling yourself you can’t achieve a competitive residency is your first barrier.  If you can’t even …

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A Muslim-American doctor on the racism in our hospitals

Physician
February 7, 2016

Recently, the wife of a prominent Boston businessman — one of my many wealthy, white patients at Massachusetts General Hospital — greeted me this way: “So what foreign medical school did you go to anyway?”

For background, I’m a petite, Middle Eastern young woman with a headscarf, and I’m guessing I do not resemble her vision of what a doctor “should” look like. That image is probably taller, whiter, male and …

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5 parenting tips from a child psychiatrist

Conditions
February 6, 2016

Without a doubt, parenting is simultaneously the most rewarding and difficult job we have as adults. As a child psychiatrist and mom, I am always asked if I find it easier to parent given my profession. I always respond by saying, “I was the perfect parent until I had children!”

I am also universally asked about how to raise happy children. I always pause before I attempt to answer this question. …

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A nurse is confronted with the death of his mother

Conditions
February 5, 2016

It will be six months since my mother passed away.

I kept my mother’s illness a secret. Not because I was ashamed and embarrassed but I did not want to advertise to the entire world of what she was going through out of respect to her and my family. So you sit there, put on a front like everything is cool and continue on your daily routine, until one day everything …

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Noise pollution is an epic problem in hospitals

Physician
February 5, 2016

Me: Hello Mrs. Smith, my name is [BEEP!] Dr. Gandolfo and I am a [BEEP!] gastroenterologist. [BEEP!] Your doctor wanted me to [BEEP!] talk to you about something that showed up on [BEEP!] your CT scan.

Mrs. Smith: Who are you? I [BEEP!] didn’t hear your name?

Me (louder): It’s Fred Gandolfo, I am the [BEEP!] stomach doctor. [BEEP!] I need to talk to you about [BEEP!] that CT scan you had.  You see, there was … [BEEP!] [BEEP!] [BEEP!] Can you straighten your …

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How do surgeons deal with their mistakes?

Physician
February 5, 2016

As surgeons we are privileged to have our hands work inside someone’s body with the intention of alleviating suffering, removing sources of pain, excising diseased organs, fixing this or that, ultimately to improve someone’s quality of life, prolong it or at times even save it.

Yet we also know that people can suffer complications from surgery, that in some cases are fatal, and where our good intentions seemingly backfire. Patient deaths …

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The truth about fevers in infants

Conditions
February 4, 2016

Fever phobia is common among parents. The vast majority of the time, these fears are unfounded, because a fever is very rarely a cause for significant concern. One important exception is in newborns under 2 months of age. Compared to older children, these very young infants are at high risk for serious infections, so any fever in this age group requires urgent medical evaluation. Here’s what parents needs to know …

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Doctors: Feel like a fraud? You’re not alone.

Physician
February 2, 2016

Imposter syndrome (n.): Term coined in 1970 by psychologists and researchers to informally describe people who are unable to internalize their accomplishments despite external evidence of their competence.

When I was in medical school, I remember walking outside the library and trying not to glance inside to see how many of my classmates appeared to be meticulously studying for final exams. I remember trying to ignore their off-hand, and occasionally self-congratulating, …

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Customer service in health care: Does AIDET really work?

Physician
February 1, 2016

Mnemonics can be incredibly cool. When I was in medical school, there was just too much stuff to remember and memory aids were so very helpful. Most specifically I refer to the vile and inappropriate one that helped me remember the cranial nerves which I remember to this day and will not share in print.

In ancient times orators used memory palaces to memorize long speeches or poems, associating words with …

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Doctors need to learn to say no. Here’s how to do it.

Physician
January 30, 2016

If you have a life where you never, ever say yes when you mean no, then you can stop reading right now.

But I guess that you’re a lot like me. Now and then, you get caught off guard.

And before you know it, you’re staying late to see that emergency patient. Bringing cupcakes for the second-grade class. Volunteering for the coffee meet-and-greet at church next Sunday.

What’s up with that? We’re smart. …

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The shocking confessions of a naturopathic doctor

Physician
January 29, 2016

I was a licensed naturopathic doctor in two states. I quit practicing naturopathic medicine after discovering my former boss, also a licensed ND, had been importing and administering an illegal cancer drug. I trusted my boss, as did his patients, because he was well respected in the naturopathic community and his credentials included “FABNO” (Fellow of the American Board of Naturopathic Oncology). This FABNO treated any kind of cancer, even …

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The benefits of trauma-informed care in the NICU

Conditions
January 29, 2016

When my twin sons were born prematurely at 26 weeks’ gestation, my family’s lives were thrust into the whirlwind of the NICU and living daily with the reality of the babies (William and Elliott) being on life support. Having had no prior intense and prolonged experiences with the hospital, and watching helplessly and fretfully as my tiny two-pounders fought for their lives, it’s almost impossible to put into language what …

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Will the real doctor please stand up?

Physician
January 26, 2016

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In 2006, graduate nursing programs started granting doctorates of nursing practice (DNP degrees). In a media fact sheet, the American Association of Colleges of Nursing (AACN) explains the thrust for the change this way:

Some of the many factors building momentum for change in nursing education at the graduate level include: the rapid expansion of knowledge underlying practice; increased complexity of …

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