I see these couples quite often: the man has been prescribed androgen deprivation therapy and his partner is distressed. He no longer has erections, although for some that had been a problem for years. But even then, they tell me, he at least tried occasionally. Now there is nothing. No hugs, no kisses, no hand holding, no touch. The partners are …
The loss of testosterone and how that affects the partner
Unless you’ve been living under a rock, you’re well aware that the United States is in the grip of a really big epidemic of opioid abuse. The epicenter of much of this has been my beloved Appalachia. My home-town, Huntington, WV, might as well be re-named “Oxycontin,” or maybe “Heroinville.” It’s ugly.
Enormous amounts of ink have been spilled on this topic, and …
How the pain scale and patient satisfaction leads to death
One cold winter night many years ago, someone dropped off a calico cat and her two kittens in our snowy driveway, and we went from a two cat family to a five cat household. I learned a few things from that.
When I was a resident, two thirtysomething family docs had an office upstairs from the residency program. Ned and Peter precepted us, and they sometimes ran downstairs to ask the …
Why managing physicians is like herding cats
The ice storm of 2013 in Atlanta, Georgia made headlines for weeks described as “snowpocalypse” and “snowmageddon.” It looked like something from a sci-fi movie — the end of the world, an alien invasion. It was the subject of social media memes and discourse for quite some time. In the midst of all that human frustration, there were ice-trapped cars, parents who struggled to reach children trapped at elementary schools.
Physicians, …
5 ways doctors can cope when natural disaster strikes
Traditionally, many medical students use the proverbial “last summer of their lives” to conduct basic/clinical research, shadow or go abroad. If you want to be a leader in health care or are simply unsure of what to do over the summer, you should try something more exotic and unexpected — work in finance or industry.
Wall Street, big pharma and private insurers have long been the moral punching bags of clinicians …
Want to change medicine? Work in finance.
I recently read an article about how the physicians’ lounge, which was once present in every hospital and an important congregating area for doctors during the day, is now mostly a thing of the past. Although the article was not a new one, it peaked my interest because I’ve witnessed the demise of the physicians’ lounge at close quarters over the last several years.
Speaking too as someone who has …
The demise of the physicians’ lounge is symbolic of the decline of the profession
As someone who talks to many physicians about burnout and life in medicine, I find myself having a lot of discussions about the circumstances of people’s jobs. Almost inevitably, there comes a point in the conversation where someone expresses dissatisfaction about an aspect of their contract or an additional responsibility that was placed on them.
As physicians, we’re groomed to take care of patients. During training, we don’t talk about compensation, …
5 things physicians can do to protect themselves
RRegardless of specialty, no physician can truly provide patients with the care they deserve if they practice in isolation. In recent years, the health care system has acknowledged this reality by embracing greater collaboration and team-based care. With an aging population increasing the prevalence of chronic disease and life-threatening conditions, the timing couldn’t be better.
For the field of dermatology, the American Academy of Dermatology’s recent Burden …
It’s time for teamwork in dermatology
1. This is a calling. Physicians do not typically start out undeclared, drink through a couple of semesters and randomly apply to med school. For many, they started dreaming in grade school. They started pushing themselves for straight A’s in third grade, fought for valedictorian, turned down frat party invites to study, and then essentially gave up four years of their lives to med school incurring an average debt of …
10 things a doctor’s spouse wants you to know
What is a doctor? Technically speaking, a doctor is a person that dedicates his or her knowledge and skills to the prevention and treatment of diseases, while maintaining and even enhancing human health.
The majority of physicians enter into the profession of medicine because they are committed to helping others. It is this mission-driven spirit and dedication that makes us grateful for the opportunity each to care for others during a …
Here’s what happens when the doctor becomes the patient
How many times have you heard resident physicians say that they do not have time to exercise and get in shape? When looking at the numbers, it’s hard to blame them. An 80-hour work week is enough to make anyone realize that time is a precious commodity.
Take away six-to-eight hours for sleep each day, plus a couple of hours for eating, showering and studying, and you are left with approximately …
Want to stay in shape during residency? Here’s how.
We all know what, in 1888, Rudyard Kipling pronounced to be the world’s oldest profession. But what’s the world’s second oldest? Hunter-gatherer? Nah, everybody did that. Primitive politician? That’s a tautology. Neolithic attorney? Nope. Too similar to the oldest.
I strongly suspect that the second oldest profession was healer/magician. Fire up Mr. Peabody’s Wayback time machine, and you’d probably find that the first healers were regarded as magicians, and the first …
Physicians and magicians are not as different as you think
We as women have to stop saying “I’m sorry” for things out of our control. When we apologize for things we are not responsible for, we take a step backwards in the advancement of women in the workplace.
I am a cardiac anesthesiologist, which means I care for patients who are undergoing open-heart surgery. I work in an academic medical center and train doctors to become anesthesiologists. The operating room (OR) can …
Before you say “I’m sorry,” I challenge you to think
According to Wikipedia, “Productivity describes various measures of the efficiency of production. A productivity measure is expressed as the ratio of output to inputs used in a production process, i.e., output per unit of input. Productivity is a crucial factor in production performance of firms and nations.”
Please tell me how this relates to being a physician or a patient. We do not produce anything. Rather we work with individuals to …
It’s time to ban productivity from medicine
A surgical resident is suing St. Louis University, its surgical residency program director, and its trauma service chief for what she claims is an unjustified decision requiring her to repeat her fourth year of training.
The St. Louis Post-Dispatch article about this has a link to a 42-page PDF describing the details of the suit. Because I suspect you won’t read that PDF and maybe not even the article, I …
A surgical resident is held back a year. Finding out who’s right will be difficult.
It’s that time of year again, the dreaded, yet exciting, residency application season. Year after year, we have learned that securing a residency position extends beyond competitive scores. It involves planning, networking and putting your best foot forward to prove you are the perfect “match” for a program. To avoid having shock and stress of an unexpected scramble, we wanted to share five tips, which extend beyond some of the …
6 tips for medical students to get the perfect match
There is a 4,300-strong grassroots movement known as “Save Our Hospital” gaining notoriety in Albert Lea, Minnesota. This story is symptomatic of the fact that hospital consolidation has slowly become a national pastime. With declining revenue under the Affordable Care Act, mergers increased by 70 percent, leaving small communities scrambling for health care access. The latest casualty in the “hospital-consolidation-for-sport” trend is Albert Lea, a small …
The story of how a hospital is being sacrificed for money
I find myself spending close to an hour on the computer each morning at the hospital. I spend this time dutifully looking up vital signs, labs, recent radiology or pathology results as well as many other valuable pieces of information about each of my patients. I watch as my colleagues frantically record values, while making sure to point out important trends and gross abnormalities.
When we round, there is always a …
This doctor spends more time at a computer than with patients
“So, I’m getting routine labs on her.”
Wait, what?
Statements like these often make the hair on the back of my neck stand up. One of our residents was seeing a healthy young woman for her “annual physical,” seen just a few days after a routine postpartum visit with her OB/GYN after the uneventful birth of her third child two months ago.
The resident was coming for his afternoon continuity clinic from an …
It’s time to stop it with the “routine” labs
My intern gazed blankly at her notes from the day.
“You OK?” I asked.
Her face was quivering with restrained tears as she turned to me, “I don’t think I helped anyone today.” This was not the first time, nor would it be the last time, that I had heard those words from a resident physician.
Medical training is no joy ride. How could it be? First, there is the intellectual challenge of …
How to find joy in practicing medicine
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