1. Due to intermittent monitoring versus continuous fetal monitoring which is standard in the hospital, the patient has increased mobility and a wider range of laboring positions/options: sitting, standing, walking, water, birthing balls. The American Congress of Obstetricians and Gynecologists (ACOG) has agreed that there is not a medical benefit to continuous fetal monitoring compared to intermittent monitoring in low-risk women.
2. …
I work in a place where nobody calls me by my name.
They all address me by a moniker of their choosing that I have asked them not to use. I have asked them to use my name. Aside from a few who respect my wish, most of my co-workers just call me by the impersonal-sounding phrase they’ve selected instead. It creates …
Kaitlyn Elkins was a medical student at the Wake Forest School of Medicine in North Carolina and a member of the class of 2015. She excelled academically, named the valedictorian of her high school class and graduating summa cum laude from Campbell University. She wrote poetry in her free time. She had a cat, lovingly named Gatito. On April 11, 2013, just …
We’ve all heard it said that learning medicine is like drinking from a firehose. Yet many students and schools don’t use one of the most effective study techniques available to them. Spaced repetition is a powerful, evidence-based study technique that can enhance learning and long-term retention of medical knowledge. Medical students and schools could both benefit from understanding and using spaced repetition to produce more knowledgeable and better-informed doctors.
Over a …
One of my favorite physician sayings is, “Don’t just do something, stand there!” Which means that it’s better to do nothing than to do something that doesn’t help. As I move through my career, I find myself agreeing. I am endlessly amazed at the number of things we do for no good reason, and that patients come to expect, also for …
As someone who has practiced hospital medicine up and down the East Coast for the last several years, I’ve had the fortune of working with some absolutely terrific colleagues. The hospital environment is by its very nature a busy and hectic one — where we all put our heads down and work tirelessly at the coalface for hours on end. Doctors …
There was once a woman whom I met for the first time when she came to the ER, on death’s door, metaphorically. I told her and her family just how seriously ill she was, and how slim the chances of survival. We all agreed on that day to take a shot at it — at survival, that is — despite lousy …
Evidence-based medicine (EBM) has been classically described as “the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.” At first look, this well-accepted approach to clinical medicine appears not only completely reasonable, but also somewhat obvious given the immense amount of research available for academic consumption.
EBM has been repeatedly preached as the gold standard of clinical care across all medical …
No one wants to hear that they have a disease. And yet everyone will develop some degree of degenerative disc disease (DDD) — or degenerative spine disease — over the course of a lifetime. DDD refers to a combination of age-related and wear-and-tear-related changes that occur within the spine over time. It is very common and a natural part of aging.
Most …
I used to be a surgical resident in the U.K. One day, I was a little dispirited during a brutal call, and my senior resident asked, “Do you love surgery?”
“I like surgery,” I replied.
“If you don’t love surgery, love it unconditionally I mean — like loving your child — you will be unhappy.” He warned.
I really liked surgery. I like radiology. …
Some months back I read an interesting interview with Jonathan Skinner, a researcher who works with the group at the renowned Dartmouth Atlas of Health Care. More than anyone else I can think of, the people at the Dartmouth Atlas have studied and tried both to understand and to explain the amazing variations we see in how …
I didn’t really notice him standing in line. But how could I? Hundreds of kids came through the high school gym yesterday. His turn for the heart and lung portion of the high school sports physical had come. He said he was going to play baseball and basketball. How could he with that arm he carried so carefully? I am not …
What is it like for physicians to fail their ABMS Maintenance of Certification® (MOC) program examination? How does the largest member board of the ABMS, the American Board of Internal Medicine (ABIM), respond to doctors who fail their secure examination?
As I continue to confidentially collect information from physicians who have failed their MOC examination, I thought it would be important to publish …
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An excerpt form Baby City: An Inside Look into Labor & Delivery.
I am going to make this medical student cry.
I don’t know how I know it, but somehow I can sense it. I know it the second she walks into the resident room on labor and delivery at Cadence …
There he stood at our beach party, the family doctor I grew up admiring. I timidly approached his circle of friends to announce I had gotten into medical school and would start in the fall. He stopped to attention. His friends stood watching. I couldn’t conceal my smile. I thought, “He is going to be so excited for me!”
“Get out now.” …
I’ve been a doctor for more than 20 years, and I hate to break it to you, but it’s time I came clean: We lie. Doctors lie. Not always. Not necessarily on purpose. But we do.
Sometimes the lies are to our patients. Sometimes, the lies are to our families. And sometimes the lies are to ourselves.
But, nonetheless, we lie. A lot. …
A disclaimer before I even get started on this post.
Some of you who know me or work with me will think that by writing this post I am talking about you or even attacking you. I am not. If you’re especially sensitive, don’t read any further.
I am simply writing something that has been kicking around in my head for a long …
I suffered from extreme nausea during my pregnancy; I had triplets, and I’m pretty sure I had a triple dose. I never threw up, but you know how your mouth salivates the moment right before you vomit, that sensation that sends you running to the bathroom? I had that. All. Day. Long. For four weeks.
By day four or five I was …
Each year children ingest an array of foreign bodies including coins, magnets, and a new subset of batteries known as button batteries. Awareness of this small yet very dangerous foreign body is important for parents to understand so they can act quickly if their child is suspected of ingestion.
What is a button battery?
A button battery is a cylindrically shaped object measuring …
A while ago, I wrote about “The secret lives of doctors.” The post must have struck a nerve because it went viral, maybe because it helped patients to realize that doctors are human.
We doctors can’t really know how human we are until we become a patient.
That happened to me recently. And it wasn’t pretty. You need to know the …
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