My grandmother’s room is silent, save for the plucks of sitar strings and Pixar movie soundtracks I try to stimulate her with. Instead of books, we fill the shelves around her bed with mouth swabs, drab hospital gowns and vials of baby powder. My grandmother — who walked an hour every day, who thrashed me in gin rummy, who rose before sunrise every morning to read — now lies bedridden …
How do we fix the apathy in nursing home staffs?
I remember one sunny day in Chicago, in June 2011, when my husband and I packed up our two young children, aged 2 and 5 months. Professional movers had collected our belongings and had driven off a day prior. We were headed out of state, to my first job at an academic hospital. It had been a rather hectic few months for me, having just had a baby 5 months …
Before my first job, I wish someone had told me a few things
Every time I walk into a bookstore, I pass Paul Kalanithi’s When Breath Becomes Air and am reminded of a specific anecdote he shared.
Kalanithi, MD, was a seventh-year neurosurgery resident and his lung cancer had metastasized – a process which was only being controlled by a new drug his oncologist had decided to try. But one day, Kalanithi had severe nausea and had to be hospitalized to stay hydrated. A …
Doctors will inevitably make mistakes because they are also human
Dr. Leon Pedell discusses how to transition from memorizing physical exam techniques to applying them with real patients to find real abnormalities. Many students have a misconception that they can forget much of what they learned in first and second year as, “low yield.” This is not the case. More than anyone else on a care team, medical students have time to perform thorough physical exams and you …
Transition from memorizing physical exam techniques to real patients
A recent Medical Economics article asked “Is the DPC model at risk of failing?”
The piece focuses on two large DPC-like organizations, Qliance Medical Management of Seattle, Washington and Turntable Health of Las Vegas, NV, working in partnership with Iora Health, which recently closed their doors. Qliance and Turntable were not actually DPC practices by strict definition; they were innovative large business operations providing health care services to patients and excluding …
Is direct primary care doomed to fail?
Here’s a question that has been debated for several years: Should radiologists talk to patients about their imaging results?
Citing several issues, I came down solidly on the “no” side in a 2014 blog post.
Two major radiology organizations have committees looking into the concept, and New York Times article said, “they hope to make their case [for it] by demonstrating how some radiologists …
Radiologists have an image problem
High-stakes standardized testing is an enduring facet of medical education, and the standardized test that is on every medical student’s mind is the USMLE Step 1. The paramount importance of this test for getting into residency creates a demand for high-quality test preparation materials. Established test prep names like Pathoma, Sketchy Medical, First Aid and UWorld fill that demand in a market consisting of more than 40,000 test takers worldwide …
Test prep companies are more powerful than medical school
I receive a significant amount of email in response to my blog posts about locum tenens work. Curious colleagues (from surgeons to internists and emergency medicine physicians) ask for insider insight into this “mysterious business” of being a part-time or traveling physician. I am always happy to respond individually, but suddenly realized that I should probably post these conversations on my blog so that all can benefit.
The most common question …
Interested in being a locum tenens physician? Read this first.
3 a.m. The alarm blares. Get up, make food, study. Maximize caffeine intake, maximize studying efficiency.
4:12 am. Take the last sip of water, pray. Maximize studying with residual caffeine power.
7 a.m. Get dressed, go to work. Stay awake, stay alert, see patients, present well, regurgitate answers, retain information. Produce saliva, clear dry throat. Study during lunch break. Stay awake, stay alert, see patients, present well, regurgitate answers, retain information.
6 p.m. …
Observing Ramadan as a medical student
Dear future medical student:
It’s graduation week. I’m running into people I haven’t seen in a long time. There are a few things on my mind currently, and in four years, you’ll have the same conversations.
“Did you have so much fun in med school? Did you love it?”
“No.”
“Wow! Those four just FLEW by, didn’t they?”
“No. They absolutely did not.”
“Well just WAIT ‘til you get to residency. THAT was hard. What you …
Medical school is miserable. Here’s the secret to surviving it.
Doctors have been bemoaning changes in the practice of medicine for years and with good reason. It’s harder and harder to make a go of it in private practice. In recent years our area has lost several small practices — Hal Grotke’s Redwood Family Practice closed, Dr. Garcia retired, Teresa Marshall’s solo office shut its doors, Eureka Internal Medicine transitioned to Humboldt Medical Specialists (which then became St. Joseph Hospital …
The slow death of private practices
My husband is a doctor. Similar to any other career, this is what he spends most of his time doing. It’s also our family’s livelihood — how we pay our mortgage, our bills and send our daughter to preschool.
He went to through seven years of training after college, often working all night or even 24-plus hour calls. He’s had to miss family dinners, birthday parties, nights of putting our daughter …
Stop asking doctors for free advice
Over the last few decades, public perception of physicians has been on the decline. Many issues are to blame, but a largely overlooked contributing factor is the media. Physicians are often portrayed negatively, with stories of narcotic abuse, greed and medical mistakes dominating the news. Rather than fight back, physician organizations have stood silently and allowed their reputations to be tarnished. On the other hand, nursing organizations have been busy …
Doctors: You have a PR problem
Throughout training, I had an idea. And that idea was — I would be a great academic physician. I had the right training. I had done research from college through fellowship. I had received research grants from medical school through fellowship, published numerous papers and started defining a niche. Everything was going great.
Academia — here I come!
Then attending-hood arrived. I looked for positions in academic centers. I was limited by …
Better care: Private practice or academic center?
At what point, we have to ask ourselves, does a medical error that we do over and over again cease to be an error, and simply become business as usual?
At one of the patient safety conferences this week, where we reviewed sentinel events that occurred in the hospital and in the outpatient setting, one of the cases was about a patient who developed an abnormal cardiac rhythm as a result …
How a one-time bridging prescription became an every time refill
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 37-year-old man is evaluated for a 2-year history of low libido, loss of morning erections, fatigue, and decreasing muscle mass. His medical history is otherwise unremarkable. He takes no medications.
On physical examination, vital signs are normal. BMI is 35. The remainder of the examination, including genital examination, is normal.
Laboratory studies:
