Being in a hospital is a scary and frightening time, and it’s easy for those of us at the frontlines — doctors and nurses — to forget that as we go about our busy work days. Patients are at a very low point in their lives and will remember everything about their hospital stay, including all their interactions, for a very long time.
As someone with a keen interest in improving …
In the hospital? Here are 7 things you must keep in mind.
I’ve had many opportunities to address physicians across the spectrum of health care settings, from those who run private practices, to those who work in large and small groups, to those who are hospital affiliated and employed. I often ask them the question “who controls the practice of medicine?” The answers I receive vary: government, insurance companies, hospitals, health systems, lawyers, employers and, rarely, patients. But one answer I never …
Why physician-led organizations work
I burned out early. I was done being a doctor at the end of fellowship. Although I took a job as a critical care physician, I desperately sought to alter my career somehow. I looked into website development, something I had been good at in high school. I took a few refresher classes on my days off and started coding my own sites. Luckily, my first job out of fellowship accepted many …
I was done being a doctor at the end of fellowship
I’ve always wanted to be a pediatrician because I love kids; if you ask most people who work in pediatrics whether nurses or physicians they may say that. It’s a very common response to the question “Why pediatrics?” Or how can you do pediatrics?” when students and physicians are asked. Yes, we love working with children for many reasons. Some love the unexpected unrehearsed things kids say; they will shock …
When healthy children die: Pediatricians are not superhumans
“Why do you eat so healthy?” or “Where’s your kale today?” I would hear regularly.
For as long as I can remember, my colleagues and friends have often smirked at my lunch choice. To me, I always ate what I enjoyed (even if it was the occasional french fry), and my diet and lifestyle were all about balance. Growing up, I played competitive soccer for 10 years and knew my performance …
The irony of the “sick” caring for the sick
Many patients are referred to me as a psychiatrist to treat their depression. The new patients that come to me for depressive symptoms usually expect that I will be recommending and prescribing an antidepressant for their depressive symptoms because that is what a psychiatrist does, right? Not always.
Often times these patients come to me having gone through several antidepressant trials without any successful resolution of their depressive symptoms. Well, sometimes …
The answer to depression isn’t always an antidepressant
Wellness. It’s all the rage these days as we try to manage our crazy work schedules while still maintaining balance in life. We have wellness committees, wellness workshops, wellness coaches, and wellness apps for our smartphones.
So, then, what does it mean to be well?
To the average person, and to the dictionary, to be well is to be “in good health” or “in a good or satisfactory way.”
However, to those suffering …
What does it mean to be well? Ask an opiate addict.
So, how do you do it all?
It’s a Monday morning. After a flurry of activities, I am walking into the office at 8:00 a.m. I think back to the past 2 to 3 hours. I was up at 5:30 a.m., and in my workout clothes soon after. I managed to squeeze in a 20-minute workout, thanks to a video on YouTube. I then reviewed my schedule and patient charts for …
How do physician-mothers do it all?
As a medical student, I had nightmares about my first day in the OR: scrubbing incorrectly, contaminating a sterile field, forgetting the anatomy I had so carefully studied the night before. It seemed like the only thing I could do in that artificially lit room was mess up. After a few cases I came to love the routine and ceremony of each surgery: the timeout; the rhythmic pattern of suture, …
A resident’s guide to being a medical student: In the OR
How do you describe the feeling when you are at a restaurant, and the waiter sees your coffee cup at less than half full (never half empty) and without asking they refill the cup or better yet, bring you a fresh cup of coffee? If you are like most customers, you have a nice feeling about the restaurant and the waiter as they have anticipated your needs. Usually, this anticipatory …
Improve the patient experience with anticipatory patient service
Here’s a quote that readers will not readily recognize: “It is a pity that a doctor is precluded by his profession from being able sometimes to say what he really thinks.”
I’ll share the origin of the quote at the post’s conclusion. How’s that for a teaser? I’ll give you a hint below.
Physicians, by training and experience, are guarded with our words. To begin, we are never entirely sure of anything, …
Doctors: Be careful, your words matter
The women’s health has a history of being a volatile sector, especially of late. It is an area of medicine where politicians think they can have access to intimate and confidential patient-physician relationships. This is unacceptable and an invasion of privacy.
Voluntary termination of pregnancy. Voluntary interruption of pregnancy. These are the medical terms for what the layperson thinks of as an abortion.
Missed abortion. Threatened abortion. Incomplete abortion. Spontaneous abortion. Septic …
Stop judging: Sometimes terminating a pregnancy is necessary
Recently, the ACGME (Accreditation Council for Graduate Medical Education) made the reckless decision to increase work hours to 28-hour shifts for new doctors. Here are the catastrophic consequences of their decision. Here are actual quotes from physicians (de-identified with some patient details changed to protect confidentiality):
“I did my internship in internal medicine and residency in neurology before laws existed to regulate resident …
The secret horrors of sleep-deprived doctors
“I can do that?”
During a recent morning practice session, a resident was presenting a patient who had had several episodes of syncope which culminated in a trip to the emergency room. She had a brief stay there, and on the discharge plan was written “follow-up with PCP and with cardiology.”
We went through her history and physical examination, we talked about how to further …
Are primary care doctors referring too much?
If you were to sit in on any routine doctors visit, you are bound to hear a few things repeatedly.
“Do you smoke? How much alcohol do you drink, if any? What is your diet like? How much exercise do you get weekly?”
These are questions we are trained to ask as early as the first week of medical school. We are taught to treat not just the conditions a patient presents …
Doctors don’t often follow their own advice
I am not God.
Nor do I want to be, but I feel sometimes that my patients and their families do.
When I entered the ICU early that overcast morning I knew judging from the throng of anxious people waiting outside that things were not right. He came to me straight away, his eyes haunting and sunken as if he hadn’t slept for the whole night. His body barely able to support …
Doctors are not God. Even if some patients want them to be.
In no other field is change received with so much resistance and skepticism than in medicine. The oath taken by physicians to “do no harm” is profoundly ingrained in the medical culture that any deviation from tradition is regarded as near blasphemy.
As a physician, I frequently catch myself relying on superstition and past experiences more than on evidence and proof of progress. As the world is witnessing an unprecedented technological …
We must challenge the health care status quo
In August of 1991, I became a family practitioner in the United States Air Force and was sent to Clark Air Force Base in the Philippines. During my time there, I was asked to go on a medical mission. This experience struck me with the missionary bug to provide my talents and to care for others in another country. With medications that were near expiration date in USAF stock and …
What this physician learned from a medical mission
Debt is destroying the lives of doctors everywhere. The cost of getting an education has moved into the ridiculous range. Many doctors are now starting their practice so far in the hole, that they do not see the way out.
I would not have been able to start on my debt-free journey (I peaked at more than $600,000) if I had not developed a new attitude toward debt. Putting debt into …
Debt should have an ICD-10 code
The year was 1976. I was graduating from a small branch of my state university with a bachelor’s in chemistry when I first applied to medical school. I was living at home and paying my own tuition. There were no physicians in my family, but I became interested in medicine after I was impressed with a surgeon who had operated on my shoulder. I had a better-than-the-medical-school-acceptance-rate average on my …
I’m retired, but I’m disgusted with medical schools. Here’s why.
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