I was sitting on hold in the resident room gearing up to beg the IT person that would soon come on the other line for enough authorization to be able to view the residents’ patient problem list, and I found myself thinking about what some of the old docs must think of us third-year students now. Talk to some of these older physicians and they’ll tell you their stories of …
The infantilization of medical students
Like many of my peers, I started medical school with idealistic dreams of providing compassionate care for poor patients. I thought being a physician was a noble profession and even discussing money, much less changing my career choices based on it seemed antithetical to that. A visit to the financial aid office quickly cured me of my naiveté. I was facing over $300,000 in debt and would be forgoing millions of …
Why this medical student joined the National Health Service Corps
Eating meat has been linked to cancer, high blood pressure, heart disease, diabetes, stroke, dementia and many other diseases. Nearly every modern lifestyle disease has been associated with meat. With so much emerging evidence against meat, it begs the question: Did we …
Think we evolved to eat meat? Think again.
As the repeal of Obamacare is debated in the halls of Congress and on cable TV, one common theme is: “What will happen to patients?” Questions loom about what might change with coverage, about cost, about whether you’ll still be able to keep your doctor, and if medications will still be covered
But what about doctors? What about how they’re doing?
There are things doctors want to tell their patients, not only about …
8 things doctors secretly want to tell their patients
I recently reported on a doctor-turned-dog-walker who says with her career switch she’ll enjoy more happiness — and income! In her own words:
Dear Pamela, Today I realized that if I become a dog walker and charge $25/hour and walk five dogs per day, I would make my equivalent salary with fewer hassles. I’m seriously considering this as a career move. I could …
Do dog walkers make more money than doctors?
Match Day results were announced recently and a record high 35,969 medical students learned the location and specialty of their first job. As these newly indoctrinated physicians chart their next steps, the majority will opt out of academia, creating a potential crisis in medicine and healthcare innovation.
Although 45 percent of graduating medical students aspire to work in an academic setting, only about 16 percent will do so. Of those who do …
Why we need more doctors opting for academic medicine
On July 1st, 2017, the updated Accreditation Council for Graduate Medical Education (ACGME) Common Program Requirements will take effect. The increase in the maximum continuous work hour shift from 16 to 24 hours has surely received the most attention, and will likely continue to do so.
However, the ACGME did make some significant improvements in this latest guideline update worth noting. Among them was a slight conjunctional switch from an “and/or” …
The little-known ACGME guideline change every resident should know
Medical school didn’t teach me about the intricacies of health insurance. My family medicine residency program took pride in caring for all patients regardless of insurance status. When I worked in New Zealand and Canada it was a relief to not worry about which diabetic test strips were on formulary or whether a patient’s insurance would cover their birth control.
In my current position as a primary care physician at an …
The problem with too many health insurance options
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 52-year-old man is evaluated for the sudden onset of erectile dysfunction that has persisted for 6 months. He reports having erections that are inadequate for vaginal penetration. He feels guilty about not being able to satisfy his wife’s requests for sexual intercourse, although he still has sexual desires. He has been sleeping poorly …
MKSAP: 52-year-old man with sudden onset of erectile dysfunction
I’m not here to tattle. No siree, Bob. I’ll save that for my kids. But what I am here to do is spell out a story in which I ended up down in the dumps.
A medical mistake happened. To me. On me.
I’ll never forget it. I can’t because I carry it with me forever.
Here’s the short of the long:
My obstetrician messed up. She took care of my pregnancy during one of the most …
A physician was the victim of malpractice. Here’s her story.
You graduate from medical school and get your MD degree. At first, when someone calls you “doctor,” you look around and wonder who they’re talking to, but after years of hard work and sleepless nights, you realize you really are a card-carrying “doctor.”
If you’re a woman, however, you start to realize that a lot fewer people call you “doctor” than your male colleagues. At first, it’s subtle. And you shrug it …
The physicians who are not called “doctor”
I am always fascinated by my colleagues’ stories about why they became physicians and when they knew medicine was the path for them. Some describe a longing to heal, some a love of science, and others a desire for respect. For me, medicine was a calling that revealed itself in my sophomore year of undergraduate studies and was the perfect culmination …
Physicians are born to do what they do
He was referred to me by a colleague with a large geriatric practice for evaluation and treatment for HIV. He was 76 years old and lived in an assisted living facility. He was, however, very independent and only required limited assistance. When asked what he expected from the visit he responded that he had been sent to me by his PCP. Review of his records suggested that in addition to …
Let older people talk about sex
Heroin abuse in the United States is reaching epidemic proportions. According to SAMHSA, between 2007 and 2012, the number of Heroin users has doubled from an estimated 375,000 to over 665,000. Additionally, in 2010, the number of deaths as a direct result of overdose surpassed auto accident deaths.
It is impossible to avoid the facts about heroin. We are bombarded daily by the national and local media and extensive online resources. …
Does tough love equate to wellness or destruction?
As a first-year oral and maxillofacial (OMF) surgery intern, I was the first responder to any facial trauma at a hospital in Queens, NY. Therefore in the past 12 months, I was a primary care provider for numerous facial lacerations of women due to domestic violence. And was a 1st assistant in providing care to patients (both men and women) with orbital floor fractures and mandible fractures due to domestic …
3 lessons I learned about domestic violence in the ER
A guest column by the American College of Physicians, exclusive to KevinMD.com.
One of the things that I dread the most about January 1 is that it’s the start of “prior authorization (PA) season” for prescription medications. It is time consuming and frustrating, plus it often jeopardizes patient safety and quality of care.
A recent Viewpoint in the …
The pitfalls of prior authorization for prescription drugs
The redefinition of a potentially functioning medical system in which each individual is able to utilize financially non-prohibitive care into a disjointed balkanized realm of income-based insurance tribes is aided by the protean definitions of the political buzzword “access.” Access to medical care does not entail the ability to reliably obtain medical care much as medical insurance reform is not, in point of fact, healthcare reform. Regardless, the conflation of …
The emergency department and “access” to care
Contrary to what my wife and colleagues think, it is not all about me. Well yes, I do get lonely sitting at my desk late at night, when my wife is busy, and the long-ago-moved-away kids are not available, and there is nothing running on NASCAR. Nonetheless, it is not really about my needs. I am talking, of course, about why I give patients my cell phone number.
It is printed …
This doctor gives his cell number out to patients. He explains why.
Despite living in Michigan for over 30 years, my cold hands disclose my Southern California origin. As a physician, these cold hands have touched many lives. For my pregnant patients, they usually sigh with relief as I touch their bellies, the coolness of my hands offering them respite from the inferno growing inside them. They smile when I tell them I can feel their baby squirming and how it is …
The phones, the phones, the phones.
Every time we look, everywhere we look, getting the phone answered seems to be a problem we just can’t lick, a continual thorn in the side of our practice, something that’s hindering all the other efforts we try to make things better, to get ourselves to the best care environment for our patients, our staff, and our providers.
Without …
Solving the telephone problem in primary care
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