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The answer to depression isn’t always an antidepressant

Conditions

March 18, 2017

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 …

What does it mean to be well? Ask an opiate addict.

Casey Grover, MD and Paul Harper

Physician

March 16, 2017

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 …

How do physician-mothers do it all?

Uchenna O. Njiaju, MD

Physician

March 16, 2017

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 …

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How do physician-mothers do it all?

A resident’s guide to being a medical student: In the OR

M. Alexandra Friedman, MD

Education

March 15, 2017

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, …

Improve the patient experience with anticipatory patient service

Neil Baum, MD

Physician

March 15, 2017

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 …

Doctors: Be careful, your words matter

Michael Kirsch, MD

Physician

March 14, 2017

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, …

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Doctors: Be careful, your words matter

Stop judging: Sometimes terminating a pregnancy is necessary

Andrea Eisenberg, MD

Physician

March 13, 2017

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 …

The secret horrors of sleep-deprived doctors

Pamela Wible, MD

Education

March 12, 2017

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 …

Are primary care doctors referring too much?

Fred N. Pelzman, MD

Physician

March 12, 2017

“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 …

Doctors don’t often follow their own advice

Jessica Celine Morgan

Education

March 12, 2017

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 are not God. Even if some patients want them to be.

Shahla Siddiqui, MD

Physician

March 11, 2017

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 …

We must challenge the health care status quo

Ioana Baiu, MD

Policy

March 11, 2017

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 …

What this physician learned from a medical mission

Dirck A. Curry, DO

Physician

March 10, 2017

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 …

Debt should have an ICD-10 code

Cory Fawcett, MD

Finance

March 10, 2017

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 …

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Debt should have an ICD-10 code

I’m retired, but I’m disgusted with medical schools. Here’s why.

Thomas D. Guastavino, MD

Education

March 10, 2017

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 …

A letter from a grateful physician to his patients

Chiduzie Madubata, MD

Physician

March 9, 2017

To my beloved patients and your families,

Over the years, it has been an incredible experience and honor to be allowed to enter into your world. It is a world that I know few people are privy to, and it is an intimate world where the deepest questions about life tend to arise. I know that when you are confronted with sickness that leads you into this world, it can be …

Retired at 37: Breaking up with a career in medicine

Valerie A. Jones, MD

Physician

March 9, 2017

Leaving your career in medicine is like breaking up in a long term relationship. It may have all started out with lofty expectations, excitement about the future, and becoming your best self. However, somewhere along the way, things got messy and twisted and not what you signed up for.

There were hiccups along the way, signs that maybe it wasn’t good for you. There was the time you fell asleep at …

The truth about Caribbean medical schools

Pamela Wible, MD

Education

March 8, 2017

Dear Dr. Wible,

I want to fill you in on what really goes on behind the scenes at my medical school and maybe you can help inform other students about what happens here before they make a huge mistake. If students slip through the cracks of a U.S. medical school, then international med schools in the Caribbean may be the next choice. Some have better residency match rates than others so …

4 scenarios surgeons need to explain to their patients

Aaron Fink, MD

Physician

March 8, 2017

Among surgeons, it’s pretty common knowledge that residents and other providers may perform non-critical parts of a patient’s procedure. This not only helps residents and other trainees gain valuable surgical experience, it also gives patients better and faster access to high-demand surgical expertise.

The question is this: How well are surgeons explaining these facts to their patients?

Recent guideline updates by the American College of Surgeons (ACS) underscore the need …

All good doctors listen to nurses

Jeffrey McWilliams, MD

Physician

March 7, 2017

Medicine, what a noble profession. As the keepers of human health and longevity, we are entrusted with a huge but solemn responsibility. It’s an ancient artwork, passed through the generations from pre-antiquity, hand in hand from physician to physician. The Hippocratic oath ensuring that we first “do no harm” and commit ourselves to the honorable calling. We often hear “see one, teach one, do one” and so propagates the training …

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All good doctors listen to nurses

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