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How nurses and law enforcement can work together

Conditions

September 7, 2016

The recent horrible events involving racial profiling, excessive force, and gun violence are deeply troubling but not new. Who can forget the Bronx shooting of Amadou Diallo in 1999 when 41 bullets rained down on his unarmed body. I can uniquely identify with the black experience because of my own numerous experiences of being pulled over for no other apparent reason except for being in the wrong neighborhood, wrong state …

The cure for a poor historian? A good medical record

Eric Beam, MD

Physician

September 4, 2016

Think keeping your life organized is hard? Try keeping your doctors organized.

In this era of fragmented health care, patients find themselves in the impossible position of having to coordinate their care themselves — a task that many can’t meet. Having multiple chronic medical conditions often means being subjected to a dizzying assortment of specialists, medical terminology, and tests that can quickly overwhelm patients.

How many times have you found yourself in …

How a board of optometry is restricting eye care to homebound adults

Helen Kao, MD

Physician

September 2, 2016

This spring, the California Board of Optometry shut down the only optometrist providing services to homebound patients in the San Francisco Bay Area. I learned about this because affected patients included several referred from our UC San Francisco Housecalls program, one of a few non-profit, non-concierge home-based practices in the state providing geriatrics care to homebound adults.

With over 1 million adults homebound in California, why would any board deliberately limit …

What kind of doctor do you want to be? Think about it.

Brian Sutterer

Education

August 31, 2016

“A doctor’s mission should not be just to prevent death, but to improve the quality of life. You treat a disease, you win-you lose. You treat a person, I guarantee you’ll win, no matter what the outcome.”
– Patch Adams (1998)

It’s that time of year where everyone begins residency applications, and you commonly hear conversations along the lines of, “What are you going into?”, or, “what type of doctor are you …

To the doctors struggling with depression: You are not alone

Elisabeth Poorman, MD

Physician

August 30, 2016

By the end of my first year of residency, I knew I was in trouble.

I was overwhelmed by the 15-hour days, the unbearable sadness of the tragedies I witnessed, my feelings of impotence and my fears of making a mistake.

My life was my work, and everything else seemed to be falling apart: my physical health, my relationships, my ability to sleep after months of night shifts.

Yet, I came to work …

Why are ERs so busy? It’s really no surprise.

Manuel Momjian, MD

Policy

August 29, 2016

If the emergency room is the most expensive place to receive health care, then why are more patients visiting the ER than ever before? There are no local doctors’ offices that can charge $1,000 to put a Band-Aid on your finger or $8,000 to tell you that your abdominal pain is due to drinking too much coffee. But, I don’t think you would mind paying this premium if you were having …

You failed your surgical boards. What’s next?

Skeptical Scalpel, MD

Education

August 26, 2016

“I graduated this July and took the QE (written general surgery boards) on July 19th. I got my results today, and I failed. Not only did I fail but my score placed me in the 5th percentile. Needless to say, I’m disappointed. You hear stories about CE (oral exam) failure but never about QE failure. I never blew the ABSITE out of the water (50, 29, 20, 34, …

The bureaucratic hassles physicians face are extraordinary

Peter Ubel, MD

Physician

August 25, 2016

Left to our own devices, most of us physicians try our best to provide high-quality care to our patients. But almost none of us provide perfect care to all of our patients all of the time. In fact, many of us get so caught up in our busy clinic schedules we occasionally forget to, say, order mammograms for women overdue for such tests, or we don’t get around to weaning …

Donald Trump’s medical letter has so many things wrong with it

Jennifer Gunter, MD

Physician

August 25, 2016

screen-shot-2016-08-16-at-5-08-11-pm

Donald Trump is talking about Hillary Clinton’s health as are two doctors who have never evaluated Clinton. This attention on Clinton has renewed some interest in the letter Donald Trump released last year from his personal physician.

Many outlets have picked it apart, but I want to tell you as a doctor exactly how bad it is. I would never write …

A physician tells a health insurance CEO what she really thinks

Cathleen London, MD

Physician

August 24, 2016

I graduated medical school in 1995. I believe in a single-payer health system. I am about championing for my patients. I left a salaried position in academic medicine to go an underserved area of rural Maine and start a practice. This is the letter I wrote to the CEO of a large health insurance company recently.

Dear Mr. CEO,

My name is Cathleen Greenberg London. I am a family medicine physician who …

Laughter? That’s the sound of resiliency you hear.

Cindy Winebrenner, MD

Physician

August 21, 2016

Sometimes, the loudest sounds I hear in the emergency department are laughter. It may seem irresponsible. It may seem discordant. It may seem callous. To me, it is the sound of survival. It is the sound of resiliency. It is the sound of making it through the day.

My father was at work when he suddenly became cold, clammy, and collapsed to the ground unresponsive. His staff did the right thing …

Death is not the enemy. More physicians need to realize that.

Nancy Wang, MD, MPH

Physician

August 20, 2016

I knew it was bad when she couldn’t tell me her name. I watched her face fill with frustration as a word she had uttered countless times over eight decades somehow got lost between her brain and her lips.

It was 2 a.m. and I was on call as the surgical resident. I had been told that a patient with bladder cancer was being transferred from another hospital, and, as these …

A reminder that life is indeed too short

Neha Sharma, DO

Physician

August 19, 2016

I recently took care of a young patient whose case left an impact on me. When I admitted him, he was fighting a lost battle with cancer.

A few months prior to admission, he had been experiencing new headaches. When he sought medical attention, he was diagnosed with an extremely aggressive brain tumor that had spread to his spine, and was given a very poor prognosis.

Unfortunately, his condition deteriorated quickly thereafter, …

Doctors experience the world differently

Starla Fitch, MD

Physician

August 18, 2016

I was in the break room at the hospital scarfing down a power bar between three-hour cases. The truth is, I was multi-tasking: eating, writing on a chart, and checking my email on my phone.

I had received an email from a businesswoman, whom I have known for a few years. She wanted to know if I wanted to join her for lunch next week.

I had to laugh out loud.

The rest …

When should physicians lie for patients?

Michael Kirsch, MD

Physician

August 17, 2016

Even the most honest among us do not tell the truth all of the time. We are flawed human beings. We covet, we gossip, we steal, we lie, and we stand idly by. You don’t think you steal? Have you ever “borrowed” someone else’s idea and represented it as your own?

A few weeks before I penned this, I was presented with two opportunities to lie in order to save a …

Hospital fires doctor for having cancer

Pamela Wible, MD & Stephanie Waggel, MD

Physician

August 15, 2016

StephanieFired

Dear Pamela,

You’ll never guess what happened to me today. Hours after the National Day of Solidarity to Prevent Physician Suicide volunteer web page went live, I received an email stating that I am officially terminated from my psychiatry residency program.

On this web page, I spoke about the fact that I had become interested in this event during my …

Read more…

Hospital fires doctor for having cancer

A miracle in the intensive care unit

Debbie Moore-Black, RN

Conditions

August 12, 2016

She fit into the palm of his hand. That long nine months. Waiting desperately for that baby they thought they could never have.

Jeff, football player from his high school days, met the love of his life, Bridget, at the school party. She was smart and beautiful; Jeff was big and burley, but as kind and gentle as a kitten. They hung out through their college days.. And finally said their …

Read more…

A miracle in the intensive care unit

Social determinants matter most to a person’s health. Here’s one story.

Franklin Warsh, MD, MPH

Physician

August 7, 2016

To close out my first week of medical school, the class was treated to a talk by a stuffy but soft-spoken lecturer on the relationship between poverty, education, and poor population health. “Social determinants of health,” he labeled them, a clunky and unwieldy term if ever I’d heard one. In those days, audiovisual aids consisted of an overhead projector for black-and-white transparencies. And boy did that talk have transparencies. Chart …

Do physicians play God?

Gian-Paul Vidal, MD

Physician

August 7, 2016

After rotating in the ICU, I began to wonder about the limitations of modern medicine. In a short time, we have come a long way with the discovery of antibiotics, high-resolution imaging, and the development of advanced surgical procedures. The medical field saves millions of lives. Nowadays, people do not go to a hospital to die; they go to be healed. As physicians, we are very skilled at extending life.

Heart …

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Do physicians play God?

MKSAP: 26-year-old woman with recurrent feelings of fear and anxiety

mksap

Conditions

August 6, 2016

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 26-year-old woman is evaluated for a 10-year history of recurrent episodes of acute-onset feelings of fear and anxiety. These episodes initially occurred approximately 4 times per year but for the past 3 months have been occurring once or twice per month, especially when she is under stress. She describes the episodes as …

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