CME limitations and how we can improve Continuing Medical Education

Education
April 16, 2012

Some people critique Continuing Medical Education (CME) programs as spoon-feeding. As a young physician struggling to learn a lot of material, I actually appreciate a bit of ready-to-consume content that I can learn quickly and effectively. The American College of Cardiology (ACC) and other reputable institutions provide CME programs that, overall, help to keep physicians up on the literature and integrate new findings with existing knowledge. However, despite the basic …

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Tips to fight depression during medical residency

Physician
April 15, 2012

Even though I love my job, I’ve been feeling a little burned out lately. I think it comes from being stretched too thin, which is something I’ve coped with off an on ever since med school.

As the saying goes, there are never enough hours in the day, and sometimes that really gets to me. While my practice is incredibly important, I also place a lot of value on my family. …

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The implications of provider versus doctor

Physician
April 13, 2012

I am used to being called a “medical provider” instead of a doctor or a physician these days, but it makes me think about the implications of our choices of words. The word “provider” was first used in non-medical contexts over 500 years ago. It is derived from the Latin providere, which means look ahead, prepare, supply.

“Medical provider” is part of the Newspeak of America’s industrialized medical machine. …

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End stage colon cancer becomes even more tragic without hospice

Physician
April 11, 2012

Mike was a runner, outdoors-man, and fitness nut. This was not so much as for health reasons as for “feeling good”, but he did hope that it would help him avoid illness. It was worrisome when he started with some belly cramping and noticed some blood streaks in his stools. It took about a month until he could be scheduled for a colonoscopy. The news was shocking. “There’s a cancer …

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The future of medicine for aspiring young doctors

Physician
April 11, 2012

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March 29, 2012

Calhoun Lecture Series
Strom Thurmond Institute, Clemson University

Thank you for the invitation to speak tonight. I’m very humbled to stand before you. And what a delight to speak to people who are neither bleeding, intoxicated nor asking for Percocet! And in a setting where no one will burst through the back door on a stretcher!

As you know, I’m an emergency physician …

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Why my patient ran away from the hospital

Physician
April 10, 2012

My patient ran away from the hospital.

This ordinarily is almost common place for a hospital bordering the south side of Chicago. In the last two years at the hospital, I had first grown surprised, and then helpless and finally weary to such mysterious absconding. This time however, it struck a chord.

Long before Mr B ran away, I had an inkling the new diagnosis of HIV would be difficult for him …

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Does contracting with third party payers compromise ethics?

Policy
April 9, 2012

Physicians have historically been fairly well compensated for their efforts and thus have enjoyed many of the comforts of modern life. Most would agree this is the result of years of hard work, perseverance, intellect and dedication. In general these are also traits along with professional integrity, which raised physicians to a position of relative prominence and trust within our society. But in recent years that social position and economic …

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When it comes to medical care, honesty is essential

Physician
April 9, 2012

Have you ever said, “I’m going to be perfectly honest with you” or something to that effect?  Have you ever had someone tell you that they were going to be perfectly honest with you?  Have you ever thought about what statements similar to these really mean?  You should.

Trust is an earned commodity and hard to get back once lost.  “Doc, I’m going to be perfectly honest with you” means that, …

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When doctors are called providers

Physician
April 7, 2012

Impersonal and self-absorbed as Manhattan may be, it’s still embarrassing to cry on West 32nd Street.  I looked for a store, any store, and ducked inside.  The pace of my steps and angle of my head as I buried myself into a back corner, thumbing through pants twice my size, gave me away.  A store clerk walked over and asked if I was okay.  I knew I’d have to meet …

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How I scored a 257 on USMLE Step 1

Education
April 7, 2012

If you are a second-year medical student, there is one thing on your mind at this time of year: Step 1. Although scary, there are things that you can do to help calm your anxiety and get your best score.

Set a goal

In my opinion, before you start really preparing for Step 1, you should have two things clearly in mind: where you are with your score and where you want …

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8 reasons why I love my patients

Physician
April 6, 2012

A few months ago, I came out with a post on why I love my own doctor. Today I want to celebrate my patients, both past and present.  For me, without the experience I have had over the past 14 years, I would not have enjoyed medicine quite as much as I do.

What I like the most about medicine is the ability to interact with people. That’s what clinical medicine is all …

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Is medicine a science?

Policy
April 2, 2012

Here’s something I read recently in a blog post (The Limits of (Neuro)science at Neuroskeptic) that started me thinking: “Will science ever understand the brain? … The notion that humans are complex and hard, while nature is easy, is an illusion created (ironically) by the successes of reductionist science. Some of the biggest questions facing mankind for eons have [been] answered so well, that we don’t even …

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The cutthroat pre-med culture needs to change

Education
April 2, 2012

I eyed my chat screen with a good amount of suspicion. A friend of a friend who I had rarely spoken to had initiated a chat conversation with me with the opening line “How are medical school apps going?” The cursor blinked in anticipation.

I began to think about possible ulterior motives that she, another pre-medical student, could have had. Perhaps she just wanted to use me as a comparison for …

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Why full code should not be the default status for patients

Physician
March 30, 2012

Full code is the universal default status for patients who haven’t chosen otherwise, but I suspect most physicians believe this policy is wrong. We know in our hearts we’re doing harm when we perform CPR on poor souls at the natural end of their lives, whose bodies can do nothing more than suffer.

Appropriately timed end-of-life discussions are the supposed answer, but for doctors, they are emotionally draining, interpersonally complex, and …

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Honesty is the basis of communicating with patients

Physician
March 27, 2012

I recently came across two articles in the press concerning doctor-patient relationships and communication. I began to reflect on what makes communication between doctor and patient most successful and many questions surfaced.

In the New York Times, a new study published in Annals of Internal Medicine was referenced. In this study, the way in which doctors communicate non-verbally was examined. Non-verbal communication was often discordant to the message being relayed, particularly …

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MKSAP: 32-year-old man is disoriented, combative, and agitated

Conditions
March 25, 2012

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

A 32-year-old man is brought to the emergency department after becoming disoriented, combative, and agitated earlier that day. He is accompanied by a friend, who states that the patient has a history of alcohol and drug abuse, including inhalants.

On physical examination, the patient is uncooperative and …

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Mexico needs more pediatricians

Physician
March 21, 2012

Being a child in 21st century Mexico utterly differs from any other era. The last decade has been a constant whirlpool for Mexico. Political, cultural and economical changes have shaken the country to its core. Primary care physicians, particularly pediatricians, have a burdensome challenge at hand.

Problems like obesity have quickly emerged in all age groups. Obese children, childhood type 2 diabetes and sedentary lifestyles have invaded Mexican homes. Nutrition related customs …

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10 strategic questions to ask yourself about the future of health care

Policy
March 19, 2012

Today and for the next few years the weather of this industry will be dominated by pervasive, discontinuous change. Structures, revenue streams, relationships of every level: All are shifting in fundamental ways. Specifically, the weather will be driven by:

i) invention and propagation of new business models;
ii) shifting risk onto both the provider and the patient, accompanied by building of new risk-based relationships, contracts and alliances;
iii) smart primary care coming to …

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Why this pediatrician quit medicine

Policy
March 17, 2012

There are an awful lot of reasons that led up to my eventual resignation from a career in primary care medicine.  I don’t know that any one of them is more important than the other (it really just depends on which day you ask me).  One that stands out for me though as a universal problem shared by millions is Managed Health Care, and the imposition it has posed on …

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Heed the 4th year medical student spoils

Education
March 16, 2012

Looking back on the first three years of medical school, it’s hard to imagine living through the endless days of studying again. Weekends were spent cooped up in the library and there were countless holidays that I wasn’t able to spend with my family. Instead, they were spent memorizing indecent aspects of the human anatomy and performing DREs on strangers. There are better ways to get to know a person …

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