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Want to keep ER nurses from leaving? Focus on patient safety instead of satisfaction.

Physician

August 6, 2015

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I have been an emergency physician for 12 years. I have had the opportunity to learn from and try to emulate an impressive number of amazing clinical physicians. These doctors seemed god-like at first, but as my training and career progressed, I realized that they were mostly teaching me through their own experiences.

One of my favorite teachers had a humbling saying: “Good …

Children with cancer are the real superheroes

Steve Christiansen, MD

Physician

August 6, 2015

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Recently I met a boy, a boy with leukemia, a young boy with comic-book worthy superpowers. This boy, this superhero, is one I will never, never forget.

When I entered the exam room, I was immediately struck by the sight of a young boy who should have been playing football with his friends at the park or jumping off the high-dive at the pool, but instead …

Why should physicians have to enter orders in the computer?

Edwin Leap, MD

Tech

August 5, 2015

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So, there I was yesterday, working frantically to keep myself above the water level of the rapidly rising swamp of patients. Navigating, haltingly, the onerous and demonic EMR. So I thought I ordered three nebulizers, but it was only one. The respiratory tech approached me and informed me that she would put them in, but only this time. That I’d have to …

Let patients know when you’re proud of them

Jordan Grumet, MD

Physician

August 4, 2015

It was only afterwords that I wondered if I had been condescending. The words had come out so naturally. We were sitting across from each other in the nursing home. It didn’t take a doctor to recognize that his leg was visibly less swollen. I had seen him walking down the hallway with the physical therapist. His face a mix of pain, …

Patients can teach doctors these 5 things

Suneel Dhand, MD

Physician

August 3, 2015

For all the talk about patient-centered care and a new health care paradigm — which is, of course, the right way forward — the doctor-patient relationship will always remain relatively one-sided because of the nature of the profession itself. Essentially, patients come to doctors for help, and the knowledge transfer, advice, and guidance flows in one main direction.

But that doesn’t mean that …

Superhero doctors are what we aspire to be

Ahmad Yousaf, MD

Education

August 3, 2015

We live in a time of great cynicism and skepticism. We seem to see only the mundane and boring in even the most interesting and spectacular things. The electrical rhythm of the heart that pulses through cardiac tissue and results in a coordinated muscle contraction that effectively ejects blood to the rest of the body for appropriate oxygen delivery is just … a …

A mother with terminal brain cancer. Her daughter brings her home.

Jessica Vogelsang, DVM

Physician

August 1, 2015

I found out my mother was dying via text message: YOUR MOM HAS A BRAIN TUMOR IN HOSPITAL — DAD

When the neurosurgery PA wheeled the computer into the exam room to show us the MRI the next morning, I found myself silently uttering an unanswered prayer that the mass would be small, resectable, peripheral. It wasn’t.

“Oh my God,” Mom whispered. “I’m going to …

I’m not a single mom. I just play one on TV.

Mandy Silveira

Physician

August 1, 2015

I’m not actually on TV, but there are days I feel like I’ve accidentally stumbled onto the set of a sitcom. When neighbors have never seen your husband in the light of day and friends joke that he is make-believe, then you might be married to a … well, you know the joke.

Being married to a busy physician can leave you playing …

You might be missing a PCOS diagnosis. Here are 10 reasons why.

Poppy Daniels, MD

Conditions

July 31, 2015

Polycystic ovarian syndrome (PCOS) is becoming a significant problem in women’s health. Between 1 in 10 to 20 women have the condition, although more than 50 percent remain undiagnosed. PCOS is the leading cause of female infertility and women who do become pregnant have higher rates of miscarriage, preterm birth, and gestational diabetes.

Women with PCOS have a greater likelihood of developing diabetes, cardiovascular disease, and endometrial cancer than women without …

Being an attending means being a teacher. Take that job seriously.

Neil B. Newman

Education

July 30, 2015

“Sometimes a simple, almost insignificant gesture on the part of a teacher can have a profound formative effect on the life of a student.”
– Paulo Freire

Think back to a moment when a teacher or “authority” figure gave you a compliment. We all have them, from kindergarten to high school to college and sometimes graduate school and work. The reason why many of you can recall such moments is that unlike …

Strong ethical principles should guide EHR implementation

Joshua Liao, MD

Tech

July 29, 2015

The U.S. health care system is headed toward a profoundly digital future. Provider organizations around the country are adopting and updating their health information technology (HIT) infrastructures. Many have begun requiring that clinicians gain proficiency in electronic health records (EHRs) in order to provide clinical care. A proliferation of start-ups and HIT companies in health care is poised to disrupt (innovatively or …

How I got 86% off my malpractice insurance. Now, you can too!

Pamela Wible, MD

Physician

July 29, 2015

I’m a physician entrepreneur. In 1998, I opened my first clinic. My malpractice: $500 per year. Then I tried life as an employed physician. Hated it. So in 2005, I opened my ideal clinic. Best. Job. Ever. My malpractice: $1,230 per year. Want low premiums? Here’s how I did it.

A quick tutorial. New malpractice policies mature over five years. So the first …

How motivational interviewing can relieve patients’ suffering

Jeff Kane, MD

Physician

July 27, 2015

The acronym “MI” has traditionally meant myocardial infarct, or heart attack. Recently it’s taken on a new, more salubrious meaning: motivational interviewing.

A growing number of docs are practicing this technique, which amounts to listening to patients to help them recognize their internal sources of behavior. Boston’s NPR affiliate, WBUR, describes typical MI interventions in which doctors, instead of demanding that patients stop smoking or drinking or overeating, gently …

Analyzing the deficit of African-Americans in academic medicine

Mary Branch, MD

Education

July 25, 2015

The number of African-American physicians in academic medicine is dismal, and this leads to an abundance of problems. Academic hospitals (teaching hospitals associated with universities) generally do not have a proportionate representation of underrepresented minority faculty as compared to the surrounding population. According to a U.S. News & World Report article, the number of African-American faculty increased by 0.2 percent in ten …

Doctors shouldn’t wear their white coats in public. But some still do.

Shivam Joshi, MD

Physician

July 23, 2015

People can wear what they want in America. Whether you want to debut the latest vogue or your midriff rife with adiposity, you are free to do so. But just because you can, doesn’t mean you should. In the span of one week, I found two people — on two separate occasions — wearing white coats, each …

A patient fails a drug test, but stays in this doctor’s practice. Here’s why.

Rob Lamberts, MD

Physician

July 23, 2015

The drug test came back abnormal. There was THC present. I walked back to Mrs. Johnson and raised my eyebrows.

“What’s wrong?” she asked, not used to whatever kind of look I was giving her.

“Uh, you forgot to mention to me that you smoke weed.”

She blushed and then smirked. “Well, yes, I guess I forgot to put that down on the sheet. I don’t …

10 things you might not know about the emergency department

Kristin Prentiss Ott, MD

Physician

July 22, 2015

1. Wait times in most emergency departments are ridiculous. But, if you have a real emergency, you won’t have to wait. If you have abnormal vital signs, a worrisome ECG, or concerning chief complaint, you will be seen long before the person who checked in with a sore throat to get a work excuse.

Patients with chief complaints like “GSW abdomen” and “found down/unresponsive” don’t wait to …

Why the Surgeon Scorecard is a journalistic low point for ProPublica

Jeffrey Parks, MD

Physician

July 22, 2015

With much hype and fanfare, the independent investigative journalism outfit, ProPublica recently released their Surgeon Scorecard, assessing individual specialist surgeons who perform elective knee and hip replacements, spinal surgery, prostate surgery, and gallbladder removal surgery.

I had blogged about the impending release. My trepidation about the idea of a non-medical, non-scientific organization analyzing complex surgical data concerned issues such as …

Asian-American discrimination: Is medical school next?

Vamsi Aribindi, MD

Education

July 19, 2015

In the news recently has been a complaint filed by over 60 Asian-American groups, alleging discrimination in admissions at Harvard. They point to such statistics as this: in 2009, among accepted applicants to the Ivy League, the average SAT score on a 1600 point scale for Caucasians was 310 points higher than Hispanics …

There’s a good reason why doctors don’t send test results

Deep Ramachandran, MD

Physician

July 17, 2015

Recently I read an article in the New York Times by Elisabeth Rosenthal. She’s the same author of the enlightening article, “My doctor charged me $117,000 and all I got was this lousy hospital gown.” That may not have been the exact title of the article.

Following that article she wrote a follow-up about the long and difficult ordeal …