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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

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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

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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

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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 …

A patient is angry with her emergency care bill. But here’s what she really got.

WhiteCoat, MD

Physician

July 17, 2015

Natalie Fuelner created a well-written article in the Bangor Daily News describing some of the tribulations many new parents go through with young children. One weekend, her toddler fell face first onto a metal patio table. Immediately, the toddler’s face is full of blood. The dad panicked. Natalie was a “trembling mess” on the inside.
Their physician neighbor wasn’t available to look at the child. …

A physician’s experience with a false positive test result

Justin Reno, MD

Physician

July 14, 2015

“Your wife has gestational diabetes.” My heart stopped when my wife’s physician called to tell me this. “I want you to tell her because it’ll be easier to give it some time and let it sink in. Tell her to call me if she has any questions.” But I had questions — about a million.

Let me give some background information. I’m …

Comfort may be the most important thing that physicians can provide

Amrapali Maitra

Physician

July 13, 2015

A hospital can be full of discomfort. My patients tell me that the food is unappetizing. The beds hurt their backs. The noise echoing through the hallways at night makes it impossible to sleep. And for those patients near the end of life, the treatments being offered may no longer be of benefit, causing more pain than good.

The answer to discomfort for those who are very ill is comfort care, …

The physician is the ultimate patient advocate

Kathryn A. Hughes, MD

Physician

July 13, 2015

“Only one rule in medical ethics need concern you — that action on your part which best conserves the interests of your patient.”
– Dr. Martin H. Fischer, German-American Physician and Author

“A physician shall, while caring for a patient, regard responsibility to the patient as paramount.”
– Principles of Medical Ethics, American Medical Association

“I pledge to pursue the practice of surgery with honesty and to place the welfare and the rights of …

What to do when your doctor says you can’t have an IUD

Jennifer Gunter, MD

Conditions

July 12, 2015

I hear this fairly often: Women telling me they asked their GYN for an IUD and were told that they couldn’t because they had never had children. Their GYNs are wrong and unfortunately it’s not just a few who think this way.

A study from last year tells us that 32 percent of OB/GYNs think that women who have never …

A quiet day in the doctor’s office: And that’s the way it’s supposed to be

Rob Lamberts, MD

Physician

July 10, 2015

It’s been a very slow week in my office. Today we almost pitched a no-hitter, having only one patient come in toward the end of the day. Overall, we’ve been quiet in nearly every way: few phone calls, few patients stopping by, few appointments, few secure messages.

What’s wrong?

That was a trick question. This is exactly what should be happening when things are going …

A neurosurgery case that this medical student won’t forget

Basheer Elsolh

Education

July 10, 2015

After the last elective case of the day, the neurosurgeon I was shadowing told me that he was on overnight call that evening, and that I could stick around to observe more surgeries if I wanted to. “Yes,” I responded. “Absolutely yes.”

My fascination with surgery stems from its ability to provide immediate results to a patient by cutting out, repairing, reshaping, or …

10 thoughts on the transition to a third-year med student

Robert Centor, MD

Education

July 10, 2015

The transition between the basic science years and the clinical years in medical school are jarring, mystifying, exhilarating and thought-provoking. Recently, I did an hour conference with approximately 30 medical students. About half started their clinical year five weeks ago, while the remainder have only three weeks left before they finish the year. They gave me permission to share our discussion. We focused on their (and my) observations about the …

There are only 3 ways to allocate health care resources

David L. Katz, MD

Policy

July 8, 2015

Manny Alvarez is a 23-year-old college student with the misfortune of having not just a devastating cancer — but the wrong devastating cancer. The chemotherapeutic agents shown to be highly active against his specific tumor cells are FDA approved for the treatment of leukemia, but not for the stunningly rare kind of sarcoma with which Manny has been diagnosed. Nothing is …

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