I’m a physician, and I’m adrift. I am pretty much lost at sea. I’ve often thought of writing this column, but afraid I’d be recognized, I’ve hesitated for years. Even now, I’ll most likely remain anonymous, because I’m in a vulnerable position. Let me preface my remarks with the reassurance that I’m not a bad person.
I developed dependence on opioids several …
A physician enters rehab. What happens next should disturb you.
I recently read an article written by a human physician about her personal feelings and other people’s reactions to her decision to quit practicing medicine.
The author frames the article around how her choice was made after she recognized how detrimental her career was to her own health. The irony of a doctor abandoning her profession because it was causing …
The darker side of being a doctor
A loyal reader alerted me to news of a lawsuit brought by an obstetrician in South Carolina who is suing a hospital for suspending his privileges. He had performed a cesarean section while sitting on a stool because he had a foot fracture secondary to diabetes. Several witnesses said that the doctor “had been unable to properly view the surgical field, …
Can a surgeon operate while sitting down?
I noticed that my writing and conversations with others convey far less emotion than usual. My reserve for tolerating stress had reached maximum capacity, which I realized upon my first day back at work from vacation three weeks ago as exhaustion immediately erased any sense of relaxation from my trip. Perhaps I should have requested two weeks off instead of one? Either way, …
A psychiatrist is burnt out and depressed. Here’s what she did about it.
I would think that when physicians decide where to set up practice, there are things that they would want to think about other than how much money they’ll make. Yet if one reads Medscape’s current list of the best and worst places to practice, it would appear that money trumps everything else (although Medscape said it also considered factors like “cultural attractions”). What Medscape apparently did not consider …
The best places for a doctor to practice: It’s more than money
Teleradiology has the same effect on radiologists as Lord Voldemort has on Muggles. It’s the feared end point of the commoditization of imaging, with Rajeev in Bangalore outpricing Rajeev in Chicago for reading follow-up CTs for lung nodules.
But despite the fears of U.S. radiologists, their counterparts in India have more pressing things on their mind.
“U.S. radiologists think that Indian radiologists are …
Indian radiologists have more to worry about than teleradiology
Idioms are expressions everyone understands as something other than what the literal words say. For example, when I talk about “putting all of my eggs in one basket,” everyone knows I’m not really talking about eggs.
We say things like:
It’s raining cats and dogs.
It was a piece of cake!
I heard it straight from the horse’s mouth.
We have a few idioms in medicine, too. If I talk about “hanging crepe” in a …
Idioms and axioms provide a glimpse into medical culture
Below is a letter I have written to parents who are hesitant about giving vaccinations to their children. I don’t know how many it will convince, but I needed a respectful and informative way to follow up with parents who expressed concerns or declined vaccinations, and this is what I now share with them after such visits. This is written not …
A letter to parents hesitant about vaccines
Twitter is a communication platform, and, therefore, it is a neutral medium. It’s not the medium itself, but how you use the medium that makes Twitter “good” or “bad.” In my five years of being an anonymous and five months of being a named individual on Twitter, I have come to realize that different people use Twitter for different purposes. In …
5 types of doctors you will meet on social media
Question from a reader: “What are your feelings about when a patient breaks up with you? I love love my doc, but …”
Patients “break up” with me all the time. Well, not all the time, but it’s not uncommon. There are many reasons, some of which are under the patient’s control, and some which are not. Moving across the country is …
So you want to change doctors. Here’s how to do it right.
I’m a family physician in Eugene, Oregon — a sweet town where folks are pretty darn friendly. I still do house calls. Patients often surprise me with gifts. And nearly every appointment ends in a hug.
Kindness is contagious.
I like to return the favor. So every few weeks I celebrate “patient appreciation day.” I thank patients with balloons and chocolates. Why? For …
Did you forget to thank someone? It’s not too late.
In case you were wondering — robots won’t replace anesthesiologists any time soon, regardless of what the Washington Post may have to say. There will definitely be a place for feedback and closed-loop technology applications in sedation and in general anesthesia, but for the foreseeable future we will still need humans.
I’ve been practicing anesthesiology for 30 years now, in the …
Should I become an anesthesiologist? Read this first before you decide.
In the world of health care, we face a lot of questions and challenges. Hospital administrations across the country are grappling with these and always on the lookout for solutions. As far as raising the standard of health care quality, there’s been great progress over the last several years in the areas of patient safety, adhering to best practices, and trying …
Want to solve health care problems? Ask the right questions.
There’s a simple way to define value. Ask why we exist.
Imaging exists because clinicians are uncomfortable with uncertainty. Imaging exists because emergency physicians feel that being 98 percent correct about the absence of pulmonary embolism is not good enough. Radiologists exist because imaging is not an assay on a Western blot with a 100 percent accuracy. Radiologists exist because information is …
It’s time for radiologists to stop hedging
A patient undergoing a colonoscopy pressed “record” on his smartphone before being sedated, hoping to capture instructions from his physicians after the procedure. What he heard instead was shocking: “In addition to their vicious commentary, the doctors discussed avoiding the man after the colonoscopy, instructing an assistant to lie to him, and then placed a false diagnosis on his chart.”
The incident cost his …
A patient secretly records his colonoscopy. It cost this doctor her job.
In the last several shifts I’ve worked in the ED I’ve had more people stop and compliment me on my care. I’ve heard the usual, “Do you have a private practice?” compliment and, “I’ve been here a lot and you really took the time to hear what I was saying, I appreciate that.”
Kudos are nice. They are what makes a tough …
How to improve patient satisfaction in the emergency department
I have received many questions on this topic from medical students so I thought I would share my thoughts on choosing the right medical specialty for you. I hope you find this helpful.
1. Relax. The medical degree offers more flexibility than any other graduate degree. Even if you realize your selected specialty no longer fits you there are multiple areas your degree …
Med students: 10 essential tips to choose the right residency
Being related to a famous person is somewhere between a cruel joke and a minor distraction. My father was immensely talented and worked very hard at his writing, but the degree of his success was a fantastically unlikely bit of luck. There are lots of talented, hard-working artists who don’t make it.
The important thing in overcoming mental illness, whether or not …
A doctor shares his story about overcoming mental illness
Here’s a question for you: Which causes more deaths, motor vehicle traffics accidents or firearms?
I asked a bunch of people that question, including a bunch of doctors, and everyone said that motor vehicles did, by a lot.
According to the Centers for Disease Control and Prevention (CDC), in 2013, 33,804 people died from motor vehicle traffic accidents — and 33, 636 died from firearms.
They kill the same number of …
Which kills more? Guns or cars? The answer will surprise you.
Quintessential Messi. One moment he is standing over the ball, in a seemingly harmless position at midfield, the next thing you know you are picking the ball out of the back of the net. How did this come to pass? How did things change so rapidly? When you watch it the first time, it’s disorienting. It makes no sense. How does …
The physical genius of Lionel Messi, and how it relates to surgery
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