Working in an urgent care center: An assault on the soul

Physician
March 12, 2013

I recently received this email message from one of my residents who has moonlighted in a local commercial urgent care center. This message is reprinted with his permission just as I received it, except I removed the brand name.

Hey Dr. Young, I’m looking for some basic mentoring advice.  I’ve been moonlighting at ZZZ Urgent Care for about a year.  Not my favorite work, but oh well.  I don’t routinely prescribe antibiotics …

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Working in an urgent care center: An assault on the soul

Let no broken hip go unfixed: When a surgeon fails to communicate

Physician
March 10, 2013

She was 94-years old with advanced Alzheimer’s. She thought it was 1954 and asked if I wanted tea. Not a bad memory for someone in a hospital bed with a broken left hip.

She’d fallen at her assisted living facility. It was the second time in as many months. She’d broken her collarbone on the previous occasion.

Over the past year, she’d lost 30 pounds. This is natural in the progression of …

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Let no broken hip go unfixed: When a surgeon fails to communicate

When it comes to medical residents, patients have a choice

Education
March 8, 2013

A resident is a person who has an MD, meaning they have completed 4 years of school, but they are not yet qualified to actually do anything.  An MD is just a piece of paper saying you did your time in the lecture hall/lab.  Residency is where you learn how to be a doctor.  The term “resident” originates from the old days in which newly-minted doctors were actually living at …

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When it comes to medical residents, patients have a choice

You may be surprised at what family physicians do

Physician
March 7, 2013

There are surprising misconceptions about what family physicians actually do in practice.

Americans maintain a fond respect for the classic image of the family physician, making house calls with black handbag in tow. They admire the Marcus Welbys of the world. While this classic image is endearing, it should not be confused with the 21st century family doctor.  The modern family physician is trained to engage in the adaptable world of health …

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You may be surprised at what family physicians do

Medical journals that accept stories and essays from physicians

Physician
March 6, 2013

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Health and health care are hot topics lately, and not just for journalists and bloggers debating Obamacare. Suddenly – or so it seems; in fact the trend has been building for years – people from all walks of life want to read about medicine.

Within medicine, a majority of journals now have essay, viewpoint, or perspectives sections. Not only are such sections frequently …

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Medical journals that accept stories and essays from physicians

When doctors dissociate themselves from the stories of their patients

Physician
March 6, 2013

As trauma surgeons we often have to disassociate ourselves from the stories that surround our patients so that we can focus on their life-threatening injuries. It’s also how I personally cope with the devastating injuries to the patient and the aftermath left for the family. Sometimes, though, I am caught off guard and my defenses aren’t strong enough.

A middle-aged man was brought in one evening after being hit while riding …

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When doctors dissociate themselves from the stories of their patients

5 reasons why you shouldn’t go into medical school

Education
March 2, 2013

The gall, you might think to yourself as you click on this link in disgust.

Before you write that brutal retort which I may/may not deserve, some simple disclaimers before we tackle this subject:

  • This is not a ruthless attempt to crush your dreams and passions
  • This is not an op-ed on our current healthcare system
  • This is targeted towards individuals who are considering medical school in order to practice clinical medicine
  • This is being …

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5 reasons why you shouldn’t go into medical school

Why energy drinks should be considered stimulant drugs

KevinMD
March 2, 2013

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A version of this column was published on February 3, 2013 in USA Today.

I’m seeing more patients than ever consume so-called “energy drinks,” a rapidly emerging class of beverage which promise to increase energy, improve alertness, and boost attention span. The energy drink business is booming, with more than $12 billion sold last year, eclipsing established beverage categories like iced tea …

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Why energy drinks should be considered stimulant drugs

What can nurses learn from doctors?

Physician
March 1, 2013

There’s a lot nurses can learn from doctors.

There I said it.

But I’m not talking about clinical ability or medical knowledge. I’m talking about expectations. I’m talking about basic behaviors that dictate a predictable response.

Nurses don’t feel valued. Much of this is warranted, but I argue that some of it is self-inflicted. I said this once to a colleague and she responded, “But that places the blame on the nurse.”

I disagree. …

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What can nurses learn from doctors?

Toradol in sports: A culture change is needed

Meds
February 23, 2013

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Former Boston Red Sox closing pitcher Jonathan Papelbon may have opened up a can of worms with his remarks about his frequent use of the injectable anti-inflammatory drug Toradol (ketorolac) during his time with the Red Sox.

Papelbon, who now plays for the Philadelphia Phillies, told ESPNBoston.com that several Red Sox players were frequently injected with the drug:

“It was kind of …

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Toradol in sports: A culture change is needed

Why physicians tend to decline CPR and other heroic measures

Physician
February 22, 2013

Radiolab recently aired a show called “The Bitter End” that discusses the end-of-life care preferences of physicians and non-physicians. Physicians are much more likely to decline “heroic” measures, such as CPR, mechanical ventilation, feeding tubes, etc. This comes as a surprise to the hosts and, presumably, to other non-physicians. It’s a good show. I recommend it. (Full disclosure: I like Radiolab.)

In the show, Ken Murray argues that …

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Why physicians tend to decline CPR and other heroic measures

4 reasons parents should enforce the age restriction on social media

Social media
February 21, 2013

During a routine office visit, I was discussing activities and extracurriculars with a bright 10-year old girl. She loved talking about her dance team, gymnastics, and her new hobby of horseback riding.

Towards the end of our conversation, however, she said something that surprised me: “And, I am addicted to Pinterest.”

I turned to her mother, who was also in the exam room, and asked, “Did you know she is on Pinterest? …

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4 reasons parents should enforce the age restriction on social media

Stop blaming patients for not doing enough to stay healthy

Physician
February 20, 2013

“Discrimination against heavy people, by the general public and medical professionals, might be a greater health and social problem than any extra pounds they may be carrying” argues UCLA Professor Abigal Saguy, PhD, in a provocative essay in the Washington Post.

“Despite the fact that body weight is largely determined by an individual’s biology, genetics and social environment, medical providers often blame patients for their weight and blame their …

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Stop blaming patients for not doing enough to stay healthy

Make patients more accountable for their own health

Physician
February 20, 2013

Let’s talk a little about health accountability.  Two news items have provoked the following rant: why is it always someone else’s responsibility?

The first item was on NPR. The FDA, reacting to the epidemic of prescription drug abuse in this country, is offering incentives to the pharmaceutical company that can come up with a less addictive painkiller.  Such a drug would be a gold-mine for that pharma company because it could …

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Make patients more accountable for their own health

Teaching children how to behave: 5 essential principles

Physician
February 19, 2013

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Young children are naturally petulant, noisy, and self-centered. We’re all born with ourselves in the center of the universe, an impression reinforced by parents who must cater constantly to their young babies. But babies become toddlers, and toddlers become children. Sometime during this transition, parents have to teach their children that they are part of a family. For a family to function …

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Teaching children how to behave: 5 essential principles

Advice for parents in medical school or residency

Physician
February 19, 2013

Being a single mother in medical school and residency isn’t a piece of cake. But, being a single parent in this world isn’t a piece of cake, either, and being a medical student and / or resident isn’t a piece of cake. Foregoing medical school isn’t necessarily the answer to any of that.

Here is some general advice I will share with parents, single or otherwise, who are facing decisions about …

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Advice for parents in medical school or residency

My first year as a locum tenens physician

Physician
February 18, 2013

Locum tenens (literally “place holder”) is professional work done to fill in where help is needed. It is what I have primarily been doing for the last year, and has been an interesting ride.

When I decided to leave my practice related to losing a couple of partners and wanting to update my knowledge base and re-evaluate my career, I decided to do locum tenens work. I had always thought that …

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My first year as a locum tenens physician

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