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Primary care requires more than knowledge

Physician

May 11, 2012

“You are too smart to do primary care.”

I have heard this far too many times, directed at me and at others seeking career advice. There are many reasons for the shortage of primary care doctors in the U.S., but at least part of it is this. Smart, capable, successful trainees are discouraged from choosing primary care. It is perceived as a less prestigious pathway than specializing.

The knowledge base of primary …

Tips for adjusting to life after residency

Adriana Tobar, MD

Education

May 11, 2012

The more I talk to new physicians who are transitioning into practice, the more I realize how many substantial life and career shifts occur post-residency.

I experienced these changes myself several years ago, but it’s taken me a while to fully process them and realize how they’ve affected my life.

In fact, it would be safe to say that I experienced a complete 180 after graduating from residency. I know other new …

No one told me that getting on with life after cancer would be so hard

Merry Jennifer Markham, MD

Physician

May 7, 2012

I met with a young patient recently, a woman who has been done with chemotherapy for lymphoma for close to a year. She was feeling well, and she had no symptoms of cancer, nothing that made her suspicious of a recurrence. After I examined her and reviewed her most recent CT scan and labs, I agreed. No recurrence. I wrote in my note, “NED,” the acronym for no evidence of …

How money influences our decisions as doctors

Ido Weinberg, MD

Physician

April 30, 2012

When you ask young medical students why they want to be doctors, you will probably get all sorts of answers. Some may say they like people and want to interact with them and offer them help. Some students will believe this is their calling. Others still may state they are intrigued by the scientific mysteries the human body is filled with. From my experience, not many medical students just starting …

When doctors are forced to accept malpractice case settlements

William Sullivan, DO, JD

Physician

April 27, 2012

Suppose your malpractice insurance company wants to settle a medical malpractice case against you – even though the case has no merit.

In many cases, insurance policy language may allow the insurance company to do just that.

In the 2011 case of Mohan Papudesu, MD v. Medical Malpractice Joint Underwriting Assn. of Rhode Island, the Rhode Island Supreme Court allowed an insurer to settle a case on behalf of the defendant physician …

Medical residents are abused more than Chinese factory workers

Anonymous

Physician

April 23, 2012

Medical residents have fewer labor protections than Chinese factory workers. While labor abuses at Apple’s factories make headlines, few people are as concerned about the lack of protections for doctors and medical students here in the United States. As a resident, I was subject to some of the worst abuses – intentionally misreported time sheets and gender-based discrimination – and after I complained, I was fired, so I sued the …

Healthcare reimbursement will change dramatically in the future

Donald Tex Bryant

Policy

April 22, 2012

Based upon the past and the current state of affairs in healthcare, healthcare reimbursement will change dramatically in the future. I believe that reimbursement based upon fee-for-service will gradually disappear and be replaced by models based upon the ability to better manage patient diseases and conditions. That is, reimbursement will be based upon the quality of service delivered by the provider. For insurers, whether private or governmental, I believe that …

What separates a developed and a developing country?

George Lundberg, MD

Physician

April 22, 2012

How can you determine whether you are in a “developed” or a “developing” country? We used to call these latter “un- or underdeveloped” or “3rd world” countries, but those terms are no longer politically acceptable, considering the tinderbox of feelings about this topic.

If one objectively examines all 20 dozen or so of the world’s countries, a geographer would divide them into either north or south of the Equator. And if, …

When doctors are incorrect in their prognosis of terminal illness

Manoj Jain, MD, MPH

Physician

April 18, 2012

In January, when my close friend’s lymph node biopsy came back as a rare form of T-cell lymphoma, I scoured the scientific literature. What was his prognosis?He was 56, a little overweight but otherwise healthy. He had helped us move into our home more than a decade ago, and I was like an uncle to his son and daughter.

In the literature I found jagged graphs plunging downward, indicating that my …

Tips for successful home blood pressure monitoring

Erin Marcus, MD

Conditions

April 18, 2012

Sometimes, the simplest tools in medicine are the ones that give us the most useful information.

Take the humble blood pressure machine, for example. It’s been around for years, and it’s cheap, compared with a lot of other medical devices. It’s simple to use, and it doesn’t require a medical or a nursing degree to operate. But the numbers it reports are valuable in helping predict a person’s risk of a …

Bullies are not born, they are raised

Katie Hurley

Physician

April 17, 2012

People often wonder what causes children to bully. Why is it that some children feel the need to hurt and humiliate other children? What do they really stand to gain from this cruel behavior?

Some studies indicate that some (not all) bullies have naturally aggressive and/or hyperactive personalities from the start. Some. But that doesn’t mean that all “spirited” kids will bully while all “mellow” kids will be perfectly empathic and …

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Bullies are not born, they are raised

CME limitations and how we can improve Continuing Medical Education

Behnood Bikdeli, MD

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 …

Tips to fight depression during medical residency

Adriana Tobar, MD

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. …

The implications of provider versus doctor

Hans Duvefelt, MD

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. …

End stage colon cancer becomes even more tragic without hospice

Jim deMaine, MD

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 …

The future of medicine for aspiring young doctors

Edwin Leap, MD

Physician

April 11, 2012

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 …

Why my patient ran away from the hospital

Kiran Raj Pandey, MD

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 …

Does contracting with third party payers compromise ethics?

Robert Sewell, MD

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 …

When it comes to medical care, honesty is essential

Stewart Segal, MD

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, …

When doctors are called providers

Shara Yurkiewicz

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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When doctors are called providers

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