An excerpt from Everything I Learned in Medical School: Besides All the Book Stuff.
My body jolts awake to a familiar sound. After a few blind swipes, my blows hit their target, and once again, there is silence. The air in the room is cool and crisp, and every fiber of my being wants me to remain in the welcoming warmth under the covers. It is Saturday morning. On any other …
Sleep deprivation as a medical student
This is an account of my first encounter with an in-patient from a little while back — I have provided only minimal details about the patient to maintain compliance with HIPAA.
After a firm handshake with each of us, our preceptor embarked purposefully up two floors to our first in-patient encounter. As we walked, I peeked into the rooms with the door left ajar and wondered what brought each individual to …
A medical student’s first patient encounter
In a widely circulated CNN article, many radiologists have been found to cheat on their board exams: “Doctors around the country taking an exam to become board certified in radiology have cheated by memorizing test questions, creating sophisticated banks of what are known as ‘recalls,’ … The recall exams are meticulously compiled by radiology residents, who write down the questions …
Radiologists who cheat on their board exams: Who’s to blame?
The third year of medical school is a lesson in humility. In the OR, you’ll invariably cut the suture too short, or too long, or too slowly. On the floors, the one laboratory value you haven’t checked is the only value vital to the patient’s survival. And just when you think you know everything there is to know about a disease, the Attending Physician will keep asking you questions until …
When pimping a medical student can backfire on a doctor
Malingering is the intentional production of false or grossly exaggerated physical or psychological symptoms motivated by external incentives such as avoiding military duty, avoiding work, obtaining financial compensation, evading criminal prosecution, or obtaining drugs. The word “malingering” comes from the French word “malinger” meaning “poor or weakly” as these are the characteristics feigned or exaggerated by the malingerer. Malingering has been documented as far back as in the Bible when …
Physicians should be concerned about malingering
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 25-year-old woman is evaluated during a follow-up visit for a 6-month history of diffuse muscle and joint pain above and below the waist, fatigue, and difficulty sleeping. She has a 2-year history of hypothyroidism treated with levothyroxine. Her only other medication is hydrocodone-acetaminophen, which has …
MKSAP: 25-year-old with diffuse muscle and joint pain
I’ve had the luck to attend medical school in the city of San Francisco during what will be looked back on as the start of transformational change in our health care system. My growing interest in technology and new business models as the disruptive forces behind this change, as well as marriage to a technology entrepreneur, has me frequently rubbing elbows with movers and shakers in the digital health space. …
A guide for entrepreneurs to get a doctor’s attention
“Do you remember my name?”
Like a broken record, I repeat this question again and again as I make rounds in the hospital. My patients’ universal answer, given with furled eyebrows and an apologetic look is “uh, no, I don’t remember”.
My response: “Don’t worry. It’s Dr. Tony Breu, but call me Tony.” Theirs’ (again with furled brow, but also a smile): “Oh, okay.”
In a busy teaching hospital, it is not uncommon …
How patients can remember their doctor’s name
Every medical student is a bit apprehensive when he/she knows they will be assigned a new resident. The same questions always come up. Will the resident be nice? Will they understand my busy schedule? Will they make me do a ton of scutwork? Will they make me write all of his/her progress notes? And maybe most importantly, will they let me leave early to study for boards or enjoy the …
The 3 types of residents that medical students will encounter
Are doctors really going broke?
According to this piece from CNN Money, some are: “Doctors list shrinking insurance reimbursements, changing regulations, rising business and drug costs among the factors preventing them from keeping their practices afloat. But some experts counter that doctors’ lack of business acumen is also to blame.”
That’s all entirely true.
Pressure on reimbursement, combined with a lack of …
Doctors: Don’t be ashamed about going bankrupt
About six weeks ago, while in clinic, I developed pain in my stomach — specifically, in my right upper quadrant, just below the ribs. I had experienced this a few times before, but this time it seemed more persistent than usual. Following the rule that physicians make the worst patients, I kept working through it until my nurse told me I looked poorly, and made me see my own primary …
Our healthcare system is unfair and unbalanced
To meet Federal patient satisfaction goals, our hospital administration is requiring community based physicians to give patient admission orders before we have a chance to see the patient. Patients who self-refer themselves to the emergency department, are evaluated by the emergency room staff, and who are determined to require admission must be admitted by their community physician within 20 minutes of receiving a call from the ER staff advising the …
Requiring doctors to give orders on patients they have not seen
Imagine this scenario. You are a male health care provider and you complete an evaluation of a woman close to your age. You establish good rapport as you always do, she laughs at some of the same jokes you make with all patients, and she expresses delight that you are listening to her problems (unlike those other providers she says she has seen), feels you are helping her, and is …
Should healthcare providers hug their patients?
An interview by MedCrunch with Ashley Wendel, MA, CMC, PDC, a Physician Executive Coach and Healthcare Organization Consultant dedicated to helping physicians create meaningful and sustainable change that positively impacts their professional lives.
MC: Thank you so much Ashley for your time!
Ashley: Thank you, I’m really happy to share anything I can.
MC: You are a physician coach, what are the most common problems you encounter in your practice?
Ashley: Well, for many …
Advice for doctors who want to change careers
I got home recently after a 14 hour day in the operating room with (predictably) a pair of really tired feet, which lead me to think about shoes, foot rubs, and the fact that no one ever talked to me about this in my training.
What kind of shoes should you wear in the hospital?
There’s a lot of walking in the hospital, but there’s even more standing. Running shoes don’t provide …
What kind of shoes should you wear in the hospital?
The principle of autonomy is one of the four guiding principles of medical ethics, the others being beneficence, nonmaleficence, and justice. It means that patients have the right to decide what is done to their own bodies. For children under eighteen, the age of majority, this means their parents decide for them. What happens when parents refuse a treatment that their child’s doctors recommend? (The right of a minor child …
Is ethical for parents to refuse surgical treatment for their child?
The third year of medical school is definitely an interesting one. You leave the classroom and enter the big bad world of medicine, and you quickly realize that much of what you’ve learned is for naught. You also realize that the medical student next to you could become your best friend, or the bane of your existence — or fall anywhere along that spectrum. Here is a list of the …
The 7 types of medical students you’ll meet
When it comes to doctor- nurse interactions, when is enough, enough?
Recently, I dealt with an upsetting situation involving a physician and nurse. A little background: The nurse has been working on our unit for years (since it first opened). She is very smart and savvy when it comes to nursing. She constantly gets feedback from the patients as being one of the kindest, most thorough nurses. I look up to …
Conflict between physician and nurse
What causes a doctor to commit suicide?
A story about a radiation oncologist from Springfield, IL brought this strange case to my attention. Dr. Thomas G. Shanahan committed suicide by cutting his throat in November of 2011. He was respected in his field, having published many research papers and traveled the world helping to set up brachytherapy clinics in several countries. He also had been an acting alderman in his …
Did hospital politics lead to physician suicide?
Political correctness and sensitivity training are interfering with medicine and healthcare. In a recent article published in the journal, Pediatrics, a group of researchers published their findings regarding parental perceptions of the terminology that doctors use to describe childhood obesity (ages 2 to 18). The researchers found that it was undesirable to use the term “fat,” “obese,” or “morbidly obese” because they were stigmatizing, blaming, and the least motivating to …
How political correctness interferes with healthcare
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