The bedside nurse is under siege

Physician
October 29, 2019

Nurses are the very heart of health care. These wonderful professionals work tirelessly for the good of their patients, spending the most time with them and often being their biggest advocates and best friends during what is a frightening experience in the hospital. In my career, I’ve worked with some truly magnificent nurses, who would be an asset to any organization. Every practicing doctor has also been in situations where it’s …

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The bedside nurse is under siege

A guide to couples matching

Physician
October 29, 2019

I consider myself one of the lucky ones because my wife and I couples matched to the same institution for residency. At the time we put our residency match lists in, we were just boyfriend and girlfriend, and the decision to couples match felt like a bigger leap forward for our relationship than deciding to ask her to marry me about a year later. It was the right decision for …

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A guide to couples matching

Each line on the radiology list is a patient’s line in the sand

Physician
October 28, 2019

Lists guide our lives.  Some are easy, even fun, like a menu or shopping list.  Some are simple tick-offs for work, like my wife’s honey-do list.  Others are frightening, like a draft list.  Some are melancholy, such as the inventory in a Will.  We are inspired by our bucket-list.  Finally, some are exciting, but stir conflict, like a wedding invitation list.  I have a list, which makes me slightly anxious, a little depressed, and which takes modest courage to open …

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Each line on the radiology list is a patient’s line in the sand

Should there be a disqualifying upper age limit to become president?

Conditions and Diseases
October 28, 2019

The health challenge recently faced by Sen. Bernie Sanders has brought two issues to the forefront of the 2020 presidential election. Should there be a disqualifying upper age limit to become president, and should an existing health issue preclude a candidate from running for president?

As scientists in the field of aging, we cannot tell the voting public how to answer these questions. What we can do is inform you about …

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Should there be a disqualifying upper age limit to become president?

An analysis of Joe Biden’s health plan

Health Policy
October 28, 2019

If the Democrats capture the White House, keep the House and take over the Senate, no matter who they elect as president, this Biden health care outline, not Medicare for all, will likely be the plan Democrats embrace in 2021.

The Biden health care proposal directly takes on the big things that haven’t worked in Obamacare. Here are the things that are most broken in Obamacare:

  • The individual health insurance premiums and …

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An analysis of Joe Biden’s health plan

Objective measures aren’t perfect at predicting real-life clinical ability

Medical Education
October 27, 2019

“Can we please try to be objective about this!” I said these words to myself over and over during this year’s interview season as we formulated our residency rank list. At my institution, the residents and faculty have equal sway in forming the rank list. The chief resident facilitates the resident half of the process. As the hours wore on during our last meeting, the discussion gradually deviated from assessing the …

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Objective measures aren’t perfect at predicting real-life clinical ability

Patients are used to seeing physicians who are not their doctors

Physician
October 27, 2019

Nowadays, patients are used to seeing physicians who are not their doctors. Often, patients may be seeing a nurse practitioner, a highly trained professional for their medical care, instead of a physician. A generation ago, patients nearly always saw their own physician, including if a patient was hospitalized. Imagine that: Your own primary care doctor sees you in the hospital, an event that occurred when dinosaurs roamed freely.

The medical universe …

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Patients are used to seeing physicians who are not their doctors

What politicians aren’t telling you about health care

Health Policy
October 27, 2019

Health care remains the nation’s top voting issue ahead of the 2020 elections, just as it was during the 2018 midterms. Surveys show voters remain frustrated with high drug prices, growing out-of-pocket expenses, and skimpy health-insurance benefits.

The leading candidates have publicly promised to fix these problems, but all are omitting certain details about their health care plans. To help voters …

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What politicians aren’t telling you about health care

When we walk into a patient’s room, we are entering a story

Physician
October 27, 2019

The doctor opened the door after a gentle knock. He was greeted with warmth, offered a seat by Mary, and promptly sat down on the end of the hospital bed. As he sat, the family stood to greet him. They discussed the grandkids, the trips taken since they last saw each other. The room felt peaceful. Time slowed down.

Walking in behind my attending, I had been ruminating about the lengthy patient list, the work to be done. Then …

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When we walk into a patient’s room, we are entering a story

Don’t use stimulants to cram for exams. It ruins sleep and doesn’t help test scores.

Medications
October 26, 2019

Along with a steeper financial burden and an increasingly competitive academic environment, this year’s incoming freshman university class will likely be confronted with the pressure to take a little pill that some popular culture references say will make you “awesome at everything.” Or they may eschew the temptation and rely on the standard practice of study, sleep, repeat.

Welcome to #GenerationAdderall, the …

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Don’t use stimulants to cram for exams. It ruins sleep and doesn’t help test scores.

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All the wellness in the world won’t help physician burnout

Physician
October 26, 2019

I will always be a vascular surgeon.

But let’s be clear; I no longer practice vascular surgery.

Despite a busy practice, happy patients, local awards, and the respect of my peers, I quit. I gave it all up. All of the education, all of the endless training, all of the time, hard work, and, yes, all of the salary — I turned my back on it.

Why?

I am a recovering patient with constant …

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All the wellness in the world won’t help physician burnout

Stop blaming people with cancer. Support them instead.

Conditions and Diseases
October 26, 2019

I am a “jack of all trades” osteopath. I practiced family medicine for over nine years and am currently on a leave of absence as I fight invasive breast cancer. Once I return to medicine, I will be moving into a more specialized role in integrative medicine and osteopathic manipulation. I have also worked in urgent care.

I have to get something off my chest (no pun intended — I’ve had …

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Stop blaming people with cancer. Support them instead.

How best to support, honor, and show gratitude for your mentors

Physician
October 26, 2019

I recently had the amazing opportunity to both witness and participate in an event where my Children’s Hospital of Philadelphia (CHOP) pediatric mentor received a lifetime achievement award for her many years of exemplary service to the pediatric community of Southern New Jersey.

My mentor’s leadership, compassion, and dedication to serving the Latino community have set an example — not only for patients and their families but for generations of pediatricians …

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How best to support, honor, and show gratitude for your mentors

What does cable news do to your brain? A neurosurgeon explains.

Conditions and Diseases
October 25, 2019

The availability of up to the minute information, presented 24/7/365, could assist a democratic society in making the best choices in determining its future. That was the promise of cable news. Unfortunately, cable news has fallen short of its potential and has led to the further polarization of America. More than that, it has changed the way your brain works. Not for the better!

The various cable …

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What does cable news do to your brain? A neurosurgeon explains.

Can CRP testing guide antibiotic decisions?

Conditions and Diseases
October 25, 2019

In response to concerns about the unnecessary use of antibiotics, researchers have sought to identify simple, non-specific tests to help clinicians determine which patients require antibiotics and which do not. Indeed, such tests could facilitate challenging management decisions, which currently rely predominately upon a thorough clinical assessment. To compound the challenge, patients often have pre-conceived ideas about whether or not …

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Can CRP testing guide antibiotic decisions?

A framework for understanding health care systems

Health Policy
October 25, 2019

First in a series.

Way back as a business strategy undergrad and then as a medical student, I developed a framework for understanding health care systems. I call it the Healthcare Incentives Framework, and I believe it clarifies the big-picture components of health care systems that people need to grasp to be able to understand the sources of problems, which then leads to appropriate solutions. The whole thing cannot be explained …

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A framework for understanding health care systems

When we ignore a child’s preventable suffering, we lose a piece of our humanity

Health Policy
October 25, 2019

Sometimes an image captures the heart of a nation by putting a face on a human crisis.  The one of Óscar Alberto Martínez Ramírez and his 2-year-old daughter Valeria lying face down in the Rio Grande after drowning was powerful.  Their family had been turned away from crossing the border and decided to take their chances and swim across the river.  They were not successful.

Why did this picture seize our attention?  Is it because …

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When we ignore a child’s preventable suffering, we lose a piece of our humanity

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