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Not all ambulance rides are emergent

Edwin Leap, MD

Health Policy

July 10, 2019

When the paramedic calls in and says “transporting non-emergent …” I think of this wonderful story.

I was once “deposed” by the state medical board to speak on behalf of a friend who had been charged with “unprofessional behavior,” because he missed an abnormal lab that resulted in a patient having unforeseen (but non-lethal) complications. It was really a systems issue, but somebody thought my friend needed to be made an …

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Not all ambulance rides are emergent

The tension between learning and the illness of others

Nathaniel Fleming

Medical Education

July 9, 2019

Every doctor and doctor-in-training has a particular thing that drew them toward a career in medicine. Whether it is an interest in science, a passion for service and helping others, a family role model, or a combination of the above, there are many ways to spark interest in the field. From my own experiences and conversations, I’ve found that finding inspiration to enter a career in medicine is rarely a …

Despite the talk about team-based care, physicians today are isolated

Hans Duvefelt, MD

Physician

July 9, 2019

My first job after residency was in a small mill town in central Maine. I joined two fifty something family doctors, one of whom was the son of the former town doctor. I felt like I was Dr. Kiley on Marcus Welby, MD. I didn’t have a motorcycle, but I did have a snazzy SAAB 900.

Will was a John Deere man, wore a flannel shirt and listened to A Prairie Home …

How physician speakers are highlighting conferences in 2019 and beyond

Kevin Pho, MD

KevinMD

July 9, 2019

Physician Speaking by KevinMD is the only physician-run, all-physician speaker bureau. We are practicing physicians and experienced keynote speakers, highlighting both large-scale events and intimate day-long workshops.

We cover today’s topics that matter, with physician speakers focusing on burnout, leadership, social media, online reputation, the opioid crisis, mobile health, and end-of-life care.

You will be …

A physician family’s enraging experiences with the U.S. health care system

Judith Graham

Physician

July 9, 2019

Dr. Hasan Shanawani was overcome by frustration. So, last week he picked up his cellphone and began sharing on Twitter his family’s enraging experiences with the U.S. health care system.

It was an act of defiance — and desperation. Like millions of people who are sick or old and the families who care for them, this physician was disheartened by the health care system’s complexity and its all-too-frequent absence of caring …

Being a doctor matters less to this physician

DocG, MD

Physician

July 9, 2019

Something funny has happened over the last year. I used to self identify as a physician. It was a large part of who I supposed myself to be. Of course, I was more than just that. I was a spouse and father, a brother and a son, and all the various other ways in which we see ourselves. But reaching financial independence and pursuing half retirement has sparked a …

The basics of the MMR vaccine from a pediatrician

Roy Benaroch, MD

Medications

July 8, 2019

As the U.S. endures its largest measles outbreak in 25 years — one that’s almost certainly going to get worse before it gets better — we’re getting a lot of calls and questions at my office. What’s measles, what’s the best way to prevent it, when should the vaccine be given to adults and children?

The measles vaccine is given as “MMR,” which teaches the immune system to fight off measles, …

After cancer treatment: It’s time to reconsider the ringing of the bell

Anne Katz, RN, PhD

Conditions and Diseases

July 8, 2019

It’s become a common practice in oncology institutions across North America: A patient completes their prescribed course of treatment and they ring a bell. Usually, it’s a large bell, like one that used to be rung in schools signaling the end of recess. Or it’s a ship’s bell, attached to a wall outside the radiation department or the chemotherapy unit. …

How our relationship with money can help or hinder physician burnout

James Turner, MD

Physician Finance

July 8, 2019

In one of the recent physician burnout and depression surveys, doctors were asked to name the causes of their burnout. The typical culprits were listed: lack of autonomy, EMRs, lack of support from administrators, insurance companies, lack of time with patients, and so on. However, when they were asked what would improve their burnout, getting paid more was the number 2 cause. Apparently, I am not the only …

A medical student before exams: the danger of neglecting the people she loves

Orly Farber

Medical Education

July 8, 2019

A couple weeks ago, I called up my family and non-med-school friends: “For the next couple months, pretend like I’m backpacking in the Himalayas,” I said. Pretend, I stressed, because, in reality, I don’t even intend to leave Palo Alto much in the coming months.

I’ve now entered one of the most-dreaded phases of med school: preparing for the first licensing exam, Step 1. During this time — which can last as long …

5 mistakes new physicians make when investing in real estate

Passive Income, MD

Physician Finance

July 7, 2019

We seem to get a ton of questions on the Passive Income Docs Facebook group about how to start investing in real estate. It can initially be a very intimidating venture.

I remember when I started with a $5,000 investment in a crowdfunded deal. It was downright scary. I’ll be honest, I didn’t have a great grasp of what I was investing in. However, I knew that …

The truth behind the care at a skilled nursing facility

Steven Reznick, MD

Physician

July 7, 2019

Reuters recently published an article on skilled nursing facilities and post-hospital stays. They discussed the often-lengthy time between hospital discharge and the patient being seen by a physician or “an advanced care practitioner.”

Older, more infirm and cognitively impaired patients tend to be seen later than other patients. The later you are seen, the more likely it is that you will be sent back to the acute care …

When “do no harm” is no longer textbook

Jim deMaine, MD

Physician

July 7, 2019

A call came about noon a few years ago that a patient I’ll call Stella was being admitted once again. She had come into the ER from her nursing home to receive transfusions. These were now needed every two weeks to keep her alive. The problem was that every time Stella was moved she decompensated. Her Alzheimer’s was severe. She no longer recognized her family. She was now 83 and slowly …

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When “do no harm” is no longer textbook

The physician part-time blues

DocG, MD

Physician Finance

July 7, 2019

The solution to most of my work related problems was half retirement. By leaving clinical practice and taking a less arduous administrative role, I was able to divorce myself from the worst part of doctoring. Being financially independent helped, but wouldn’t have been the complete solution. I am not ready to retire. I would be remiss, however, if I didn’t also point out the downsides. The part-time blues …

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The physician part-time blues

What’s the biggest lesson of intern year?

Sara Walker, MD

Physician

July 6, 2019

Even during medical school, there was always the running joke about getting kidney stones. With the frenetic pace of many rotations, it was always difficult to squeeze in bathroom time, and I suspect many of us adopted the same solution – drink less water. That is certainly how I survived my month on vascular surgery. After a nine-hour case, I was told by one of the residents that everyone was …

Is the journey in medicine leading me to my best self?

Scott Hippe, MD

Physician

July 6, 2019

“Medicine robbed me of my 20s.” I’ve heard the line many times in my medical training. It often comes accompanied by a long sigh, a slow sip of coffee, and a glazed stare off into the distance. “Imagine what could’ve been,” the seasoned physician muses, “if I had my 20s to do over, without medicine.”

But now, I am mere months away from leaving my 20s behind. To be completely honest, I often feel similar …

Take a break from all the bad news, and praise hope

J. Leonard Lichtenfeld, MD

Physician

July 6, 2019

Reading the headlines in the morning newspaper lately can downright depressing. It was with that feeling that I recalled three conversations I had recently with people who have various cancers. And I realized that despite all the chaos around us, maybe it’s time to say something in praise of hope.

Hope is very real, especially when you or a loved one or someone you know is diagnosed and treated for cancer. Hope …

MKSAP: 69-year-old man with chest pressure and dyspnea

mksap

Conditions and Diseases

July 6, 2019

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 69-year-old man is evaluated during a follow-up visit. He initially presented with a 3-month history of chest pressure and dyspnea that occurred primarily with exertion. Despite maximal medical therapy, his symptoms have not abated and adversely affect his quality of life. Medical history is significant for type 2 …

American physicians deserve timely payment

Peter Ubel, MD

Health Policy

July 5, 2019

Health care reimbursement in the U.S. is frighteningly complex. We have federal payers, like Medicare; state/federal payers, like Medicaid; private, for-profit insurance companies, like Aetna; private, not for profit insurers, like many local Blue Cross Blue Shield networks. Oh yes, and we have private insurance companies managing reimbursement for many Medicare and Medicaid recipients.

This complexity comes with costs. Doctors and hospitals need to hire armies of people to process bills …

Thinking about changing jobs? Here’s what physicians should consider.

Smart Money, MD

Physician Finance

July 5, 2019

A large percentage of doctors end up switching jobs within the first five years of practice. This really isn’t surprising given that the medical training experience doesn’t necessarily correlate with the medical practice experience. Many doctors work hard throughout their entire training only to realize that their expectations do not necessarily align with reality. Is it our fault that we don’t really know what we got ourselves into?

Perhaps taking q3 …

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