To my knowledge, three people who were under my care killed themselves.
The first was a young man — late 20s, maybe? — who I met while I was a psychiatry intern. He was hospitalized in the psychiatric unit where I had just started my rotation. I did not have the opportunity to get to know him well. Our paths crossed, at most, for two days. He had a diagnosis of …
The end of a life never just impacts the individual who died
What does it mean to actually be financially free? If we make it a goal, what are we really working toward?
Rather than looking at financial freedom as an abstract concept, it can be very useful to visualize exactly how it could impact your life.
Ultimately, financial freedom means different things to different people. To me, true financial freedom comes when you can quit your day job and still be able to …
What does it mean for physicians to be financially free?
The residency interview trail quickly becomes a lonesome journey, so when I was on it this winter, I’d usually have the hotel room television turned on for some background noise and often find myself watching ESPN’s SportsCenter. On my last interview in Philadelphia, the show was featuring the high flying phenom Zion Williamson, who’s set to be drafted this year to the NBA. When I finally returned to home in …
The sigh of relief on Match Day quickly changed into a sobering reality
How doctors treat patients’ need for information has changed significantly over the past decades. Sixty years ago medical practice was much more paternalistic than it is now, although some would say it continues to be so in important ways. Still, not too long ago it was common for doctors to tell patients or their families next to nothing about what was going on. The presumption always was: the doctor knows …
What to do with physicians who don’t explain
I used to loathe being an employee. I felt like I was always a slave to the whims of my employer. Exposed. So it was with great excitement that I started a business of my own. Yet, it took only a short period of time to realize that being your own boss carried it’s own perils. The buck stops with you. And so does the …
Physicians and the employee conundrum
In August 2014, a 13-year-old boy with Type 1 diabetes died after being treated by self-described “master herbalist” Tim Morrow who was tried for child abuse resulting in death and practicing medicine without a license.
He had told the boy’s mother to stop administering insulin and instead prescribed herbs which he sold. According to one report, Morrow told the parents that insulin was poison, and if they took …
The consequences of being treated by a master herbalist
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 52-year-old man is evaluated for a 1-year history of progressive weakness that began as right foot drop and bilateral tingling in the feet. Within the past 2 months, the patient has developed progressive weakness, which makes walking difficult; he also notes weakness in the hands and burning below …
MKSAP: 52-year-old man with progressive weakness
Our practice will no longer see nursing home patients in our office. If a nursing home patient is already established with us, then we will see him; but, we have decided not to accept new patients.
Of course, we believe that these individuals — like the rest of us — deserve medical care. This demographic not only deserves care, but has the greatest need for medical services. Our practice will see …
Why this physician will no longer see nursing home patients
I’ve known Pat McCann (identifying information changed) for many years. He carries a diagnosis of COPD and has a preventative and a rescue inhaler, but he has never really had any serious flare-ups.
He fell and broke his hip. Then he went to skilled rehab, one of a half dozen near Cityside Hospital. His stay turned longer than expected because he fell, luckily didn’t break anything, but had to go back …
A diagnosis of pneumonia in a rehab facility: We can do better
If you’re done with your residency or fellowship, you’ve paid your dues. And I am excited for you. Life is about to get better. A lot better.
If you read my prior article about going unmatched, you know that things have not always gone smoothly for me. But now, after a reasonably good first year out of training, I feel compelled to reflect on why things are going well, and also—to offer any …
10 tips for success after you finish residency
A piece of advice I would give to any younger physician, especially one who is just graduating residency, would be to expect a whirlwind ride into the realities of frontline medical practice. It’s something that you are totally not prepared for in the controlled environment of education and residency training. A steep learning curve awaits you once you start practicing medicine. And one of the biggest things you will have …
Physicians: Do not be intimidated by administrators
We had just exchanged “I love yous” about 15 minutes before the intercom blared: “Code blue.”
Just like that, my sister was gone — all from what seemed like a simple knee surgery. Simple in the fact that the type of surgery my sister was supposed to have had that fateful morning was an open reduction and internal fixation (ORIF). Thousands of these surgeries have been performed every day. But something …
Pulmonary embolism: the killer clot in your veins
“Complementary and alternative medicine” (CAM) is a category that includes all the methods of physical or mental healing that do not fall under the umbrella of western medicine. Examples include comprehensive healing traditions from other cultures, such as Chinese or Ayurvedic (Indian) medicine; herbal remedies; and a wide variety of mind-body treatments, such as meditation and yoga. CAM treatments are popular everywhere, including here in the U.S. …
The allure of complementary and alternative medicine
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I received an email from our hospital accreditation coordinator/quality coordinator in a manner that wasn’t clear if it was directed to me personally or if it was sent to the entire medical staff. It said that she was reviewing the Joint Commission’s recent survey which found that the charts did a poor job of reflecting the patient’s “code status.” The institution only received a 40 percent rating.
Some patients were listed …
Don’t ask caregivers to be data entry clerks for the Joint Commission
The HPV vaccine saves lives. It does so by reducing a person’s chance of being infected by the human papilloma virus, a virus that causes a whole range of cancers including, most importantly, cervical cancer. Vaccinate your teenage daughter against HPV, and you will increase the chance she will live to old age. Simple as that.
Yet currently, the majority of American teenagers, boys and girls, are reaching adulthood without the full …
If we don’t pay now to vaccinate our children, they will pay later
Global climate change is reaching a critical mass.
Since the advent of the industrial revolution, we have seen the global mean temperatures increase by 1°C (1.8°F), and significant steps must be taken by 2030 to mitigate an even larger global temperature increase of 1.5 to 3C as predicted by 2030. In other words, we are in dire need of change.
This change is not only reliant on governmental policy change but is …
How climate change affects your skin
I’ve finally stopped thinking about the process of getting into medical school. But with friends going through the application cycle, waiting on and making decisions, I’ve been reflecting on my process and remembering just how terrible the whole thing felt. To offer some support to those going through it, I wanted to confess a few things. These confessions feel silly and small in retrospect, but I hope they’ll help at least one …
5 confessions of a medical student
It’s no secret that society has encountered a student loan crisis. Politicians from both sides of the aisle share similar concerns but promote widely disparate solutions. With over $1.5 trillion of student debt outstanding and default rates skyrocketing, it’s clear that student loan debt management is important for all student borrowers, particularly medical professionals.
Some 75% of medical school graduates start their careers with student …
The quest to cure medical professionals’ student loan debt
Being a physician has served me well. It has given me purpose and identity throughout my career. It has also provided me with a stable income. I knew, however, from the beginning that things were changing. From the earliest days of practice, I pursued lazy side hustles and real estate. I learned about investing. You might suspect that I did this …
Physician compensation is on the chopping block
For centuries, doctors felt that their notes were their property, and none of the patients’ business. This attitude slowly shifted, and the Health Insurance Portability and Availability Act (HIPAA) of 1996 put into law the fact that patients must be allowed to review and get copies of their medical records. Despite this, access to records has remained a daunting task for many. A study done in 2017 of 83 hospitals, …
Why patients should read their medical notes
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