Raise your glasses (of juice, water, champagne, or whatever you fancy) and join me in celebrating a dream come true: I’m officially a physician who practices medicine from home. To think that it was only four years ago that I was burnt out. It took having that eye-opening experience to take myself off the grid and begin practicing medicine on my own terms. I left nephrology to practice as a …
A physician’s journey to working from home
I’m an orthopaedic surgeon, but if you told me I’d be here when I graduated from college, I’d be laughing at you. When I got started in college, I thought I was going to be pre-med and apply to medical school. It was not a well-thought-out decision. I thought that this was what good Chinese-American children do: Grow up to become doctors. It became clear that this goal was parent-driven …
The journey from a low GPA to an orthopaedic surgeon
Samuel was an English gentleman hailing from London. Close to 10 percent of the U.S. population, over 30 million people, lives with diabetes. Five years ago, Samuel was diagnosed with type 2 diabetes. Taking lisinopril and glipizide, he also goes on hour-long walks every morning at 6:30 a.m. to keep his A1c at his comfort number of 5.5. It has not always been this way for Samuel as he was …
A patient’s tale of type 2 diabetes
A commencement speech to the graduating class of 2019, Frank H. Netter MD School of Medicine, May 10, 2019.
In less than 30 minutes, you will all finally be physicians! (cheering) And this summer you’ll be set loose on your very own patients. (laughter) How exciting is that? Maybe a little nerve-racking.
During your career (depending on specialty and work ethic) you may care …
“We are brothers and sisters in medicine. Protect and defend each other.”
In recent years, a flood of cannabis and cannabis-derived products like CBD have entered the market – often claiming to cure or treat an array of health issues and ailments.
These products are everywhere, but there is little scientific evidence to support the hype that surrounds them.
As a doctor, I’m deeply concerned at where this industry is heading – and the potential risks to patients and consumers.
I urge my peers to …
Unapproved CBD products may not be as safe as they seem
I was recently asked to give a speech to the graduating residents in my department, and while preparing my talk, I reflected upon what I wish I had known when I had first embarked on a career in academic medicine — and what nobody was willing to tell me. So what follows are a few thoughts that I learned on the job, often without warning, sometimes too late. I should …
What they don’t tell you at medical graduation
A recent New York Times piece had the catchy title, “Don’t visit your doctor in the afternoon.” It was prompted by a study published in JAMA Network Open that had the much less catchy title “Association of Primary Care Clinic Appointment Time with Clinician Ordering and Patient Completion of Breast and Colorectal Cancer Screening.” The study found that the frequency of appropriate ordering of …
Why you should see your doctor in the morning
Physician compensation in most employed positions is based on how much a physician “produces.” I work as a psychiatrist, and this amounts to how many patients you see per hour. The more patients you see, the more “productive” you are, the more money you generate, the more valued you are by your organization and the more RVUs you churn out for a larger paycheck. But, in human terms, what exactly …
It’s time for physicians to be less “productive”
A recent New York Times article described a 77-year-old retired gardener in England who had not spoken with another human being in more than six weeks. He told the reporter through tears that he felt “very lonely, and bored.” Recent budget cuts prevented him from taking the bus to the grocery store. Younger people, including his own son, had left town for better jobs in larger cities.
I see this loneliness …
Older adults and the epidemic of loneliness
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 60-year-old woman is evaluated for persistent constipation symptoms of 2 years’ duration. She has reflex sympathetic dystrophy syndrome involving the right arm and neck that began 3 years earlier and requires chronic opioid analgesic therapy. She reports passing two hard bowel movements per week. Trials of several fiber …
MKSAP: 60-year-old woman with persistent constipation
I chose endocrinology to be my lifelong profession out of love for the complex interactions of endocrine glands and intricate feedback loops. I take pride in preventing medical complications, prolonging life expectancy, and providing complex care to type 1 and type 2 diabetics. At times, this field of work requires spending hours — either with the patient or before or after patient visits — counseling, examining blood glucose data and …
Endocrinologists are needed more than ever. Why are they being devalued?
Physicians often, by virtue of their degree, have easier access to medical care. Yet the care they actually receive may be substandard. Here’s why.
Years ago, I broke my wrist. Visiting a local hand surgeon, I was relieved to hear that surgery would not be required — wearing a cast for a few months would probably do the trick. But then the doctor, knowing that I’m a swimmer, asked if I …
Physician patients shouldn’t be special
It was recently National Teacher Appreciation Week, and many were busy recognizing their superhero teachers. Schools dedicate the week to their teachers, parents bustle about with flowers, handmade cards, and gift baskets. For me, though last week was an interesting reflection on how I define a teacher. During Teacher Appreciation Week I recalled my fourth-grade teacher, Ms. Frazier, who had me memorize Martin Luther King, Jr.’s “I Have a Dream …
Recognizing the secret identity of physicians
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The trend of increasing specialization in medicine may lead to unintended adverse consequences. There is an old saying, “We see what we recognize and we recognize what we know.” My wife’s recent adventures in ophthalmic care is such an example. I offer it as a cautionary tale.
She was born with granular corneal dystrophy (GCD). We would later learn that this autosomal dominant gene was thought to have originated in a …
How tunnel vision can lead to bad medicine
The numbers are scary: The average woman has a 12 percent risk of developing breast cancer at some point in her life. For women with certain genetic mutations or risk factors, lifetime risk can climb to 85 percent.
Even more terrifying than the numbers, however, are the rumors; rumors that the contrast dye used in MRIs for breast cancer screenings is harmful; rumors that are driving women away from an adjunctive …
MRI safety in breast cancer screening
This is a brief explanation of Medicare from a physician’s perspective, as well as my thoughts on how Congress could make adjustments that would bring us closer to universal care and provide the private market the freedom to improve health care outcomes.
Medicare is a national health insurance program that provides health insurance for Americans ages 65 and older, and those who are disabled or have specific chronic conditions. Medicare covers …
A physician suggests how to improve Medicare
As a college freshman in 2012, my life seemed perfect. I was attending Rhodes College in Memphis, TN, with the dream of becoming a pediatric oncologist. To that end, I was serving as a volunteer, researcher, and clinical intern at the world-renowned St. Jude Children’s Research Hospital. I was thriving in my classes and building incredible relationships with my peers and professors. I had never been happier.
Everything changed when I …
How a disability changed this medical student
Two years ago, something happened that — not to be overly dramatic — changed my life, including my everyday experience of my job as an emergency specialist.
My older brother, Martin died of a rare and aggressive form of non-Hodgkin’s lymphoma that spread despite every treatment that was thrown at it.
When he was dying, I managed to unleash in myself a raging anxiety, which caught me by surprise. In the year …
How this physician does her job while grieving
Every time I hear that there is a nursing shortage in America, I feel myself cringe. There is not a shortage of nurses in America. There is a shortage of nurses who choose to work at the bedside. There is a reason, and it is called post-traumatic stress disorder.
Medically, we have learned that PTSD can occur after a single event or as a result of chronic stressors for a period …
The boy is three years old and quite curious about the world. He watches his father leave the house and wants to go find him. He looks to his mother but she is napping beside him on the couch, and he would rather not wake her, so he grabs his stuffed dog, Dory, and walks to the door. The door is unlocked, and he heads out of the apartment, wandering …
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