“I would submit to you that those (small hospital nurses) probably do get breaks. They probably play cards for a considerable amount of the day.”
– Maureen Walsh
For the first ten years of my professional life, I was an inpatient nurse, first on a surgery floor and later in an ICU. After working three shifts in a row, I learned that I’d need to spend a day recuperating. I called it …
Like more than half of older men, I take a cholesterol-lowering medication called a statin. Sometimes that seems a bit strange, because I don’t have high cholesterol. My doctor prescribed it based on a formula that largely hinges on age and sex.
I’m 71 and male. Those two factors alone put me in the high-risk category for …
We need more than medicine to prevent heart disease
I think the time has come for us all to do a little more than put our 2 cents in.
Our health care system is a mess, and while many of us fighting in the trenches and taking care of patients are working to make things better (despite the best efforts of much of the rest of the system), the challenges and …
What do we want our health care system to look like?
I am a nocturnist (a nocturnal hospitalist). I love my job, but many nights my work can seem unfulfilling. For one, taking care of hospitalized adult patients is primarily spent managing exacerbations of chronic diseases. Therefore, the reality is that most patients will not be cured, only managed. Additionally, there is the loneliness factor, the incessant beeping of my pager, and the fact that I am forced to disturb the …
How the death of a patient affected this nocturnist
To reach my current position as a general cardiologist, I have taken nine board exams. I have also been teaching medical students for over ten years with several colleagues who write questions for the USMLE Step 1 exam. Through this experience, I have observed a number of themes about what works and does not work for board preparation. I share these with you now in the hopes they may help …
USMLE Step 1 tips that may surprise you
These events happened over 18 years ago. Some content has been changed to protect the innocent and the guilty. Searching for positive changes in the health care industry. We are not a number, and the patients are not a number.
I’m not good at lying. My eyes go to the left or look downward, and I start to stutter and pause. There is no eye contact, and I fall deep into …
A nurse’s downfall was telling the truth
When I was five years old, I wanted to be Aurora from Sleeping Beauty. I admired her because I, too, had long, blonde hair and loved to play in the woods. During the movie, I sang with the music. “I know you. I walked with you once upon a dream. I know you. That look in your eyes is so familiar a gleam … Once upon a dream.”
However, I didn’t …
Accomplishing both my childhood and medical school dreams
Within the clinics, hospital corridors, and halls of medicine, a new phrase has emerged and taken hold of the practice of medicine. Whenever confronted with the challenging, inconvenient, undesirable, underinsured or maybe when just overwhelmed, health care personnel have begun to utter the phrase “I’m not comfortable with …”
Upon the utterance, all responsibility to the patient, institution or the honorable practice of medicine is immediately and completely discharged until the …
The powerful phrase that’s ruining medicine
You’re finishing your training this year and finally have a job. Never mind the fact that you have never had a “real” paying job and this is the first time you’re going to have more money left at the end of the month. And I’m not talking about a little bit of money left over; you’re going to be making 5-10x your current salary.
I have buddies finishing this year in …
Finished medical training? Get your finances in order. Now.
What do you think about your patients whom you believe need to lose weight? Do you consider them lazy or non-compliant? Or wonder why they don’t they take better care of themselves and listen to your diet or exercise advice?
You’re not alone in feeling frustrated and maybe even professionally inadequate treating patients who struggle with food. Most doctors and health care providers are unprepared for the challenge of changing patients’ …
Why aren’t patients with eating problems following your advice?
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 39-year-old woman is evaluated for fatigue, intermittent rectal bleeding, and abdominal pain over the past 2 months. She reports that the bleeding is not accompanied by anal pain or itching. She has experienced an unintentional 2.3-kg (5.1-lb) weight loss since her symptoms started. She has no personal or …
MKSAP: 39-year-old woman with fatigue, intermittent rectal bleeding, and abdominal pain
As someone who can’t stop talking about passive income investments, I inevitably end up having a lot of conversations about investing in real estate.
I’ve heard countless stories of how real estate investing has helped people achieve their goals, but from those who don’t invest, I often hear this objection commonly voiced, “I don’t want to be called in the middle of the night to unclog a toilet.”
What I …
What physicians should know about investing in real estate
It is not easy being a professional woman, spouse, parent, and content producer all at the same time. The superwoman phenomenon is real.
We are surrounded by a community of superwomen. While I find this quite awe-inspiring and cool, I can’t but also wonder if it is truly fair.
Do we ask the same out of men?
I was listening to the Hippocratic Hustle Podcast episode with …
The superwoman phenomenon is real
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In recent years, it feels like we’ve been inundated by stories of greedy pharmaceutical companies jacking up the price of important generic medications. In 2015, “Pharma Bro” Martin Shkreli, recognized that no other generic companies were manufacturing Daraprim, a drug used to treat infections common among people with AIDS, from $13.50 a pill to $750, confident that no generic competitor was around to cut into his market Read more…
Are generic drug price hikes media hype?
Hospitals are busy, hectic, and unpredictable places. Professionals who work in health care are highly trained and competent individuals, and if you are receiving acute care in America — the standard of your treatment and access to high-quality tests and an array of specialists, is unparalleled (take it from someone who has worked in different countries). Nevertheless, the hospital experience itself, despite our best efforts, often falls short. Here are …
8 things to watch for if you, or a family member, is hospitalized
In medical school, I’m having a hard time choosing among extracurricular activities. Some of the difficulty comes from the fact that our mandatory classes are hard enough for me to manage. On top of managing coursework, I feel an enormous pressure to question what I should and shouldn’t do to best plan for my future. A little voice inside my head always asks, “How will this look on my resume?”
I …
A love-hate relationship with the resume-guided voice
Late last year the New York Times reported that Dr. José Baselga, the chief medical officer of Memorial Sloan Kettering Cancer Center, had resigned for failing to disclose his conflicts of interest at professional meetings and in scientific and medical journals. The Times report says that Dr. Baselga — who also served as physician-in-chief at the center — “had failed to disclose millions of dollars in payments from health care companies in …
How can we fix the research bias from industry sponsorship?
My friend and practice advisor showed me two very negative anonymous reviews of my practice this week. Both were posted within a one-month winter period and were written about family members. They were not written by patients.
My staff and I tried diligently to identify the stated situations as they did not resonate with any of us. Unfortunately, we were unsuccessful. That frustrates each of us.
Combined, these reviews were aggressive and …
Do not take online physician reviews at face value
One thing that gastroenterologists know about is stool. But, I’m not referring to that kind of stool in this post. Follow along.
When we do a colonoscopy, for example, we are relying upon stool, or more accurately a stool, as in a three-legged stool. This metaphor illustrates that the three legs must be equally strong or the stool will not stand. The three pillars of support that a colonoscopist needs include:
What distinguishes good physicians from truly seasoned medical professionals?
In the 1960s, Lew Goldberg showed that a physician’s intuition and judgment can be fatally flawed. Interestingly, the same fatal flaw that was exposed by Goldberg is the same fatal flaw that causes some of the biggest financial mistakes that doctors make with money. Why aren’t doctors rich? Psychology has an interesting explanation that everyone should understand.
Tag along as we dive into the mind of physicians …
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