I didn’t know that he and I were on the same train. At the Othello stop, I got out of the last car and walked towards the front of the train. The morning chill seeped through my coat and I slid my hands into my pockets.
“Dr. Yang!”
The doors of the train were still open, and there he was: A baggy black hoodie was pulled up over his head, but it …
The surprising people who inspire
Back when cholesterol target numbers ruled unopposed (before 2013), we all checked fasting lipids every three months. Before 2012, we also checked liver function quarterly in hapless riders on the cholesterol pill merry-go-round. That year the FDA announced there had not been enough reports of statin-induced liver problems to recommend routine monitoring.
I have many colleagues who still do this, and who also routinely monitor routine labs quarterly …
Shock. Horror. Did you just read the title correctly, or are you seeing things? Well, after you recover from the shock of reading a line you probably never thought you could possibly see in writing — let me tell you this: Physicians and politicians are probably as opposite as you can imagine in terms of their daily work life, guiding principles, and yes, level of respect shown to them by …
3 things physicians can learn from politicians
Physician well-being is a major focus of many physician organizations and is frequently highlighted in popular media. Some have described the root of the problem as a disconnect between expectation and reality. This is a helpful framework for situations that result in disappointment. I recently rented a house on Airbnb. Eagerly anticipating our vacation, I was dismayed to find upon arrival that the house lacked electricity and water. Camping in …
Changing the focus from physician burnout to physician well-being
Compassion. Empathy. These are some of the words commonly thrown around in medical school and residency training. If you ask most medical students why they chose medicine, they will respond with something like this: “ I love to help people,” or “I want to save a life.”
I remembered when I entered medical school, one of my professors said, “In order to be good a doctor, you must be compassionate and …
Make your 15 minutes with a patient memorable
The bloated nature of health insurance in the United States has been a much-discussed topic in recent years. Particularly with the advent of the Affordable Health Care Act as well in response to physicians’ frustrations and increasing burnout from dealing with the constraints imposed on them by insurance companies, and at times being forced to provide suboptimal care for their patients in response to these constraints.
As an example, I had …
It is time for stewardship of our health insurance system
As an ER doctor, I often meet people on the worst day of their lives. I’m the guy who gets to tell you your mom is dead. I’m the one who works the futile code on your four-year-old, while your screams cut right through everyone in the room. I find your cancer. I tell you your husband overdosed in the McDonald’s parking lot. When you decide you want to shoot …
The civilian casualties of being a doctor
When my father reached his mid-80s, an accelerating accumulation of physical and mental functioning issues persuaded him to switch to a primary care physician in a concierge medical practice.
Although the doctor’s pedigree proclaimed his competence, he mostly excelled as the medical equivalent of a hotel concierge who can magically procure hard-to-get restaurant reservations at the last minute. The doctor would see my dad on short notice and make sure he …
The complex expectations of patients toward their physicians
This article is sponsored by Careers by KevinMD.com.
Daily headlines in newspapers and on websites across the nation and around the Internet seem to inspire and anger, and it’s only natural that politics is a topic on everyone’s mind. We’re all concerned about the economy. We’re all eager to see our political leaders solve the problem of unemployment. …
How to deal with politics in the workplace
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 64-year-old man is evaluated in follow-up after recent abnormal findings on intraoperative liver biopsy. Two days ago he underwent right colon resection for a large villous adenoma with high-grade dysplasia. At the time of surgery, an abnormal-appearing liver was noted and biopsy was performed. His medical history is notable for type 2 …
MKSAP: 64-year-old man seen after an intraoperative liver biopsy
Recently, several high-profile institutions have called attention to the issue of inclusion and equity when artificial intelligence (AI) algorithms are applied in medicine. Leaders from the law, medicine, social sciences and computer sciences are speaking out about the challenges of using smart algorithms to solve social problems.
While this topic might easily be dismissed as anti-progress by the tech community, it should be reexamined as a genuine …
Slow thinking and machine learning in medicine
After countless hours of hard work and three demanding years of medical school, it’s now time to face the spotlight! If your interview invites have started rolling in and you are feeling intimidated by the thought, follow these tips to land your first choice of clinical residency.
1. Be prompt with your responses to interview invites
Be sure to set your inbox to automatically refresh every hour during the interview season so you …
8 tips to land the residency of your dreams
I think you can tell a lot about how things are going in a hospital based on the amount of consumption of coffee by its employees. Visit the Starbucks, Au Bon Pain, Roasterie, Einstein Brothers, or whatever coffee shop inhabits square footage in your hospital, and I’d venture to say that you can take the pulse of the hospital. Lots of large coffees to go? It’s either just about shift change and …
You can measure the pulse of a hospital by its coffee shop
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Doctors and other caretakers are the pawns of the health care system. We provide the services that allow hospitals and medical groups to bring in big revenue. Unless we are contracting directly with insurers, doctors will never realize the true financial firepower that we have. As the health care environment evolves, we are seeing fewer individual physician-owned groups and more conglomerates. The larger the system that we belong in, the …
Doctors are pawns of the health care system
I don’t mean to pick on McDonald’s. Insert any other large retail business where customer satisfaction massively trumps every other consideration of the relationship between employee and customer.
Telemedicine companies have exploded the past few years. I suspect a lot of my readers have already seen this, but just in case not, a recent study in JAMA Internal Medicine measured the correlation between customers with a cold who called …
Physicians are trapped between patient satisfaction and unnecessary prescribing
Effective clickbait doesn’t just happen. It’s carefully crafted.
Take this wildly misleading article from CNN: Not exercising worse for your health than smoking, diabetes, and heart disease, study reveals.
It’s one example — among many generated daily by various news outlets — of how a mundane observational study can be transformed into viral internet gold. In the days after it was published, this story was liked and …
The carefully crafted way of how health misinformation spreads
Figuring out what’s actually true is far harder than most people realize. Our brains are both hypothesis-generating machines and incredibly credulous. As a result, most of the things we believe to be true turn out to be false. We don’t just mistakenly believe that vaccines cause autism, that the flu shot can give us the flu, and that astrology can predict our future. We also mistakenly believe that the salad …
The main difference between functional medicine and evidence-based medicine
Comparing the 2018 U.S. Preventive Services Task Force (USPSTF) recommendation statement on prostate cancer screening in the October 15th issue of American Family Physician with its previous recommendation, the first question family physicians ought to ask is: What new evidence compelled the USPSTF to move from recommending against PSA screening in all men to determining that there was a small net benefit for screening in some men? …
PSA-based screening for prostate cancer: Interpreting the changing guidelines
I’ve only worked four shifts of urgent care so far, but four 12-hour shifts means I’ve seen a lot: a lot of patients, a lot of different ailments, a lot of different reasons that people come to urgent care centers.
I have to admit that this has been a breath of fresh air for me; compared to primary care, I work less frequently, I feel like the monetary compensation is fairer, …
Urgent care isn’t the answer to our broken system
“Sondor” is a made-up internet neologism that captures the fleeting but poignant sense of “the realization that each random passerby is living a life as vivid and complex as your own — populated with their own ambitions, friends, routines, worries and inherited craziness.”
I think about this word often when I see my patients. Everyone is the main character of his or her life, and during the third year of medical …
A medical student as storyteller and story-listener
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