I loved my endocrinology block in medical school. It was one of my favorite units. One hormone acts on another gland, which either induces a positive feedback releasing its successor hormone or a negative feedback blocking its predecessor. It was step-by-step. It was straightforward.
I loved the material so much that I reached out to an endocrinologist to shadow her. I wanted to see the power of what we were learning …
Patients are more than lab results
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 24-year-old woman with longstanding atopic dermatitis is evaluated for an acute worsening of her disease in the past week. She has had increased pruritus and now has multiple painful areas within the involved skin. She has been applying petrolatum jelly and triamcinolone ointment and washing with gentle cleansers without improvement. She is otherwise well …
MKSAP: 24-year-old woman with atopic dermatitis
I recently listened to DDx, a new podcast from Figure1. In their third episode, a 37-year-old man presents to the emergency department in the middle of the night with persistent vomiting and retching. He is highly vocal and agitated. Upon questioning, he reveals that he experiences these episodes frequently and previous investigations have all been inconclusive. His skin is noted to be flushed and his father …
What is the pediatrician’s role in marijuana use?
Several years ago, a colleague of mine did a procedure on my daughter. What was supposed to be routine has become a nightmare for her. When he saw her post-op, he told her she was fine. Because of this obfuscation, years went by before she really understood how damaged she was. By then, the statute of limitations had lapsed and she had no recourse.
Still seeking closure on this disaster, my daughter …
Doctors are conditioned to deny
In the wake of Pride Month, I have been reflecting on how our health care system impacts the lives of individuals with identities across the gender spectrum. Sometimes, when sending a prescription to a pharmacy for any given patient, we will get a phone call that the date of birth on file with insurance does not match the date of birth we have on file. Typically, this is a clerical …
Pronouns matter: How we can do better in LGBTQ patient care
A guest column by the American College of Physicians, exclusive to KevinMD.com.
Trust is the belief that another person or entity will act in your best interest, and it serves as the foundation upon which the doctor-patient relationship and our health care system are built.
But we have a significant trust paradox in American medicine. As …
Restoring the trust in the medical profession
My (sometimes solicited, but often unsolicited) advice for graduating medical students, residents, and fellows:
June is one of my favorite times of the year. One, because it’s summer, but also because it’s graduation season. I love seeing and hearing about everyone’s accomplishments, and seeing years of hard work come to fruition – although if I’m being honest, it’s bittersweet, because it’s also a reminder of how I’m getting older.
This year, I’ve …
6 pieces of advice for graduating medical students and residents
A recent post by the White Coat Investor got me pretty fired up. Dr. Dahle spoke about three of the main financial enemies that face physicians. The third one that he mentioned had something to do with medical culture. The gist of it was that talking money in academic medical centers is considered taboo. While I think WCI is right, it really made me angry. As an academic …
It’s time for academic attendings to teach personal finance
Parents cheer, students rejoice, and teachers relax — it’s graduation season, one of my favorite times of the year. A few weeks ago, the Class of 2018 at Harvard Medical School (HMS) marched across campus to complete their final hoorah as medical students. I observed in awe and noticed something spectacular: most graduates who delivered a speech represented minority groups.
This sighting was not happenstance. Energy is allocated to bolstering racial …
Here’s why we need socioeconomic diversity
As I was reviewing his chart, I noticed under social history that “freelance artist/painter” was listed as his occupation. I’ve never met a patient of such talent and honestly, I was excited to meet him. When I arrived at the ER, I was introduced to an unassuming elderly man. He wore a pair of worn out jeans and a burnt orange T-shirt. Tufts of white hair emanated from under his …
Every patient has a rich history behind their current state of health
I could see the excitement on my six-year-old daughter’s face as we pulled into the parking lot and unloaded her new bike from the car. She had been anxiously awaiting this moment for several weeks — she was going to learn to ride a bicycle. She watched with increasing interest as I unscrewed the training wheels, tightened her handlebars and handed her the bike. She got on her new bike …
Third year of medical school is like learning to ride a bike
An excerpt from 7 Ways to Stop Drama in Your Healthcare Practice.
Although the ability to initiate difficult conversations is part of good leadership, I’ve never met a leader who enjoys it. Whether your conversation is about body odor, rude behavior, dress code, personal conduct or performance issues, difficult conversations …
8 steps to have those difficult conversations
No news attracts attention like a physician who’s in trouble with DEA or their state medical board. So, how does it happen, what are the common issues and what can a physician do to safeguard themselves?
First, let’s look at what the numbers and the research tell us.
The Federation of State Medical Boards (FSMB) tells us that 4,091 physicians were disciplined during …
10 ways to stay out of the DEA’s crosshairs
ADVERTISEMENT
I have neck pain. It’s been going on for years. Usually, I get sore stiff muscles once a week and a headache. This is the consequence of having a big bobblehead on a pencil thin, weak neck. In the throes of pain, I have thought many a time about doing the right thing, and going to see a physical therapist. But then I get a heating pad, take a Tylenol, …
One day, I was full of moderate despair, overworked, befuddled by the EHR with a tinge of burnout, staring at my computer, I treated myself to something I’ve not done before. It was my 62nd birthday that day, and I gave myself a birthday present. Before rising from that swivel chair, I had written down on a sticky pad the day that would be my retirement date, exactly one year …
An excerpt from the Docs Outside the Box podcast, episode 1: When the going gets tough… MOVE!
Dr. Nii: All right, well thank you very much for joining us on the Doc’s Outside-the-Box podcast. You are our first guest — first victim, I guess. It’s the inaugural episode, so I just wanted to thank you for joining us. I know you are in New Zealand, which is roughly 18 hours away.
Dr. Brown: It’s …
A conversation with a doctor who was tired of feeling burned out
Literature coming from business and human resource management suggests that women are over-mentored and under-sponsored. However, if you have been reading reports about women in medicine, then you likely have heard that women are both over-mentored and under-mentored. Where does the truth lie? That depends on various factors including the definitions of these terms.
What exactly do these words mean? In the business sector, mentorship is …
What’s better: mentorship or sponsorship?
The Centers for Disease Control and Prevention reports that 63,632 individuals died in 2016 as a result of drug overdose. Among these, 66 percent died from opioid overdose. The statistics are derived from in-depth research that was carried out by the research institute in 2016. The Centers for Disease Control and Prevention warns that cases of drug abuse are swiftly spreading geographically and increasing demographically. The …
Prescription drugs are killing students and the educational system
Just like so many teenagers out there, I found myself hooked on the Netflix show 13 Reasons Why from the first episode. The only difference is that I am not a teenager, but a physician practicing child and adolescent psychiatry and managing inpatient child and adolescent psychiatric units for the last nine years. I was surprised to see the number of emergency room evaluations of my admitted patients indicating that …
The problem with the adults in Netflix’s 13 Reasons Why
The keto diet has recently garnered much fame for its apparent ability to improve diabetes and obesity – results so impressive the Journal of the American Medical Association recently highlighted the diet and thereby christened it as something more than a low-carb craze. However, not all the evidence supports such a positive outlook, leading the diet to straddle the increasingly blurred lines between faddist snake oil and …
A physician’s warning on the keto diet
Get free updates delivered free to your inbox.
