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Bullying immigrant children in the name of politics

Health Policy

June 26, 2018

We’ve all seen the news and heard the stories about children being separated from their parents as they cross over the U.S. border. The pictures of human beings, including very young children, behind wire mesh (some argue that they are not really cages) is simply horrifying. Over the past decades, we have seen atrocities happening in many other countries around the world. And we sit and wonder why the citizens …

The biggest health care fix: a relentless focus on primary care

Suneel Dhand, MD

Health Policy

June 26, 2018

There are so many theories out there about what we should or shouldn’t be doing with our complex and fragmented health care system. We are facing a perfect storm of factors: an aging population, a huge increase in chronic disease, new and expensive treatments, and rising expectations of what care we should be receiving. All of this is sending costs spiraling out of control. As a nation, we spend almost …

Shouldering the experiences in medicine is both a burden and an honor

Laura Selby, DO

Physician

June 25, 2018

I’ve been a doctor for one year. Two years of clinical rotations in medical school ill-prepared me for the reality of this job. Not that I went to bad medical school by any means; working in health care is simply something you can’t learn from a textbook or even on the sidelines as a marginally involved medical student. It is immersive.

Working around death and dying individuals can be mentally and …

How medical training can affect the physician psyche

Ami B. Bhatt, MD

Physician

June 25, 2018

Since the two very sudden public suicide deaths of Kate Spade and Anthony Bourdain, society has again recognized that we never know what is under the surface of another’s façade. As physicians, these tragic occurrences emphasize that our caregiving requires seeing the entirety of an individual’s many parts.

While we acknowledge that the façade is not fake — it is but one true representation of an individual, well-curated, like pages on …

Confronting sexism in medicine

Christopher Johnson, MD

Physician

June 25, 2018

The recent prominence of the #MeToo movement has shined a light at many places in our society where insidious or even obvious sexism against women has long gone unremarked. Even when noticed it’s just shrugged off as the way things are. In honor of this, #MeToo was named Person of the Year for 2017 by Time Magazine. Medicine is no exception to this pervasive problem. A very interesting recent essay in the New …

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Confronting sexism in medicine

The physician reluctance to seek mental health treatment

Sara Reader, MD, MPH

Conditions and Diseases

June 25, 2018

The recent suicides of an NYU resident and a medical student highlight the growing mental health problem among physicians and physicians-in-training in this country. This crisis is certainly not exclusive to physicians, as evidenced by the suicides of designer Kate Spade and television personality Anthony Bourdain. However, suicide among physicians is of particular concern. A literature review of physician suicide in Medline and PubMed yielded alarming results …

Dear CVS: Please change your hold music

Steve Schlozman, MD

Physician

June 24, 2018

Dear CVS,

Please change your hold music.

Please. Do the right thing.

It’ll take you, or someone who works for you, or even a barely pubescent adolescent who nevertheless knows how to program music on his iPhone with more aplomb than anyone born before 1975, only about 48 seconds.

And 48 seconds is substantially less than the amount of time I have listened to your never-changing hold music.

I have researched the source of this …

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Dear CVS: Please change your hold music

5 reasons to get involved in organized medicine

Frances Mei Hardin, MD

Health Policy

June 24, 2018

The following are intended to inspire to medical students and residents to learn more about organized medicine. Whether it be at the national, state, county, or specialty level, there are numerous societies with opportunities for contribution.

1. To pull back the curtain. Many physicians are innately curious and like to “see how the sausage is made,” so to speak. There is a great deal of policy behind the scenes of our …

Bilateral empathy lowers patient expectations

Kevin R.R. Williams

Patient

June 24, 2018

Generally speaking, patients and physicians are working towards good health. While many patient expectations can be unreasonable, others are practical; this article amalgamates them. Can you identify the absurd demands?

But multiply half of the listed expectations by hundreds or thousands of patients, and we begin to understand why there is such a high rate of physician burnout. Bilateral empathy lowers expectations.

Bedside manner. Don’t accept a walk-in patient and leave us waiting …

How to create an app as a physician

Passive Income, MD

Health Technology

June 24, 2018

“There’s an app for that.”

The phrase became so popular with the advent of smartphones that Apple even trademarked it. There are currently 3.8 million apps available on Android devices and over 2 million available to Apple iPhone users.

Does that mean that we’ve reached a limit on new and useful apps that can be created? Absolutely not. Especially in the medical world, it seems as if there’s so much room to …

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How to create an app as a physician

How to fix bullying in health care

Andrew C. Bland, MD

Health Policy

June 23, 2018

When we think of bullying, we’re usually worrying about our school-age kids or remembering bad experiences from high school.

We learn quickly in the health care field that bullies don’t change once they enter the clinical world. Health care, with its incredible differential in knowledge, authority and pay creates large power differentials and easily generates subordinate/superior relationship dynamics.

Bullying occurs within professions between trainees and trainers and faculty, and across clinical areas …

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How to fix bullying in health care

Health care is making the classic mistake that many startups make

Praveen Suthrum

Health Policy

June 23, 2018

Before managed care became the dominant force that it is, patients and doctors had the opportunity to get to know each other well. Doctors treated multiple generations within families. This helped establish a strong bond among patients and their doctors.

While it might have intended to mean preventing expensive care, managed care began to mean organized care. Run by institutions such as health maintenance organizations.

Insurances began to decide which doctors you …

How every female physician can be a somebody

Amy Faith Ho, MD

Physician

June 23, 2018

We live in incredible times.

A time when a millennial with a YouTube account clears six-figures a year (sometimes, seven figures!) with just a computer and a webcam.

A time when a small-town girl with a love of fashion and an Instagram account can go from Nowheresville, America to front row at New York Fashion Week.

A time when the shy girl in the back of the classroom amasses a following of hundreds …

MKSAP: 30-year-old woman with systemic lupus erythematosus

mksap

Conditions and Diseases

June 23, 2018

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 30-year-old woman is evaluated during a follow-up visit for systemic lupus erythematosus. She was diagnosed 3 months ago after presenting with pericarditis and arthritis. She was initially treated with prednisone, 40 mg/d, with improvement of her presenting symptoms. The prednisone has been tapered over 3 months to her current dose of 10 mg/d with …

Is altruism killing medicine?

Anonymous

Physician

June 22, 2018

Altruism is killing us. Take a second to let that sink in. Truly think about it. Resist your conditioning to refute this claim and try to apply it to your life. Still having trouble? Let me try to explain.

In order to understand the truly destructive force of altruism on medicine, one must first define altruism. This can be difficult to do in the United States as any “good” or “charitable” …

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Is altruism killing medicine?

What happens to the health of children taken from their parents at the border?

Maria Perez-Johnson, DO

Physician

June 22, 2018

It’s a Sunday evening in a local South Texas emergency room with the expected ER traffic for a weekend evening. Lots of simple traumas: ankle sprains, abrasions, lacerations, falls, common URI symptoms, and fevers.

The EMS radios in with a call of a five-year-old male who has altered mental status. The patient is brought in around five minutes later and placed in an open emergency room. The patient is accompanied by …

Why this mother is still a surgeon

Kerianne Holman, MD

Physician

June 22, 2018

Why does she work? It’s a question that she must answer, for it begs itself every time she picks him up from daycare.

She always finds him happy there. And yet that — selfishly? — is part of what tears at her. Shouldn’t she be the one making him happy at 11 months?

It’s more important to her than any other role that she plays – she wants to be everything that …

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Why this mother is still a surgeon

You are never just a primary care physician

Ronald A. Zent, MD

Physician

June 22, 2018

I am frequently asked what I do at social gatherings. My response, naturally, is that I am a physician. The individual then asks what your specialty is and I respond that I am a board-certified family physician. Then, I hear, “Oh, you are a GP.” Really! After all these 35 years, I am perceived as just a GP. “Just” is the key word at social gatherings — implied or stated.

Well, …

Family therapy via medical missionary work

Belen Gallarza-Wilson, MD

Physician

June 22, 2018

The initial doubts first surfaced mid-way through our flight bound for Montego Bay, Jamaica. In fact, we were not entirely sure that this trip was such a good idea after all. Our eldest son, 13 and in eighth grade, was already complaining about how much school he was missing and how much homework he had been assigned. Our daughter, a sixth-grader prone to procrastination, had her nose buried deep within …

Your greatest financial asset? Your spouse.

Cory Fawcett, MD

Physician Finance

June 22, 2018

Often a stay at home mom, like we have in our house, is not thought of as a contributor to wealth. Too often, only the person who “really” works and brings home an income is considered to be generating wealth. This is a case of incorrect thinking.

The non-working spouse is a very big factor in attaining wealth. In the book, The Millionaire Next Door, the spouse is considered one …