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Sometimes not doing surgery makes you a better surgeon

Physician

November 28, 2017

Having been surgically trained and surgically-minded, I’ve had expression ingrained in my psyche such as “a chance to cut is a chance to cure,” “when in doubt, cut it out” and “nothing can heal like cold, hard steel.” Indeed, as a surgeon, I see patients in my office and in the hospital with the specific question of whether or not surgery is indicated, what type of surgery and how urgently …

Health care professionals need balance

Nathalie Martinek

Physician

November 28, 2017

There are highs and lows in doing any job and throughout one’s career. The highs, and the possibility of highs, can often overpower the effect that the low moments have on well-being and professional satisfaction.

The health care context is no different. But unlike most professions, physicians, nurses and other health care workers are exposed to a higher frequency of distress, pain, suffering, death and trauma and all the accumulated personal …

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Health care professionals need balance

Compassion and empathy can solve so many of the pains that arrive in the office

Gil C. Grimes, MD

Physician

November 28, 2017

There she was — compassion. It had been so long since I had caught sight of her, I wasn’t sure at first if I recognized her. Had she had changed so much over the years or had I? She was peeking around the corner checking in to see how I was doing. I am surprised she still visits me, after the way I treated her all those years ago. If …

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We must ask patients obvious questions

Weijie Violet Lin

Medical Education

November 28, 2017

Four o’clock on a Friday afternoon is an anxiety-inducing time to be running behind in clinic as patients and staff both begin to show signs of wanting to leave. After finishing with a particularly complicated case involving chronic pain with multiple spinal and abdominal surgeries, I rushed into the room of the patient scheduled for 3 p.m. frazzled. The patient was an elderly man, seated with arms folded, looking sternly …

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We must ask patients obvious questions

Here’s how to win the opioid war

Dr. Leonard A. Sowah

Medications

November 27, 2017

Trump recently declared a national public health emergency. In this statement he was not talking about HIV or hepatitis C nor was he referring to the increased incidence of gun violence in the country. The president’s statements focused on a very different public health problem; he was talking about America’s high incidence of opioid-related deaths mostly from overdose.

This declaration has been met with various pronouncements including …

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Here’s how to win the opioid war

Is there danger in hoping too much?

Darrel Moellendorf

Patient

November 27, 2017

According to Hesiod’s version of an ancient Greek legend, because Pandora has opened a jar stuffed full of evil by the Olympian gods, “countless plagues, wander amongst men … earth is full of evils … Diseases come upon men continually by day and by night, bringing mischief to mortals silently.” Curiously that jar was closed before hope was also allowed to escape.

Is the legend an expression of how bleak the …

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Is there danger in hoping too much?

The hidden threat of the 80-hour resident workweek

Anonymous

Medical Education

November 27, 2017

In an article published by the Atlantic earlier this year, Ryan Park writes that neither truck drivers nor bankers work the kind of gruelingly long hours that doctors — particularly young doctors in their residency programs — do. It is no secret that residency life is demanding and exhausting. Over the last decade, it has also become controversial. Almost a test in itself, as if gauging doctors’ …

Do children need to exercise their Second Amendment rights?

Jarret Patton, MD

Health Policy

November 27, 2017

Over the past several years there have been numerous reports on the rates of death and injury in children with firearms. In fact, a 2-year-old child recently accidentally took his own life in Philadelphia recently. Although the studies don’t entirely agree, two things are certain; 1 death is one too many and children don’t need to exercise their second amendment rights.

The United States has by far the highest rate of …

It’s time to stop prejudging your patients

Melissa Welby, MD

Physician

November 27, 2017

Recently I had an interaction online with a physician regarding his thoughts on ADHD treatment. (Let’s call him Dr. Stigma). This post is not about doctor-bashing but more to point out the prevalence of stigma against those with a psychiatric diagnosis even from within the medical community. Stigma, unfortunately, is so indoctrinated into our culture that sometimes people don’t recognize the pure ugliness of their words.

Dr. Stigma’s comments:

Many patients use …

Medical education must be patient-centered

Christian Rubio

Medical Education

November 26, 2017

“I know you think your organization is patient-centered … but it really isn’t.”

The statement from a rare disease foundation president to a room full of industry partners stung as we observed a candid but cordial exchange about what “patient-centered” has come to mean in today’s health industry world. Everyone knew what they were hearing was right.

Rewind a few days to the CBI Independent Medical Education and Grants Breakthrough Summit, where …

Physicians must embrace the business side of medicine

Davis Liu, MD

Physician

November 26, 2017

“Does physician leadership matter?” asks cardiologist and author Dr. Sandeep Jauhar in his New York Times opinion piece “Shouldn’t Doctors Control Hospital Care?” He opens his piece with the termination of the elected leaders of the medical staff office at the Tulare Regional Medical Center due to poor performance. He answers his rhetorical question with the obvious and simple response that doctors should control hospital …

Today’s divisive political climate and our ability to treat our patients without bias

Shane Sobrio, MD

Medical Education

November 26, 2017

Politics are divisive. That should not be a shock to anyone. However, the political climate in the USA at the moment is more than just divisive. Lately, I have noticed that there is an underlying disdain for those we disagree with in a way that even my grandparents say they have never seen in this country. The current political climate pervades nearly every aspect of our society, from pop culture …

Attending physicians should not pass down their impressions of trainees

Cherilyn Cecchini, MD

Medical Education

November 26, 2017

In 1968, Rosenthal and Jacobsen introduced the concept that expectations in the classroom can positively or negatively affect students. This phenomenon was dubbed, “The Pygmalion Effect.” Since then, there has been controversy surrounding the topic. Other authors have argued that the data was insignificant or inconclusive. From my own personal experience, having been in school for over ten years, I believe that the concept carries validity. Furthermore, I believe that …

Doctors can buy happiness by buying time

Ryan Bayley, MD

Physician

November 25, 2017

While enjoying good incomes, physicians and other health care providers chronically suffer from a lack of time. Between scheduled clinical work and being on call, it is not uncommon to have only one full day off in seven. Not surprisingly, it is far too easy to spend that entire day just trying to keep your life afloat, catching up on mundane tasks for yourself and your family that fell by …

Navigating the minefield of medical speak in your relationship

Sarah Epstein

Medical Education

November 25, 2017

An excerpt from Love in the time of medical school: Build a happy, healthy relationship with a medical student.

My dad is the oldest of four boys and my grandfather was an anesthesiologist for many years. Apparently, the women who wanted to marry into the family all had to pass the “test” of listening to my grandfather tell gory surgery stories over dinner. My mother tells me about one …

Picking up the pieces of a broken medical dream

Marteney Jacobs

Medical Education

November 25, 2017

I was in the midst of my family medicine clinical rotation when my world came crashing down. I had failed my Step 1 boards. I would never be a doctor. It was a nightmare that unfolded over three failed attempts, from which I awoke in a new reality where I was no longer a medical student — and there was absolutely nothing I could do to change that.

I poured everything …

MKSAP: 40-year-old woman with amenorrhea

mksap

Conditions and Diseases

November 25, 2017

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

A 40-year-old woman is evaluated for amenorrhea of 4 months’ duration. She has had weight gain, facial hair, alopecia, and debilitating fatigue. Her medical history is significant for psoriasis. She seems to be gaining weight in her face, abdomen, and neck. She also bruises easily. Her only medication is clobetasol for psoriasis.

On …

The lessons of Harry Potter and the Deathly Hallows

Divya Yerramilli, MD

Physician

November 24, 2017

Harry understood at last that he was not supposed to survive. His job was to walk calmly into Death’s welcoming arms … All those times he had thought that it was about to happen and escaped, he had never really thought of the thing itself: His will to live had always been so much stronger than his fear of death … It was over, he knew it, and all that …

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The lessons of Harry Potter and the Deathly Hallows

The worst-case scenario question you must ask patients: even healthy ones

Sarah Fraser, MD

Physician

November 24, 2017

The last few passengers filter in and buckle themselves up before takeoff. The emergency exit row is occupied by an elderly couple, and I am seated behind them. The flight attendant asks whether they are comfortable in those seats, given that they’d have to respond in the case of an emergency.

“Not that I expect anything bad to happen,” the flight attendant adds with a smile.

I, too, am familiar with discussing …

4 problems with the Joint Commission

Anonymous

Physician

November 24, 2017

I’m passionate about patient safety. In no small part because I was raised to be. My mom has a lot of letters behind her name (RN, BSN, MSN), and she’s dedicated her career to the field.

Before I was accepted into medical school, I knew about “six sigma,” the “Swiss cheese model” and root-cause analysis. I’d been taught about creating a culture of safety and the example of the airline industry. …

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4 problems with the Joint Commission

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