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Don’t be impatient with your doctor

Health Policy

#Medicare4All won’t fix the problem

Shannon Tapia, MD

July 13, 2017Jul 13, 2017

I already know I sound like a broken record. Yet, I can’t fathom why I seem to be the only person talking about this. There have been numerous articles in both syndicated journals and the blogosphere about the many things wrong with the American health care system, including the overspecialization which we know leads to higher costs (but not necessarily better outcomes). Just as I feared, the New York …

#Medicare4All won’t fix the problem

Medical students: Don’t take the easy way

Anonymous

July 13, 2017Jul 13, 2017

Dear fellow students, I am addressing you today as a comrade, a peer, as someone who shares your concerns and understands the pressure and stress you experience in medical school. It is true that medical schools attract very similar kind…

Dear fellow students,

I am addressing you today as a comrade, a peer, as someone who shares your concerns and understands the pressure and stress you experience in medical school. It is true that medical schools attract very similar kind of people: Medical students are smart, hard-working individuals who are striving for excellence and achievements. They want to help the sick, the poor and the needy and cultivate a sustainable change …

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Resiliency training in medicine is a farce

Anonymous

July 12, 2017Jul 12, 2017

I knew that residency would be indentured servitude for (in my case) three years. I knew it. I prepared for the fear, the shaming, and the isolation as best I could. And I have for the past 11 months done…

I knew that residency would be indentured servitude for (in my case) three years.

I knew it. I prepared for the fear, the shaming, and the isolation as best I could.

And I have for the past 11 months done OK. I am not the smartest or fastest. But I am told that I am passionate about my patients and have an “adequate fund of knowledge.”

Woohoo. Adequacy!

I have had dark moments. And …

Doctors experience PTSD every day

Jeff Kane, MD

July 12, 2017Jul 12, 2017

A long time ago, when I was interning in an emergency department, several ambulances arrived at once from the site of a bombing. They unloaded three victims plus a mass of assorted limbs. As I placed an endotracheal tube in one patient, the awfulness suddenly hit me: These people had probably been sitting peacefully at home only a half-hour earlier, and now they were a mass of gore. Overwhelmed, I …

Doctors experience PTSD every day

Conditions and Diseases

Children suffer mentally, but no one helps

Jack Turban, MD

July 12, 2017Jul 12, 2017

Imagine that you come home to find your daughter in tears. She’s been acting strangely for the past year, but she never tells you what’s going on. This time she finally tells you: She can’t stop thinking about killing herself with a knife in the kitchen. After an hour of talking, you realize that she doesn’t want to die, but she has obsessive thoughts about hurting herself. She’s overwhelmed, and …

The great dilemma: Go part-time now or retire early?

Dr. Curious, MD

July 12, 2017Jul 12, 2017

Early retirement is a hot topic these days, particularly in the field of medicine. It is associated with the concept of financial independence, and together they are known by the acronym FIRE (financial independence and retiring early). In essence, FIRE means having enough saved that you can live off your investments, and no longer need to work for a salary. While FIRE is not for everyone, it is something my …

Dear intern: Some advice about your first year

Muthu Alagappan, MD

July 11, 2017Jul 11, 2017

Dear intern, It will be the best of times, and it will be the worst of times. But what a special time this will be. It will be a time of learning the details and nuances of clinical medicine —…

Dear intern,

It will be the best of times, and it will be the worst of times.

But what a special time this will be. It will be a time of learning the details and nuances of clinical medicine — the diagnostic features of sarcoidosis and the second, third and fourth line treatments for community-acquired pneumonia. You will learn how to learn, and you will forget what you learned, only to learn …

Conditions and Diseases

Impairments vs. diseases in the aging process

Stephen C. Schimpff, MD

July 11, 2017Jul 11, 2017

Part of a series. Beginning at about age 40, our bodies begin a process of organ and functional decay of about 1 percent per year. Bone mineral density decline leads eventually to osteoporosis and fracture risk, cognition decline leads to…

Part of a series.

Beginning at about age 40, our bodies begin a process of organ and functional decay of about 1 percent per year. Bone mineral density decline leads eventually to osteoporosis and fracture risk, cognition decline leads to memory and thinking impairments, and muscle decline leads to loss of strength while increasing the fracture risk of a fall.

According to the Centers for Disease Control, almost …

It’s time to stop the bullying in medicine

Farah Khan, MD

July 11, 2017Jul 11, 2017

In a recently published JAMA meta-analysis, medical students were found to have a higher prevalence of suicidal ideation and depressive symptoms than the general population. From the mental exhaustion that begins in medical school to the physical fatigue that peaks with residency, it is not shocking that medical trainees are suffering. Current discussions have ignored one of the biggest hindrances for the …

11 tips medical interns need to hear before they start

Canting Guo, MD

July 10, 2017Jul 10, 2017

When I started my intern year, I was told that I was going to be sleep deprived and it was going to be the worst years of my life. Yes, there were times I racked up a sleep debt, but…

When I started my intern year, I was told that I was going to be sleep deprived and it was going to be the worst years of my life.

Yes, there were times I racked up a sleep debt, but it was for patient care. And because of the camaraderie and relationships I formed (both inside and outside the hospital), I will forever remember residency with a smile.

Rather than the words …

Patient

Stop the war against patients with intractable pain

Angelika Byczkowski

July 10, 2017Jul 10, 2017

An open letter to doctors still prescribing opioid medication when necessary: Thank you so much for standing up for us pain patients. My chronic pain comes from a genetic connective tissue disorder (Ehlers-Danlos Syndrome), so there is no treatment or…

An open letter to doctors still prescribing opioid medication when necessary:

Thank you so much for standing up for us pain patients. My chronic pain comes from a genetic connective tissue disorder (Ehlers-Danlos Syndrome), so there is no treatment or cure for my slow, but relentless, physical deterioration as the collagen holding my body together falls apart.

I, like so many other pain patients, spent years (1982-1995) trying other therapies (yoga, acupuncture, …

Health Technology

Artificial intelligence in medicine is still a long ways off

Bruce Campbell, MD

July 10, 2017Jul 10, 2017

"Medicine is a science of uncertainty and an art of probability." - Sir William Osler Two people presented to my clinic on the same day with classic symptoms of head and neck cancer. Each reported several weeks of unilateral throat…

“Medicine is a science of uncertainty and an art of probability.”
– Sir William Osler

Two people presented to my clinic on the same day with classic symptoms of head and neck cancer.

Each reported several weeks of unilateral throat discomfort, ear pain, and a neck mass. Each was having some trouble swallowing and had changed his diet to accommodate the soreness. When they opened their mouths, each had a mass with a …

Diane W. Shannon, MD, MPH

What this physician practice did to fight burnout

July 10, 2017Jul 10, 2017

As a physician who left clinical medicine because of burnout and as a writer, I’m drawn to stories of physicians whose professional and personal lives have improved after reasoned interventions. So my ears jumped to attention earlier this month when a colleague at a summit on physician burnout described the positive results his practice had achieved in reducing burnout. Read Pierce, MD, is interim director of the Hospital Medicine Group …

Medications

Don’t blame doctors for medication nonadherence

Skeptical Scalpel, MD

July 9, 2017Jul 9, 2017

The New York Times says nonadherence to prescribed medications is “an out-of-control epidemic” in the U.S. and quotes a review in Annals of Internal Medicine, which found “20-30% of medication prescriptions are never filled, and approximately 50% of medications for…

For example, “a third of kidney transplant patients don’t take their anti-rejection medications, 41% of heart attack patients don’t take …

Think doctors make too much money? Think again.

Patrick Connolly, MD

July 9, 2017Jul 9, 2017

Lots of people write about how “doctors work so hard.” But let's look at it from an economics and value-creation perspective. I’m a neurosurgeon, so you know I do pretty well financially, but how much value am I adding to…

Lots of people write about how “doctors work so hard.” But let’s look at it from an economics and value-creation perspective.

I’m a neurosurgeon, so you know I do pretty well financially, but how much value am I adding to society? Here are a few examples:

1. A mail carrier couldn’t work because of a herniated lumbar disc. We’ll figure he makes $50,000/year. I operated on him; he goes back to work. …

Physician Finance

Don’t just learn about medicine. Educate yourself about money, too.

Zoe Smothermon, DO

July 9, 2017Jul 9, 2017

In honor of everyone graduating and moving on to the next step, let's talk about money. And by money — I mean debt because new doctors don't have any money! All we have are bills to pay! I am the…

In honor of everyone graduating and moving on to the next step, let’s talk about money. And by money — I mean debt because new doctors don’t have any money! All we have are bills to pay!

I am the one who does the finances in our household. It really happened by accident. My husband was deployed shortly after we got married, so all daily responsibilities were de facto handed off …

We’re smart doctors. But why aren’t we so smart about our health?

Jenny Hartsock, MD

July 9, 2017Jul 9, 2017

As doctors, we are good at lots of things — we are smart, efficient, hard-working, proficient, role models and leaders. Then why do so many of us place our own health and well-being after our jobs? As a physician, my…

As doctors, we are good at lots of things — we are smart, efficient, hard-working, proficient, role models and leaders. Then why do so many of us place our own health and well-being after our jobs?

As a physician, my most prevalent discussions with patients always boil down to very simple recommendations: eat right, exercise, sleep and manage your stress. Lifestyle changes are really the key to solving many of the …

Is the medical profession at its end?

James C. Salwitz, MD

July 8, 2017Jul 8, 2017

At the graveside, they still talk about judgment, intelligence, and the wisdom that is the practice of medicine. Deans and health care leaders wax poetic as they tell stories of great cures to lift in memoriam remarkable healers. Yet, though…

At the graveside, they still talk about judgment, intelligence, and the wisdom that is the practice of medicine.

Deans and health care leaders wax poetic as they tell stories of great cures to lift in memoriam remarkable healers. Yet, though we bow to Hippocrates, Osler, and Salk, the time has come to mark a revolution in human history: The art of medicine is dead.

It is not that doctors have fallen from …

Is the medical profession at its end?