KevinMD.com

March 17, 2017Mar 17, 2017

There was a lot about that place I didn't want to see or hear. The buzzing and whirring of ventilators; the loud call bells; near-dead patients; nurses running around with IV pumps and tubes dangling along behind them; the heart-stopping…

There was a lot about that place I didn’t want to see or hear.

The buzzing and whirring of ventilators; the loud call bells; near-dead patients; nurses running around with IV pumps and tubes dangling along behind them; the heart-stopping “Code Blue” warning; or the electrical sizzle of a patient getting shocked as someone screams, “All clear!”

I didn’t want to do it.

Just a few days before, I had buried my mom.

First …

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How hospice helped my mother find peace

Medical Education

It’s time to teach residents money management skills

Taison Bell, MD

March 17, 2017Mar 17, 2017

The scene at the resident teaching session was all too familiar: Awkward silence with either blank stares or brows furrowed in deep valleys of confusion. As I scanned the room, I recognized the moment many lecturers experience: I had completely lost my audience. And, whatever I had planned for the next 10 minutes, would now be spent “taking a step back.” We weren’t talking about a crazy exam finding or …

Physician

How hospital executives wish their hospitalists would act

Leslie Flores

March 17, 2017Mar 17, 2017

Recently, I wrote a letter to hospital executives, urging them to deliberately invest their own personal time and effort in fostering hospitalist well-being. I suggested several actions that leaders can take to enhance hospitalist job satisfaction and reduce the risk of burnout and turnover. Following the publication of that post, I heard from several hospital executives and was pleasantly surprised that they all responded positively to my message. Several execs …

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Physician

Finding contentment in rural emergency medicine

Mitchel Schwindt, MD

March 17, 2017Mar 17, 2017

The frenetic pace and chaos of working in an urban trauma center are addicting -- at least for a while. Interesting, unusual, and tragic patients test the mettle of even seasoned physicians. For some, the lure is too strong to…

The frenetic pace and chaos of working in an urban trauma center are addicting — at least for a while. Interesting, unusual, and tragic patients test the mettle of even seasoned physicians. For some, the lure is too strong to step away.

For others, the attraction of a quieter life and promise of a more sane existence is too powerful to resist.

My story

After training in one of the busiest level 1 …

Physician

Today’s version of the Hippocratic oath

Paul D. Simmons, MD

March 16, 2017Mar 16, 2017

I swear by Epic, by eClinicalWorks, by Allscripts, by AthenaHealth, and by all the coders and accountants, making them my witnesses, that I will carry out, according to my ability and judgment, this oath and this indenture. To hold my…

To hold my mouse in this art equal to my own hand; to make it right-click as well as left-click; when my ACO is in need of money to share an “at-risk” portion of …

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Today’s version of the Hippocratic oath

Physician

The one immigrant who has nothing good to contribute to the American story

Sean Gallagher, MD

March 16, 2017Mar 16, 2017

To be clear, this is about one person. It warms my heart to know that people want to come and start new lives as Americans. Some of the best doctors got their education and training overseas. Not only have I worked with many of them, I’m related to three by marriage. Most people have heard of Mr. Andrew Wakefield. He used to be a British doctor before being stripped of …

Physician

It’s 2017. There’s no excuse to be disconnected.

Greg Smith, MD

March 16, 2017Mar 16, 2017

“I attribute my success to this-I never gave or took any excuse.” -Florence Nightingale I was publicly thanked today for doing my job. No, really. By two of my coworkers, actually. It sort of took me aback just a bit.…

“I attribute my success to this-I never gave or took any excuse.”
-Florence Nightingale

I was publicly thanked today for doing my job. No, really. By two of my coworkers, actually. It sort of took me aback just a bit.

Over the past Christmas holiday a couple of patients, being human as we all are, forgot to get their medications squared away before the clinic was going to close for a total of …

Physician

What does it mean to be well? Ask an opiate addict.

Casey Grover, MD and Paul Harper

March 16, 2017Mar 16, 2017

Wellness. It’s all the rage these days as we try to manage our crazy work schedules while still maintaining balance in life. We have wellness committees, wellness workshops, wellness coaches, and wellness apps for our smartphones. So, then, what does…

So, then, what does it mean to be well?

To the average person, and to the dictionary, to be well is to be “in good health” or “in a good or satisfactory way.”

However, to those suffering …

Medical Education

How to apply business to medicine

Akhilesh Pathipati, MD

March 16, 2017Mar 16, 2017

Just after I started at Stanford’s Graduate School of Business, I wrote an article on why I’m doing an MD/MBA. I argued that business school can help clinicians develop a new perspective, acquire important skills and build bridges between doctors,…

I heard from dozens of students, faculty, and physicians who supported the idea of an MD/MBA. However, a question repeatedly came up about as to …

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How to apply business to medicine

Physician

How do physician-mothers do it all?

Uchenna O. Njiaju, MD

March 16, 2017Mar 16, 2017

So, how do you do it all? It’s a Monday morning. After a flurry of activities, I am walking into the office at 8:00 a.m. I think back to the past 2 to 3 hours. I was up at 5:30…

So, how do you do it all?

It’s a Monday morning. After a flurry of activities, I am walking into the office at 8:00 a.m. I think back to the past 2 to 3 hours. I was up at 5:30 a.m., and in my workout clothes soon after. I managed to squeeze in a 20-minute workout, thanks to a video on YouTube. I then reviewed my schedule and patient charts for …

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How do physician-mothers do it all?

Health Policy

The fundamental problem with the American Health Care Act

Marshall Chin, MD, MPH

March 15, 2017Mar 15, 2017

As the immediate past-president of the Society of General Internal Medicine (SGIM), the major professional association of academic general internists, I participated in SGIM’s Hill Day on March 8, 2017. Hill Day is when an organization mobilizes its members to visit the offices of Senators and Congresspersons on Capitol Hill in Washington, DC to discuss key issues. Coincidentally, March 8 was also the day two House Committees began deliberations on …

Medical Education

A resident’s guide to being a medical student: In the OR

M. Alexandra Friedman, MD

March 15, 2017Mar 15, 2017

As a medical student, I had nightmares about my first day in the OR: scrubbing incorrectly, contaminating a sterile field, forgetting the anatomy I had so carefully studied the night before. It seemed like the only thing I could do in that artificially lit room was mess up. After a few cases I came to love the routine and ceremony of each surgery: the timeout; the rhythmic pattern of suture, …

Health Policy

The AMA’s letter on the American Health Care Act was too narrowly focused

Corey Howard, MD

March 15, 2017Mar 15, 2017

I am a member of the American Medical Association and chair the Delegation from the Florida Medical Association. As an advocate for the medical profession, I am very proud of the work that we do, but I also realize that much more is needed. In particular, we desperately need to address the growing disconnect between the AMA and the broader physician community. This disconnect is one of the key reasons …

Physician

The decisions that changed this physician’s career

Jeremy Topin, MD

March 15, 2017Mar 15, 2017

I knew the moment when my career in pediatrics was over. I was in the fourth year of my med-peds residency, taking overnight call in the pediatric ICU. Nights were busy, stressful and I was alone. A young boy came in as an unrestrained MVA after his father hit another car. Dad was OK (although severely distraught), but the five-year-old towhead boy in front of me was not, with his head immobilized in …

Physician

This the one thing that makes me feel like everything is OK

Jordan Grumet, MD

March 15, 2017Mar 15, 2017

"Too many times I feel We are losing time once shared And only when you're in ecstasy You seem to really care" I recognize the song immediately — Chuckii Booker's "Turned Away." Not the regular version, but the extended one.…

“Too many times I feel
We are losing time once shared
And only when you’re in ecstasy
You seem to really care”

I recognize the song immediately — Chuckii Booker’s “Turned Away.” Not the regular version, but the extended one. As the words rush over me, caressing my nostalgia, a memory, a moment comes back.

I was standing behind the counter at Homer’s Ice Cream on a brilliant summer morning before the doors opened. We …

Medications

The feds say restrict opioid use. Now what?

Cindy Perlin, LCSW

March 15, 2017Mar 15, 2017

The federal government has declared, through its major health policy agencies, that the number of pain patients on opioids and the dosages they are on should be severely restricted. The Center for Disease Control (CDC), Veteran’s Administration (VA) and Centers for Medicare and Medicaid Services (CMS) have all issued new guidelines within the past year to that effect. Private insurers are following suit, in many cases refusing to pay for …

Patient

My mother isn’t a drug-seeking patient. She’s in pain.

Christina Phillips

March 15, 2017Mar 15, 2017

The patient, age forty-nine, complained of abdominal pain. She was taking both slow- and fast-acting oxycodone to manage the pain, and she also took antidepressants and a sleeping aid. She’d come to the hospital several times in the past year, always with the same complaint. This time, not feeling well enough to drive, she’d come by taxi. The veins in her arms were small, threadlike and collapsed, like those of …

Physician

Improve the patient experience with anticipatory patient service

Neil Baum, MD

March 15, 2017Mar 15, 2017

How do you describe the feeling when you are at a restaurant, and the waiter sees your coffee cup at less than half full (never half empty) and without asking they refill the cup or better yet, bring you a fresh cup of coffee? If you are like most customers, you have a nice feeling about the restaurant and the waiter as they have anticipated your needs. Usually, this anticipatory …

Physician

What the Oscars can teach us about patient safety

Evan M. Benjamin, MD

March 14, 2017Mar 14, 2017

Recently, one of the biggest mistakes ever observed on live television occurred when Warren Beatty and Faye Dunaway, presenters of the award, announced the wrong film as winner of the Academy Award for best picture. Not since Janet Jackson's costume…

How could this have happened? How could it have been prevented? Moreover, what can this error teach us about how we care for patients?

A …

Physician

The great unspoken secret

Yvette Youssef, MD

March 14, 2017Mar 14, 2017

Sometimes it feels like the great unspoken secret between doctors and nurses. The words that we dare not utter to patients and families. Perhaps it is our hope that we're wrong. Perhaps, we dread providing unwanted news. Perhaps, we don't…

Sometimes it feels like the great unspoken secret between doctors and nurses. The words that we dare not utter to patients and families. Perhaps it is our hope that we’re wrong. Perhaps, we dread providing unwanted news. Perhaps, we don’t want to face reality or extinguish our patients’ hope.

As a daughter, I felt that sense of sadness and dread, waiting to hear the news that would not be told. It was September …

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The great unspoken secret

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