These articles are written by anonymous clinicians. They have been selected and edited by Kevin Pho, MD.
Why would anyone want to become a doctor? Seriously. Think about it, because this is a very important question for the future of healthcare in our country.
The future of medicine is somewhat unclear in this age of healthcare reform, but we do know a few things. Physician compensation is currently falling while lawsuits and malpractice premiums are rising. Doctors must see many more patients in a day to maintain their …
Hard time is here
And ev’rywhere you go
Hard times is harder
Than th’ever been befo’
The opening lines of a century-old Delta blues song rings out among the stars and the dark of a rural Virginia night. I sit tenuously awake atop an old wooden stump in front of a farmhouse, where four minds sleep peacefully inside. It is 3:00 am. From the window, I hear the sound of the needle dragging …
Medical residents have fewer labor protections than Chinese factory workers. While labor abuses at Apple’s factories make headlines, few people are as concerned about the lack of protections for doctors and medical students here in the United States. As a resident, I was subject to some of the worst abuses – intentionally misreported time sheets and gender-based discrimination – and after I complained, I was fired, so I sued the …
How many students enter college and immediately proclaim that they are “pre-med?” Often this declaration is accompanied with an already well thought-out choice for his or her future specialty. This incredible ability to see into the future must be hereditary, as I have had 3 or 4 different parents tell me about how their kids are going to have to choose between medical school A and B, and/or how Johnny …
Full code is the universal default status for patients who haven’t chosen otherwise, but I suspect most physicians believe this policy is wrong. We know in our hearts we’re doing harm when we perform CPR on poor souls at the natural end of their lives, whose bodies can do nothing more than suffer.
Appropriately timed end-of-life discussions are the supposed answer, but for doctors, they are emotionally draining, interpersonally complex, and …
Where is the physician outrage?
Right. Here.
I’m speaking, of course, about the required-transvaginal-ultrasound thing that seems to be the flavor-of-the-month in politics.
I do not care what your personal politics are. I think we can all agree that my right to swing my fist ends where your face begins.
I do not feel that it is reactionary or even inaccurate to describe an unwanted, non-indicated transvaginal ultrasound as “rape.” If I insert any …
A heretic essay in JAMA by Vinay Prasad (Northwestern of Chicago), Adam Cifu (U. of Chicago) and John Ioannidis (Stanford) should be required reading for every medical student and resident and to pass any board certification exam in any specialty … in my humble opinion.
John Ioannidis became one of my personal heroes with the publication of his great paper in PLoS Medicine, “Why Most Published Research Findings Are False,” and its …
My wife and I met in medical school. Both of us went “straight through” from high school to college to med school. So, like most of you, we are as educated as it gets.
But when our daughter reached “school age,” we decided to homeschool her. My son, who is two years younger, followed in his big sister’s footsteps, so we are now homeschooling both of our children.
Unlike our traditional paths …
Four brutally honest declarations:
1. I can perfectly decide what is best for myself, my family, my patients, and my practice. I don’t need outside guidance telling me how to lead.
2. I decide what works best on my terms to practice the best medicine.
3. I will succeed and lead because I am focused on my goals just as much (if not more) than my patient’s goals.
4. My goal is to make …
Lots of pressure out there for you to be on Facebook and Twitter, right? The ultimate question is, how are you using Facebook and Twitter to support your goals? Are you connecting with patients? Are you reaching out to peers and friends? It is great to have a big following, but does that turn into real, authentic meaning for you? If you are like most doctors, the answer is a …
I’m sure Ezekiel Emanuel hates being referred to as Rahm Emanuel’s brother, so I won’t describe him as such. After working as one of Obama’s main health care advisors, he’s now at U-Penn in a job spanning medicine, economics, and ethics. He’s also been writing engaging essays in JAMA about health care reform and economic change that give us an augur into where health care reform might lead us.
Here, …
Jack and John are identical twins but have varying interests in life. One day Jack, 43 years old, decides he has had enough of these headaches and calls his family doctor and asks what he should do. He is told that his doctor can see him in 4 days and to take some over-the-counter ibuprofen. And to go to the ER if the headaches worsen.
John, who has also been having …
I am a little fish in a big sea. And so are most of us. Or we are used to be. For better or worse, the era of private practice, outpatient medicine as we know it, is ending.
And faster than we thought. The choice now: downsize or supersize. No longer can a doctor operate a private practice as a solo practitioner or in a small group practice. We are getting …
“I don’t need no doctor ’cause I know what’s ailing me.
He gave me a medicated lotion
But it didn’t soothe my emotion.”
-John Mayer
If someone asked you to draw your image of medicine, what would you sketch? Would it be a person wearing a long white coat with a stethoscope? Would your picture be set in a hospital room, the ER, or the office setting? Would there be any patients in your …
Why is a trip to the doctor’s office more like going to the DMV than to Disney World? Both the DMV and Disney World involve waiting in long lines, but Disney has made the entire experience fun and exciting, while the DMV has made it cold and frustrating.
“But medicine is different,” you may say. After all, seeing the doctor was never meant to be a fun or exciting experience. When …
Being a physician certainly biases how I view the world around me. I can’t help but think in terms of problem-solving and healing. But have you noticed how medicalized our society has become? The other night watching television, we watched at least four drug commercials and one health insurance commercial — during a half-hour show! I believe we are in the middle of the medicalization of America, and I don’t …
All medical students and residents, those with any sense of introspection anyway, wonder if we (they) should be on the front lines. We wonder if we should be meeting, examining, trying to diagnose and treat families and children when we know that an experienced clinician just around the corner or in the next room could see the patient, perform the procedure faster and with more panache than our feeble …
Always covered by an employer health plan, I had never given a thought to prescription costs – my medications had been covered by moderate copays. This changed when I retired and enrolled in Medicare (and a Medicare Part D plan).
Just prior to retirement, my eyes suddenly began tear and swell so much that it impacted my vision. The eye doctor diagnosed an allergic reaction and prescribed prednisone drops to …
con·nect (from dictionary.com)
verb (used with object)
1. to join, link, or fasten together; unite or bind: to connect the two cities by a bridge; Communication satellites connect the local stations into a network.
2. to establish communication between; put in communication: Operator, will you please connect me with Mr. Jones?
To connect with your patients is truly the key solution.
Connect takes on two meanings:
I am an enigma. I always have been. Some doctors think of me as a challenge while others make it clear they dislike dealing with my case. I’ve had gastroparesis since I was born. Idiopathic gastroparesis. I’ve had debilitating migraines since I was 3. Idiopathic migraines. I’ve had several-month bouts of low grade fevers for years. Idiopathic fevers. Over the past 6 months I’ve started going into anaphylaxis. Idiopathic anaphylaxis.
Every …
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