As a medical scribe working with a large, well-known scribe company, unnamed to protect my job, it makes me proud reading all the articles published about how much having a scribe benefits a physician, especially in the emergency department. I enjoy my job immensely and I am grateful for the opportunity to learn and engage in patient care. However, as a …
The disturbing confessions of a medical scribe
It’s 11:00 a.m. when we finish listening to a somewhat pointless series of talks from various medical school administrators on interview day — one on financial aid, one on the medical curriculum, another on the school’s student organizations. It’s time for the medical school tour. All the applicants rise from their seats in unison, button their suit jackets, pat down any newly …
How to stand out as a medical school applicant
I have been actively engaged in the clinical practice of radiation oncology for the last 40 years, and over the last 10 years have been asked to participate as a radiation oncology expert witness in a variety of medical malpractice cases. Radiation therapy, together with surgery and chemotherapy, is one of the major cancer treatment methods. It is estimated that 50-60% of all cancer patients seen in the USA receive treatment with …
A physician expert witness speaks out
Dr. Cheryl Bettigole, a New Jersey-based family practitioner and a National Physician’s Alliance board member, has written an interesting editorial in the New England Journal of Medicine in which she states she is no longer surprised when laboratories charge her patients $1000 or more for a Pap smear.
According to Dr. Bettigole, the reason for the exorbitant charges are not the actual Pap smear itself (although she does mention the fact liquid-based preps …
The $1000 Pap smear: A pathologist responds
As a nursing student, I have always enjoyed the opportunity to see firsthand new procedures, treatments, wounds, and wound care on patients. Many of the patients were older and resided in the nursing homes where we conducted our clinical rotations. It was not unusual for several of us to gather around a patient while the wound care nurse or doctor cleaned, debrided, and dressed a pressure ulcer. For us students, …
Our patients are more than the sum of their parts
Lung cancer screening CT took its most important step toward widespread implementation last week when the U.S. Preventive Services Task Force (USPSTF) released a draft of its forthcoming recommendation that the 9 million U.S. people meet entry criteria for the National Lung Screening Trial (age 55-79, with 30+ pack-years smoking history and quit < 15 years) should undergo yearly low-dose lung cancer screening CT.
The recommendation earned a Grade B in …
Will lung cancer screening CT become standard of care for smokers?
As a physician in a rural health clinic, I frequently see patients who complain of anxiety. The majority of these patients are in their 20s to 40s. Some have never been evaluated by a mental health professional, and many of these patients take benzodiazepines on a chronic basis. After current review, I wonder if we as primary care physicians are good at treating anxiety, or are we contributing to drug …
Stop prescribing benzodiazepines for anxiety
The fight for equality for lesbian, gay, bisexual, and transgender citizens has been a long and storied one. We have fought for rights related to family, marriage, anti-discrimination and service to our country. We have reveled in the freedom to be openly ourselves in public and have cheered as the fight for equality became a priority not only for ourselves but also for our straight allies. As Rhode Island recently …
LGBT health care equality: Be your patient’s advocate
Hi. I’m a 44-year old emergency physician. And I’m an addict.
My addiction came to light when my Press Ganey scores plummeted after I started to stand up to the chronic pain and frequent ER patients.
The fact that I have an addiction was reaffirmed when I went to my state’s Prescription Drug Abuse Summit. When I saw so many professionals from varying fields (medicine, law enforcement, pharmacy, education) assembled, I realized …
I’m addicted to prescribing pain medications
A response to Dear lawmakers: This is what it’s like to be a doctor today.
With a family and financial background that eerily matches Dr. Moeller’s, please count me as one soon-to-be physician who does not share the notion that lawmakers should spend their time being overly concerned with the demands placed on physicians or physician compensation. In fact, I find …
Lawmakers shouldn’t care about the personal hardships of doctors
Growing up, I rarely had a steady primary care physician. Every school-physical, immunization, sports injury, and sore throat was addressed with care and diligence at a family clinic affiliated with a major suburban hospital.
I opted to visit the clinic a few weeks ago for a minor concern but as I drove-in, I was attuned to the fact that the clinic I visit—my clinic—is a teaching site.
Before entering medical school I …
Medical students need to learn to be patients
My mom wrote me the following letter during my first semester in medical school. She has been a patient, and a mother/wife/sister/daughter of patients. She has been around countless doctors. Here is her take on what makes a great one.
Dear Son,
I am so very proud that you are becoming a physician and that you chose this profession, not for the prestige or the financial advantages, but because you want to …
From Mom: Here’s what it takes to be a great doctor
After a week of medical school orientation, followed by two weeks in the classroom studying cellular organelles and biochemical pathways, our class was finally going to start the centuries-old rite of passage that is human gross anatomy. For many students, it will be first time seeing a dead body. The anatomy lab is where future surgeons will make their first cut with a scalpel, without the pressure of life and …
How gross anatomy changes you forever
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Physicians who liberally prescribe empiric antibiotics are often maligned as irresponsible or unthinking by condescending colleagues and policy wonks. But are these doctors actually courageous and prudent, saving countless thousands of lives every year by refusing to bend to misguided pressure from antibiotic-conserving paper-pushers?
As antibiotic resistance has emerged, many hospitals have begun requiring physicians to provide a rationale for every antibiotic dose prescribed. The Centers for Medicare and Medicaid (CMS) …
Doctors who prescribe too many antibiotics: It’s not that simple
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 …
The reasons our future doctors are choosing medicine have changed
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 …
Listening is what a patient needs most
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 …
Medical residents are abused more than Chinese factory workers
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 …
Use social media for MCAT help and to get into medical school
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 …
Why full code should not be the default status for patients
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 …
Physicians should rise up against mandated transvaginal ultrasounds
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