Anonymous

These articles are written by anonymous clinicians. They have been selected and edited by Kevin Pho, MD.

Will lung cancer screening CT become standard of care for smokers?

Anonymous

Conditions and Diseases

August 28, 2013

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 …

Stop prescribing benzodiazepines for anxiety

Anonymous

Medications

June 14, 2013

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 …

LGBT health care equality: Be your patient’s advocate

Anonymous

Medical Education

May 12, 2013

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 …

I’m addicted to prescribing pain medications

Anonymous

Physician

April 25, 2013

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 …

Lawmakers shouldn’t care about the personal hardships of doctors

Anonymous

Health Policy

April 4, 2013

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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 …

Medical students need to learn to be patients

Anonymous

Medical Education

March 3, 2013

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 …

From Mom: Here’s what it takes to be a great doctor

Anonymous

Medical Education

January 31, 2013

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 …

How gross anatomy changes you forever

Anonymous

Medical Education

October 21, 2012

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 …

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How gross anatomy changes you forever

Doctors who prescribe too many antibiotics: It’s not that simple

Anonymous

Medications

August 15, 2012

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) …

The reasons our future doctors are choosing medicine have changed

Anonymous

Medical Education

June 8, 2012

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 …

Listening is what a patient needs most

Anonymous

Medical Education

May 29, 2012

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 …

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Listening is what a patient needs most

Medical residents are abused more than Chinese factory workers

Anonymous

Physician

April 23, 2012

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 …

Use social media for MCAT help and to get into medical school

Anonymous

Medical Education

April 11, 2012

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 …

Why full code should not be the default status for patients

Anonymous

Physician

March 30, 2012

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 …

Physicians should rise up against mandated transvaginal ultrasounds

Anonymous

Physician

March 29, 2012

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 …

Bias and error are rampant in medical literature

Anonymous

Physician

March 18, 2012

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 …

What medical education can learn from homeschooling

Anonymous

Medical Education

March 10, 2012

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 …

Doctors need to stop being so complacent

Anonymous

Physician

February 24, 2012

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 …

Why physicians may not buy into ACOs

Anonymous

Health Policy

February 6, 2012

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, …

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Why physicians may not buy into ACOs