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The unintended consequences of the night float rotation

Elaine Khoong, MD
Education
January 24, 2016

This past month has been a particularly difficult one for me because I’ve been on our float rotation. I have worked only night and swing shifts throughout our hospitals; this means my work hours are primarily from 8 p.m. to 10 a.m.

There are certainly other rotations during which I worked longer hours and had more emotionally draining conversations, but I have never felt as burned out as I have this …

Read more…

The unintended consequences of the night float rotation

How poor interoperability affects patients

Elaine Khoong, MD
Tech
December 17, 2015

I spent the past month working on an inpatient medicine team at our tertiary care hospital. As a referral center, we often care for incredibly complex patients who require multiple consulting services. One of the most vexing parts of caring for our patients is attempting to track their care through many previous hospital systems.

Unless a patient is both extremely vigilant about his or her medical care and highly health literate, …

Read more…

How poor interoperability affects patients

When patient-centered care becomes patient-dictated care

Elaine Khoong, MD
Physician
September 21, 2015

“I’d like an MRI for my leg pain. I haven’t had an MRI for many years, and I’m worried.”

These were some of the first words I heard from a patient I was seeing for a new patient visit. Based on this patient’s story and physical exam, her pain was most consistent with a muscle strain. My preferred approach to manage this complaint was to ask the patient to rest her …

Read more…

When patient-centered care becomes patient-dictated care

A geriatrics-driven health care system

Elaine Khoong, MD
Physician
April 29, 2015

We have all seen the statistics; America is an aging country. The baby boomer generation is retiring, and families are having fewer and fewer children.

In health care, we often hear about this issue in the context of an inadequate health care workforce. An aging population in conjunction with the ACA has created a quickly growing pool of patients that outpaces the slow growth in the supply of health care providers.

But …

Read more…

A geriatrics-driven health care system

Will the pendulum of pain management swing too far?

Elaine Khoong, MD
Conditions
March 19, 2015

They say that the path to hell is paved with good intentions. Few things in medicine illustrate that as well as how we’ve approached chronic pain management in the past 10 to 20 years.

The advances that we have made in medicine in the past few decades have been truly remarkable. But, unfortunately, pain is one of the ailments we still do not treat well. One of the difficult aspects of …

Read more…

Will the pendulum of pain management swing too far?

It’s time to train physicians to practice in nontraditional settings

Elaine Khoong, MD
Education
December 31, 2014

Despite the changes around us, the training of physicians has stayed much the same. Sure, there are new work hour limitations and a push to move towards competency-based assessments, but the overall structure of our training remains largely untouched. We spend the vast majority of our time training in hospitals, with the remaining time spent practicing in traditional outpatient clinics.

However, health care is being increasingly delivered outside these two arenas. …

Read more…

It’s time to train physicians to practice in nontraditional settings

Suicide puts the medical profession in a difficult position

Elaine Khoong, MD
Physician
October 26, 2014

shutterstock_185853248

Recently, I wrote about the importance (and difficulty) of maintaining a healthy lifestyle as a resident. Now, I’d like focus more specifically on the toll that residency — and in general, a career in medicine — takes on a health care provider’s mind and soul.

As you may have heard, in August two young physicians decided to end their lives. No one …

Read more…

Suicide puts the medical profession in a difficult position

The value of continuity clinics cannot be understated

Elaine Khoong, MD
Education
September 22, 2014

There is much talk about cynicism in medicine, and I remember being confronted by it almost from the beginning. In fact, I still remember how shocked I was the first time I heard a provider describe a patient in a disparaging matter.

We were responding to a 911 call regarding a woman in her 30s who was feeling short of breath. I remember being worried; she seemed too young to be …

Read more…

The value of continuity clinics cannot be understated

The unhealthy behaviors of physicians

Elaine Khoong, MD
Physician
August 17, 2014

As a fourth-year medical student, it was fairly easy to maintain a healthy lifestyle. When you have much leisure time and are relatively stress free, you can eat healthy, stay physically active and maintain quality mental health. However, as I begin the journey called residency, it is clear that the task of maintaining my own health will be much more difficult.

But the importance of this task should not be overlooked. …

Read more…

The unhealthy behaviors of physicians

Physicians are noncompliant too

Elaine Khoong, MD
Physician
May 30, 2014

Patient noncompliance.

I wasn’t very familiar with this term until I started my clinical rotations. But after just the first week, I started noticing that health care providers throw this phrase around all time.

We particularly like using it as an excuse. Why did this diabetic patient require a foot amputation? Why does this patient come in monthly with congestive heart failure exacerbation? Why did this patient suffer a stroke? It’s often …

Read more…

Physicians are noncompliant too

Ask if new technology will make a difference in patient outcomes

Elaine Khoong, MD
Policy
April 16, 2014

Earlier this year, I completed a medical rotation in Africa. It was an amazing, eye-opening experience. While I expected it might be difficult to acquire newer, more expensive medications and procedures, I had anticipated that, given limited resources, there would be some rationale in deciding which medications and procedures would be available. I was deeply mistaken in this assumption.

During my time abroad, I watched several patients with heart attacks pass …

Read more…

Ask if new technology will make a difference in patient outcomes

The bottleneck in ensuring sufficient primary care physicians

Elaine Khoong, MD
Education
March 3, 2014

The past few months I have joined thousands of individuals hoping to match into a residency program in 2014. I have had interviews all over the country and spent way too much time living out of a suitcase.

For many students, residency interview season is exciting. For others, it’s stressful and exhausting. But for me, more than anything else, the interview trail was inspiring.

I am currently applying to internal medicine-primary care …

Read more…

The bottleneck in ensuring sufficient primary care physicians

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  • Most Popular

  • Past Week

    • Politics and fear have replaced science in U.S. pain management [PODCAST]

      The Podcast by KevinMD | Podcast
    • Evidence-based medicine vs. clinical judgment: a medical student’s perspective

      Jay Pendyala | Education
    • The controversy over Maintenance of Certification for grandfathered physicians

      Bernard Leo Remakus, MD | Physician
    • How hindsight bias distorts clinical medicine

      Olumuyiwa Bamgbade, MD | Physician
    • When side effects are actually a cry for help with medication costs

      Shuchita Gupta, MD | Physician
    • The hidden math behind physician hiring costs and recruitment

      Timothy Lesaca, MD | Physician
  • Past 6 Months

    • The dangers of vertical integration in health care

      Stephanie Waggel, MD | Policy
    • Why does sex work seem like a more viable path than medicine in 2026?

      Corina Fratila, MD | Physician
    • The 9 laws of health care quality: Why metrics miss the point

      Constantine Ioannou, MD | Physician
    • Politics and fear have replaced science in U.S. pain management [PODCAST]

      The Podcast by KevinMD | Podcast
    • From Singapore to Canada: a blueprint for primary care transformation

      Ivy Oandasan, MD | Policy
    • How board certification fuels the physician shortage crisis

      Brian Hudes, MD | Physician
  • Recent Posts

    • Why measuring muscle mass matters more than tracking your weight [PODCAST]

      The Podcast by KevinMD | Podcast
    • Health insurance incentives and alternatives to opioids for chronic pain

      Molly Candon, PhD and Daniel Clauw, MD | Conditions
    • Independent medical practice: Why private clinics are essential

      Marcelo Hochman, MD | Physician
    • How hindsight bias distorts clinical medicine

      Olumuyiwa Bamgbade, MD | Physician
    • Do no harm: Why physician burnout requires bottom-up reform

      Desiree Francis, MD | Physician
    • Institutional distrust in health care: Why a doctor lost faith

      Joshua Mirrer, MD | Physician

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