I shared my assessment and plan with the preceptor as she walked into the room. She cut me off, “You think this patient needs surgery?” she smirked. “He has no idea what he is talking about, don’t mind him,” she whispered loudly to the patient. I kept quiet until the patient left, and my preceptor began writing her note. I pulled up a recent research article I had found prior …
“Planned death.”
When you put it like that, this can only mean one of two things: suicide or murder. For most of us in medicine, the very idea of “planned death” seems safely outside our purview. After all, the bulk of medicine is concerned with staving off death. And the very nature of death’s uncertain timing enables practitioners of everyday medicine to take refuge in its mystery.
When necessary, we prognosticate. But …
“The Big Sick” is an intimidating name for a movie. I never know what to think when “sick” is used as a noun. Does it mean vomit? Are we referring to ailing people? Just as the name doesn’t give you much insight, neither does the beginning of the film. It has nothing to do with illness. It’s about a Pakistani standup comedian/Uber driver who starts dating a white girl, but …
“What’s the most common missed fracture?” my supervising PA asked during my clinical rotation in the emergency department. “The second one,” I answered confidently. It was the right answer, and I surprised him by knowing it. He had previously given a lecture to my class and had emphasized this clinical pearl in such a way that I knew it was one of his favorite trick questions.
Unfortunately, I didn’t always know …
Many consider the novel the House of God, written by Samuel Shem (pen name for Stephen Bergman), to be a must-read for any physician or soon-to-be physician. A fictionalized account of his internship year, the book details how the accumulated stress, fatigue, and powerlessness of being a first-year doctor inexorably accumulates during that year — with sometimes hilarious, and but also disastrous, results.
The survival strategies of the interns in …
It is no secret that health care providers shoulder a lot of responsibility. As a whole, they take this on with both competence and kindness. Sacrificially, they go above and beyond in order to provide patients with the highest of quality care. They juggle a multitude of professional and personal responsibilities in creative and admirable ways. Meanwhile, each health care provider learns to adopt a unique combination of coping mechanisms …
Although pediatric (children’s) hospitals are not yet mandated (as are their general population counterparts) to participate in value-based contracts (VBCs), as competitive medical institutions they are very cognizant of the market changes toward value-based payment models while tirelessly seeking to increase value in pediatric health care delivery.
The push towards better alignment of payers and hospital systems continues to change the landscape of competitive health care. Children’s hospitals “are the backbone …
Our job as health care professionals is not just to diagnose our patients by applying our scientific knowledge and clinical skills, but also to be the “communicator-in-chief,” “listener-in-chief,” and “reassurer-in-chief.”
Any doctor who doesn’t fully grasp this, is not doing the best job they can or being the best doctor they can be. I truly believe that over 90 percent of our everyday job as a physician involves being a good …
Though the news at first stayed local in Philadelphia and the northeast, it’s gaining traction nationwide. ZDoggMD is on it. Bernie Sanders held a rally.
What happened? The venerable Hahnemann University Hospital, the main teaching hospital for Drexel University College of Medicine in Philadelphia, is bankrupt and will soon close its doors after more than 170 years as a safety-net hospital serving inner-city patients.
Why should we care? After all, there …
Physicians and health care providers across the world are trained to treat disease processes and disease states. Often, this approach becomes technical. And while directed towards the patient, it paradoxically distances itself from the patient. The distance created between the patient and the physician through diagnostic and therapeutic approaches is related to the patient’s dissatisfaction with their medical journey.
Being sick and ill, whether it is a major or minor illness, …
A guest column by the American College of Physicians, exclusive to KevinMD.com.
In the late 1800s, William Osler stated, “… if you want a profession in which everything is certain, you had better give up medicine.” He made this observation at a time when the science underlying health care was nascent, and little was understood …
Recently, thousands of new residency and fellowship graduates have earned their wings and will be, mostly metaphorically, hanging out their shingles. Sadly, though, as the excitement of finally finishing training after decades of schooling wears off, even great work can become routine.
There is a parable about three men laying bricks. When asked what they were doing, the first man said, “Laying bricks.” The second man said, “Building a church.” And …
When I decided to become a doctor, little did I know that medical school and residency would be like a hazing for future physicians. We are broken down mentally and physically and then remade in the image of the “strong” doctor and to admit to being sick is equivalent to being weak. We are publicly shamed for admitting we don’t know the answer to daily pimping on morning rounds. We …
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Locum tenens is a great way to make a living or earn some extra income. But frankly, there are some groups of physicians who should not even consider doing locums work. When you pair the right person with the right job, you can get employment bliss. But when the wrong person takes a job, both the employer and the employee are often unhappy.
I believe everyone should enjoy the work they …
Health care is a tough job to work in — whether you are a doctor, nurse or any other professional. We are dealing with matters of life and death, our patients expect (and deserve) the best from us, and we always have a hundred-and-one things to do at the frontlines of medicine. I remember reading somewhere when I was a teenager that a career in medicine would be a “mentally, …
Reuters recently published an article on skilled nursing facilities and post-hospital stays. They discussed the often-lengthy time between hospital discharge and the patient being seen by a physician or “an advanced care practitioner.”
Older, more infirm and cognitively impaired patients tend to be seen later than other patients. The later you are seen, the more likely it is that you will be sent back to the acute care …
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If you’re done with your residency or fellowship, you’ve paid your dues. And I am excited for you. Life is about to get better. A lot better.
If you read my prior article about going unmatched, you know that things have not always gone smoothly for me. But now, after a reasonably good first year out of training, I feel compelled to reflect on why things are going well, and also—to offer any …
A piece of advice I would give to any younger physician, especially one who is just graduating residency, would be to expect a whirlwind ride into the realities of frontline medical practice. It’s something that you are totally not prepared for in the controlled environment of education and residency training. A steep learning curve awaits you once you start practicing medicine. And one of the biggest things you will have …
We’re all gonna die.
It’s a simple truth that an astounding number of people neglect to acknowledge or accept. Some people die sudden, unexpected deaths, but most eventually fall victim to chronic or terminal conditions like COPD, heart failure or cancer. As a palliative care physician, I often meet patients who have had conversations with their families about their end of life wishes and have completed supporting legal documents.
While I appreciate …
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To my residency class:
The clock is ticking, its hands spinning around its face faster and faster until I feel dizzy and disoriented. The remainder of the academic year can be measured in days, even hours for some. The carousel is slowing down to let some off, some on. Some, like me, will remain in the saddles of their brightly painted ponies. The cheerful calliope melody becomes distorted with the change …
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