Hospital-Based Medicine

The public’s unrealistic expectations about CPR

Physician
March 19, 2018

A survey of 1,000 volunteer adults found 71% regularly watched medical television dramas, but only 12% said the shows “were a reliable source of health information.”

The participants were given some brief vignettes describing scenarios where CPR was administered: a 54-year-old who suffered a heart attack at home and received CPR by paramedics, an 80-year-old with a postoperative cardiac arrest in the hospital after surgery, and a post-traumatic arrest in an …

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Communication skills: a tale of 2 doctors

Physician
March 18, 2018

There are two doctors working at the local hospital. They are both around the same age, been in practice for several years, and in the same specialty.

Dr. Cooper grew up in Ohio and went to medical school in California, before moving to New York after his residency training. Dr. Steele grew up in Michigan, where he also went to medical school, before completing his residency in Florida, and then ending …

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Intern year is still universally hard. Intern year is also universally great.

Physician
March 17, 2018

4:00 p.m. Right on time.

I am walking down the street with my brother on his first visit to me in residency; I’m only two weeks in.

I turn to him: “Wait a second.”

I place my hand on the cement wall next to us, and I start to heave.

“Um … are you OK?”

“Yeah. No worries. My body’s just adjusting.”

I go on to describe how every day at 4 p.m. after a 24-hour …

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10 tips for surviving and thriving throughout your partner’s residency

Education
March 13, 2018

Your partner’s residency is hard for you both, but it is possible to both survive and thrive throughout it! Finding happiness and success while your partner is in residency comes down to a handful of simple lessons, at least in theory if not in practice.

1. It’s your residency, too. It’s a simple but powerful departure point: residency is both your partner’s job and a significant period in your life together. Your …

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A physician’s faith in God

Physician
March 8, 2018

My testimony is quite an odd one, similar to my professional journey.

I came to believe in God on a medical mission trip in Honduras when I was about twenty-one years old. A staunch atheist at the time, I was interested in beefing up my medical school application. A local church donated thousands of dollars for my college group’s mission trip; I was stunned. I had never even attended church! Finally, …

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HIPAA: Are you in violation?

Physician
March 7, 2018

HIPAA (Health Information Portability Accountability Act of 1996) is the privacy care act involving electronic transfer of records so that the identity of a patient remains unknown. It includes any electronic, written or oral transfer of information. When I was a kid, there was no such thing. As a grown-up medical professional, you are surrounded constantly by HIPAA. Charts are placed on doors, so the names are hidden, instead of …

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If academic medicine is to avoid becoming academic, it must prioritize patient care

Physician
March 6, 2018

One of the definitions of “academic” is the following: Not of practical relevance; of only theoretical interest.

When we look at the term academic medicine, sadly the descriptor “academic” increasingly falls under this definition.

To be fair, there have been some wonderful scholars in the field of medicine: Semmelweis, Fleming, Salk, Sabine, Starzl, and Marshall to name a few. And these few were not readily embraced by their peers in medicine. Barry Marshall was ridiculed …

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Is your spouse experiencing physician burnout?

Physician
March 5, 2018

Many things in life can only be truly appreciated once reflected upon — like the onset of dementia, depression, and cancer, just to name a few. This got me thinking about the onset of burnout and how the true presentation in life is quite different than reading about it.

The term “burnout” is often thrown around loosely but is an actual syndrome comprised of the progression of “exhaustion, cynicism and reduced …

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Medicine systematically disadvantages women physicians at every stage of their careers

Physician
March 5, 2018

When my friend was in her fourth year of medical school, she and her boyfriend sat down with their dean to discuss their residency applications. Both have since gone on to have successful academic medicine careers, but on that day in the dean’s office, they were nervous. My friend asked the dean for reassurance.

“I’m sure it will all work out,” she recalled the dean saying. “After all, in 20 years …

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The unjust prosecution of physicians is not unique

Policy
February 28, 2018

Dr. Pramela Ganji had just finished her lunch when she was told that the appellate court had reversed and vacated her conviction.  At first, she didn’t believe it.   

After all, this whole experience had been surreal.  Dr. Ganji, a 68-year-old well-respected medical doctor and married mother of 3 children, had practiced medicine for 40 years without incident.  Her patients loved her, and she had dedicated her life to helping others. …

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Physicians don’t know everything, and that’s OK

Education
February 27, 2018

Physicians face a host of challenges in practice, but the one that looms largest is often this — they don’t know everything.

It would be tempting to think that they do. As patients, we want them to. We want our doctors to tell us that they know what’s wrong and how to fix it. Medical mysteries are fun on television, but in our real lives, they’re profoundly unsettling and can have …

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Radical realism: A hospice doctor prepares for death

Physician
February 26, 2018

Bruce Wilson, MD, is a hospice doctor and former cardiologist who was diagnosed with pancreatic cancer in February of 2017. In the months that followed, he publicly discussed events as they unfolded on a CaringBridge blog. The irony of the situation was profound: a hospice doctor being handed what some consider a death sentence. A physician who dedicated his career to changing the conversation about end of life care now …

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When a patient dies, do you cry?

Physician
February 24, 2018

Apparently, I wanted to become a doctor since I was four. My mother tells the story of me getting ready for bed and simply saying: “Mommy, when I grow up I want to be a doctor so I can make people better.”

This notion stuck with me, and, luckily, I took a liking to biology, anatomy and all the sciences throughout school making my little four-year-old dreams come true. And now, …

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5 lessons every woman doctor must learn

Physician
February 24, 2018

Recently, I wanted to find some inspirational articles for female doctors. This letter to the young female physician by Dr. Suzanne Koven was one of the first things I came across. I wish someone had written me a letter when I was young and dumb and entering internship. Maybe it would have been a good warning. I mean, I was clueless about what lay ahead. I …

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Influencing your resident evaluations for success

Education
February 21, 2018

Performance appraisals are an integral part of an organization’s assessment of employee and trainee standing. Management and human resource literature is full of analysis and debate regarding how to best rate subordinates. Regardless of evaluation system utilized, some of the common goals of individual appraisals are to monitor progress, identify areas for growth, set goals, guide development, provide and elicit feedback through open communication, and document issues that may require …

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Are all of those morning labs really necessary?

Physician
February 18, 2018

After a complicated stay in the hospital, my patient was finally ready to be discharged. After all he had been through, I was excited to tell him the good news.

“You will be leaving this afternoon,” I said, heartened by the smile I saw spreading across his face. He thanked me, and then said something that made me cringe.

“Finally! I thought you guys were going to keep sticking me with needles …

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How to get back into the medical workforce if you’re a mom

Physician
February 16, 2018

As women in the medical workforce increase, women physicians are faced with the unique position of training the hardest they ever had in their lifetime cutting into precious childbearing years. Many women physicians seek time off or engage in part-time jobs to address the dilemma of fulfilling the obligations of their careers while enjoying the tender years of their babies. Others pursue non-clinical routes such as medical chart reviews or …

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Why are there vending machines in hospitals?

Policy
February 16, 2018

Why are there vending machines in hospitals? This seems like an odd question to ponder, and it certainly would seem to have nothing to do with the current state of medicine and health care in our country. But it is a question that I am having a hard time wrapping my brain around. Certainly, most hospitals do have vending machines that sell snacks and soda, and they are by no …

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