Hospital-Based Medicine

5 mistakes hospitalists should avoid when starting a locum tenens position

Physician

June 15, 2018

For the last 8 years, I have worked as a locum tenens hospitalist. I began on this path when it was the least popular option upon graduation from residency.

I did countless hours of research trying to find accurate information about locum tenens companies, but never found anything written by physicians, only by the companies themselves. So, I stepped into this field blindfolded and learned the hard way. Since then, I have …

The worst enemy of a doctor should never be another doctor

Edgardo Olvera Lopez, MD

Physician

June 14, 2018

“The worst enemy of a doctor is another doctor,” said one of my professors during rounds when I was doing my internal medicine clerkship as a third-year medical student.

I remained skeptical. That did not match the idea of becoming a doctor nor did it support what Dr. Pellegrini said: “Medicine is the most humane of the sciences.”

Nonetheless, my old professor explained that when it comes to patient care planning and …

7 habits of being on call

Angela Seabright, DO

Physician

June 11, 2018

1. You sleep when you can. Despite what medical television dramas portray, call room beds are for sleeping. Period. As you curl up into the bed you have no idea whether you are about to get a couple hours of sleep or a couple of minutes, but in that moment of sheer exhaustion, the drab hospital cot or bunk suddenly transforms into a luxurious sleeping pad. Bonus if you can …

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7 habits of being on call

5 ways to live through medical malpractice lawsuits

Stacia Dearmin, MD

Physician

June 8, 2018

Nothing troubles physicians more than an unforeseen outcome and a malpractice lawsuit. It cracks open self-doubts and assumptions about medicine and may be life-changing.

It commonly fuels burnout, loss of confidence, PTSD and early retirement. And there are links to depression and physician suicide.

There’s another side to this story, though. Like all of life’s great challenges, a patient’s unexpected loss, and professional litigation present us with huge opportunities for growth.

I am …

Here’s why I left nursing

Sarah E. Jorgensen, RN

Conditions

June 5, 2018

Leaving the nursing profession is bittersweet. My heart left nursing a while ago when I came to the realization that nursing left me first. It never was a two-way relationship. The profession left me without acknowledgment of work-related stress, specifically post-traumatic stress (PTS).

First responders and emergency workers often hear the phrase, “It’s just part of the job.” So we all just deal with it — or not. I’ve heard this …

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Here’s why I left nursing

The caste system is thriving in medicine in the U.S.

Pramod Theetha Kariyanna, MD

Policy

June 4, 2018

On my morning commute as I read this NPR article, memories started flooding my brain. I could not control myself and had to write this.

My last name “Theetha Kariyanna” has its origin from a small village Theetha and added to it is my dad’s name Kariyanna (a local folk god). Back in my school days, the name was weird to my friends as the name …

It’s time to recognize the rights of medical students and residents

Thad Salmon, MD

Education

June 1, 2018

Goodbyes were confusing during my third and fourth years of medical school. Even on my way to a 28-hour labor and delivery call, I tended to say, “I’m leaving for school.” Rather quickly, my wife trained me to say, “I’m leaving for work.” I was never quite reconciled to this, as I couldn’t forget the upcoming exams and tuition costs around $30,000 per year.

For the uninitiated, “work” as a medical …

Life on the night shift at the hospital

Torree McGowan, MD

Physician

June 1, 2018

It’s 7 a.m. The hospital is just starting to wake up from its slumber, stretching arms and blinking eyes. I’m 54 minutes away from the end of another night shift.

Night shifts are curious creatures. They are a part of the fabric of emergency medicine life — one of the often hated aspects of our jobs. They steal us away from our families, cutting short bedtime snuggles and picture books so …

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Life on the night shift at the hospital

How to ask for a great letter of recommendation for residency

Ted O’Connell, MD

Education

May 25, 2018

Strong letters of recommendation are essential for supporting your residency application and matching well. This article details how to ensure you get great letters of recommendation.

Knowing what constitutes a great letter of recommendation is crucial to obtaining outstanding letters. A strong letter of recommendation clearly conveys knowledge of the medical student, how that student performed and qualities that predict excellent performance in residency. Strong letters of recommendation include the following:

How to deal with devastating criticism

Varun Verma, MD

Education

May 24, 2018

“Why don’t you just get a shotgun and blow his brains out next time? Better yet, next time stay the hell away from my patient!”

I was frozen, and the ICU attending wasn’t even talking to me. My co-intern had barely started her presentation when she met damnation. Mind you — there was a senior resident, a pulmonary fellow, and a team of nurses caring for the patient also. Yet the …

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How to deal with devastating criticism

Don’t be mean: Treat your team members with respect

Aaron Lacy

Education

May 23, 2018

“Those emergency room residents are f**king retarded!” This was the comment that rang through the workroom. I had only been on this hospital service for three days, and I was having a discussion about a patient with my attending when the on-call resident had burst into the workroom and sat down next to me. He was fuming.

“Why the f*** would they think I need to be consulted for this? Only …

Why the battle against being called a provider is probably lost

Suneel Dhand, MD

Physician

May 22, 2018

I recently needed to transfer my patient to a larger medical center for some urgent care. As I sat there in my relatively small hospital working out where they would be best served, a famous academic medical center that was not too far away, came to mind. I placed a call to the facility’s bed facilitator, who took the patient’s details from me, and was told to await a callback …

Medical residents and academic due process: Know your rights

Todd Rice, MD, MBA

Education

May 20, 2018

I recently received a call from a physician resident in the Northeast U.S. who had been notified that she would be terminated from her residency program for a “weak knowledge base.” There would be no contract offered to her for the coming academic year. She reports that her scores are no worse than several of her colleagues and that her accredited program has a history of arbitrarily dismissing residents. She …

Never undermine the work of a nurse

Nabeela Patail, MD

Physician

May 9, 2018

A few months ago a nurse I know vented her frustration at a misperception she had received several times, unfortunately. She recalled a conversation in which someone had asked her in a condescending manner if she does anything else at work besides “handing out pills.”

I became visibly irritated at this, not only was this person purposely making disrespectful comments to bring her down but was also perpetuating her own biased …

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Never undermine the work of a nurse

Your patient has judged you 7 seconds after meeting you

Suneel Dhand, MD

Physician

May 3, 2018

A doctor is working down their long list of patients, powering through the day, striving to use their skills to get them better. Some of the patients will be follow-ups who they already know; others will be brand new patients, who they are meeting for the first time. Of course, the job of any doctor is first and foremost to heal their patient in whatever way they can. That’s what …

How to give patients bad news

Paul Bunge, MD

Physician

April 30, 2018

I would like to give some tips to younger doctors regarding how to tell your patient that he is going to die. Your approach should also incorporate your unique personality, as well as published literature and other resources.

For your first case, watch someone more senior tell the patient. See what you think worked and what could be improved. When it is your turn, make sure to have …

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How to give patients bad news

Why is it difficult to be a doctor?

Peggy A. Rothbaum, PhD

Physician

April 30, 2018

As part of the interview for my book, I asked why it is difficult to be a doctor. Some of it has to do with integrating information and making decisions.

“The public thinks that we know more or can do more than we can. Ultrasounds don’t mean it’s a perfect baby. All of the tests and technology moves so fast that we don’t know what we see.” A doctor explained, “You cannot know …

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Why is it difficult to be a doctor?

Are you an artisan or just a medical professional?

Charles Dinerstein, MD, MBA

Physician

April 28, 2018

Take a moment to ask yourself the following:

1. Did I come to practice medicine because it was a calling, rather than a possibly lucrative career path?
2. Do I consider the practice of medicine primarily an art, a craft and the consistent application of evidence-based care?
3. Do I respond to inner measures of prideful work more than the appeal of external motivators?
4. Are there lines that cannot be crossed, even if …

Oh, are you a nurse? The physician gender bias

Karen Tran-Harding, MD

Physician

April 26, 2018

A man and a woman step into an elevator wearing the exact same hospital scrub uniforms. The man’s pager suddenly starts beeping, and the stranger in the elevator says to him, “Do you doctors really still use pagers?” The stranger then notices the women next to him and asks her, “Oh, are you a nurse?”

It’s something that has happened to every female physician. It’s not that we mind getting mistaken …

A medical intern’s 3 greatest fears

Kirk Sidey, MD

Education

April 19, 2018

A 76-year-old gentleman with a history of kidney failure, myasthenia gravis and recently diagnosed with esophageal cancer presented for evaluation of melena and hypotension.

The patient was my first admission to the medicine team as an intern, and he was as near to an ICU admission without actually being admitted to the ICU as one could come. After examining the patient, I briefly staffed with the busy attending physician, placed the …

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A medical intern’s 3 greatest fears