I just finished reading a very delightful A Piece of My Mind essay in JAMA. JAMA is primarily a research journal, filled with new scientific or semi-scientific studies and comments on those, plus reviews of the literature and editorials on science or politics. There are also letters and announcements and educational sections for doctors or patients, even poems, but the part I like to read all the way through is …
Over the last several years since I graduated from residency, I’ve worked in many different hospitals up and down the east coast. These have ranged from large urban medical centers to rural community outposts. In all of these places I’ve felt the inevitable conflict that exists between physicians and administrators — to varying degrees.
It almost seems like a rite of passage that the world of clinical medicine and administration are …
Most physicians are smart and very talented. They’re skilled clinicians and technically superb. But despite such abilities, they fail to get others to follow them, once they take on the role of leader. As a consequence, they’re unable to get physicians to change or improve performance.
Jay Conger, a professor of business at Claremont McKenna College who has devoted his career to the study of leadership, has helped me understand why …
An excerpt from Road Warrior Physician: Locum Tenens a How-to Guide.
There are few things that are more frustrating than to be delayed while en route to your assignment. It happens, so be prepared for it. Keep all travel emergency contact numbers handy. This is one of my prime Evernote …
In a few weeks, thousands of medical students find out where they have matched for residency. I still remember the excitement and anxiety of peeling back that envelope and hoping I would see my top choice. My medical school had a tradition of putting each 4th year’s name in an old doctor’s bag. One by one, our dean would pull out a name, the student would contribute $1 to the …
Recently, the wife of a prominent Boston businessman — one of my many wealthy, white patients at Massachusetts General Hospital — greeted me this way: “So what foreign medical school did you go to anyway?”
For background, I’m a petite, Middle Eastern young woman with a headscarf, and I’m guessing I do not resemble her vision of what a doctor “should” look like. That image is probably taller, whiter, male and …
It will be six months since my mother passed away.
I kept my mother’s illness a secret. Not because I was ashamed and embarrassed but I did not want to advertise to the entire world of what she was going through out of respect to her and my family. So you sit there, put on a front like everything is cool and continue on your daily routine, until one day everything …
Me: Hello Mrs. Smith, my name is [BEEP!] Dr. Gandolfo and I am a [BEEP!] gastroenterologist. [BEEP!] Your doctor wanted me to [BEEP!] talk to you about something that showed up on [BEEP!] your CT scan.
Mrs. Smith: Who are you? I [BEEP!] didn’t hear your name?
Me (louder): It’s Fred Gandolfo, I am the [BEEP!] stomach doctor. [BEEP!] I need to talk to you about [BEEP!] that CT scan you had. You see, there was … [BEEP!] [BEEP!] [BEEP!] Can you straighten your …
Mnemonics can be incredibly cool. When I was in medical school, there was just too much stuff to remember and memory aids were so very helpful. Most specifically I refer to the vile and inappropriate one that helped me remember the cranial nerves which I remember to this day and will not share in print.
In ancient times orators used memory palaces to memorize long speeches or poems, associating words with …
During medical school, we are taught the physiology, anatomy, and pathophysiology of hundreds of disease processes. One thing medical schools don’t teach well is how to cope with losing a patient. Some physicians will go many years as a physician before having their first patient die on them. Others will lose a patient earlier on during their career. I was the latter. I hadn’t even graduated from medical school yet …
Another workday comes to an end. 11 a.m. rolls around and freedom from the hospital beckons after another 24-hour call is finished. In the span of the preceding day, it is likely that numerous important decisions had to be made with the expectation that all of your mental faculties would be used, irrespective of what time of day it was or how much sleep was obtained. It is a day …
Since undergoing a double-lung transplant at the Johns Hopkins Hospital in December 2011, Podge Reed Jr. has had four medical admissions, two surgical admissions, eight outpatient procedures requiring anesthesia, more than 100 outpatient appointments, and 700 labs and other tests. He’s amassed enough experiences with the health care system to write a book. So far, though, he’s mostly kept it to two letters, totaling 12 pages, to our patient relations …
Hospital culture is largely influenced by the relationship between administrative and clinical staff leaders. In the “old days” the clinical staff (and physicians in particular) held most of the sway over patient care. Nowadays, the approach to patient care is significantly constricted by administrative rules, largely created by non-clinicians. An excellent description of what can result (i.e., disenfranchisement of medical staff, burn out, and joyless medical care) is presented Read more…
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One word: gun. That is all it takes to spark a debate between two very different camps. One end of the spectrum feels guns are an evil haunting the nation by their mere existence, and they need to be dealt with by restricting (or even eliminating) everyone’s ability to possess them. The other end believes it is a core right to keep and use firearms for sport, personal defense, collecting, etc., and that no …
As a physician, you are required to have keen senses. Touch, smell, hearing, and sight are absolute necessities for most practicing physicians while we can only hope that taste is reserved for meals and non-professional situations. I recently returned from a week of vacation in the great outdoors and found myself wishing that I had more olfactory agnosia. Olfactory is a Latin adjective from olfacere that translates “of or relating …
This story is a great one.
It’s about a female dog with only three legs. Her fourth leg was amputated following a traumatic accident as a puppy.
Now, when she walks, she has a hitch in her step. And, when she hitches, she kicks the stump of her injured leg outward.
Step, step, hitch. Step, step, hitch.
One day, the female dog has puppies. And, her puppies do what all puppies do. They nurse. They watch. …
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“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 …
In psychology, the Lake Wobegon effect refers to a mythical town where “all the women are strong, all the men are good-looking, and all the children are above average.” In other words, humans have a tendency to overestimate their capabilities, particularly in relation to others.
As a physician, I have yet to meet a fellow doc who didn’t think that their patients loved them or that they weren’t great clinicians. And …
Hospital cafeterias are important places. Great progress has been made over the last few years in raising the standard of the food served (to both patients and staff!), with much more emphasis too on making the options healthier and nutritious.
Speaking as someone who has worked in several different hospitals, and with my own general interest in health care quality and improving the patient experience, it’s always very interesting to look …
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Earlier this month I read a Wall Street Journal article about Zeynep Ton’s Good Jobs Index. Who is Zeynep Ton? She is a professor at the Massachusetts Institute of Technology’s Sloan School of Management who has ranked retailers on employee happiness. This was so positive. It was good to hear about businesses concerned about employee happiness and not just about profits and shareholders.
Two weeks later I was dismayed to …
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