In October of 2011, I left my job of 17 years, which I loved, mostly, and started a 2 year sabbatical. Since sabbatical implies that there is one year of rest every 7 years, I have built up at least 2 years since finishing medical school in 1986. Nobody in my office or medical community did sabbaticals, but we discussed that it would be a great idea when we first …
Medscape published an article titled, 4 Top Complaints of Employed Doctors, and it was a very interesting read. Turns out the things employed physicians complain about are basically that they are employees.
Let me lay out these employed physicians gripes for you with a little detail so you will see what I mean. I will finish this article with a solid way to address all of them. These …
Injury to the brain continues to be a unique thing in medicine. These injuries are scary and unfamiliar to many health care providers. There is a finality to them. Their consequences are hidden a little bit; the asystole is easy to figure in the emergency room but the suppression and brain death isn’t something so easily recognized.
They’re what you might imagine, along with polytrauma, as poster child conditions for tertiarization …
I sometimes explain to medical students that they are entering a profession being transformed, like coal to diamonds, under the pressure of a new mandate.
“The world is going to push us, relentlessly and without mercy, to deliver the highest quality, safest, most satisfying care at the lowest cost,” I’ll say gravely, trying to get their attention.
“What exactly were you trying to do before?” some have asked, in that wonderful way …
Being a part time hospitalist, I am frequently on overnight call in the hospital, spending the night admitting sick patients from the emergency room, or dealing with any calamities that happen on the medical floors. I would have to say the that the most dreaded events are: “Code blue” (this means a hospitalized patient in cardiac or respiratory arrest waiting to be resuscitated), followed closely by a nurse calling with: …
To resuscitate or not to resuscitate, that is the question. Whether ’tis nobler to beat the heck out of a person on his or her way out in the hope of saving his or her one precious life, or to allow death to proceed at its own pace with expectation of a peaceful passing.
The United States has come a long way in the last 2 decades since 1991 when the …
I must confess that I love my job as a hospital medicine doctor. To me, very few specialties in medicine can be as rewarding as the one I’ve had the privilege of practicing for the last five years. We manage an array of medical illnesses, interact with staff from across the hospital in every different specialty, and follow our patients all the way through their—hopefully very short—hospitalization. We take ownership …
As a physician, I experience first-hand the impact that internal communication at a hospital—both good and bad—has on patient care.
If I am able to quickly access clinical systems, analyze patient information and collaborate with colleagues, I can diagnose and interact with the patient much more efficiently and effectively. Conversely, breakdowns and inefficiencies in the communications process can inhibit the delivery of quality patient care by bogging down workflows, creating delays …
Too often patients feel like they’re in the passenger seat when entering the hospital. Even in the best of circumstances — such as planned admissions — patients often don’t feel in control of their own care.
One of the most unnecessary issues facing patients when they enter the hospital is untreated (or undertreated) pain. Often the focus of the medical team is to treat a condition, and controlling a patient’s pain …
One of the more contentious topics on my site is the scope of practice for non-physician providers, such as nurse practitioners. This echos the debate on the national stage where leaders of physician organizations, who want to protect their scope of practice, conflict with those of nurse practitioners’, who want to perform the tasks that physicians traditionally have.
Simply Google “nurse practitioner” on this site, for instance, and you’ll see …
It was bound to happen.
By “it,” I mean that the small group of specialty hospitals (usually orthopedic or cardiology-focused) across that country that are owned by doctors were going to have their “See! We Told ‘ya so!” moment.
Doctor-owned hospitals. How many are there? Two hundred and thirty-eight of them in the whole country (out of more than five thousand)–somewhere between four and five percent of the total in the U.S. (numbers courtesy …
Over the past twenty years, Wall Street business has covertly taken over the medical profession while doctors have been distracted by a deluge of procedural, financial, and legal paperwork. A strategic plan was launched to extract exorbitant profit benefiting business, and is now mainstream without challenge from our profession nor the public.
Legal boardrooms were abuzz in the 1990s as a blueprint assault was made against organized medicine, redirecting a profession into a …
Being a clinical student is not a walk in the park. When we get together for “Reflections on Clerkship” days every two months in our small groups, students let the floodgates open about the hardships they have been facing on rotations. I am no exception. Transitioning to a strict schedule in the hierarchical world of academic medicine has been no small feat. In fact I was planning earlier this morning …
ADVERTISEMENT
We are fortunate in our country to have the best medical technology in the world. Unfortunately, delivery of this technology, reflected in a worldwide healthcare ranking of 37th, is a disservice to the American people and must be rectified especially when Cuba is ranked 39th.
As provisions of the Affordable Care Act are put in place, a daunting factor is the shortage of doctors who will be needed to provide this …
Full Code. Do not resuscitate. Do not intubate.
Ask anyone without a personal or family history of a hospitalization on the implication of these terms and you’d likely get a blank stare in response.
Unfortunately, this incomprehension often rings true with those who need to know it most: the hospitalized patients themselves.
Many clinical reports (see here and here) have demonstrated that most physicians are not only inadequate in discussing code status with …
Al Franken, the humorist-turned-senator, once published a book that was titled “Oh, the Things I Know!” Indeed, by the time we reach parenthood, it is truly amazing what we keep up there in that attic of a brain.
Here is a brief selection of things about the practice of medicine that I have had to discover for myself or never quite figured out, including clinical pearls, aphorisms, dictums, platitudes, mysteries and …
ADVERTISEMENT
She was 94-years old with advanced Alzheimer’s. She thought it was 1954 and asked if I wanted tea. Not a bad memory for someone in a hospital bed with a broken left hip.
She’d fallen at her assisted living facility. It was the second time in as many months. She’d broken her collarbone on the previous occasion.
Over the past year, she’d lost 30 pounds. This is natural in the progression of …
A resident is a person who has an MD, meaning they have completed 4 years of school, but they are not yet qualified to actually do anything. An MD is just a piece of paper saying you did your time in the lecture hall/lab. Residency is where you learn how to be a doctor. The term “resident” originates from the old days in which newly-minted doctors were actually living at …
As trauma surgeons we often have to disassociate ourselves from the stories that surround our patients so that we can focus on their life-threatening injuries. It’s also how I personally cope with the devastating injuries to the patient and the aftermath left for the family. Sometimes, though, I am caught off guard and my defenses aren’t strong enough.
A middle-aged man was brought in one evening after being hit while riding …
ADVERTISEMENT
There’s a lot nurses can learn from doctors.
There I said it.
But I’m not talking about clinical ability or medical knowledge. I’m talking about expectations. I’m talking about basic behaviors that dictate a predictable response.
Nurses don’t feel valued. Much of this is warranted, but I argue that some of it is self-inflicted. I said this once to a colleague and she responded, “But that places the blame on the nurse.”
I disagree. …
Get free updates delivered free to your inbox.
