I enjoy talking to random people about their experiences with health care. As somebody who regularly travels all over the country, for both work and pleasure (I far prefer the latter), whenever I meet people in situations where you end up talking — be it on airplanes, a guided city tour, or at a social function — as soon as I say I’m a physician, the conversation invariably ends up …
3 common complaints patients have
Retirement has gotten me edgy. Three months after departing, I had begun spending too much time horizontal, which I forced myself to remedy but then finding myself with nothing to do.
Moreover, things have gotten more noticeably like Bowling Alone, an often-cited book by Robert Putnam published in 2000 that describes attrition of diverse communal activities over the previous 30 years. For physicians, our daily activities prevent us from working in …
As doctors, our social capital is changing
Health care safety efforts have long focused on improving the behavior of providers and improving the systems of care. A proven model of safety is in the airline industry. There are undoubtedly many parallels between airline safety and health care working toward common goals. This work should continue in both industries to ensure the safety of the people they serve.
The airline safety model, though, can only look at health care …
I was recently seeing a rather complicated medical patient in the hospital. We were treating both a heart and kidney condition, and things were not going so well. To spare anyone non-medical who is reading this the scientific details of the bodily processes involved, we were essentially balancing hydrating, with the need to get rid of excess fluid. After seeing the patient, I spoke with the nurse, went over the …
There’s no room for ego in health care
First impressions are critical. We are taught early in our careers that first impressions truly matter. Whether interviewing for medical school or a residency program, our goal is to make a positive first impression in hopes of making the cut at each checkpoint in our early careers.
These processes in our academic lives and careers are exhausting. As residencies and medical schools are becoming more competitive, the importance of first impressions …
You must make a good first impression with patients
On a recent vacation, I went out to eat at a small, out-of-the-way restaurant we always visit on our trips to the Outer Banks.
There, I spotted a poster on the wall explaining why the cafe no longer uses plastic bags or plastic straws: to keep the material out of the ocean where it never really goes away.
Plastic bags, straws, eating utensils, plates, bowls, and cups are everywhere in hospitals these …
Lead your health care organization toward a culture of sustainability
I am considered a “xennial” physician. Not quite a millennial — but also not fitting into the generation of the respected preceptors I had in medical school and residency. I took my MCAT via paper and pencil. My mini boards during my clinical rotations were on paper and pencil. All of my licensing and board exams were computerized.
It was not an option to sit at home and log on to …
Advice from a “xennial” physician to aspiring physicians
Two weeks ago, while I was helping with an emergency medicine course that I’m a teaching assistant for, I started feeling extremely light-headed, and the chest tightness that I had dismissed as heartburn earlier that morning got worse. I was tended to by the emergency medicine doctor who I was teaching with, admitted to the ED with a resting pulse rate of 130 beats per minute, later admitted to the …
A medical student as a patient. She thanks her support systems.
In 1976 I graduated from medical school and proudly joined the medical profession. Thirty-seven years later, I retired as an employee of the biggest business in the country. In 2016 the medical industry was responsible for 3.3 trillion dollars of expenditure, comprising 18 percent of the United States GDP. For perspective, there are only four countries with a GDP more than the amount spent on health care in the United …
Medicine: noble profession or big business?
It was the 24th hour of my call shift, and I was running on fumes. Despite my weariness, I could see the first rays of morning sunlight coming through the window in my patient’s room. It was then I knew I could make it to hour 30 (quitting time). It was grueling to keep going, but hitting the 30-hour mark only required me to keep my head down and do …
The evolution of residents’ hours
The health care experience is so much more than a buzzword to be talked about in administrative circles. Some physicians I encounter (a minority, but still enough) really scoff when they hear this term. Responses I’ve heard from doctors include: “Hospitals are not hotels!” or “If that means giving our patients as much Dilaudid as they want, then count me out!”
Aside from these sweeping statements being entirely silly, they are …
3 reasons why we should care about the health care experience
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.
“To care for him who shall have borne the battle and for his widow, and his orphan.”
– Abraham Lincoln
With these words, President Lincoln affirmed the government’s obligation to care for those injured during war and to provide for the families of those who perished …
Not your grandfather’s (or even your father’s) Veterans Affairs
Among the many recurring topics, this year has been the impact of machine learning in our lives, especially the implications for our future work life. Prophecies range from ubiquitous utopian machine servants to a dystopian ravaging, hollowing out the work and economic standing of the middle and lower classes. “What can machine learning do? Workforce implications” by Erik Brynjolfsson and Tom Mitchell in Science provides some perspective on machine learning …
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I woke this morning at 3:30 a.m. My mouth was dry. I tried to urinate, but something roughly the color of quinoa came out in small quantities. So I assumed I was dehydrated. It could have been the bourbon and scotch before dinner — or the two IPAs at dinner. Or the four IPAs after dinner at trivia. Or the scotch after trivia. But something told me I was dehydrated.
I …
An ode to residency interview season
I walk by the closed double doors and frosty windows of the ICU. You’re lying in there, intubated. It feels weird to go to work now. I can’t see you or talk to you, don’t know the drips, don’t know the plan … and it’s killing me. I, along with many others, desperately want to express my love. So many feelings are swirling inside:
Guilt. For having a chill workday that …
It was during the first few weeks of medical school that I realized that I was joining a secret society. Like many physicians, I was called to medicine at a young age. For me, it was Doctor Beverly Crusher from Star Trek: The Next Generation. I admired her — I wanted to be who she was and do what she did. (More or less, my dreams of space medicine transmuted …
The Osteopathic Oath vs. the Hippocratic Oath
I was moved when a family entrusted me to give a eulogy for their beloved. This great privilege highlighted a hallmark of a physician’s service to humanity: “to cure sometimes, alleviate often, but comfort always.” But I was horrified to learn that his death at the hospital may have been the result of a preventable error — one that was withheld from the family.
Sadly, that patient …
Silence in health care is a crisis
Patients legally using medical marijuana (cannabis) at home may be stunned if they are admitted to a hospital because many hospitals may prohibit them from using it.
In the United States, medical marijuana is legal in 31 states, and research shows that medical marijuana can effectively treat pain — but patients beware. The issue of medical marijuana is a complicated one, and patients may be precluded from …
The thorny side of medical marijuana
The stethoscope. Nothings says “I’m a doctor” more than the stethoscope in a pocket or draped around the neck. Forty-five years ago when I got my first one, a gift from my physician-father, the former was more common. Then we were more likely to wear coats — white coats or suit coats — and pockets were available. I had suit coats in which the lining was worn out from the …
The evolution of the stethoscope
It’s Sunday, and the clock is approaching 8 p.m. Every computer in our team room is still on, and the sound of typing is filling the small space. A spread of snacks, interspersed between stethoscopes and stacks of faxed records, is ignored for the time being.
This scene was a familiar one on inpatient medicine, where call days can stretch long into the evening. Although those days were challenging and draining, …
Embrace the teamwork involved in becoming a physician
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