During my third year of medical school, I received a harrowing phone call, “Can you please go over to Steve’s place? I am worried about him. He might want to hurt himself.” The person requesting this was the mother of one of my best friends in medical school. I was a third-year medical student on my surgical rotation. Steve’s mom was concerned he might commit suicide. Sleep deprived as I …
The “doctor switch,” a protective coping mechanism ingrained into the emotional training of doctors, is a double-edged sword.
Doctors see and experience things that many people would consider intimate, gory, horrifying and even repulsive on a regular basis. Doctors must balance the scales of life and death in their hands in addition to the heavy responsibility of carrying the health and wellness of their patients in addition to living their own …
I realize today that shame, and the stigma about needing help if you’re a care provider, profoundly affected my career path and even my sense of identity. When I was overwhelmed, exhausted, stressed, and scared, did I reach out for help? No, I kept going until I hit a wall, burned out, and left clinical practice. After leaving, did I talk publicly about the chaotic conditions and broken system that …
The messages that sanctify a culture of physician burnout
“We are playing the same sport, but a different game,” the wise, thoughtful emergency medicine attending physician once told me. “I am playing speed chess – I need to make a move quickly, or I lose – no matter what. My moves have to be right, but they don’t always necessarily need to be the optimal one. I am not always thinking five moves ahead. You guys [in internal medicine] …
It’s time to widen the clinical footprint of hospitalists
Unnecessary testing wastes money and can lead to further testing. Why does it occur?
Almost 60% of medical personnel surveyed at a large academic medical center believed that hospitalized patients should have daily laboratory testing.
Of 1,580 attending physicians, fellows, residents, physician assistants, nurse practitioners, and nurses sent surveys, 837 (53%) responded; 393 (47%) were RNs, and 80% of those nurses felt that daily laboratory testing should be done on all patients.
Nurses …
Unnecessary testing wastes money and can lead to further testing
A confounding and deadly disconnect teems throughout hospitals. Professionals whose careers are devoted to improving health outcomes consistently put their patients at risk of infection. Less than half of nurses and other caregivers consistently wash their hands before interacting with a patient, despite decades of studies and guidelines heralding the positive impact this simple — but not easy — action can have.
The Centers for Disease Control estimate that …
Solving health care’s hand-washing puzzle
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, …
An excerpt from Physician: How Science Transformed the Art of Medicine.
While working at a community hospital in the Midwest in the early 2000s, I came to know Walter Stephenson (name changed), who was under my medical care during a lengthy …
Do doctors see patients as machines?
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 …
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 …
If academic medicine is to avoid becoming academic, it must prioritize patient care
I recently attended a conference in San Francisco, California, where the increasing amount of physician suicide was discussed in concert with the ramifications of a psychiatric diagnosis for physicians. An attendee addressed the audience after the presentation. She disclosed that she was a resident physician and that she had been previously hospitalized for five days with symptoms of severe anxiety, depression, and suicidality. As tears welled in her eyes, she …
A stigma no physician can afford
A single error oft inters the good that doctors do. The case of Dr. Hadiza Bawa-Garba, a trainee pediatrician in the NHS convicted for homicide for the death of a child from sepsis and hounded by the General Medical Council is every junior doctor’s primal fear.
A boy in shock
Friday, February 18th, 2011 was not a typically unusual day in a British hospital. Dr. Bawa-Garba had recently returned from a 13-month …
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 …
Is your spouse experiencing physician burnout?
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When I was two years old, I ran naked through my living room. Mom reached out and playfully swatted my rump. I skidded to a stop, planted my fists on my little hips, and faced off. “Don’t touch that! It’s mine!” Everyone who knows me and hears the story just laughs and says my sassy started early.
Now, I read story after story of inappropriate comments made to women, and I …
#MeToo: Tactics for fighting harassment
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 …
Medicine systematically disadvantages women physicians at every stage of their careers
As physicians, we are seen as leaders whether we like it or not. And as such, we are charged with modeling greatness. But do we? Our training, while teaching us to be experts and authorities, does not teach us how to be leaders.
One thing our training does teach us: self-neglect, self-sacrifice and unrealistic expectation. This is where I believe our training has failed us. For most of us, our training …
Leaders can bring doctors out of burnout
When I was an intern the Durham VA Hospital, there was a sign taped to the ceiling of one of the workrooms. It said in big, bold letters: SUBDURAL HEMATOMA/PULMONARY EMBOLUS. This was to remind all house officers, at work in the middle of the night, about likely diagnoses for mysterious or confusing diagnostic puzzles. When you slapped your head in desperation and looked up, you would see the answer. …
Who knew I went to medical school to save my own life?
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. …
The unjust prosecution of physicians is not unique
It was a perfectly comfortable morning when suddenly it was discomforted by a request for a stat palliative care consult. A stat consult is disquieting because “stat” is a dissonant adjective for the compound noun, “palliative care.”
“Stat” is the medical abbreviation for the Latin adverb “statim” meaning “immediately.” Stat orders always imply the necessity of an immediate response to an emergency: an inadequate blood pressure, an erratic hear rate, a …
A “stat” palliative care consult: cognitive dissonance meets cognitive ignorance
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 …
Physicians don’t know everything, and that’s OK
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