How to raise a doctor
An excerpt from 
I know what you’re thinking, I thought this book was about how to raise a doctor, and now this guy is telling me not to raise a doctor! That’s exactly right. I’m telling you to not …
Pediatrics
What happens to the kids of child abuse when they grow up?
As he sat in the driver’s seat and started to whistle that dreaded Willie Nelson song, my heart started racing, and my world started to spin. While most kids may be annoyed hearing their father whistling that toneless noise, terror started seeping into my very bones. I knew what that sound meant and it was no Pavlovian response, but rather a foretelling of the horror coming. Simply put, it meant …
A patient becomes a medical student
I was a four-year-old kid when I was about to begin my first day of school. I was born and raised 20 kilometers away from the big city in a small rural area with minimal essential amenities — schools, roads, and hospitals. Like all other kids, it was a momentous occasion for me to start my first day of school, and I remember how exciting it was.
As I started to …
Dear Mom and Dad: Are you calling your pediatrician’s office too often?
I work as a pediatrician in a bustling metropolis, in an outpatient setting of a world-renowned academic center. One of those non-profit hospitals you see in television ads. For the last three years, our outpatient encounters have plummeted, and the mothership has put all efforts into recuperating financial losses. Meanwhile, our office phones are ringing off the hook, and we cannot seem to hire enough nursing staff to deal with …
What I learned from the ICU (other than medicine)
This week I had some particularly emotionally tough cases at work, and it got me thinking about life in general and how, in spite of having a tough job, I have learned so much from it.
When I think of childhood diseases, there are the ones that are chronic, the ones that let you process that your baby is sick and has a potential life-threatening condition. You have weeks and months to …
Insurance companies manipulate the doctor-patient relationship for financial gain
I am pediatrician who has been practicing for almost twenty years. During my career, I have been employed by two different free-standing children’s hospitals, a non-profit community-based health center, and now I own my own practice. In every setting, I have had to generate coding and billing for my work even when my salary was independent of that billing.
There is no other profession that would dutifully learn the “rules” of …
Learn about Salter-Harris fractures with a Medcomic
Pediatric physeal fractures have traditionally been described by the five-part Salter-Harris classification system.
Type I fractures occur through the growth plate. These injuries may present with normal radiographs, and the diagnosis is often made clinically when tenderness is palpated over the growth plate.
Type II fractures occur through the growth plate and metaphysis. Type II injuries are the most common physeal fractures.
Type III fractures occur through the …
A physician lurked on Facebook mom groups. Here’s what she found.
In my off time, as a mom and a physician, I spend a decent amount of time lurking in a rather strange environment, even for the internet. A place so filled with anxiety, stories of ill-chosen spouses and little glimpses of unbridled joy, that you’d think you were somehow inside a taping of the Real Housewives of This-crying-baby-makes-me-hope-that-I-end-up-having-a-dissociative-fugue. You know, *that* place.
Online mommy groups on Facebook.
And, there I am, lurking …
The moment I became a passionate doctor
I was nearing the end of my pediatrics rotation as a third-year medical student when the senior resident asked me to admit a patient to the general pediatrics floor. The only information I had as I headed down to the intensive care unit was that she was a ten-year-old girl who had survived an extensive resuscitation at home.
By this point in my education, I was certain that I wanted to …
The hidden threat of the 80-hour resident workweek
In an article published by the Atlantic earlier this year, Ryan Park writes that neither truck drivers nor bankers work the kind of gruelingly long hours that doctors — particularly young doctors in their residency programs — do. It is no secret that residency life is demanding and exhausting. Over the last decade, it has also become controversial. Almost a test in itself, as if gauging doctors’ …
Thank you for performing CPR on my child
I wonder what the best thank you any physician has ever received? I think this one is mine. This recent thank you was for our efforts to not save a child but for simply allowing this family to have a few more days with their infant who ultimately passed away. This amazing thank you has deeply and positively affected me so much …
This doctor spends more time at a computer than with patients
I find myself spending close to an hour on the computer each morning at the hospital. I spend this time dutifully looking up vital signs, labs, recent radiology or pathology results as well as many other valuable pieces of information about each of my patients. I watch as my colleagues frantically record values, while making sure to point out important trends and gross abnormalities.
When we round, there is always a …
How anti-vaccine parents are finding doctors willing to exempt their kids
Dr. Tara Zandvliet was inundated with calls and emails from parents last year, after California passed a law nixing personal beliefs as an exemption from school vaccinations. Suddenly, many parents sought exemptions for medical reasons.
Someone even faked two medical exemption forms purportedly written by the San Diego pediatrician, copying a legitimate document she’d provided for a patient and writing in the names of students she’d never treated, she said. She …
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Gamification of medical education: Choose Your Own Medventure
More and more health care practitioners are turning to social media for their medical education. Fellows are learning ultrasound from Snapchat, nurses are learning how to insert NG tubes from watching YouTube, and learners are learning pathophysiology from blogs and podcasts. To reach this audience with credible and reliable content, it is important for medical educators to be present where the learners are, and that means social media.
Users are also …
The mythical unicorn of vaccine denialists
I swiped this editorial cartoon by Steve Sack from the redoubtable Dr. David Gorski’s blog, who goes by the nom-de-web of Orac. Recent epidemiology shows reducing the fraction of vaccinated children in the population rather promptly leads to a resurgence of the diseases vaccines protect against. This is the concept of community or herd immunity.
Epidemiologists debate the concept around …
This resident’s childhood friend inspired him to help other children as a physician
“You find joy that people are doing better because of what you did for them.” #BornToHeal
Courtesy of the American Medical Association (AMA).
A letter from a parent to her child’s pediatrician
I am a child psychiatrist who is also a patient, a mother of patients and the wife of a patient. I have lived all sides of health care and appreciate the complexity that is our American health care system. After a recent move to a different part of town, we decided to find a new pediatrician for our daughters.
I knew that we had several good options near our home. When …
Why pediatricians should not kick out unvaccinated children
We in the medical community believe wholeheartedly in the prevention of all illness, especially by vaccination. Science and history continue to show that vaccination dramatically decreases both the mortality (death rate) and morbidity (severity of illness) of infectious diseases. And, more than 98 to 99 percent of the general population (non-medical) agrees with those statements as well.
Yes, it is absolutely frustrating when parents refuse to follow our advice and protect …
Let’s talk about the ethics of breastfeeding
In the spirit of World Breastfeeding Week, I want to highlight all we can about breastfeeding; why it’s great for you and your baby, some ways to make it easier, and how to manage common challenges.
But one challenge that often gets ignored in the offices of doctors and lactation consultants is the issue revolving around the ethics of breastfeeding. That is, addressing uncomfortable questions like these:
- Are moms who choose …
Listen up GEHA: Vaccines should not be an out of pocket cost
In a little piece of legislation known as the Affordable Care Act, preventive services are mandated to be covered with no out-of-pocket expense to consumers. According to the Healthcare.gov website, approved insurance plans must cover a “list of preventive services for children without charging a copayment or coinsurance.”
Number 18 on that preventive care list is childhood immunizations for children from birth to age 18, acknowledging regional variation in the standard …
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Past Week
-
Why patient trust in physicians is declining
-
Why doctors struggle with treating friends and family
-
Why insurance must cover home blood pressure monitors
-
Is tramadol really ineffective and risky?
-
When racism findings challenge institutional narratives
-
5 things health care must stop doing to improve physician well-being
-
Past 6 Months
-
Why patient trust in physicians is declining
-
The blind men and the elephant: a parable for modern pain management
-
Is primary care becoming a triage station?
-
Psychiatrists are physicians: a key distinction
-
The loss of community pharmacy expertise
-
Accountable care cooperatives: a community-owned health care fix
-
Recent Posts
-
Pediatric respite homes provide a survival mechanism for struggling families [PODCAST]
-
The role of operations research in health care crisis management
-
Personalized scientific communication: the patient experience
-
From law to medicine: Witnessing trauma on the Pacific Coast Highway
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Why doctors struggle with treating friends and family
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The emotional toll of leaving patients behind
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