I’m a family doctor in upstate New York. My patients include active NRA members and ardent pacifists. Most probably fall somewhere in the middle — they own guns for hunting or encourage neighbors to hunt the deer that feed on their lush gardens.
As a mother, I tried not to let my boys play with toy guns when they were little. In a young boy’s imagination, though, everything became a gun …
Physicians can’t ignore health risks posed by guns
Where is everybody?
It’s a Wednesday morning, and after 8 o’clock grand rounds I headed back from the medical college auditorium to our practice, and as I walked back into the office our med-tech told me that my first two patients were already in their exam rooms.
So I dove right in, starting with a husband and wife there for their annual physical exams, and I set about getting to my morning …
Let’s put those empty exam rooms to use
He looked tired and worn down, more so than many of the other patients I had seen that day. He didn’t speak English and I did not speak his language, but I could feel his anxiety as it filled the exam room. One of my employees translated, in fact, what his “boss” was telling us. The boss was worried that he was more tired than usual, and not getting his …
Would you know human trafficking if you saw it?
After a Harvard endocrinology course several years ago, I walked out into the weak afternoon spring sunshine and crossed the street to the Boston Public Garden. Among the multitude of faces of the other flaneurs I was certain I saw scores of people suffering from endocrine diseases — probably undiagnosed, I thought to myself: I saw tall men with big jaws, typical of acromegaly; stout women with skinny extremities and …
Clear your mind from all the distracting requirements clinicians face
The path to becoming a physician is a long and character-defining one. From the moment one first realizes that they want to become a doctor, applies to medical school, and then goes through the rigorous next few years of exam after exam and exhausting clinical rotations — the road is certainly not for the faint-hearted. Everybody is aware of how much knowledge and hard work is required to become a …
These 2 events made this doctor a more compassionate physician
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 47-year-old man is evaluated during a follow-up examination. He is obese and has hypertension, type 2 diabetes mellitus, and obstructive sleep apnea. He reports that he has always has been overweight, and over the years, his weight has gradually increased to 123 kg (271 lb). During the past 2 years, he has …
MKSAP: 47-year-old man with hypertension, type 2 diabetes mellitus, and obstructive sleep apnea
I log onto KevinMD every day to get my much-needed dose of physician commiseration. At least once a day, one of us writes an article about burnout. It typically leaves me feeling quite validated. I particularly enjoy reading the comments section, as many of you make me laugh with your physician reality-based humor.
I am more burned out than I ever hoped to be. I work in primary care, have a …
This burned out physician was happier as a resident
In 2013 I began searching for ways I could change my career to reduce my workload, but not give up medicine altogether. During that time I took a cruise and looked at various jobs I could do on a cruise ship. One of the jobs I was qualified for, I thought, was to be a Cruise Ship Doctor.
After talking with the ship’s doctor to find out what it was like …
What to do if you want to be a cruise ship doctor
Why do we say “curiosity killed the cat?”
Isn’t curiosity what drives people to ask insightful questions? To keep an open mind? And to continue learning at age 6 or 60, alike?
Curiosity is what sets apart people who are fixed in their opinions and beliefs and those who adjust in light of new information. Recently, I read an article in The New Yorker that suggested that Donald Trump doesn’t read books …
What does curiosity have to do with patient safety?
I recently needed to transfer my patient to a larger medical center for some urgent care. As I sat there in my relatively small hospital working out where they would be best served, a famous academic medical center that was not too far away, came to mind. I placed a call to the facility’s bed facilitator, who took the patient’s details from me, and was told to await a callback …
Why the battle against being called a provider is probably lost
The most common response when I introduce myself as a preventive medicine resident is an interjection, “You mean family medicine?” I have come to realize that the majority of the healthcare field has never heard of preventive medicine as a unique medical specialty. It’s a shame, because preventive medicine is truly the best medical specialty you’ve never heard of.
Preventive medicine practices at the intersection of public health and clinical medicine …
The best medical specialty you’ve never heard of
Modern technology needs to do better. This is the message delivered by every CEO after every Silicon Valley scandal in recent memory. This time, they should really do it. Medicine can show them how.
Let’s have the professionals building our future abide by industry-wide standards, just as doctors do. As both a startup founder and a physician, this idea makes intuitive sense to me. Drawing on my experience treating patients and running …
A Hippocratic Oath for technology
Although my father did not discover penicillin, he helped do the research showing its effectiveness in curing infective endocarditis. As an internist, he then became enamored with the role antibiotics could play in treating infections. Growing up, my siblings and I can attest to his unbridled enthusiasm, as every time we contracted a cold, we would get a shot of the wonder mold in our butts. The fact that colds …
The unscientific lure of antibiotics
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It is no secret that President Trump’s former nominee to run the Veterans Administration, Navy Rear Admiral Ronny L. Jackson, has withdrawn his nomination amidst allegations related to his behavior: that he drank on the job, was a bully in the office and improperly gave out prescription medication. He has vehemently denied the allegations and characterized them as false and fabricated.
Dr. Jackson is an Iraq War veteran who …
Dr. Ronny Jackson: A victim of political accusations, or physician burnout?
Having a mentor leads to a more successful and satisfying career for doctors. So how does one go about finding a mentor mid-training or after training? Many medical schools and residency programs have mentorship requirements for trainees. But those mentorship needs may change if a student or resident (like myself!) changes their mind about what they want to be when they grow up. I have been …
Why all physicians need mentors
“Paying attention in a particular way: on purpose, in the present moment and nonjudgmentally.” That’s how Jon Kabat-Zinn, PhD, describes mindfulness. In the book Zen Mind, Beginner’s Mind, another thought leader in mindfulness, Shunryu Suzuki, says that, “In the beginner’s mind there are many possibilities, but in the expert’s there are few.” In my experience, I’ve found that cultivating a beginner’s mind opens doors and improves clinical diagnosis.
Medical training has …
How mindfulness helped this physician’s primary care journey
“Put me out of my misery!” I’ve pleaded to anyone within earshot in the throes of a grueling day, a rant from one feeling burnt out. There are days I want to pull my hair out, even the ones that aren’t gray. One night I caught myself grunting, “I hate my life,” while heading out the door at 12 a.m., after an already exhausting day in the OR. No sane …
How this physician handles burnout
He was younger than I was — still in his twenties — but the patient had already had his chest opened twice. Deadly bloodstream infections contracted from sharing needles had destroyed his heart valves on two separate occasions. And now six months out from his most recent operation, he was back with fever and chills: ominous signs of another infection.
That was years ago. The opioid epidemic hadn’t yet been declared …
Stop shaming those with addiction
Just sign here.
How many times a day are we asked to do this? “Just sign here.” “Just put down your license number.” “We need a stamp with your doctor’s info on it.” “Give us your NPI.” “Initial here, here, and here.”
If we took the time to read all the things we’re signing, we wouldn’t have time to do any doctoring.
The other day I was asked to hand-write the date on …
Too many things need physicians’ signatures
Undoubtedly, my favorite part of my non-clinical work is hearing from fellow physicians about their lives in medicine. Every once in a while, I receive an email that puts beautifully into words some of my own struggles.
A few weeks ago, I received an email from a colleague outlining her personal journey through her career, which she was hoping other physicians would benefit from as well. I know it spoke to …
How do we keep women physicians in medicine?
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