Many months have passed since the spring day when I was hit with the news from my yearly mammogram, but those typewritten words are forever etched in my memory: “The density appears greater in left breast.”
My doctor comforted me with statistics showing that mammograms aren’t 100 percent accurate — but she also lost no time in sending me to a surgeon named Dr. Prewitt. Upon meeting him, I immediately felt …
Do not underestimate the power of touch
Take a moment to ask yourself the following:
1. Did I come to practice medicine because it was a calling, rather than a possibly lucrative career path?
2. Do I consider the practice of medicine primarily an art, a craft and the consistent application of evidence-based care?
3. Do I respond to inner measures of prideful work more than the appeal of external motivators?
4. Are there lines that cannot be crossed, even if …
Are you an artisan or just a medical professional?
The first week of residency of any program is usually comprised of several orientation sessions in which the new interns are introduced to various important aspects of the residency program. My orientation week was no different with a river of new information flowing towards me. Needless to say, I felt a bit overwhelmed and struggled to keep track of everything that was being introduced. Later on, I found out that …
Has patient-centered care gone too far?
While I was reading an issue of New England Journal of Medicine, I came across an interesting perspective article. Usually, I skip these articles and focus on clinical studies, images in medicine and review articles that usually have higher yield information that I can apply to help care for my patients. However, Dr. Jerry Avorn’s article, “The Psychology of Clinical Decision Making- Implications for Medication Use,” …
How behavioral finance can be used in medicine
The tendency to look back and impose self-criticism for the past is an all too common human tendency. A more robust strategy involves looking far ahead — not just dreaming, but making a detailed plan after careful analysis of goals, hopes, and reality. What follows are some thoughts and wishes applied through the filter of the retrospectoscope.
Father time
The bravado of youth often overlooks critical developments that alter the landscape of …
What I wish I knew as a young doctor
The common critique of surgeons from their medical colleagues is the scant amount of time spent with their patients. As the argument goes, surgery is more impersonal than other specialties and those who practice it see their patients in one dimension.
In some sense, they aren’t wrong.
For those who wield the scalpel, speed and efficiency are a priority. It’s a philosophy perfectly illustrated during morning rounds, the daily tour of patients …
The doctor will see you now. But only for a minute.
A man and a woman step into an elevator wearing the exact same hospital scrub uniforms. The man’s pager suddenly starts beeping, and the stranger in the elevator says to him, “Do you doctors really still use pagers?” The stranger then notices the women next to him and asks her, “Oh, are you a nurse?”
It’s something that has happened to every female physician. It’s not that we mind getting mistaken …
Oh, are you a nurse? The physician gender bias
Two years ago, much ado was made about what appeared to be a decline in obesity rates among 2- to 5-year-olds, a finding based on a national study of fewer than 1,000 children that age. However, subsequent analyses have shown the decline to be transient at best. The number of overweight, obese and severely obese children in that age group — as well as older children, …
Why obesity rates continue to climb. And what can be done to stop it.
“Doctors are people too,” I once was told, by a patient no less. Sarcasm colored her choice of words, implying we doctors ought to descend from the heavens above and relate to patients like … well … people. Not a bad idea, one that humanizes the incomprehensible doctor-speak we unwittingly projectile-vomit onto our patients. Hmmm … talk to patients like one normal person to another?
Easier said than done. A doctor’s …
Want a better relationship with your patient? Make it personal.
An unusually calm morning in the ICU led our amiable attending start rounds by asking how we took care of ourselves so that we could look after others. While scrambling to gather patient details, we all struggled to answer them, except for my eccentric British-Canadian friend (who is still confused about his nationality since Brexit) who said he did so by reading Hemingway.
In medical school, board scores seem to be …
You can’t put metrics on purpose and resilience
Women’s voices are finally being elevated on a national level to the prominence they deserve on workplace, political, and social issues.
But as a physician (and father of two adult daughters), I’m concerned that women may not feel empowered to use their voices for their own health care. A 2015 survey found that only 22 percent of women in the United States possess health literacy skills, although health literacy is critical …
Empowering young women to use their voices in health care
After a semester of studying and taking written exams, we had our first OSCE in medical school. An OSCE — or an objective structured clinical examination — is the real deal. Instead of filling out multiple choice boxes, we instead work with a real human being, which for me is a welcome change.
The actor is given a script with their unique condition and story — it’s a simulation of what …
My first objective structured clinical examination
When you see your doctor, you want to know what’s wrong, follow the steps to recovery and get predictable results. Sadly, this is not always possible. Medicine is an art based on science that is constantly changing and full of things we don’t know.
Here are four reasons why it seems like your doctors didn’t get it right — when we actually did:
Why can’t my doctor get it right? Here are 4 reasons.
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Shortly after the publication of “Independent practice: Both nurse practitioners and physicians should be outraged,” the nurse practitioner (NP) leadership responded with a press release, denouncing the concerns that were cited, calling them “rhetoric.”
But in contrast to this criticism from the political end of the NP spectrum, I was inundated by emails from working NPs across the country in support of the article.
Since …
Independent practice: Nurse practitioners respond
Humans need human touch
Patients sometimes need a shoulder to cry on. When I say that, I normally mean it on a completely figurative level.
However, at times, it needs to be interpreted differently. There are instances in a medical encounter where an actual shoulder could be of service — a physical crutch that takes off an emotional load — and that’s when the popular adage can be beneficially carried out in …
The human touch in medicine: good or bad?
One late evening on pediatrics call, a frantic young couple brought in their few weeks old baby. She had spiked a fever which refused to go down and was fussier than normal. The cause of her symptoms could have been anything — at best, a mild respiratory infection, in which case we would simply watch her and manage her symptoms, but at worst, it could be meningitis, an infection attacking …
The art of medicine is slowly being pushed out. Is that a good thing?
In some circles of medicine, going long periods of time without eating a meal is considered a rite of passage and one’s ability to forgo his or her basic metabolic needs is considered a badge of honor. In other circles of medicine, there are gourmet lunches of kale salad and lobster bisque being delivered by pharmaceutical company representatives on a daily basis.
No one in either circle seems quite comfortable with …
Lunch shouldn’t be so controversial in medicine. But it is.
An excerpt from At Peace: Choosing a Good Death After a Long Life. Copyright © 2018 by Samuel Harrington, MD. Reprinted with permission of Grand Central Publishing. All rights reserved.
The momentum to treat in America is unmatched around the …
The momentum to treat in America is unmatched around the globe
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 28-year-old man is evaluated for right knee pain that began 2 days ago. He was playing football when he stopped suddenly and pivoted to make a catch. He heard a popping sound and immediately developed severe pain in his right knee. Within 30 minutes, the knee became swollen. Since the injury, he …
MKSAP: 28-year-old man with right knee pain
Alice wept in my arms as she described her father’s last days. He died of metastatic prostate cancer. She felt lighter as she shared beautiful memories of him. It will never be the same for Alice, nor will it be for me. I was running behind for my next patient, a healthy 86-year-old woman. I apologized for keeping her waiting. She did not mind; she knew I would give her …
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