Primary Care

20 anecdotes that describe the world of female medical students and physicians

Education
January 13, 2018

I recently collected anecdotes from women in medicine who have noticed the same thing I’ve noticed: We’re not as comfortable here as our male counterparts. Despite progress, medicine remains a patriarchy — an “old boy’s club” — and the women in this world are frequently reminded of this status quo. In collecting these anecdotes, I’ve noticed two main themes for the type of advice and comments women receive.

The first one speaks …

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15 minutes aren’t enough for a primary care visit

Physician
January 9, 2018

Have you bought a new memory foam mattress recently? Many come vacuumed in shrink bags. Once air gets in the bag, the mattress expands to its normal size. It is fascinating to watch how they expand.

It is not so fascinating to watch a patient expand to their actual size, when they are forcefully squeezed into an enclosed time space like an office …

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The non-difference between MDs and DOs

Education
January 8, 2018

“What’s a DO?” is something virtually every osteopathic medical student and physician have been asked at some point in their training. There is this public misconception that professionals who carry MD after their names are the only qualified people to medically treat their ailments. Any other degree is categorized as “alternative medicine” in their mental schema. Truth be told, DOs, or doctors of osteopathic medicine are just as qualified as …

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Why the social history is important

Physician
January 3, 2018

From the notes I read, it seems that other medical specialties limit “social history” to whether or not someone uses tobacco, drinks alcohol, or uses drugs.

“Social history” is meant to get a sense of the context in which people live. Where do they live? Who do they live with? How did they come to live there? Where did they grow up? What sort of work do they do? How much …

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The physician’s relationship with the beeper

Physician
December 29, 2017

If you’re thinking about a career in medicine, there’s a piece of technology you’ll come to know intimately. It’s small and sleek, with excellent battery life and remarkable durability. It’s not an iPhone; it’s not a Pixel. It’s a beeper. You will come to know, and to respect, this tiny black rectangular prism. It will govern your life. You will be at its mercy, yes, but it also offers you a chance at salvation. …

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Why nurse practitioners train on the backs of physicians

Policy
December 19, 2017

“Nurse practitioner (NP) education is seriously underfunded. The profession is attempting to saddle private physicians with this cost.”

That is how “Dr. X” replied to my email asking whether he would be willing to precept a nurse practitioner student for her clinical rotation. I read through his clearly disgruntled letter and wanted to explain to him why NPs have to train “on the backs” of physicians and why funding for nursing …

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A doctor saved a patient’s life. Twice.

Physician
December 18, 2017

I have good days and bad.  Some days I am content, connected, focused, and motivated.  On those days I enjoy my job, I enjoy the people I’m with, I am willing to be inconvenienced by interruptions.

On other days, not so much.  I wake up as grumpy Rob and (despite multiple cups of coffee) the old codger doesn’t leave me alone.  I keep score of all the ways in which life …

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The myth of multitasking in primary care

Physician
December 15, 2017

Primary care doctors don’t usually have scheduled blocks of time to read incoming reports, refill prescriptions, answer messages or, what we are told the future will entail, manage their chronic disease populations. Instead, we are generally expected to do all those things “between patients.”

This involves doing a little bit of all those things in the invisible space between each fifteen-minute visit, provided we can complete those visits, their documentation and …

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An eye-opening rotation at the Indian Health Service

Education
December 8, 2017

For the month of September, I embarked on the experience of a lifetime, living and working on the largest Native American reservation in the United States. Sprawled across the four corners region of Utah, Arizona, New Mexico and Colorado, the Navajo Reservation in Chinle, Arizona, encompasses an area as large as the entire state of West Virginia. Its population, however, is only about 300,000, making it extremely rural. To leave …

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4 reasons why patients don’t take their medications

Physician
December 7, 2017

I often see patients for follow-up and learn they are not taking the medications either I or another health care provider prescribed. Sometimes the reason is obvious, and other times the patient is reluctant to give up the information. Patients have the right to take or not take medication that was prescribed. But, sometimes by not doing so, they are putting their health at risk.

As a doctor, I want my …

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A patient called me the N-word

Physician
December 7, 2017

Editor’s note: This article contains a racial slur crucial to the writer’s story.

It took only 57 hours of working as a new attending physician in Charlottesville, Virginia for a patient to call me the N-word.

Fifty-seven hours. In fact, a racial slur found me before I found the shortcut to the hospital cafeteria. So, when torch-bearing White supremacists gathered downtown earlier this year, I saw more confirmation of my conclusion that …

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Is there ever a right time for a doctor to have a baby?

Physician
December 4, 2017

When is the right time to have a baby? This question plagues professional women across industries. It takes on more significant importance for women training as physicians. Medical training is long and coincides with a woman’s late 20s, often stretching into her 30s. Waiting to have children until completing training is not always biologically feasible.

Medical schools and residency training programs still lag behind in developing formal parental leave policies. Outside …

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How being an immigrant shaped the way I treat patients

Education
November 30, 2017

I was born in Shanghai, China. In September 2000, my parents and I left behind our family and friends, a language and culture dear to our hearts and social and financial stability to immigrate to the United States. I was six at the time. Although I don’t claim to have fully understood the weight of their decision to start a new life, I knew that my parents were making a …

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How to inspire medical students to pursue primary care

Education
November 29, 2017

I distinctly remember the excitement I felt during my first year of medical school when exposed to the breadth of general and specialty fields that seemed all so equally rewarding and medically influential.  I envisioned myself holistically understanding my patient, seeing the problem in the context of her other medical issues, her personality, her family and her environment — an approach I considered at the heart of the oath we …

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It’s time to stop prejudging your patients

Physician
November 27, 2017

Recently I had an interaction online with a physician regarding his thoughts on ADHD treatment. (Let’s call him Dr. Stigma). This post is not about doctor-bashing but more to point out the prevalence of stigma against those with a psychiatric diagnosis even from within the medical community. Stigma, unfortunately, is so indoctrinated into our culture that sometimes people don’t recognize the pure ugliness of their words.

Dr. Stigma’s comments:

Many patients use …

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The worst-case scenario question you must ask patients: even healthy ones

Physician
November 24, 2017

The last few passengers filter in and buckle themselves up before takeoff. The emergency exit row is occupied by an elderly couple, and I am seated behind them. The flight attendant asks whether they are comfortable in those seats, given that they’d have to respond in the case of an emergency.

“Not that I expect anything bad to happen,” the flight attendant adds with a smile.

I, too, am familiar with discussing …

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The doctor-patient relationship is everything

Physician
November 22, 2017

While doing my doctoral dissertation research at a clinic for kids with diabetes, I observed the attachment that some of them had to the physician faculty member who directed the clinic. I particularly remember one teenager who complained that this doctor “did not care” about her, as he sent “fake doctors” (residents) to take care of her, not coming himself. She was refusing to cooperate. When I suggested to the …

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