Throughout training, I had an idea. And that idea was — I would be a great academic physician. I had the right training. I had done research from college through fellowship. I had received research grants from medical school through fellowship, published numerous papers and started defining a niche. Everything was going great.
Academia — here I come!
Then attending-hood arrived. I looked for positions in academic centers. I was limited by …
As Southern states entertain legislation granting nurse practitioners independent practice rights, there are some finer details which deserve careful deliberation. While nurse practitioners are intelligent, capable, and contribute much to our healthcare system, they are not physicians and lack the same training and knowledge base. They should not identify themselves as “doctors” despite having a doctor of nursing practice (DNP) degree. It is misleading to patients, as most do not …
Burned out cardiac surgeon seeks opportunities or empathy,” one message reads. “I feel stuck,” another confides. A third says simply, “I don’t want to be a doctor anymore!”
The posts come in from across the globe, each generating its own thread of commiseration and advice. “I just wanted to reach out and let you know I feel your pain,” a doctor-turned-MBA replies to one surgeon. “Your story is so similar to …
Monday morning and no place to go. After 35 years of practicing medicine and GI, including a year of eager anticipation, the day had arrived when there were no patients in my schedule. Nor would there be tomorrow. Nor the next day.
I was happily accustomed to a scheduled life. For me it had been decades of awakening early, working out, assembling a breakfast to inhale in the car, kissing the …
Last fall I was witness to a miraculous event. I rarely take off from work, but did so on a Friday to go to Baltimore to lend moral support to my family doctor friend, Cathy Maslen. She and her workmates at Chase Brexton Health Care (a community health clinic in the Baltimore area with a focus on the gay and transgender community and the inner-city poor) were doing something that …
My cousin visited me in sunny Cali this past weekend. She lives a life that many in the medical community can appreciate: a stable and successful job for many years, but burnt out. She then decided to take six months to work on her writing and try establishing herself through various pursuits. While successful in some ways, she decided she needed a more stable position. So she found a job, …
Recently, the Harvard Chan School of Public Health reported on the effect of surgical checklists in South Carolina. The press release was titled, “South Carolina hospitals see major drop in post-surgical deaths with nation’s first proven statewide Surgical Safety Checklist Program.”
The Health News Review, for which I review, grades coverage of research in the media. Based on their objective criteria, the Harvard press release would not score highly.
The title exudes …
I stood in line behind a physician, slightly balding and in a long, starched lab coat at the coffee shop in our hospital. As he paid and took his coffee, I noticed that he smiled and called the clerk by name, “Thank you, Terri.” He went on about his day, and I was left to wonder about the man, his practice and what type of person he was.
My friend has …
When I am facing an alcoholic in the office, I do not advise him to stop drinking.
Other physicians may advocate a different approach. We live in a free society and individuals are free to make their own choices. I have decided, for example, not to own a firearm, ride a motorcycle or bungee jump as these activities are not only beyond my risk tolerance threshold, but are also activities that …
When it comes to the review of systems, I’ve been a natural, a savant — a prodigy you might say.
During my first few weeks of medical school, I remember doing mock interviews with fake patients. This was long before I learned anything about “HPI,” “ROS,” physical exams, billing or anything medically relevant for that matter. As other students stuttered, trying to figure out what to ask a lady pretending to …
During a recent internal medicine rotation, a senior resident expressed disappointment that I’ve chosen a career in family medicine. He was concerned that my talents would be wasted, because — in his words — I wouldn’t get to care for the “more complex patients” he sees in internal medicine. Although I appreciated his confidence in my abilities, I felt my heart sink, as it does each time I am faced …
Doctors and nurses like facts. After all, we’re evidence-based thinkers — rational scientists. Yet, we can be surprisingly superstitious.
Many of us believe in a thing called “call karma,” which is when certain doctors attract sick patients while working on call (these people are said to have bad call karma). Other doctors attract less sick patients, meaning they have good call karma.
As a medical student, I quickly learned that I fell …
It is not something that is taught enough in medical school, but practicing physicians quickly realize that in this business: Communication is everything. The reality of health care is that you can be the worst physician in the world clinically (not that it’s something desirable to be), display great interpersonal skills, communicating well with your patients — and they will do absolutely anything you say and put you up on …
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Walk with me, why don’t you? It’s time, don’t you think? We have been avoiding this for quite a while. But it’s best to bring this out from the shadows and into the light. Let’s take a walk through part of my day.
Be careful.
You won’t like what you see. I don’t like this much, but I just keep moving forward, one foot in front of the other. Don’t stop. Can’t …
A guest column by the American College of Physicians, exclusive to KevinMD.com.
Lately, I’ve been asking myself whether today’s patient is less able to self-manage minor illnesses than their parents or grandparents. That question was inspired by my review of notes from my patients’ visits with my nurse practitioners or to our after-hours clinic, as …
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. However, somehow we get out into practice and are automatically seen as leaders, and thrown into positions that require a skill that we don’t have. And we …
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In the podcast below I interview a dear friend and therapist, Sydney Ashland, who shares the top 10 fears that hold doctors back.
What prevents us from being the doctors we always imagined? We enter medicine as inspired, intelligent and compassionate humanitarians. Soon, we’re cynical and exhausted. How did all these totally amazing and high-functioning people get screwed up so fast? Attention, medical …
I have now been out of the active medicine for two years. I still have dreams about being a doctor and practice. I don’t think you can do the same thing day in and day out for 40 years and not have it be a part of who you are. I am still asked my opinion by friends and family about their health issues, and frankly, I find my fund …
“Do you have sex with men, women or both?”
This is the way that we were taught in medical school to ask a patient about their sexual history. When we took our sample standardized patient exams, we were scored whether or not we asked this question. In my understanding, this was supposed to be a non-judgmental, non-assuming way to elicit a sexual history.
However, romantic partners generally come before sex (unless we …
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“Help!” I yelled out of our open apartment door.
I was seven years old, and my family had recently emigrated from Egypt to the U.S. We’d been feeling elated that week because, after months of interviews, my father had matched into a pediatric residency.
That morning, he’d awoke feeling nauseated. My mother and sister went to buy some soothing food. I noticed that he’d vomited in the bathroom; now he was feeling …
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