You’re a physician and a parent. Which comes first?

Physician
March 1, 2018

If you’re a physician-parent, no doubt you’re familiar with the helplessness associated with the phone call informing you that your child is sick — and needs to be picked up within the hour.  You know, the one that coincides with when you were about to start a procedure or a time where there’s no backup available to take over your responsibilities.  Murphy’s law.

Many of us have nannies exactly for this …

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You’re a physician and a parent. Which comes first?

How psychiatrists became lesser physicians

Physician
February 28, 2018

Recently, a form showed up on my desk to sign, approval for something or other. Not uncommon, given my role at the time as a chief psychiatrist, I signed dozens of such letters, memos, or forms, drafted by an administrative assistant.  I signed so many; I never looked at the last line — at how my name had been typed out.  Just once my eyes wandered to the end and …

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How psychiatrists became lesser physicians

The unjust prosecution of physicians is not unique

Policy
February 28, 2018

Dr. Pramela Ganji had just finished her lunch when she was told that the appellate court had reversed and vacated her conviction.  At first, she didn’t believe it.   

After all, this whole experience had been surreal.  Dr. Ganji, a 68-year-old well-respected medical doctor and married mother of 3 children, had practiced medicine for 40 years without incident.  Her patients loved her, and she had dedicated her life to helping others. …

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The unjust prosecution of physicians is not unique

Physicians don’t know everything, and that’s OK

Education
February 27, 2018

Physicians face a host of challenges in practice, but the one that looms largest is often this — they don’t know everything.

It would be tempting to think that they do. As patients, we want them to. We want our doctors to tell us that they know what’s wrong and how to fix it. Medical mysteries are fun on television, but in our real lives, they’re profoundly unsettling and can have …

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Physicians don’t know everything, and that’s OK

We are all aging every day. But mostly we ignore, do not recognize, or deny it.

Conditions
February 26, 2018

Part of a series.

We are all aging every day, but mostly we ignore, do not recognize or deny it. Then all of a sudden, we look in the mirror and realize that older age has found us. Even then each person deals with aging differently. There is Dr. Seuss’ “Cat in the Hat” who sees nothing but adversity in aging. There are others who accept aging but …

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We are all aging every day. But mostly we ignore, do not recognize, or deny it.

Radical realism: A hospice doctor prepares for death

Physician
February 26, 2018

Bruce Wilson, MD, is a hospice doctor and former cardiologist who was diagnosed with pancreatic cancer in February of 2017. In the months that followed, he publicly discussed events as they unfolded on a CaringBridge blog. The irony of the situation was profound: a hospice doctor being handed what some consider a death sentence. A physician who dedicated his career to changing the conversation about end of life care now …

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Radical realism: A hospice doctor prepares for death

There’s more to the story of the fired patient

Physician
February 26, 2018

She could have been my charming tiny kindergarten teacher, sitting there nonchalantly in her wheelchair with neatly folded arms in her lap. The delicate, airy cloud of silvery blonde hair on her head resembled Queen Elizabeth’s style. I named her Ms. Elizabeth. A few moments ago, though, she looked like a young child who could not comprehend the meaning of her condition. Whenever she was spoken to, her mind seemed …

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There’s more to the story of the fired patient

Are diploma mills hurting the nursing profession?

Policy
February 26, 2018

I have worked with some great nurse practitioners (NPs) who I consider to be friends. They play a vital role in team-based practice. This is not about NP bashing. Nor is it a turf war; now that I’m retired, I have no turf to protect. I am a member of Physicians for Patient Protection out of real concern for the future of medicine in this country.

I want there to be …

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Are diploma mills hurting the nursing profession?

Fixation error can be deadly in medicine

Conditions
February 26, 2018

John Grover is a nice guy. He’s fifty-five, short, a little chubby, and he has a neatly trimmed red beard. He’s the kind of guy whose eyes light up the moment you walk into the room; The kind of guy who remembers your kids’ names, their ages, and their interests. I’d met him a few times before. He’d come in once to refill his blood pressure medication because he couldn’t …

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Fixation error can be deadly in medicine

Rappers: Stop glamorizing prescription drug use

Physician
February 25, 2018

During his 2004 stand up “Never Scared,” Chris Rock said, “I love rap music, but I am tired of defending it.” That statement, for me, holds true more today than ever before. Mumbling about nonsense is already hard to defend and only gets worse when the first line to every song these days has a reference to drugs.

Drugs, sex, and money have always been an important part of music, and …

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Rappers: Stop glamorizing prescription drug use

10 tips that make me a happy doctor

Physician
February 24, 2018

Burnout is defined as emotional exhaustion, feelings of cynicism and detachment, and a sense of ineffectiveness at work. The inverse of burnout is engagement — a persistent, upbeat sense of fulfillment characterized by vigor, dedication, and absorption. I haven’t seen that doctor in the hospital lounge in a long time.

I am a neurologist practicing for 25 years in both academic and community hospital settings. I have a busy outpatient practice, …

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10 tips that make me a happy doctor

When a patient dies, do you cry?

Physician
February 24, 2018

Apparently, I wanted to become a doctor since I was four. My mother tells the story of me getting ready for bed and simply saying: “Mommy, when I grow up I want to be a doctor so I can make people better.”

This notion stuck with me, and, luckily, I took a liking to biology, anatomy and all the sciences throughout school making my little four-year-old dreams come true. And now, …

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When a patient dies, do you cry?

5 lessons every woman doctor must learn

Physician
February 24, 2018

Recently, I wanted to find some inspirational articles for female doctors. This letter to the young female physician by Dr. Suzanne Koven was one of the first things I came across. I wish someone had written me a letter when I was young and dumb and entering internship. Maybe it would have been a good warning. I mean, I was clueless about what lay ahead. I …

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5 lessons every woman doctor must learn

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A medical student’s first day in anatomy lab

Education
February 23, 2018

During the first week of medical school classes, we visited the anatomy lab. As far as I can remember, I had extremely mixed feelings on that day. I felt the thrill of taking my first baby steps towards my medical journey blending with a certain feeling of fear. Was I afraid of the pure existence of cadavers in that gloomy, long and hall-like room? Or was it the fear of embarking …

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A medical student’s first day in anatomy lab

How this physician started his consulting business

Physician
February 23, 2018

I do some of my best thinking while exercising.

A few years ago, I was swimming laps in the still-dark early morning.

Swimming is one of my favorite activities. But in a pool, it gets boring staring at the bottom, so my mind often wanders off to tackle difficult problems.

That morning, like many of you, I was wrestling with the question of how to turn my passion into a successful side gig …

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How this physician started his consulting business

We are a product of our upbringing: a tale of 2 cities

Finance
February 22, 2018

We are a product of our upbringing.  For many of us, this means we develop values and beliefs about money and work from our parents.  Our communities, however, also play a role.  It is in these communities that we learn a joint value system, a blueprint for how to approach and interact with the world.  It’s easy to underestimate the profundity of this effect.

I grew up in vastly different cities.  One …

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We are a product of our upbringing: a tale of 2 cities

Influencing your resident evaluations for success

Education
February 21, 2018

Performance appraisals are an integral part of an organization’s assessment of employee and trainee standing. Management and human resource literature is full of analysis and debate regarding how to best rate subordinates. Regardless of evaluation system utilized, some of the common goals of individual appraisals are to monitor progress, identify areas for growth, set goals, guide development, provide and elicit feedback through open communication, and document issues that may require …

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Influencing your resident evaluations for success

A physician’s life as an FBI informant

Physician
February 21, 2018

“Where is Saipan?” I typed into Google to search for this little U.S. territory island in the Western Pacific when I was told about a need for an OB/GYN in 2016.

Next, I inquired to the private physician looking to expand his practice, “Do you really have a significant volume to support another doctor?” My vision of island medicine was that there were a smaller number of births due to a …

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A physician’s life as an FBI informant

The miscalculated fear of an opioid crisis in Haiti

Policy
February 20, 2018

Opioids are an essential class of drugs used in pain management. In recent years, complex mechanisms pertaining to their abusive use have prompted a deadly crisis which is unfolding in the United States. The U.S. Centers for Disease Control and Prevention stated that 91 Americans lose their lives daily due to an overdose of opioid drugs. This public health crisis has inspired much apprehension even among Haitian …

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The miscalculated fear of an opioid crisis in Haiti

It’s time to treat C. diff diarrhea

Conditions
February 20, 2018

For millennia, blood-letting was the standard of care for many diseases; today it is a joke, evoked only to mock our predecessors.  But it is time to dismount our high horse and realize that there is at least one infection that we still primitively try to drain from the body, not from the bloodstream, but from the colon.  This is our friend Clostridium difficile.

According to the CDC, there are about …

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It’s time to treat C. diff diarrhea

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