“You’re making a huge mistake because you’re threatening a nurse.”

Policy
September 1, 2017
YouTube video

Alex Wubbels, the head nurse at the University of Utah Hospital’s burn unit, was arrested for refusing to draw blood from an unconscious patient.   She was absolutely correct, since it was against hospital policy, and constitutional law, to do so.

ZDoggMD dedicated an episode of his Facebook Live show, Incident Report, highlighting the travesty:

“Sir, you’re making a huge mistake because you’re threatening a …

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“You’re making a huge mistake because you’re threatening a nurse.”

The parable of the pizza shop

Physician
September 1, 2017

One day a man decided to open a pizza shop. The first week he sold pizzas and collected money from his customers; the happy customers ate hot pizza, and the man made some money.

The next week many of his customers who came in had pizza insurance, and had already paid Blue Wall Insurance for their pizzas. Since so many of his customers had purchased pizza insurance, the man signed a …

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The parable of the pizza shop

Dear insurance doctor: You are not my peer

Physician
September 1, 2017

I am a gynecologic-oncologist. I work in the high-stakes realm of cancer care. I strategize complex treatment plans involving surgery, radiation, chemotherapy and the newer biological agents to treat the myriad of disease that we call collectively “cancer.” Cure — or at least control — requires urgent and timely administration of these modalities along with various imaging or blood work to assure that the treatment prescribed is effective. I love …

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Dear insurance doctor: You are not my peer

5 keys to a successful long-distance relationship during medical school

Education
August 31, 2017

When my husband Brian started first-year of medical school at the University of Miami Miller School of Medicine, I jettisoned off to Thailand to spend a year teaching English and traveling.  We figured if we were going to date long-distance, why not go all in? Why not ensure that we were a full 12 hours apart, on literal opposite sides of the world. What can I say? We like a …

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5 keys to a successful long-distance relationship during medical school

Nurse practitioners! Tips for negotiating your first job

Policy
August 31, 2017

Congratulations on the new job! After countless, grueling hours of juggling school with the rest of your life, you’ve finished and secured a job, a huge accomplishment indeed.

Negotiating your compensation package can be a nail-biting, heart-racing all around anxiety-producing experience.  While some of this anxiety might just stem from inexperience with negotiating a contract, you might also be worried about not knowing what to ask for as a new nurse …

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Nurse practitioners! Tips for negotiating your first job

A day in the life of an OB/GYN chief resident

Physician
August 30, 2017

It’s 5:50 a.m. and my alarm is buzzing. It’s been going off intermittently since 5:30 a.m. Even though I really don’t need to be out of bed until 6:00 a.m., I’ve lived with myself long enough to know my biggest vice is the snooze button.

I roll out of bed and get ready for the day — blue scrubs, messy bun, enough makeup to feel like I tried, freshly clean teeth …

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A day in the life of an OB/GYN chief resident

The Big Short in health care: What happens after the bubble bursts

Policy
August 30, 2017

Last week a physician friend recommended watching the movie the Big Short. The description given to me was that it was a great movie that was all about a bunch of guys who saw the 2008 financial crisis coming. Sure enough, that very weekend, I planned a night in to get take out and watch it on Netflix.

And it sure didn’t disappoint. Starring Ryan Gosling, Steve Carrell, Christian Bale, and …

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The Big Short in health care: What happens after the bubble bursts

9 reasons the “golden age of medicine” was golden

Physician
August 29, 2017

To listen to all those desperate to reform health care, you get the impression that physicians are pretty horrible people. We are all sexist, greedy, money grubbing tyrants who will perform unnecessary tests and procedures just to make money. We don’t care about quality or cost. We are killing off 250,000 patients every year with our ignored “errors.” We purposely keep our patients in pain, or we addict them to …

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9 reasons the “golden age of medicine” was golden

15 tips for working with women

Physician
August 28, 2017

I work in a male-dominated field. As a cardiac anesthesiologist, I work with mostly male cardiac surgeons in a department where the majority of my fellow anesthesiologists are male. I work with some fantastic male colleagues. They are caring, skilled doctors, and I consider many of them to be friends.

While most of them know how to handle emergencies, trauma and difficult work situations, many times they clam up when we …

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15 tips for working with women

The mythical unicorn of vaccine denialists

Conditions
August 28, 2017

I swiped this editorial cartoon by Steve Sack from the redoubtable Dr. David Gorski’s blog, who goes by the nom-de-web of Orac. Recent epidemiology shows reducing the fraction of vaccinated children in the population rather promptly leads to a resurgence of the diseases vaccines protect against. This is the concept of community or herd immunity.

Epidemiologists debate the concept around …

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The mythical unicorn of vaccine denialists

5 ways virtual doctors can help during a natural disaster

Physician
August 28, 2017

In Houston, all of my colleague’s offices are closed, and there is limited access to the Texas Medical Center due to Hurricane Harvey. As a virtual medical doctor, there was only one thought on my mind this entire weekend, “How can I help?”

As a Floridian, I have certainly faced my share of natural disasters beginning with Hurricane Andrew, a category 5 hurricane in 1992. Living through Hurricane Andrew gave me …

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5 ways virtual doctors can help during a natural disaster

Physicians: Use your voice to make the difference

Physician
August 28, 2017

Recently, there have been many times when you may have gotten a news alert on your phone or checked the latest Twitter hashtag and wanted to scream. Or you were too busy to even check until later that day and did not know what to say other than to lurk and watch a train wreck in progress. You may have thought about saying something, but paused and wondered, “Is this …

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Physicians: Use your voice to make the difference

The white coat symbolizes 2 important commitments

Education
August 27, 2017
YouTube video

A white coat ceremony address to the University of California, Riverside School of Medicine, August 4, 2017.

“It takes a village” is one of my favorite proverbs, an African proverb, that resonates with each of us on this monumental day. There is without a doubt that every one of you worked very hard to get into medical school. However, this difficult journey was supported by dozens of important individuals: teachers, …

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The white coat symbolizes 2 important commitments

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Fix the pay imbalance between specialists and primary care physicians

Policy
August 27, 2017

Reformers have expended considerable effort to change the way Medicare buys health care for millions of Americans, finding a wide range of support across the political spectrum. But Medicare’s current structure may doom these reforms. Some primary care doctors fear that the skewed incentives in Medicare’s pricing system will get built into any new system, whether it is “accountable,” “affordable,” or “value-based.” This fear is well-founded. If special interests buy …

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Fix the pay imbalance between specialists and primary care physicians

Good clinical care takes more than medical acumen

Physician
August 25, 2017

When I finished my medical training almost sixty years ago, I was like many new graduates: I thought I knew it all.

I opened a private office in Los Angeles and paid courtesy calls on the local physicians to let them know my qualifications and my availability for consultation, as both an internist and a nephrologist. (The treatment of kidney disease was then in its infancy, and I was the area’s …

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Good clinical care takes more than medical acumen

4 reasons to choose emergency medicine

Physician
August 25, 2017

There is a definite finality to the decision of which specialty a physician pursues. The reasons are as vast as they are individual. Hopefully, the med student has done due diligence and has a solid grasp on what their future entails, at least for the future as far as anyone can confidently foresee. Here is my story.

1. Challenge. No day is quite like another, and life as an emergency medicine (EM) …

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4 reasons to choose emergency medicine

A surgeon makes a mistake, and couldn’t stop crying

Physician
August 25, 2017

“F*ck!”

I pried my eyes open and had the realization of exactly what time it was. I was going to be late — again. I jumped out of bed as fast as my stiff and weary body would allow, threw scrubs on I was mostly sure were clean, ran a brush through my hair so I didn’t look totally disheveled when I had to look like professional in a few minutes …

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A surgeon makes a mistake, and couldn’t stop crying

48 hours in the life of an on-call gynecologist

Physician
August 25, 2017

An on-call weekend: 48 hours of being at any moment “on,” of being edgy, of being exhausted. This weekend included a full house of patients to see in the hospital, a patient list of three pages to be exact. As I went from patient to patient, room to room, each held its own unique story filled with the yin and yang of life. I realize too, this may be a …

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48 hours in the life of an on-call gynecologist

This resident’s childhood friend inspired him to help other children as a physician

Video
August 24, 2017

“You find joy that people are doing better because of what you did for them.” #BornToHeal

Courtesy of the American Medical Association (AMA).

This resident’s childhood friend inspired him to help other children as a physician

Help me help doctors in recovery

Physician
August 24, 2017

Approximately 12 years ago, I hired my first physician in recovery. He had temporarily lost his license following a bout with alcohol. After a stint in a rehabilitation clinic, he was ultimately reinstated. My journey to hire this physician was arduous at best. During the interviewing process, I narrowed the field down to two candidates: one with a past and one without. I wrestled with the “in recovery” situation and …

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Help me help doctors in recovery

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