Fifty years ago, it was very uncommon to find doctors married to other doctors. Why? To answer that question, we need to explore the sociology of the time. Fewer women went to college, which meant fewer female doctors. Many couples married early, right out of high school or right after college. If the wife had career aspirations herself, these were often put aside in order to help her husband get ...
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When I was finishing my fifth year of studies as clinical psychology doctoral student, I fell in love with a second-year medical resident; a wanderer at heart with the softest smile and a way of listening that made me feel like the whole world stopped when I spoke. Whenever possible, we found ourselves in the forest exploring the world on foot or, if the weather was bad, on long drives ...
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It was a concept intimately familiar to me long before anyone gave it a name. From my earliest days in college, I felt surrounded by people who packed their days with meetings, activities, sports practices or competitions; classes, study groups, and research; for whom every moment had been spoken for and each day didn’t so much end as spill over into the next. The standard was clear: to do any ...
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“Let’s say a Chinese patient comes into labor and delivery … simply logs onto the CultureVision website. Next, click on the Chinese section and finally click 'Labor, Birth and Aftercare.' Just that quickly you have the information you are looking for.”
CultureVision boasts that it is the “first comprehensive, user-friendly database that gives health care professionals access to culturally competent care.” The website’s automatic slideshow, entitled “Did you Know?” shifts between ...
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On a typical day in a major hospital, patients pass through the emergency room with different ailments. Some of them are coming in to check out minor aches and pains, and others are coming in barely responsive with a life-threatening condition. Outside of the pediatric ward, all of the patients coming in are adults, and the majority of them are advanced in years, showing signs of chronic conditions taking effect ...
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What if you woke up tomorrow and learned that your grandmother had been kidnapped overnight by a couple of strangers, thrown in a white van, and taken to a distant warehouse where she spent the subsequent forty-five minutes being tortured before finally succumbing to her death?
Where she was repeatedly beaten in the chest, where a tube was shoved down her throat, where she was tasered with high voltage, where a ...
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The numbers haven’t changed significantly in several years -- only five percent of the U.S. population consumes a full 50 percent of annual health care spending, and just one percent is responsible for nearly 23 percent of spending.
Within the top 10 percent of high spenders, most (nearly 80 percent) are age 45 or older. About 42 percent are persistent high consumers year after year, while the majority requires high ...
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Jeffrey Lurie is the owner of my beloved Philadelphia Eagles. He pays the players. He picks the coaches. But I think we would agree that his checkbook should not allow him to be the one who calls the offensive plays. The coach should do that.
So why is it different in health care?
I have a patient who was diagnosed with polymyositis. Polymyositis is an autoimmune disease that causes inflammation of muscles ...
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Psoriatic arthritis can be a debilitating condition. It can lead to painful complications such as neuropathy. Its treatments can lead to complications such as shingles, which can leave a patient with continuing pain. Ehlers-Danlos Syndrome is for most patients a painful condition that leads to spontaneous dislocations, early arthritis, and frequent migraines. My husband and I have decades of experience between us in living with these conditions.
My husband and I ...
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Comments have again morphed into an essay. And, once again, they’re in response to a blog post by Dr. Suneel Dhand: When it comes to positive change, physicians are their own worst enemy. I thought it was excellent and spot-on. My first comment read in part:
When reading this post -- before I read the comments -- I found myself silently nodding ... maybe because I agree with much ...
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I am an ENT surgeon, a friend of the author, the patient, and their daughter, whose intervention saved his life. This is a smart, loving family caught in a terrible vortex of terrible medical care until they pulled themselves out, and a story that physicians must read, as we struggle to reinstate humanity and humility into our noble profession. Here is Paul's tale, as told by his wife.
***
On a mid-December ...
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As a child and adolescent psychiatrist, I have the privilege of working with many children who are victims of severe abuse, neglect, and trauma. Some, in turn, become perpetrators of violence. One adolescent, let's call him Steven, told me that he wants to be an electrician, but he is struggling to earn his high school diploma, which he needs in order to enroll in technical school. When I inquired about ...
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It’s still flu season, although the flu gods have shown a bit more mercy than in years past. So many variables determine whether each winter brings a relatively mild flu season, a “flunami,” or something in between. I’m a country boy doing primary care in the city, and I have only a modest understanding of which influenza strain is circulating, the concepts of antigenic drift and shift, and how the ...
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I’ve written a lot lately about caring for our patients, and about caring for our spouses, and those things make me very happy. But now and then, things rub me the wrong way.
I was recently working at TMH, or Tiny Memorial Hospital, my vague name for small facilities since I work at several and wish to preserve their anonymity. While there a patient checked into the ED for a fairly unremarkable ...
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Though I am two years into my residency, I still experience flashbacks to my time as a medical student on the wards. The adrenaline of arriving at the hospital 2 hours before rounds, scrambling to see my patients, constructing a note that no one would ever look at, and preparing a hastily-constructed presentation to deliver in a half-performance, half-examination outside of our patient’s room.
I remember being the object of a ...
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1. You either over or under-react to everything related to your child’s health. Your kid chokes? You perform the Heimlich and are back to dinner conversation 2 minutes later. Your infant spits up a little more than usual after their introduction to rice cereal? You decide they may have FPIES and stay up all night worried they may require tube feeds. True story.
2. You can’t go to any ...
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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 53-year-old woman is evaluated for a slowly enlarging, telangiectatic, pearly, ulcerated 1-cm plaque on the left temple. It bleeds periodically when traumatized. Medical history is significant for atrial fibrillation. She takes warfarin daily. She is otherwise in good health.
On physical examination, vital signs are normal. Cardiac examination shows an irregular heart ...
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38 states currently have an apology act. This means that if doctors feel they owe a patient an apology, they may provide one without any ramifications, if future legal actions are taken by the patient/patient’s family.
In 2006, I spent 218 days in the hospital after the healthy birth of my daughter. My chronic autoimmune disease, scleroderma, masked certain signs of preeclampsia, which went undiagnosed. This led to a massive infection ...
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My name is Dr. Neha Sharma, and I have a confession.
Recently, a patient was transferred to me from New Mexico. He was found in his house, unresponsive. By the time I admitted him, he was connected to a breathing machine, and had a serious lung infection. Over a course of a few days, his condition improved. We were able to remove his breathing tube and successfully treat his infection. However, ...
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Mental illness has long been associated with shame and stigma. Although progress has been made through the efforts of global celebrities like Stephen Fry and many others to de-stigmatize mental illness -- many are still ashamed to admit to it, and the stigma is far from being annihilated.
Nowhere is this stigma more entrenched than within the medical profession itself. A fact that should shock us out of our judgmental slumbers ...
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Past 6 Months
We lose a medical school full of physicians every year to suicide: An interview with Dr. Pamela Wible
Pamela Wible, MD | PhysicianThe first step to combat the nation’s obesity epidemic
Vincent DeGennaro, Jr., MD, MPH | ConditionsThe story of the pot-smoking neurosurgeon is more complicated than you think
Vamsi Aribindi | MedsWhy medical scribes are the ultimate answer to our health IT woes
Suneel Dhand, MD | PhysicianWant to help fix health care? First you have to care about costs.
Chris Trimble, MBA | PolicyWise rules of medicine that doctors and patients should follow
Thomas D. Guastavino, MD | Physician