On November 1973, I had an epiphany.  My first week on my internal medicine clerkship, I realized that I had found my specialty: internal medicine. Prior to medical school, I had worked with emotionally disturbed children in an inpatient hospital.  I really enjoyed the experience, and learned a great deal.  During my first two miserable years in medical school (I disliked how they taught the basic sciences and even more how ...

Read more...

One of the terrible things about being a physician who has spent his adult life working in emergency rooms is that you have a certain terrible clarity about the dangers of this life. It’s why we’re forever pestering our loved ones with phone calls and texts: "Are you there yet!" Or telling the children, "Be careful! After midnight there are too many drunks on the road!" Met, of course, with ...

Read more...

asco-logo Ten years ago, I first met this patient, newly diagnosed with intermediate-risk prostate cancer. As I walked into the examination room, I was struck by the juxtaposition of his wife, crumpled in a chair and weeping silently, with the patient himself, pacing the 12'-by-4' room with a look of either anger or frustration. This difference in response between the man and ...

Read more...

It’s widely acknowledged that the American health care system achieves relatively poor ­quality outcomes compared to most industrialized nations and at much higher cost. A new survey, conducted by Nielsen Strategic Health Perspectives and commissioned by the Council of Accountable Physician Practices (CAPP), provided important insights into why this could be the case — and more ominously, why the future may be no better. CAPP is made up of ...

Read more...

Man collapses at 30,000 feet. Quick, who’s in charge? Hint: It’s not the doctor. Last month, Dr. Tamika Cross was told to sit down when she tried to help an unresponsive man. Why? Apparently, the flight attendant was looking for an “actual” medical doctor, not a black woman. Turns out she’s not the only doc making headlines for being turned down in a medical crisis. What ...

Read more...

A recent story in U.S. News & World Report described how a Seattle hospital is taking a systems approach in improving health care quality and cutting costs. It said, "Virginia Mason Health System ... has looked to adopt many of the much-admired and often-emulated business philosophies from Toyota." The best-known of those philosophies is the so-called lean methodology which is based on eliminating waste and focusing on things that ...

Read more...

As I sit behind a computer in my office today at the physician’s workstation, I am baffled at the steady flow of pharmaceutical representatives that flow into our office on a daily basis. Each rep comes in with a fancy glossy print detailing the data concerning their particular drug. My office is busy; patients are coming in and out, and medical assistants are busy checking vitals and verifying medications (and of ...

Read more...

Buprenorphine was a fantastic drug in the emergency department. Patients would come to our ED feeling awful from opiate withdrawal, and we made them feel so much better. We can recall so many patients coming in vomiting, anxious, sweaty, dehydrated, and looking awful -- and with one or two shots of buprenorphine, we made them feel well enough to take on the task of beating opiate addiction. A clinic in ...

Read more...

As a family practice resident, I've found that a premium is placed not only on my clinical acumen but also on how well I respond to my patients' mental and emotional experience of illness. Yet the work of learning to be a doctor is just that — work. (And in overwhelming amounts.) Time management becomes ever more vital: As I take the time needed to gently break bad news and to ...

Read more...

Dear doctor mom, I’ve been a physician for 13 years.  For the past 7 years, I have also been a mom.  A growing number of experiences made me decide to write this letter.  I hope other moms don’t attack me.  I do not mean to downplay their struggles, or to insinuate that doctor moms necessarily all have a harder time compared to other moms.  I only focus on you, because I ...

Read more...

540 Pages

Most Popular