I just recently attended a meeting where there was a panel discussion on caring for Holocaust survivors. The person who opened the meeting spoke about how she felt inadequate when dealing with this population because she had no personal place of reference -- she had no family members who died during the Holocaust, and so she couldn’t truly understand what the survivors went through. I have a different thought. Although every experience ...

Read more...

Fall in love with medicine againFall in love with medicine again An excerpt from Remedy for Burnout: 7 Prescriptions Doctors Use to Find Meaning in Medicine. A doctor’s self-worth can be tied up with a lot of issues. How well can we make a diagnosis? How elegantly can we perform the surgery? How happy are our patients? Our staffs? Our families? How many articles ...

Read more...

Another day, another pacemaker, at least so it seemed at first. The usual greeting the patient, answering the last questions, consent signing, placement of the IV, EKG leads, prepping of the surgical site and initiation of the preoperative antibiotics were all recent memories.  He laid there, smiling, knowing he'd made the right decision after years of struggling with his arrhythmia in other ways.  His heart was showing signs of slight weakening and ...

Read more...

Glory days: Is a golden age of medicine on our doorstep? The practice of medicine is changing faster than anyone can keep pace with. As a hospital physician at a relatively early stage of my career, I’d say that a sizeable number of physicians that I work with are towards the latter end of the spectrum. I find that these doctors, typically over the age of 50, are struggling the most to keep ...

Read more...

My journey in the specialty of family medicine started in 2004 during my third year family medicine clerkship. I was assigned to an office located in the southwestern town of Yauco, Puerto Rico. The practice had two providers who saw patients of all ages. My family medicine attendings made me appreciate the way our specialty approaches patient care. We treat our patients taking into account their psychosocial framework and partner ...

Read more...

Medicine cannot be reduced to just a job. Heres why. A few months ago I was paged by a medical student in the emergency room at ten o'clock. I had just changed my clothes, and before my pager went off my attention had been squarely fixed on the newest Jack Reacher novel. You can usually tell when someone is going to ask you to come into the hospital from home, because there ...

Read more...

Brittany Maynard has passed from this life.  This brave but unfortunate 29-year-old woman with incurable progressive brain cancer drew public attention by choosing to go public with her choice about end of life care. "Brittany suffered increasingly frequent and longer seizures, severe head and neck pain, and stroke-like symptoms," according to a statement Sunday night from Sean Crowley, spokesman for Compassion & Choices, a national nonprofit working to expand end-of-life ...

Read more...

Every physician is public and has an audience An excerpt from The Public Physician -- Practical Wisdom for Life in a Connected, Always-On World. What you do, where you live, and what you intentionally create as a physician in public should be determined by what you want to accomplish. What are you trying to get done? Perhaps you want to …

  • build a strong public presence to keep your ...

    Read more...

Does Brittany Maynards decision affect the future of oncology? Would you base a life or death decision based on one doctor’s opinion? One research article? Google searches? What would it take? I recently read that Brittany Maynard took her own life. Plagued by glioblastoma, she chose to reject chemotherapy, radiation, and hospice. Tomorrow, I have a schedule packed with glioblastoma patients who personify courage, determination, and faith. Glioblastoma (GBM) ...

Read more...

There is abundant evidence for malaise in the physician workforce, but little agreement about etiology, treatment options, or prognosis.  As a senior physician who still has a lot of involvement with physicians of all ages, I want to propose an etiologic framework. Perhaps if we agree on etiology, we can look at treatment options. There are three ways to look at what doctors do: the artisanal, the economic, and the scientific. The ...

Read more...