Recently I attended the funeral of a prominent gastroenterologist in my community whom I knew socially as the father of my son’s friend. It was an untimely and rapid death due to pancreatic cancer. He left behind a young wife and four children, two of whom are in college. I would see him periodically at school functions; he would sneak into an event at the last minute and often struggle ...

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Dad had taken a turn for the worse, but my family was not ready to give up on him and consider end-of-life care. Nevertheless, choices had to be made. Would Dad be allowed to pass while in assisted living or have his life prolonged in a skilled-nursing facility? What kind of a doctor am I? When perceiving that a patient is dying, what type of physician neglects to intervene and ...

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In early 2014 I decided to use the six state licenses I had obtained as a locum tenens physician to start practicing telemedicine. Since then I have worked with several telemedicine platforms. I use telemedicine to keep up my outpatient skills. I have found that telemedicine companies differ dramatically in their overall ease of use for the provider. Here are my top 7 tips for deciding which telemedicine company to work ...

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Many stories have been shared by physicians detailing their experiences during their years as house officers. I trained at an inner city hospital in the early 1970s, and my story was unique. Hospital J was built in the early part of the twentieth century. The structure was nine stories tall, with the ICU, the only air conditioned floor, located at the top. The elevators had not been automated and were still ...

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“I solemnly pledge to consecrate my life to the service of humanity.”  Standing with my medical school colleagues, we continue: “I will respect and hold the secrets that are confided in me. I will exercise moral integrity.” I easily agree. But then, “The health of my patient will be my first consideration.”  I’m 40 weeks pregnant, with swollen feet and raging heartburn. My baby kicks wildly. With certainty, I know that ...

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As a physician who is planning an early retirement, and is writing about the topic often, I find that retirement is frequently on my mind. It’s not difficult to articulate my desire for an early retirement. I crave the freedom and time with my family. I look forward to restful nights free from the threat of the loathsome pager. Another round of MOC is not for me, and I’m ready ...

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“It’s an 8,” I heard him say from behind the curtain as I walked into the room. The nurse’s aide dutifully recorded the number while the automated blood pressure cuff searched for his pulse, and the plastic clip on the tip of his index finger measured his oxygen saturation. “What does an 8 mean?” I asked. “Oxycodone!” he chirped cheerfully, without a moment’s hesitation.  “An 8 means oxycodone.  Five milligrams!” “Ah, but you’re wrong,” ...

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Sometimes when I’m working at the hospital overnight, I go for walks. Every now and then, things calm down in the operating room, and you can get some time to relax. Life moves at such a break-neck pace, especially within the world of hospitals, that taking a moment to reflect, is beneficial. Walking around a hospital at night is very different than during the day. During the day, it feels like ...

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Once upon a time, not that long ago, there was man who lived an uncomplicated life. One morning he awoke and did not feel well. He could not really describe his malaise, but he definitely was not his usual self. Nothing particularly noteworthy had happened to him except that his dog had recently died of old age. William, a scruffy little terrier, was 17 years old, and the man knew ...

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The first time I wore a white coat was during the white coat ceremony in medical school. It was a beautiful day in New York City. Scores of young, bright-eyed medical students and their proud family members were all congregated in a ballroom, which shared its building with a bowling alley, in the heart of Harlem. It was particularly warm inside the building, and we were being served hot coffee while ...

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