As a physician, you have endured many years of schooling, and you have received many A’s on your report cards. You have passed exams with flying colors, and you have pleased your higher-ups in the food chain. You have come so far, and you now find yourself in a rarefied position that most people only dream about. So what’s standing between you and your thriving life? Clearly you’re smart ...

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shutterstock_131910137 American anesthesiology reached a significant milestone last year, though many of us probably missed it at the time. In February, 2014, the number of nurse anesthetists in the United States for the first time exceeded the number of physician anesthesiologists. Not only are there more nurses than physicians in the field of anesthesia today, the number of nurses entering the field is ...

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Many of the patients that I treat have brain injuries. Whether caused by a stroke, car accident, fall, or drug overdose, their rehab course has taught me one thing: nobody likes to be forced to do things against their will. Even the most devastated brains seem to remain dimly aware of their loss of independence and buck against it. Sadly, the hospital environment is designed for staff convenience, not patient ...

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One of the cornerstones of the practice of medicine is finding imperfection in things. When the doctor encounters the patient, the latter expects the former to find out what is “wrong.” In fact, I often see a patient and find nothing wrong, and when I voice this out loud the parents often ask, “Are you sure?” I completed medical school over 7 and a half years ago. During that time I’ve ...

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american society of anesthesiologistsA guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. The health care landscape is changing, and now more than ever we as physicians should be focused on quality of care and ensuring the safety of our patients. Anesthesiology was the first medical specialty to champion patient safety as a specific focus. Over the past century, physician ...

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I remember one day a few years ago when I was talking with one of my friends about the challenges of being a doctor after a tough day at work. I had seen a large number of patients within the span of a few hours, and in addition to many of them being sick, I dealt with family members who had so many questions and who wanted to provide me ...

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shutterstock_224345509 I have a unique perspective as a physician. Having traveled to many hospitals in the past two years, working as a locums emergency physician, I can comment on a variety of issues with a reasonable amount of experience. One of those issues is EMR, or electronic medical records. I have spent plenty of time writing about this in the past, and I ...

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GVE8468-640x424 Standing on the edge of his hotel balcony, a doctor describes the rolling hills. He tells me, “It’s a beautiful place to die.” Ten minutes later, he agrees not to injure himself -- for now. I’m not running a physician suicide hotline. But doctors keep calling me. It’s midnight, and I’m speaking to a psychiatry intern. Bullied by residents and her attending, she ...

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In the last year and a half, I've been able to go to Africa 4 times and Haiti once, for which I give thanks that the world still produces abundant fossil fuels. That much airplane travel does make me feel a bit guilty, even though I'm not actually vacationing. Going to far away places to practice medicine has always been something I hankered after, and it turns out that knowing how ...

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“The patient’s pain is still 9/10, doctor. We’ve already given morphine IV and then changed to Dilaudid IV and then we increased the dose of Dilaudid. Can we give it every two hours instead of every three hours?” the nurse asks me over the telephone. I sigh heavily into the receiver, unsure what to do, feeling more like a drug dealer than a doctor. The patient is on horse-sized doses ...

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