“I want to die, I want to die,” she repeated over and over as the trauma team stabilized her body. The patient, a female in her late 70s with Parkinson’s disease, presenting with a self-inflicted gun shot wound to the head.  It was at that moment I saw the complex cruelty of her situation. The despair in which she found herself and in the manner in which she sought to ...

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I will not argue that drugs are “bad” and holistic care is “good.” I have seen the way medications can transform a person’s life for the better, and I could never invalidate the experience of someone living with mental illness. But I will argue vehemently that holistic, preventive, and integrative health measures should come first, and medication should be used as a secondary option. The current structure of psychiatry -- ...

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The ultimate goal of every young physician while in medical school and residency should be to become a remarkable doctor. However, what if one of the biggest factors of being a great doctor was not addressed from the start? Financial wellness may not directly correlate with being an incredible doctor, but stress can and does, and today's young medical professionals have a lot on their plates — beginning with $200,000 in ...

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As a physician from Ghana brought up in a very religious family, I must admit that when it comes to gay rights and other issues related to sexual minorities I was as far to the right as anyone could be.  My first experience with openly gay individuals was when I came to the United States. Needless to say, gay behavior in Ghana was so stigmatized as to be nonexistent in ...

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Recently, my friend had a patient. The guy, patient with a history of autoimmune disease came in with pain, anxiety, and tachycardia.  She walked in and felt the psychosomatic overlay. What was her intervention? Meds? Psych? Nope. She closed the door, held his hand, pulled out her mom self and let him tell her for 15 long minutes about his hard life. The nurse watched the monitor as his heart rate dropped in ...

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The reason for Chandra’s office visit is to fill out form N-648. Chandra* is a fifty-nine-year-old Bhutanese refugee who has been my patient for the last nine months. Form N-648 is a six-page bureaucratic nightmare that is guaranteed to bring my clinic day to a grinding halt. My refugee patients bring me this form to certify that they are unable to take the test to become a U.S. citizen due ...

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In my former life as a hospital-based, shift-working physician with young children at home, this time of the year inevitably brought the same question from at least a handful of individuals:  “Isn’t it hard on your kids not to have you home on Christmas?”  Thankfully, I was always able to answer truthfully, “no.”  With consistent effort and a no-nonsense attitude, my kiddos either didn’t know the difference because they were ...

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I spent one year working full-time as a pharmacy technician at a high-volume community pharmacy prior to entering medical school. Besides learning the intricacies of billing and the dispensing process, I was granted personal access into a world nearly all patients, but few providers are aware of.  At the time my job was just that: a job. There were fun perks like counting pills in multiples of five and visualizing ...

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When was the last time your child read a book featuring someone different from them? When did they last read a book about an African American girl celebrating her birthday, a Mexican American girl celebrating her quinceañera, or a Jewish American boy celebrating his bar mitzvah? What about a book featuring Chinese American, Native American, Indian American or Muslim children? Think of the last few books you read to your children. Chances are, ...

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I am a family physician who has been in practice since 2007. My practice is broad in scope; immediately out of residency I worked in a community health center where I practiced obstetrics, newborn care, and inpatient medicine and pediatrics, along with my outpatient obligations. Since 2011 I have been a locum tenens physician working in rural Colorado in emergency departments, clinics, and hospitals. I recently received your American Board of ...

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The most exciting and difficult part of my job is keeping up with all the rapid changes occurring in the field of cancer treatments.  It is amazing how each day there seems to be a breakthrough treatment coming along, shifting old cancer paradigms.  Although this is a good problem to have, finding time to stay current is easier said than done.  Even more difficult is making sure we can explain these ...

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Since being fired from my program as a result of my cancer diagnosis, I am on a mission to help medical students and doctors. After starting the website, Improve Medical Culture, I have found that much of the general population has little sympathy for doctors. Some find us completely unrelatable. Because of this, I wrote the following comparison between dogfighting and medical training. I aim ...

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For any health care professional, a typical day in the hospital brings about its unique challenges. Depending on the patients that we see, one second the situation can be routine, and the next second, it can become complex. In the midst of this flux, there is an expectation for us to make important decisions, with the speed of these decisions dependent on how a patient is doing at a given ...

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"Well?  Did you save him?" "No. We did better than that." He came in pulseless. The machine performing chest compressions with the rhythmic thud, thwack, thump. His ribs heaving under the force of the compressor, keeping his heart artificially beating. The plastic tube secured in his airway forcing puffs of air to inflate his lungs.  His skin slightly purple-gray, on that narrow brink between life and death. His eyes like speckled ...

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On November 18, the World Health Organization (WHO) declared that Zika will no longer be classified as a public health emergency, while maintaining that the epidemic remains “a highly significant and long-term problem,” and emphasizing that this change in designation did not represent a downgrade, but rather an escalation in its long-term importance. Most major news outlets rushed to report the news, with headlines focusing on the end of the emergency ...

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I thought long and hard about the financial ramifications of medical school before I started. I already had a job in the medical field that I enjoyed, and I was happy with my level of compensation at the time. After running the numbers, I knew that the choice to pursue medicine would result in a delayed economic benefit that would take at least 15 years to recover, and only through ...

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Voluntary termination of pregnancy. Voluntary interruption of pregnancy. These are the medical terms for what the layperson thinks of as an abortion. Missed abortion. Threatened abortion. Incomplete abortion. Spontaneous abortion. Septic abortion. Inevitable abortion. These are medical terms for the failure of a pregnancy. All these medical terms are just that: medical terms. Nomenclature to differentiate biological processes, so as doctors, we can clearly communicate what is happening with our patients. However, ...

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An excerpt from Physician—Time to Invest in Yourself: Work-Life Balance, the Needs of the Patient, and Medical-Legal Risk Management. What is an essentialist? What is an essentialist lifestyle? Essentialism focuses on identifying the important signals in life and eliminating the noise. The noises are the distractions that add no value to your life and frequently monopolize time and meaning. When you assume the role of an essentialist you will ...

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When I wrote the article, “My future as a physician looks mediocre at best,” I did not expect the traction that it received. When it received so many shares, I realized there is an important point for us to shed light on. So, I pose the simple question: Is it possible for the modern day doctor to be happy? Now I don’t mean an overly dramatic happiness involving euphoria, ...

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acp new logoA guest column by the American College of Physicians, exclusive to KevinMD.com. When the Trump Administration takes office, health reform as we now know it will not go away, but it will take a different form. I don’t think the changes will be as easy as opponents of the Affordable Care Act make them appear to be. ...

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