These articles are written by anonymous clinicians. They have been selected and edited by Kevin Pho, MD.
“We fear that CPS is going to take them away,” the mother of my patient chokes with tears. My patient on the inpatient pediatric wards looks at me with guarded eyes. I can still see the markings on their neck where they tried to strangle themselves. They were intubated in the pediatric ICU. This transgender patient and their family have gone through a living hell only to come out again …
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It is nearly universally agreed that the United States of America is a “great nation” with the world’s strongest economy, an expansive international presence, and being physically one of the largest countries in the world. The groundwork for this expansion, both in size and economically, was grounded in our concept of “manifest destiny” – the belief that as a nation, we were intended to span from ocean to ocean. For …
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My previous post on this topic described long-term cultural and organizational challenges facing emergency medicine (EM) that pose greater threats to the specialty than temporal challenges (e.g., overproduction of emergency physicians (EPs)). Some challenges are not remediable; they are inherent to the specialty:
- short-term patient relationships
- unpredictable workload/intensity
- frequent, rapid fluctuations of stressful and less-stressful periods
However, many detrimental aspects of EM can be substantially …
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I won’t judge you for asking for help because that is how I hope you treat me.
It took me five years to accept the fact that I needed help. As I pursued athletic endeavors at the highest level in high school and college, my mind developed a twisted, compulsive mindset towards eating to control my life, navigate my cultural heritage, and succeed in my sport. For those five years, I …
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There has been much hand-wringing about the 555 (18.4 percent) unfilled match spots in this year’s emergency medicine (EM) residency match. Several long-standing, excellent programs with outstanding patient pathology and well-known faculty in major metropolitan areas did not fill.
Most hand-wringing has focused not on inherent attributes of the specialty, but temporal issues likely to fluctuate over time, including:
1. An overproduction of 8,000 emergency physicians (EPs)
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How big is my ego? The trouble with a career in medicine is that you spend four years in a classroom and not managing people. It is impossible to gauge the size of your ego if you don’t have a stack of small unit leadership situations with which to calibrate it. The most needed quality as a physician leader (or any leader) is humility. Athletes and prior military folks tend …
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Premedical students are more stressed out and burned out than ever. It’s easy to see why: pre-med courses, medical school admissions committee expectations, and application process and cost are daunting and, in their current iteration, often harmful to students and society.
I am an emergency medicine and internal medicine physician at public and private teaching hospitals and direct and teach undergraduate courses at an affiliated university. I mentor/advise pre-med (particularly …
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I was unsettled by an email that our graduate medical education (GME) office recently sent out to all residents at my institution “sharing a friendly reminder that parking spaces identified as ‘physician parking’ are for attending physicians only” and “residents and fellows who park in ‘physician parking spaces’ will receive a parking ticket.” I have parked next to only non-physician (including non-resident physician) staff in those spaces every day for …
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Despite advancements in health information technology (HIT), the prevalence of diabetes in the United States continues to be high and is the seventh leading cause of death. Diabetes management in underserved communities has challenges concerning health care access for high-risk groups, often resulting in debilitating health outcomes worsened by adverse socio-economic consequences. Optimal HbA1c levels, controlled for by risk reduction, are essential. If diabetics encounter barriers to health care services, …
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As oncologists, we encounter numerous patients on a daily basis and form emotional bonds with many of them, especially if they survive long enough and continue to see the same doctor for several years. This bond can grow so deep that we feel their pain, cry with them, and sometimes even realize that some of our patients are our soulmates.
According to Wikipedia, a soulmate is a person ideally suited to …
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While we appreciate the importance of trust, not all patients have the same windows of opportunity to establish it with their physicians. The nature of each specialty and the severity of the patient’s condition influence how quickly and deeply trust can be created and maintained. The STEMI patient will quickly learn to trust the interventional cardiologist, and the trauma victim, and the surgeon.
Not surprisingly, it’s very challenging for physicians …
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I have been fortunate in my forty-five-year medical career never to have been sued for the care I delivered to a patient. I attribute this, in part, to being a family physician and having ongoing relationships with my patients and, in part, to being willing to admit to my mistakes if I make them and things turn out badly. I see how gut-wrenching going to court is for doctors so …
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When I finished my pediatric residency almost 20 years ago, I embarked upon a career in general pediatrics because I didn’t enjoy any particular subspecialty enough to commit my career to it. After spending several years in a mostly outpatient setting (peppered with child abuse consults, circumcisions, and an unsatisfyingly small number of hospitalized patients), I knew I had to change and move across the country to pursue pediatric hospital …
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I was surprised when I began receiving gift cards to a national chain of coffee shops in recognition of positive patient satisfaction comments from my emergency department patients.
Reviewing them in my provider report card genuinely felt good, especially when someone remembered my name in a follow-up phone call while saying something positive. Still, the token incentive met with disapproval for several reasons.
In particular, the most meaningful comments expressed gratitude for …
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I have to write a “perfect medical school personal statement.” I have to write about learning and growth. I want to show empathy and grit. Most of all, I must resonate with the medical school admissions committee reading my story.
The overwhelming consensus around Student Doctor Network, the forum of terrible but successful premeds, is: don’t make waves. Adcoms can be radical feminists or religious fundamentalists, born from wealth or recently …
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Most people, should they be in need of a transcatheter aortic “valve-in-valve” replacement procedure for a failed aortic valve replacement, would be delighted to have one of the world’s foremost experts (who has performed over 6,000 of these procedures at one of the world’s foremost heart hospitals) perform the procedure.
But not my father, despite having dyspnea on mild exertion owing to a trans-valvular gradient of 50 mmHg.
Naturally, he wanted a …
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Recently, I read an article by an ICU nurse that discussed the disturbing trend of replacing seasoned nurses with inexperienced ones in the name of cost-cutting. This issue is not limited to the ICU but is rampant in every area of nursing.
As a psychiatric nurse with 45 years of experience, 35 of which were as a board-certified psychiatric nurse, and a former mentor and preceptor, I have witnessed the …
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The word “career” has two meanings. A career in medicine fulfills both meanings quite neatly. In the traditional sense, it can be defined as an occupation undertaken for a significant period of a person’s life. On the other hand, it can mean moving swiftly and in an uncontrolled way. As in, “Her car careered across the road and into a ditch.”
Being a physician is a blur of late nights, cold …
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Speech recognition software is an important part of my clinic workflow. I use the industry-leading application, which has saved me at least 1,000 hours of documentation time over the last decade. My typing is much slower than my speaking, and since my goal is to leave the office at a reasonable hour every day, using it is the obvious choice for …
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A good cup of soup can be comforting during illness. It’s like a form of medicine. Soups have many vitamins and minerals, protein and carbohydrates, and of course, water or cream to help stay hydrated. Salt makes a sore throat feel better (like warm salt water gargling) and heat clears nasal congestion (which relieves pain and sinus pressure). As such, a typical cup of restaurant soup costing $5 or $10 …
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