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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 57-year-old man with a 15-year history of type 2 diabetes mellitus is evaluated for bilateral burning sensation in his feet for the last 6 to 12 months. The sensation worsens at night. His HbA1c levels have remained less than 7.0% for the last 2 years but were between ...

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Putting physicians in charge of hospitals seems like a no-brainer, but it isn’t what usually happens. A study published in Academic Medicine states that only about four percent of hospitals in the United States are run by physician leaders, which represents a steep decline from 35 percent in 1935. In the most recent 2018 Becker’s Hospital Review “100 Great Leaders ...

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Now that you’ve turned in your AMCAS (phew!), you’re probably wondering how to tackle the monster of secondaries coming your way. One of the most common questions asked in one form or another is the diversity essay for medical school. Have you ever wondered why diversity is such an important component of the medical school admission process? I’ve heard a lot of pre-med students eager to write this off ...

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An interesting phenomena recurs when I work with physicians to makeover their finances. They almost never believe that overspending is the problem. They believe the reason their credit card balance is growing, and their large monthly income isn’t enough to pay their expenses can’t be due to their own choice to overspend. They always have a reason for the lack money: They have huge student loans. They have eight kids. They are in ...

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Last year, my high school aged son took an interest in healthy eating. He began examining nutrition labels and scrutinizing the foods that we routinely keep around the house and came up with a list of criticisms and suggestions -- some well-founded, and others a bit extreme. At first, my wife and I were quick to debate him on certain choices like eliminating any breakfast cereal that has enough sugar ...

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The health care system has never been so complex as it is today. As doctors, we’ve seen the struggles that happen just trying to help patients get the medical care they need. Patients are now ladened with high deductibles and often are the victims of baseless denied coverage for diagnostic tests and medication. Insurance companies insist that they are not practicing medicine, merely making coverage determinations and that the patient is ...

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“Yes, you are like that,” said my husband one night as I was lamenting criticism I had heard about myself that day. “I am?” I asked, shocked, a little hurt, and angry. “You are, “ he replied. “Everyone who knows you knows this.” Gulp. No one likes to hear criticism. Our lives are so busy, so over-extended, that stopping to hear that something we said or did upset or annoyed someone is ...

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Fake news is a term that’s become notorious over the last couple of years. For notorious reasons perhaps. But there’s actually another serious arena where there is inadvertently an awful lot of “fake news” on a daily basis. And that is, well you guessed it: in health care throughout our nation’s hospitals and offices! Let me explain, and I suspect anyone who works in health care will be familiar with the scenario. ...

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We have all heard of the one more year phenomena.  Financially independent people, such as myself, hit the wall of fear.  Although we have enough, we persist in our W-2 day job for no reason.  There are many explanations for our persistence.  Yet none of them adequately account for why it is so hard to shake our indentured servitude once it becomes unnecessary.  While I personally ...

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I was a little taken aback when Dr. C. changed my patient from warfarin to one of the novel anticoagulants. And one I seldom use, at that. I have only worked with her for about three years, and we seem to come from the same mold: seasoned family docs with a penchant for teaching and patient empowerment. I had not imagined she would step in and completely change my treatment plan ...

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"If there is a physician on the plane, please press your call light!" The vast majority of doctors who have flown on airplanes have heard this, and most of us are willing, if not entirely eager, to respond. What follows is usually a far from ideal encounter with inadequate information, too much noise, a cramped space to work in and little knowledge of what is expected or even possible. My experiences (I ...

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Many residents and fellows will contribute to a 401(k) or 403(b) over the course of their medical training. They should be commended for saving for retirement on just a resident’s income. Often, newly-minted attendings wonder what to do with these 401(k)s or 403(b)s from their training hospitals. In particular, they wonder whether they should convert their 401(k) to a Roth IRA. 4 options: some better than others In general, there are four things ...

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As more doctor pay is being tied to patient satisfaction and “outcomes,” a recent Forbes article argues that “It’s only a matter of time before physicians will see the bulk of their compensation tied to quality measures.” To prepare for this pay-for-performance apocalypse, the article cites Medical Group Management Association (MGMA) CEO Haylee Fischer-Wright, MD, who urges physicians to “build data ...

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Just recently, New York and Virginia became the first two states to mandate that mental health become incorporated into school curriculums. New York passed a law for educators to teach material on mental health beginning from elementary school continuing on to high school. Virginia’s legislation intertwines mental health education with physical and health education for 9th and 10th graders. While these two states should certainly be ...

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Fear can show up at inappropriate times uninvited and unexpected, like a knock on the door in the middle of the night. We have all felt it. Sometimes, it can stop us from an adventure or getting into trouble. Sometimes, it can prevent us from living up to our potential or considering a new path. Sometimes, it can stop us from taking care of our health. A few years ago, in ...

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As I prepare to go into work for another string of night shifts, I become aware that this is just another holiday that I will be working. It’s the Fourth of July, not a major holiday as is designated by any scheduler, so no credit will be given to those of us who work today. Some previous employers have given extra pay for said days, as little as $200 to ...

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When I first began writing about the “doctor” title, I led with my personal beliefs. But as my research expanded, I realized there were so many variables and so many experiences that have shaped other women’s views on being called “doctor.” Call me “doctor,” please A few years ago, I was at a charity event for underprivileged kids in Detroit. One of the board members was a well-spoken nurse with a PhD. ...

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With burnout on the rise, many physicians are choosing to leave clinical medicine for alternative careers. Other physicians are wondering if it’s worth it to stay in a workforce that does not pull for the well being of their frontline workers. Gone are the days where physicians stay stuck suffering in a practice or career that is no longer fulfilling or worse, causing burnout. Those physicians are considered old-school and are ...

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Let’s say your loved one is at the end of life. She’s 84, with advanced cancer that is no longer treatable. A decision has been made to put her in hospice -- which is a level of care more than an actual location. (Most hospice actually occurs at home.) The patient waxes in and out of consciousness, sometimes lucid, but mostly not. While no one is ready for her to die, this end-of-life ...

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