President Donald Trump held a rally near my medical school last week. While sitting in a small conference room during a lecture the morning of the event, my professor chuckled while clutching his phone. He looked up and around at all of us, remarking that his friend had texted him about the Trump supporters waiting outside for the rally to start; the message read, “Jesus, the maggots are already here!” My ...

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As an elder millennial physician, I’ve been straddling two worlds, that of the “old-school” mentality of training and this newer one of “wellness.” I’ve become disheartened with new physicians being increasingly unable to tolerate any criticism by teaching faculty, even when patient harm is at risk. However, it wasn’t until I was accused of bullying and bullying exclusionary by a group of colleagues — not trainees — that I grew ...

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“Why did you wait to schedule this meeting until September, why not July or August?" Candidly, I replied, "I have a family and being on nights, spending those 90 minutes with them a day is very important to me." It was then, behind closed doors, in an office where he held all of the power that he said: “You know, I don't think women with families make as good of ...

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Rural hospitals are closing their obstetric wards and stopping all obstetric services — at least those hospitals that manage to remain open at all. The tertiary care centers don’t seem to mind.Always wary of those rural hospital disasters in the middle of the night. Accepting transfers from a place where they must not have the latest technology, clearly, your little hospital must be behind the times, only subspecialty care is ...

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In my first year of medical school, I attended a lecture on health disparities that focused on the difference in patient outcomes based on race and socioeconomic status. The lecture cited multiple peer-reviewed studies that extensively demonstrated these disparities and how health care professionals, not solely social determinants of health, contribute to them. The lecture concluded with an appeal to improve our cultural awareness and acknowledge our conscious and unconscious ...

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At some point in my career, I had the crazy idea that if I could scale the patient-centric work I was doing in my community at a small rural hospital — then I could make more of an impact. This is why, when a technology company came calling, dangling a carrot in front of my nose to “disrupt” health care, it seemed like a no brainer to make the leap ...

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In my clinical practice, I have encountered patient aggression typically with narcotic medications, in particular with the refusal of a refill due to evidence of concerning behavior, like a positive drug screen for drugs not prescribed. Aggressive behavior can include yelling, threatening physical violence or intimidation. I have had less trouble with narcotic-related aggression nowadays especially with media coverage of the dangers of narcotic abuse and especially since a lot ...

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I remember September 27, 2018 like it was yesterday. When Ashley* picked me up from my apartment Thursday morning, I thought it would be like the 138 past Lyft rides I’ve taken since 2017. I was wrong. After I waived to Ashley from the curb, I got settled into the right back seat. The doors locked, and she asked me the usual question. “You from here?” “Yes, I’m a local.” “That’s great! I’m from ...

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I was a resident. He was a physician in a position of power. He took things too far, and I spoke up. Here are some of the actual comments I received. “He’s just a flirt.” “You must have misunderstood him.” “What were you wearing?” “Somebody must have hated him, to do that to him.” “Perhaps, he just really, really liked you.” “Maybe you had a crush on him too and encouraged him.” I had started a new ...

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When I was a third-year resident, I was invited to join a practice owned by a doctor who had once been my chief resident. This was considered by all of my fellow residents to be the plum job in town, and I was thrilled. The doctor, whom I shall call “John,” was smart and funny and had a huge practice that he had purchased from a retiring physician. We figured ...

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I have spent the greater portion of my 20s enduring a premature quarter-life crisis. Patterns of self-doubt and debilitating anxiety became my new normal. I was rejected from medical school — again. After taking time to process the reality that I would have to wait another year to re-apply, I fervently journeyed through a messy jungle of introspection that led me to these six lessons. Although I learned more than I could ...

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We learn about it in school as a formula. There is a checklist that we are given, and we ask our patients these eight questions and then calculate whether or not they have depression. It’s so simple. Anyone can do it! I never once thought that I would be calculating my own score at the prime of my education. I entered medical school full of hope after years of failures and ...

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As a first-generation college graduate with the honor of earning my MD and PhD at a federally funded medical scientist training program (MSTP) and nearly no debt upon embarking on the journey of residency, I have a lot to live for and am grateful for all that life has offered me with regard to both mental health and capacity. I am a product of the Baltimore City Public School System. My ...

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About two months ago, a 15-year-old Native American male was riding around in a stolen car on the reservation. “M” and the driver were drinking. And somehow, after he exited the vehicle at 4 a.m., the car struck him. Hours later, it became clear that something was wrong. M was transferred to our pediatric hospital as a trauma and was found to have an unstable vertebral fracture. Conservative treatment with ...

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In response to the increasing burdens of administrative work and cumbersome charting levied upon healthcare providers in recent years, medical scribes have been touted as a potential solution for streamlining the documentation process.  Interest in the use of scribes has certainly been increasing, with the American College of Medical Scribe Specialists estimating that the number of medical scribes nationally will increase from 15,000 in 2014 to more than 100,000 by ...

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I woke this morning at 3:30 a.m. My mouth was dry. I tried to urinate, but something roughly the color of quinoa came out in small quantities. So I assumed I was dehydrated. It could have been the bourbon and scotch before dinner — or the two IPAs at dinner. Or the four IPAs after dinner at trivia. Or the scotch after trivia. But something told me I was dehydrated. I ...

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Imagine being a cancer patient afraid of seeing an oncologist because they would likely need to discuss chemotherapy and all the lifestyle changes that it entails. Imagine being a patient with heart failure afraid of seeing the cardiologist because they may be prescribed a diuretic to remove excess fluid from their body and may need dietary counseling. Imagine being a patient with severe rheumatoid arthritis with excruciating joint pain, who ...

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Recently, I saw a photo of a slide from the American College of Surgeons Clinical Congress: “The Program Directors Guide to Implementation of Well-being Programs.” While I applaud the ongoing focus in medicine on wellness for both trainees and faculty, I am troubled by the perceived need to standardize and program wellness, creating a “checkbox” that may not improve actual well-being. As a recent graduate now living my best life ...

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I’m struggling — truly struggling. This year has been beyond hard. I honestly never thought this time last year that I would be in this predicament. Things were good, I had a great job, and I was working on our fixing up our dream retirement home. We had great vacations every year. Yes, the home remodel wasn’t quite on track, but we were making progress. But then, my world fell ...

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Doctors know high-pressure exams. The day before one is the worst. There is cramming followed by anxiety and insomnia. When sleep finally beats anxiety, the dreaded nightmare falls upon anxious test takers. Every doctor knows. Walking into the testing center, opening the exam, realizing you studied for the wrong exam. The questions might as well be a foreign language. This nightmare was a reality according to this year’s group of ...

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