I think I’m finally burned out. And it’s been a long time coming. It likely started when my private physician-owned emergency group got bought out by one of the big corporate groups. The changes were small at first. Turning us into hourly paid employees instead of an RVU-based salary. Shiny new VPs and directors sending us emails. Things seemed fine for a while. Then came the many, many emails about better ...

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A physician health program, PHP, is a state agency that is responsible for advocating, treatment referral and physician monitoring, residents and medical students who have substance abuse disorders, psychiatric disorders and/ or boundary issues. There are two ways of becoming a part of these programs, self-referral or be reported. Currently, 47 states have a PHP, and the issue is that there is no set guideline and several variables in the ...

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After third-year medicine, I was required to withdraw for handing in an assignment late. It was a paragraph of self-reflection; I couldn't believe I was being kicked out for something so seemingly inconsequential. My dealings with the faculty became increasingly hostile and negative. I realized that my fellow students had to band together. Otherwise, there will be no change. I have to say that at my medical school, they have been ...

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I did not want a baby.  As a 26-year-old third-year medical student who had quite recently ended a far from ideal relationship -- of this, I was certain. On vacation, in New York City, walking in Soho carelessly, I laughed with my friend Noelle over the fragility of condoms. “Trust me,” I said. “They break.” How many months in my sexually active life did I apprehensively count and recount the number of ...

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I woke up to him, pacing the bedroom. Within an hour, I was pacing the ER at his bedside. Our experience at one of the country's best-ranked hospitals lasted only three days before we were discharged home. What led us there will last a lifetime in our minds. When faced with your own mortality (or that of your husband's), you are forever changed. We are grateful for his continued recovery from myopericarditis. ...

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It’s hard to describe the feelings I had when I received my first letter of intent to sue. I think I went through the Kubler-Ross stages of grief — denial at first, of course. This denial didn’t last long since the letter was clearly addressed to me — first, middle, and last name. Anger was almost immediate … I was immediately upset at the deceased patient’s family who were bringing the ...

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I sat in the back seat of a police patrol car handcuffed with a mind imprisoned by addiction. My day had finally arrived after months of a manhunt by state detectives for operating a fraudulent prescription enterprise to support my obsession and compulsion with cocaine. No more unmarked police cars staked outside the crack houses that I frequented or my mother’s home or in pharmacy parking lots waiting to capture ...

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Imagine your typical yearly physical. It’s probably booked for 20 to 40 minutes. Since you, like many of us, may see your physician only once a year, it is important for you to have your physician’s complete attention and to have all of your concerns addressed. Some of these concerns may be of a sensitive - even embarrassing - nature. Your physician may likewise ask you some probing questions about ...

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The first two years of medical school are geared towards learning enough so you can pass your first round of boards. All the sleepless nights and the tears can be overwhelming, but to finally get to the finish line is an incredible achievement. It reinforces that these first two years were worth it and that you learned some things along the way. However, some students don’t receive the same good news. ...

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Over the last three decades, surgery has slowly but steadily evolved towards a minimally invasive technique. The standard of care for appendicitis now involves creating three half-inch incisions and using a laparoscopic technique to remove the appendix.  This technique uses a camera to see inside the body via a large screen. Instruments that are over a foot long are used.  Sufficient research has shown that this minimally invasive technique leads ...

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A debate highlighting gender discrimination in medicine currently rages within the pediatric hospitalist medicine community. The debate centers on the board certification process for "grandfathering" for the new pediatric hospitalist subspecialty which effectively excludes women on the basis of motherhood. For those not familiar with "grandfathering in," this is the process by which a new subspecialty may grant board certification to physicians who have been practicing in the specialty. The alternative option ...

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I'm sorry you are sick. I'm sorry you had to wait a long time in the waiting room. I'm sorry you haven't gotten your pain medications. I'm sorry I don't have an answer. I'm sorry the department is busy. I'm sorry it's loud. I'm sorry I don't know why it smells in here. I'm sorry your neighbor is screaming. I'm sorry you are in pain. I'm sorry you are uncomfortable. ...

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At the moment, I should be studying for my first round of boards, but there is something I can’t get off my mind: sacrifice. If you ask a medical student what they have had to sacrifice to study medicine, the list could go on for days. It could be small things like watching their favorite teams play or being caught up on current events. But more than likely we will list ...

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I am at a conference that is encouraging physicians to engage in social media. This is something I was always a proponent of. I felt strongly that as physicians, we help set the tone of accurate medical information. Especially now in this age of disinformation and "alternative facts," our voices are crucial. I used to be an active Twitter user. I had 21,000 followers and was verified — with a blue ...

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The eulogy of a profession should be a relatively uncommon undertaking. And yet, the death of the physician appears to be such a fait accompli that one feels late to the wake. It has been a long and lingering death, like the proverbial frog in the pot, and but there are moments, increasing in frequency in my day-to-day clinical practice when it seems so sudden, unexpected and even surreal. This ...

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Physician compensation in most employed positions is based on how much a physician “produces.” I work as a psychiatrist, and this amounts to how many patients you see per hour. The more patients you see, the more “productive” you are, the more money you generate, the more valued you are by your organization and the more RVUs you churn out for a larger paycheck. But, in human terms, what exactly ...

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“I don’t know what happened” is probably one of the most common phrases any parent hears. Last weekend, while wrapping my son’s bleeding head in gauze from our first aid kit, this was the best explanation my daughter could muster as to why her two-year-old brother was screaming, holding tightly to a blood-covered plastic ice cream cone. In the end, it was a complete accident (he hit his head on ...

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In many countries around the world, women giving birth still face substantial risks to their own lives and that of their baby. Women travel for days to reach facilities that are understaffed, unsafe, and unequipped to provide life-saving surgical care. They are pushed into financial catastrophe as a result of paying for surgical care, if they are able to afford it all, and they return home with little support in ...

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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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