My introduction to internship was during my hooding ceremony at graduation when the revered Dr. David Wagner hooded me and told me that internship was a time to become “intimate with disease and the suffering caused.” “You will live with it so that it becomes so much a part of you that you instinctively know what to do, what to expect, even without sleep, food or outside contact.” Filled up with this ...

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Undoubtedly, those pursuing a career in academic medicine have a tough time line.  In most medical schools, somewhere between the 7th and 10th year, depending on whether the academic clock was stopped for pregnancy, the fate of the academic physician is decided.  During these years when women have the biologic clock ticking, they also have the “up or out” academic clock ticking. This rush to create academic contributors is pure insanity, ...

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The healthcare workplace is undergoing profound changes.  Where once a letter and a handshake were enough to create a life-long working relationship between colleagues, now the multiple work settings and relationships create many possibilities.  Understanding not only how to get into the relationship, but also what might happen when you need to leave or are forced out of a relationship is critical. True case report:

A woman internist arrives at work one ...

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More people are dying because they commit suicide than in motor vehicle accidents this year.  The number of suicides is rapidly approaching the number of deaths from breast cancer.  The trend upward has been noted for the past decade. Physicians are the professional group with the highest rate of suicide. And studies have estimated that women physicians have as much as an eight fold rate of suicide compared to their male colleagues.  Is ...

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A dichotomy has emerged as we consider the best way for women physicians to realize both their potential and their dreams in the service of patients and society.  One position states that women have to internalize behaviors that are known to result in success and are based on a long history of professionalism, albeit developed for and by men physicians over the last 100 years.  This is more along the ...

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Do you report it to your supervisors?  Go to the police?  Go to a rape crisis center?  Or would you try to carry on the next day because you are the only one who has certain duties that need to be done? Or do you keep quiet because you are afraid of the negative publicity and treatment that might befall you, your department, and your medical center? This is not an ...

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For those who haven’t been following, earlier this month, Dr. Carol Warfield, a Harvard doctor and chief of anesthesia at Beth Israel Deaconess Medical Center was awarded a settlement of $7 million dollars for gender discrimination. It was a massive settlement to be sure, certainly one of the largest ever for a gender discrimination case. But the large dollar figure is not the real story here. The real story is found in ...

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Once upon a time a doctor first attended 3 or 4 years of college, then finished 3 or 4 years of medical school, trudged through 1 to 8 years of residency training to hang out “a shingle,” and finally begin to practice medicine, usually in solo practice.  Those days are long gone.  Time has expanded—schooling and training are longer. Breaks are taken between and during this once but no longer traditional ...

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Here are the sad the financial facts. You have heard them before:

  • Women physicians earn $0.62 on the dollar as compared to men (US Census Bureau, 2010).
  • Women physicians start out their careers with a $17,000 pay gap, after all other factors are accounted for (LoSasso, Health Affairs 2011).
  • Mid-career women physician researchers are paid $12,000 than their male counterparts (Jagsi, JAMA 2012).
Anyone who discounts that fact that we women physicians are discounted ...

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A war is brewing in the House of Medicine.  It's a war of philosophy based on how we physicians approach our patients--the people who come to us to be cared for and to be cared about.  The people who come as patients to the physician as healer, a healer who also has a wealth of scientific knowledge which can be used to stamp out disease and bring long, healthy lives ...

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I remember the first gunshot wound I treated in the emergency department at Jacobi Hospital in the South Bronx 35 years ago.  Only one of two I saw that month in the second busiest trauma ER in the country.  Gang fight.  Troubled youths.  In the middle of the night. Hand guns. We couldn't save him.  I was devastated.  My chief resident, an aspiring trauma surgeon, took me aside and matter of ...

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Physicians are being attacked in many ways and in many places.  It is no longer about how able, available, and affable you are.  It is about how well you toe the line when it comes to going along to get along while being watched by an ever increasing line up of watchdogs.  Many of whom have sharp teeth. Here are a few questions that might indicate you are headed for trouble: Do ...

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Outrage #1: Wasting time of skilled caregivers. Everyday skilled nurses and physicians’ assistants waste hours of time on the telephone either getting approval for medications that we prescribe for our patients or trying to fight a rejection for a medication we requested. Outrage #2: Choosing a medication for cost, not effectiveness. A child cannot breathe because the acid and other nasty stomach ...

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Did you know that urine pregnancy tests are routinely performed on all females before every surgery? No exceptions. The Children’s Hospital in Buffalo tests 9 years and above. Don’t know if a parent or a patient has a right to refuse the test, but I do know that the anesthesiologist will refuse to give anesthesia, except for a life-threatening emergency. I have never paid much attention to these tests. The nurses ...

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It is nearly impossible to ignore the need for clear thinking, confident and “in control” leaders. And whether in Congress or in a physician’s office, medical school department or hospital administrative suite, women leaders are notably absent. And while recent research tells us that women aspire to be leaders, the barriers to achieving this nebulous goal are enormous. So whose fault is it anyway?   I say both the women and the ...

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I was trained at a time when medical care was not a commodity.  It was part art, part science, and not delivered in bits in pieces but imparted with an eye to the whole patient. And I was trained by a master of the art and the science and the whole patient.  Dr. Robert Ruben has spent his life studying the effects of communication disorders on the lives of children who ...

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Viewpoint #1.  Training programs might say: we are headed for a major league collision in the training of women physicians.  Soon 50% of all trainees will be women, and in some specialties, such as OB/GYN, they will be 80-90% of the residents in any particular program. Training years coincide with prime child bearing years. Imagine if even only half the residents in a program were pregnant at once.  What would happen ...

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In my office, every new patient encounter starts the same way.  I walk in and say, "Hello."  Then I put down my computer (which I take from room to room), wash my hands (which I purposely point out that I do before I touch anyone or anything else), and then I turn to the family and greet the child first.  Depending on the age, I might be squatting and gently ...

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