The practice of medicine is a lot like the practice of parenting. It is full of highs and lows, moments of pure joy and those of devastating heartache. When I talk to my friends who are parents, they agree with me. Some of the most difficult times as a parent is watching your kids fail. When your child is hurting, it hurts far worse than if you had experienced it first ...

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After about the first week of anesthesia residency, I was told, “Don’t get pregnant, you are going to ruin the call schedule.”  Initially, I took it as a joke because I was getting married that year and I wasn’t thinking of having children yet, but I did think, “what if it happened accidentally?” After it’s told to you over and over again by your male co-residents and even some of my ...

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Years ago in a 15-bed acute medical-surgical ICU, the nursing supervisor contacted me about a special assignment. Once I knew what it was, I said, “Absolutely.” We were about to admit a patient in his 40s with end-stage AIDS/HIV. He asked to be a DNR, but his MD wanted to admit him to the ICU for close monitoring. But the patient had a special request. Even with IV antibiotics and pain ...

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It is not enough to know that a patient’s medical condition warrants an MRI. For most insurance companies, a diagnostic test of this sort requires what is known as a prior-authorization. But, the doctor saying the patient needs this test often fails. The insurance company has a certain guideline the patient must travel first before they will consider the test. For example, a patient with back pain and numbness in one ...

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To accomplish certain tasks, we need a little help from our friends. No one can do it all, although many of us are more resourceful than others. Some folks are adventurous and dive into a new arena with excitement. They may be tinkerers who aren’t afraid to play with new gadgets. Sure, they might break some china, but they are apt to widen their skill set and enrich their lives. ...

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T was the last patient of a busier than usual morning. “New patient, establish care” was her reason for visit. As I would soon find out with the help of our remarkable Arabic interpreter, T and her family recently moved to our area after spending the better part of 3 years moving from refugee camp to refugee camp trying to escape the ravages of the civil war in their native ...

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When I walked into the hospital room with my team to meet him for the first time, what struck me was how young he looked. He was listed as 26 years old, but he looked younger than that. He looked so young that it was hard to believe he had served a tour in Iraq a few years prior, or that he likely saw things there that no one would ...

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In loving memory of my grandfather, my first physician mentor. Earlier this year, my 90-year-old grandfather passed away unexpectedly after undergoing transcatheter aortic valve replacement (TAVR). Similar to many elderly patients who die each year in the United States, his death was preceded by a litany of costly and time-consuming tests and treatments. Despite this extensive workup, the end of his life was shadowed by suffering left unaddressed. But, unlike the ...

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It is not unusual to see a patient for a timely transition of care visit after a hospital admission and within a minute of entering the exam room know with all the bones in your body that this person needs to go back into the hospital. The funny thing is that when that happens, if the patient has Medicare, we may indirectly suffer financially from such “avoidable readmissions.” We belong to ...

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You’ve probably heard this story before: a young physician, who has spent all of his or her life succeeding and building goals, stumbles into a career without meaning or enthusiasm. Indeed, my story about burnout is much like the rest. Like so many before me, I entered into a career in medicine motivated and eager to change the world through the care of my patients. I grew up in a family ...

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