I was recently seeing a rather complicated medical patient in the hospital. We were treating both a heart and kidney condition, and things were not going so well. To spare anyone non-medical who is reading this the scientific details of the bodily processes involved, we were essentially balancing hydrating, with the need to get rid of excess fluid. After seeing the patient, I spoke with the nurse, went over the ...

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First impressions are critical. We are taught early in our careers that first impressions truly matter. Whether interviewing for medical school or a residency program, our goal is to make a positive first impression in hopes of making the cut at each checkpoint in our early careers. These processes in our academic lives and careers are exhausting. As residencies and medical schools are becoming more competitive, the importance of first impressions ...

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I am considered a “xennial” physician. Not quite a millennial — but also not fitting into the generation of the respected preceptors I had in medical school and residency. I took my MCAT via paper and pencil. My mini boards during my clinical rotations were on paper and pencil. All of my licensing and board exams were computerized. It was not an option to sit at home and log on to ...

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On the outside, most American hospitals appear completely modernized. If resources are utilized correctly, they appear equipped for any disaster, any CMS audit and any surprise joint commission inspection that may come. The procedural appearance of hospitals seems robust and reflective to medicine in the 21st century. However, the framework for the daily function of many American hospitals is architecturally weak and weathered (metaphorically speaking). With the progression of times ...

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Two years ago, when I was still in residency I happened to be on overnight call the day prior to election day. An associate program director of my residency program asked me if I wouldn't mind being a doctor of record who evaluates whether I agree a patient is too sick to go to the polls. They forwarded to me names of patients who expressed interest in voting and were already ...

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Not knowing what else to do after finishing my pediatric residency 15 years ago, I became a general pediatrician. Not knowing how to find a job halfway across the country and closer to home, I relied on a recruiter from a smallish town in South Dakota to woo me into private practice. Not knowing how to choose my future partners, I let them choose me. Despite my unbelievably naive approach to ...

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This past week was one of those weeks looming ahead of me that I was already dreading as I entered into it. I was to be working through another holiday and following a string of nights, and I would have a quick turnaround into a mid-shift. As a nocturnist by choice, I rarely work mornings or mid-shifts. I find the nights busy but also less intrusive — i.e., less administrative ...

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When you or a loved one is sick or injured, health care decisions are fundamentally a matter of trust.  You trust your physician will have the answers you need, because you know that, as a highly-trained medical professional, they’re qualified to make the best recommendation for each and every patient under their care. Physicians receive some of the most rigorous education and training of any profession. They spend the better part ...

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The surgical team filed out of the patient’s room. I looked over my shoulder to see a shaken daughter holding the wrinkled hand of her quiet, elderly mother who lay in the bed. I shuddered as I thought of the surgery her body would endure the next day. I knew I needed to return to her room later in the day to find out more about her history. After rounds ...

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I learn all manner of interesting things from the information sheets posted on the walls of the employee bathrooms at my hospital. I learn, for example, about upcoming CME offerings for advance practice providers, how many seconds one has to scrub the hub of a central line, and what the new process is when nurses need to call in sick. They call a specific phone number and state that they ...

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