“I give up! I can’t help these people.” Emily was completing the final month of her emergency medicine residency and flopped into her chair with exasperation. “What’s up?” I asked. We were on the final two hours of our shift together. And I, as her attending, was already feeling apprehensive about the patient encounter that awaited me. “They want so much from me, and I can’t fix them!” She began to tell ...

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Let’s begin with a quiz question: Patients may be allergic to: A. oxygen B. carbon C. iodine D. none of the above If you answered anything but "D," better keep reading. Consider this scenario: If a patient is allergic to penicillin, you would document “penicillin” in the medical records. It would never occur to you to list “antibiotics” as an allergy, and you certainly would not call it a “carbon” allergy for slang, just because penicillin contains ...

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Today is a strange day. I treated myself to a slice of nondescript doughy hospital pizza for lunch today. If this was an actual pizza place, and I had a choice, I would never order this pizza. But today, the pizza tasted fantastic. In fact, it tasted like the best pizza I’ve ever had. Why you ask? Because this would likely be the last time I’d ever eat this hospital pizza. I enjoyed ...

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Having worked at both community hospitals and major medical centers, the issue of ultrasound in pregnancy has revealed itself to be more complex over the years. As a resident, I worked with an obstetrics office that only scanned their own patients who had private insurance and would send uninsured or Medicaid patients (often with a high risk of inadequate prenatal care) to the hospital late in the day to be ...

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In a 2012 blog post called “Things that puzzle me about surgical education,” I wrote the following:

There was the emphasis that still exists today on making sure every resident did research. At last, some are questioning the value of this for the average clinical surgeon. Contrary to the prevailing wisdom, there is no evidence that a resident who is dragged kicking and screaming through a clinical research project or ...

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Artificial intelligence, or AI, is a term that is often associated with robots or computers that “learn” by having material introduced to them. Different people have different reactions to the idea of AI, especially with its potential use in medicine. AI can perform many tasks at the same time and in the same way producing results that will always be precise, but not necessarily accurate. This is relevant to fields ...

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As someone who has been in IT health care supporting hospitals, radiologists, and specialty surgeons, I’ve seen the struggle from just about every angle when it comes to the problems with health care technology. One of these struggles that continue to be a problem for myself, our patients, and our physicians are the imaging CDs that patients bring in. Sometimes the patient brings in a disc that is found to be ...

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“So, will this mammogram save my life?” she asked. I thought for a few seconds … "I have no idea.” “What?” she sounded perplexed. “Well, if you have a cancer that’s aggressive enough to kill you before everything else, but not aggressive enough to have already had cells metastasize, and not so aggressive that it responds appropriately to chemo but it still needs to be rapidly dividing enough to respond to chemo, and we ...

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I asked a colleague at a recent dinner meeting about his children. They’re all grown, he said, one is actually a doctor. But, he added quickly, “I had nothing to do with it.” His son had chosen his father’s field of radiology, though my colleague similarly disavowed any influence. He did mention, with some relief, that his son was happy with his choice. About a year earlier, I was catching up ...

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There is a movement afoot. I can feel it. I can see it. Women in medicine are no longer going to tolerate the subtle and not so subtle discrimination that has stymied their career growth. They are not going to be complacent while their male colleagues are paid higher salaries, offered speaking engagements and research opportunities and promoted at a greater rate. Women in medicine are pulling together in an ...

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