If a doctor has a bad day, someone dies. Remember that.
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KevinMD Plus: Sep 9, 2019
If a doctor has a bad day, someone dies. Remember that. For what seemed like an hour, I stood staring at the flat lines scrolling endlessly across my monitor in the OR. The once pulsatile waves, rendered useless and flat due to the absence of a beating heart. After a frenzied six hours of pouring blood into the patient while it poured back out of her […] Advancing women in medicine — with a whisper Personal journal entry, September 11, 2017: Sometimes we wear womanhood like a yoke — burdensome on our shoulders, as we carry the torch for younger women coming behind. Sometimes, we swing womanhood as a sword, slicing, and jousting for survival in a world that started without us and in some cases, would be more than […] A thank you from doctors to nurses Earlier this year, I asked a group of nurses what gifts doctors could give that would help them know they are appreciated. There were hundreds of comments that included many I expected: Food (pizza, chocolate, cake, tacos, bourbon, Starbucks, healthy snacks), pens, cash, and/or gift cards for all shifts. There were some interesting “high end” […]
Sometimes it takes more than asking, “Are you OK?”
The attending physician looked concerned. My fellow medical student’s face was wet with tears. I knew the next words out of the attending’s mouth would be “Are you OK?” and indeed they were. I have encountered this phrase many times, almost exclusively in psychologically traumatic situations. It’s a reflex response to an uncomfortable social situation, the […] The blind man who helped this physician “Go through the gate. You will see an old white fence on the right, and the broken-down shack to your left.” I listened intently to the mysterious blind man over the phone as the reception came in and out. “Drive for about a minute and then park where the fence ends. “Walk down the mountainside, […] Physician coaching: the new normal? What is coaching? It’s a conscious effort to notice and evaluate how our thinking impacts our experiences, how perspective shows up in the results of our life. Coaching has been integral to fields other than medicine for many years. Yet, many physicians don’t know much about it — much less anything about its potential to […] Have you forgotten the most important health care leadership skill? Physician burnout is a hot topic right now. Some don’t agree with the term and choose to use “moral injury.” Regardless of the term you want to use, the problem is real. Christina Maslach describes burnout as “an erosion of the soul caused by a deterioration of one’s values, dignity, spirit, and will.” I think […] How hospitals prepare for hurricanes We all expect hospitals to be open and operating when we need them, but extreme weather events like hurricanes are a strain on resources and pose significant challenges for hospitals. Closing a hospital is an extreme action, but several hospitals in Florida, Georgia and South Carolina did just that before the arrival of Hurricane Irma in 2017. […] Want to crush USMLE Step 1? Here are some evidence-based study tips. Interleveling is the process of studying/learning multiple unrelated concepts across different subjects during the same study session. This can make studying appear difficult and more disjointed. However, research shows it yields better exam results. This is attributed to better simulation of the exam environment as questions are presented in random order, and concepts […] Sharing mental health issues on social media Susanna Harris was sitting in her lab class for her graduate program at the University of North Carolina at Chapel Hill when she received an email that told her she had failed what she describes as “the most important exam in grad school,” the doctoral qualifying exam. She took the rest of the day off, […] Is the National Institutes of Health stifling academic freedom? An episode pitting top administrators at the National Institutes of Health (NIH) against senior scientists at the organization serves as a vital reminder of the importance of academic freedom and the need to communicate and express concerns about scientific research. NIH administrators prohibited two of its senior scientists from speaking out about a research study […] Is overachieving a sign of past trauma? Ever feel like you are always on the go, not feeling comfortable slowing down? All through school, college, medical school, residency, and then practicing medicine, the one thing that I got really good at was staying busy. Planning projects, test-taking, solving cases, treating patients, emails, meetings, joining boards, organizations, getting more certifications, a world of […] Here’s what true grit looks like in health care As a medical director and practicing physician, I count myself fortunate to meet and engage in meaningful conversations with many health care professionals throughout the state of Pennsylvania. Recently I was both humbled and inspired when I visited with a group of primary care physicians who operate their private practice in a rural community. These […] This patient got an estimate before surgery. The bill was so much more. From a planning perspective, Wolfgang Balzer is the perfect health care consumer. Balzer, an engineer, knew for several years he had a hernia that would need to be repaired, but it wasn’t an emergency, so he waited until the time was right. The opportunity came in 2018 after his wife, Farren, had given birth to […] The problem of overdiagnosis: What can patients do? An interesting article in the journal Pediatrics is both intriguing and sobering. It is intriguing because it lays bare something we don’t talk much about or teach our students about; it is sobering because it describes the potential harm that can come from it, harm I have personally witnessed. The issue is overdiagnosis, and it’s related to our relentless […] How telemedicine intersects with AI, social media, and precision medicine Telemedicine will eventually become a more prominent part of our clinical practice, with the incorporation of artificial intelligence (AI) and social media and networks, and integration with precision medicine in electronic health records. As clinicians and scientists, we should be thinking about where and how these four innovative strategies intersect, so that we can continue […] Use pediatric research to solve the threat of gun violence The recent Philadelphia-, El Paso- and Dayton-area shootings brought all my memories back. As a pediatric pulmonary and critical care physician, I have been here so many times before. At 11:12 a.m. on a Wednesday last September, as I sat in my office enjoying a sunny day in the Midwest, I received a two-word text […] How can we address retention in the era of physician burnout? As we’ve seen, the lives of those working in the health care system has become overwhelmingly challenging, burdened by all of the excess nonmedical stuff that has been added into our lives as we try to take care of patients. From prior authorizations, to clicking in the electronic medical record, to endless streams of regulatory […] The insanely brazen effort to remake medicine into a consumer industry For over a decade, Washington, DC has been busy with fixing health care. For over a decade, the same government bureaucracy, the same advocacy (read lobbying) organizations, the same expert think tanks, the same academic centers, the same business associations, with the same people hopping around from one entity to the next, have been generating […] MKSAP: 50-year-old man with a left lower extremity ulcer Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 50-year-old man is evaluated for a left lower extremity ulcer. He has a 15-year history of worsening arthritis for which he has never been evaluated. He takes ibuprofen as needed. On physical examination, vital signs are normal. The spleen tip […] Settlements in the opioid cases need these non-negotiable conditions The judgment in the Oklahoma trial against Johnson & Johnson for their role in the opioid crisis is a good start to what deserves to be an ongoing pursuit of justice for the victims, their families, and the states. Any financial settlement is only a Pyrrhic victory unless the following non-negotiable conditions are met: 1. […] Social media: a social disease killing our kids? Much has been written and said about the role of Facebook and social media in our society. Only recently has the increasingly dark side of what was once thought to be a monumental transformation of humanity come into public discourse. Initially, the potential threats to privacy and the normal political process of our democracy grabbed […] Are you using this benchmark for physician personal finance? Many physicians have a poor understanding of personal finance. Since personal finance isn’t a required course in high school, college or medical school, physicians are often unprepared to handle their high income when they become an attending. Sometimes the results of this lack of education are not pretty. Other times it’s a downright disaster. Yet […] Why should you belong to a medical professional society? A guest column by the American College of Physicians, exclusive to KevinMD.com. Because I work for a medical specialty society, I’m frequently asked by non-members why I believe they should belong to a medical professional society. This is a particularly relevant question these days given the rapidly changing landscape of medicine and with physicians becoming […] 345 Hudson Street New York NY 10014 USA | ||||||||||||||||||||||||
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