November 27th, 2009 by Dr. Val Jones in Humor, True Stories
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Sometimes it’s hard to know what kind of doctor you’d like to become. The first two years of medical school are devoted to memorizing text books, and then suddenly in third year you are expected to function as part of a team of different specialists, rotating at 2-6 week intervals. At the end of the third year you’d better have a clear sense of what kind of medicine/surgery you’d like to practice for the rest of your life. No changing your mind! (At least, that’s how the process is supposed to go.)
I asked a physician friend of mine how he came to choose family medicine as a career. I expected him to say that he liked the autonomy of figuring out conundrums on his own – to take care of the entire family and be there for them throughout the life cycle, etc… But what he actually told me was a little unexpected. Read more »
November 23rd, 2009 by KevinMD in Better Health Network, Opinion
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In medical schools, primary care continues to be among the least respected fields a student can choose.
No where is that more starkly illustrated than in Pauline Chen’s recent New York Times piece, where she tells a story of a bright medical student who had the audacity to choose primary care as a career:
Kerry wanted to become a primary care physician.
Some of my classmates were incredulous. In their minds, primary care was a backup, something to do if one failed to get into subspecialty training. “Kerry is too smart for primary care,” a friend said to me one evening. “She’ll spend her days seeing the same boring chronic problems, doing all that boring paperwork and just coordinating care with other doctors when she could be out there herself actually doing something.” Read more »
*This blog post was originally published at KevinMD.com*
September 5th, 2009 by Bongi in Better Health Network, True Stories
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When I got accepted into medicine as a last minute add-on due to one of their other applicants turning down the post, I knew how lucky and privileged I was. It was the first step in a very long journey and I wasn’t going to mess it up.
The first year in those days was spent at the main campus and we would only be at the medical campus from second year onwards. Second and third years would be spent on the pre-clinical campus and only from fourth year onwards would we be in close proximity to the big boys. All this I didn’t know when, during first year orientation they bussed us to the medical campus so we could see the preclinical buildings and watch with a fair amount of jealousy when the higher year students walked past. The whole medical training thing was very hierarchical. It didn’t bother me. I had been in a similar system before and had moved up the ladder. I could do it again.
The preclinical campus was a very relaxed place. There were essentially only two buildings (ok, ok there was also the dentistry building but we didn’t go there) with a large grassy lawn between them. There were a few trees providing shade for groups of students lying on the grass and reading or chatting. Our group of first years on orientation clearly didn’t seem to fit in. None-the-less we found a tree to sit under during a short break in the orientation program.
And there I sat in a state close to euphoria with my hopes and my dreams all layed before me. I knew I stood at the beginning of a journey that would lead me to what I one day would be. What I was at that stage was of little significance other than the fact that it was a pointer to what I would become.
I lay under the tree and, as best I could, told my friend who was with me about these thoughts. I then added that I would use the tree as a sort of temporal marker that I could come back to when I was finally what I would be. Then I would stand under the tree and remember that exact moment when I looked into the unknown future with innocent hopes and dreams.
Recently I had the opportunity to go back to the preclinical campus. I remembered that moment so many years ago and was quite eager to stand under that same tree and reflect about the years that had passed and what I had become. On that day, so long ago, I would never have guessed that I would have gone on after medicine to specialise in surgery, so I actually achieved more than I dared dream. I was really looking forward to a moment that would link one specific moment in the past with the present.
The campus was just as I remembered it. The lawn was still there and there were still students sitting in small groups. they just looked so much younger than I remember being. Then Iwent towards the far side of the lawn to have my moment under the tree.
They had cut the tree down! It was gone. Everything else was exactly the same except my tree. Is there nothing sacred?
*This blog post was originally published at other things amanzi*
July 13th, 2009 by DrWes in Better Health Network, Health Policy, Opinion
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It was supposed to be delayed gratification.
After all, that’s the American way: work hard, put your nose to the grindstone, get good grades, be obsessively perfectionistic, then you’ll be rewarded if you just stay with it long enough. It’s the myth that perpetuated through medical school, residency and fellowship, and our poor residents, purposefully shielded from the workload they’re about to inherit, march on.
But then they graduate and find that just as the population is aging, chronic and infectious diseases are becoming more challenging, health advances and potential are exploding. Just then, we decide to launch a full scale attack on physicians and their patients with increased documentation requirements, call hours, larger geographic coverage of their specialties, reduced ancillary workforce, and shorter patient vists.
Physicians get it – burn out and dissatisfaction are higher now than ever before. This is probably the greatest real threat to the doctor-patient relationship and health care reform discussions don’t even put it this on the table.
At the same time that we expect our doctors to be devoted, available, enthusiastic, meticulous and at the top of their game with perfect “quality” and “perfect performance,” while simultaneously cutting their pay, increasing documentation reqirements and oversight, limiting independence, questioning their professional judgment, and extending their working hours. We must become more efficient!
Deal?
*This blog post was originally published at Dr. Wes*
December 18th, 2008 by Dr. Val Jones in Audio, Expert Interviews
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I often cringe when I see charts displaying parallel growth lines of these two variables: the number of American fast food restaurants in a given country and local obesity rates. The bad news is that our unhealthy eating habits have been exported successfully to foreign countries. The good news is that we’re going to export hospitals and health services next.
I spoke with Emme Deland, Senior Vice President of Strategy at New York Presbyterian Hospital, about the globalization of healthcare and the exportation of American health technology and expertise. You may read my summary of our discussion, or listen to the podcast here:
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Dr. Val: Where does New York Presbyterian Hospital stand in terms of the global marketplace for medical tourism?
Deland: We’ve spent the last couple of years reviewing our strategy regarding medical tourism because we want to be a part of the global healthcare economy. There is a growing market for hospital development overseas, particularly in India, the Middle East, Eastern Europe, and China. The US offers the most advanced medical care in the world, and it’s only natural that other countries want to begin importing it. Whether it’s minimally invasive surgery, infertility techniques, or prenatal diagnostics and care – America is among the global leaders in health technology and services.
Dr. Val: What do these countries want to import exactly? Providers, infrastructure, physical plants, data systems, consultants who can advise on ways of doing things to reduce errors and improve quality?
Read more »
