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Career Counselor? Thoughts On Becoming A Doctor

As a physician, I’ve had several people ask my “honest” opinion of their plans to become a doctor. I know what my response is to this question, but I wonder what others in my profession would answer. Would your response depend, in large part, on who’s doing the asking — could you answer your own child as you would someone you just met? Be careful, your answer to this question, if honestly given, might shine an unsettling light on your own feelings about your current career choice.

Last week I spoke with a college junior working to fulfill her lifelong plans to become a physician. She told me about a recent conversation with her own doctor where she shared her plans to go to medical school and he’d tried to dissuade her. She couldn’t recall a single cogent reason given for avoiding the medical profession, yet it appeared to me that his odium had negatively imprinted her image of the medical profession, which is a shame. At this time more than ever, we –- doctors and patients alike — need to encourage the most talented of our youth to join the medical profession. Read more »

Get Yourself Into A “Medical Jam”

Thanks to the PSP Blog which linked to the “Culture Map” article by By Douglas Newman — Medical jams: From plastic surgery to cancer to sex changes, it’s been rocked about.

Newman has put together the following list with audio links included in his article. I hope you will pop over and give them a listen. Do you have any to add to the list? 

“Heart Doctor” by Lee “Scratch” Perry

This late period track by the legendary (and legendarily kooky) Lee “Scratch” Perry finds the reggae/dub artist and producer doling out “advice” to his patients…

“A Nurse’s Life is Full of Woe” by Billy Bragg

An unreleased track taken from the sessions of Talking With the Taxman About Poetry, “A Nurse’s Life is Full of Woe” finds Bragg taking on the plight of the working class…

Read more »

*This blog post was originally published at Suture for a Living*

Minnesotans Get More Lower-Back MRIs: Why?

Kudos to Christopher Snowbeck and the St. Paul Pioneer Press for digging into new Medicare data to report that the state the newspaper serves is out of whack with the rest of the country in how many expensive MRI scans are done on Minnesotans’ bad backs.

Snowbeck artfully captures the predictable rationalization and defensive responses coming from locals who don’t like what the data suggest. Because what they suggest is overuse leading to overtreatment. So here’s one attempt a provider makes to deflect the data:

“The Medicare billing/claims data, which this report is generated from, would not capture conversations between a patient and provider that may have addressed alternative therapies for lower back pain,” said Robert Prevost, a spokesman for North Memorial Health Care. “It’s important to recognize the limitations of this data.”

No, data don’t capture conversations. But wouldn’t it be fascinating to be a fly on the wall during those many patient-physician encounters that led to an MRI to see what level of truly informed shared decision-making (if any) took place? Read more »

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

Patient Safety: Doctors Must Report Each Other’s Incompetencies

Recently, JAMA published a study concluding that doctors are hesitant to report incompetent physicians or those who were impaired. According to the article:

“…more than a third of docs don’t think they’re responsible for reporting those who aren’t fit to practice, according to the results just published in JAMA. And only 69 percent of the docs who knew about an impaired or incompetent colleague reported them.

To those who advocate that the medical profession self-police, the numbers aren’t encouraging. Read more »

*This blog post was originally published at KevinMD.com*

The Insulting Term “Physician Extender”

“Physician Extender.” It sounds like the name of a male enhancement product. It’s a term often used to describe a nurse practitioner or a physician’s assistant. I hate it. It’s insulting.

A nurse practitioner is not an adjunct physician. They do not supplement the care of a physician. They provide essential advance-practice nursing services, services that include diagnosis and provision of medical care.

While some of these services overlap those of medicine, nurse practitioners are not extensions of another profession, they provide care in their own right — as educated, licensed practitioners. Sometimes the only care provider for a community is a nurse practitioner. Read more »

*This blog post was originally published at Emergiblog*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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