Attending Status
What’s in a title?
My ID badge now says “Attending Physician.”
I guess that’s my title now.
Last month I worked two hospitalist shifts. A week later I followed it up with 7 MOD shifts.
As a hospitalist I was responsible for my entire set of patients. I did get to work with one resident who was spending the month doing a hospitalist elective.
During the MOD shifts, I was the attending on one of our Internal Medicine teaching teams. I had a senior resident and two interns.
It is definitely a new feeling to have “the last say.” All my previous experiences on inpatient medicine had been as a re...
Source: JeffreyMD.com - October 13, 2015 Category: Internal Medicine Authors: Dr. Jeff Tags: Chief Residency My Life attending attending status doctor medicine physician Source Type: blogs
NLM Interns Sign On for an Active Summer
Every summer, interns flock to the NIH campus, eager for a chance to work side-by-side with professionals and experts in their fields. These enthusiastic college and high school students don’t come to take it easy, and they definitely don’t want only to make copies and fetch coffee. They want practical experience, exposure to real-world challenges,… (Source: NLM In Focus)
Source: NLM In Focus - September 30, 2015 Category: Databases & Libraries Authors: Posted by NLM in Focus Tags: People Source Type: blogs
Table rounds prior to bedside rounds
For 30 years I have always conducted “table rounds” prior to seeing the patients. Many colleagues champion bedside rounds solely. While we each must find our most comfortable rounding style, I hope to convince other attendings of the value so that they might consider this style.
What are table rounds? We start rounds by quickly having students or residents give a brief report on each known patient. They need not provide every detail, but rather report on test results, consultant recommendations and any major clinical change. We look at pertinent images.
During this time we have several goals. First, the e...
Source: DB's Medical Rants - September 17, 2015 Category: Internal Medicine Authors: rcentor Tags: Attending Rounds Source Type: blogs
Proud to be a General Internist #ProudtobeGIM
SGIM (the Society for General Internal Medicine) launches today its #ProudtobeGIM campaign. As a full disclosure, I am a previous President of the Society. I am very biased towards SGIM and I am Proud to be a General Internist. Please consider the ProudtobeGIM website to learn more.
Here is my story. I finished medical school in 1975 and stayed at my home institution (Medical College of Virginia – part of Virginia Commonwealth University) for residency. During residency the idea of academic medicine intrigued me. In those days, academic GIM had not yet started at my institution. My advisors convinced me to do ...
Source: DB's Medical Rants - September 15, 2015 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
Play to Learn: NLM Interns Develop Animations, Games to Teach Science
“Play,” Albert Einstein said, “is the highest form of research.” Implied in that observation is that often, with play, comes learning. That’s an idea that high school teachers Brock Eastman and Wendy Sparks have fully embraced. Both Eastman and Sparks interned for the second summer in a row with the National Library of Medicine Specialized… (Source: NLM In Focus)
Source: NLM In Focus - September 14, 2015 Category: Databases & Libraries Authors: Posted by NLM in Focus Tags: Products Source Type: blogs
Hillary Clinton: "I Am Going To Make Some Employers Go To Jail"
“I’m going to make sure that some employers go to jail for wage theft and all the other abuses that they engage in,” said presidential hopeful Hillary Clinton at a Labor Day rally in Illinois.
“Wage theft” is an elastic sort of epithet. These days, it gets used to describe employer practices ranging from the offering of unpaid internships – a practice, it should be noted, that Hillary Clinton has engaged in herself – to not paying employees overtime when they send or read work-related email after hours. Last year, union advocates in the press widely accused an Amazon.com contractor of “wage theft”...
Source: Cato-at-liberty - September 11, 2015 Category: American Health Authors: Walter Olson Source Type: blogs
Good to Great in Graduate Medical Education
My last evening shift was an example of all that is right with our current graduate medical education (GME) system. In spite of spending a Friday night in the hospital, the residents all seemed enthusiastic, engaged, caring, and collaborative. The surgeons treated a prisoner with a pneumothorax as if he were a VIP donor to the hospital, and the internal medicine residents whisked a patient with hyperkalemia to the ICU for aggressive treatment and monitoring without complaint. A pharmacist helped the nurses and the emergency medicine residents speed the preparation of the antidote for a rattlesnake bite. The attending traum...
Source: Academic Medicine Blog - September 3, 2015 Category: Universities & Medical Training Authors: David P. Sklar, M.D. Tags: Featured From the Editor GME graduate medical education residency residency training workforce planning Source Type: blogs
Why these medical interns did not die in vain
About a year ago, I wrote a piece on my blog called “How to Welcome Incoming Residents.” It was about my struggle with getting the right messaging, messaging about the reality of stress during residency and the necessity of incorporating self-care and outreach to others. This year at orientation, in addition to adding the great suggestions posted by readers of the article, I took a different tack. It was imperative. There was a huge elephant in the room.
As most residents and fellows — and their educators — know, the medical community of New York City was rocked by the suicide deaths of two interns in the s...
Source: Kevin, M.D. - Medical Weblog - August 30, 2015 Category: Journals (General) Authors: Michael Myers, MD Tags: Physician Psychiatry Source Type: blogs
Medical treatment has its limits. Empathy does not.
“This is our sickest patient,” my co-intern began as she told me about one of her patients I would care for overnight. It was my first week of intern year, and I was assigned the overnight cross-cover shift for a busy cardiology service. Introducing myself as “Dr. Tredway” still rolled awkwardly off my tongue, but I had grown more comfortable throughout the week in my new role as a physician. I could field multiple pages about the forty-something patients I was responsible for each night. I proficiently prescribed bowel regimens and repleted electrolytes. I carried a code blue pager, but it had not chirped once.
...
Source: Kevin, M.D. - Medical Weblog - August 29, 2015 Category: Journals (General) Authors: Caroline Tredway, MD Tags: Physician Hospital Intensive care Pulmonology Source Type: blogs
Make the past medical history more meaningful
I listen to around 10 presentations each week. Students, interns and residents present patient histories and I often have to interrupt. My expectations are, apparently, different from how they were taught. Here are some of my pet peeves – please feel free to expand the list:
Diabetes – please tell me what type and how long the patient has had diabetes. A 1-year history of diabetes has very different implications than a 15-year history
CHF – systolic, diastolic, valve related – what is the ejection fraction – what is their current function
COPD – on home oxygen, emphysema or bronchitis...
Source: DB's Medical Rants - August 28, 2015 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
August Man of the Month: Dr. Timothy Harlan
Today begins our Culinary Nutrition Series, through next Wednesday we will be running posts from experts who will explore the relationship between food and health. Bon appetit!
With an August theme of The Link Between Food and Health, Dr. Timothy Harlan was the natural choice as one of the two Disruptive Women in Health Care’s Man of the Month. While many physicians have developed an interest in food, Dr. Harlan was a chef and restauranteur first, and then developed an interest in medicine. As he puts it, “I kind of took a wrong turn” on his way to college for a hotel and restaurant management degree and wound up...
Source: Disruptive Women in Health Care - August 24, 2015 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Food Man of the Month Nutrition Source Type: blogs
August Men of the Month: Dr. Timothy Harlan & Chef Bill Barum
Today begins our Culinary Nutrition Series, through next Wednesday we will be running posts from experts who will explore the relationship between food and health. Bon appetit! In August we have the pleasure of naming two Men of the Month, the first Dr. Harlan (post below) and the second Chef Bill Barum (see his post here).
With an August theme of The Link Between Food and Health, Dr. Timothy Harlan was the natural choice as one of the two Disruptive Women in Health Care’s Man of the Month. While many physicians have developed an interest in food, Dr. Harlan was a chef and restauranteur first, and then developed an in...
Source: Disruptive Women in Health Care - August 24, 2015 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Food Man of the Month Nutrition Source Type: blogs
Thoughts while attending the White Coat Ceremony
The White Coat Ceremony is always thrilling. One of my former interns gave the keynote address. He made a most important point. Once you don the white coat, you always where the coat.
Having graduated 40 years ago, I think he makes an important point. Being a physician becomes an integral piece of our existence. No matter what I am doing, being a physician influences who I am and how my friends and family view me. I interpret the world through physician eyes.
This rant is not a complaint rather it speaks to the power of our profession. I am not just a physician only while I am seeing patients.
Being a physician re...
Source: DB's Medical Rants - August 17, 2015 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
What happens when the best medicine has to offer can’t be offered to everyone?
“We have an admission.”
The dreaded four words for most interns on a day you are swamped with discharges while trying to get your post rounds orders in.
“Hypertensive emergency and possible osteomyelitis of the foot,” my senior informed me with a few other details as we made our way to the emergency department. Mr. Rodriguez was a very pleasant middle-aged gentleman, with graying hair and a goatee. I introduced myself, explained my role in the healthcare team, and informed him why he was being admitted to hospital. Mr. Rodriguez nodded his head every few seconds, but his blank stare betrayed the fact that he did ...
Source: Kevin, M.D. - Medical Weblog - August 10, 2015 Category: Journals (General) Authors: Taimur Safder, MD Tags: Physician Hospital Source Type: blogs
The problem with resident training hours: The numbers don’t add up
Being an intern and resident in today’s day and age of medicine is proving to be more difficult than ever. I’ve written about resident work hours before, but now that I have finished intern year, I have a lot more to say regarding this issue. I recently reread Dr. Pauline Chen’s article “The Impossible Workload for Doctors in Training,” and also read “The Real Problem with Medical Internships” by Dr. Sandeep Jauhar published in New York Times, and it really got me thinking. An op-ed published in JAMA last year urged doctors and the higher-ups responsible for residency program accreditation...
Source: Kevin, M.D. - Medical Weblog - August 9, 2015 Category: Journals (General) Authors: Joyce Ho, MD Tags: Education Residency Source Type: blogs
