You are here: Home / Archives for My Life / After Residency
post

Obesity Week 2019

December 6, 2019 by Leave a Comment

I had the chance to attend Obesity Week 2019 in Las Vegas from November 3-7. Obesity is not really a topic or area that I had much exposure to during training. But in the past few years I have wished that I knew more about it. After residency I worked exclusively in the inpatient setting as a hospitalist. For those of you unfamiliar with this term, it means that I only worked in the hospital treating patients who were sick enough to be admitted in the hospital. During this time I would frequently encounter patients with chronic medical conditions, many of which would improve with significant weight loss. But the extent of my intervention was to advise the patient about the importance of lifestyle changes and to follow up with their primary care physician. Because for the hospitalist, the physician-patient relationship ends when the patient is discharged from the hospital.

A few years ago I asked around our division why our outpatient Internal Medicine clinics did not have an obesity clinic. After all, I thought, this should be well within the scope of practice for an internist. This is not to say that no one at my institution was treating obesity. In fact, we had a medical weight loss program as well as a bariatric surgery program. But Internal Medicine did not have a dedicated clinic for obesity. Instead, internists had to address obesity along with any other medical conditions during a patient visit.

Fortunately, while I was asking around and looking into obesity treatment, I discovered that one could become board certified in obesity medicine by the American Board of Obesity Medicine. And, through asking around, I learned about the annual Obesity Week meetings held by The Obesity Society (TOS) and the American Society for Metabolic and Bariatric Surgery (ASMBS).

Over the last year I have transitioned out of inpatient medicine. Currently I see patients in the Internal Medicine clinic at my institution as a primary care physician. But I am also starting a new learning/educational journey with the obesity medicine. I am not sure where this journey will take me. But as with the journey thus far, I’ll continue to try and write and reflect on it here.

Filed Under: After Residency, My Life Tagged With: , , ,
post

Back To Writing

November 6, 2019 by Leave a Comment

Over the last few years my activity on this blog has definitely decreased. I suspect that it is a combination of a lack of time and a sense of not having an audience. The blogosphere has changed over the last few years. This is the age of the social media influencer. I see a lot of activity on Twitter and Instagram now. When I started my blog I was an undergraduate student trying to apply to medical school. That seems like a lifetime ago. And in a digital/technology world, that is several lifetimes ago.

But I have to remind myself that when I started blogging, it wasn’t for the audience. It was for me. At the root of it all, writing was cathartic. And I need to get back to writing for me. And if there are friends who want to follow the journey, then that is a bonus.

Filed Under: After Residency, My Life Tagged With: , ,
post

Aging

May 1, 2019 by Leave a Comment

I’m not talking about the aging of my patients.

I’m talking about my own aging.

I looked at the medical students rounding with me last week and realized that these “kids” have only ever known an Electronic Medical Record.

I recalled to them my experience as a medical student when I would handwrite orders for the team on triplicate forms and then turn the orders in to the unit secretary to be faxed off to the pharmacy and/or distributed to the nurses.

Their faces clearly showed their shock and disbelief.

The idea was totally foreign.

I think I felt an ache in my back at that moment.

Filed Under: After Residency, Education, Medical School, My Life Tagged With: , , , , ,
post

July – It’s That Time of Year Again

July 11, 2017 by Leave a Comment

It’s July.

It’s that time of year again.

Those involved in medical education — or just those that work at academic medical centers — know that this is the time of the year when brand new interns step into their roles as doctors.

Cue all the jokes about July being the worst time to be sick in a hospital.

During my chief resident year I was in charge of the first Journal Club session of the academic year. I assigned the residents an article about the July effect. You can find that article by here: Annals of Internal Medicine.

Jokes aside, I think the month of July is an exciting month to be involved in medical education. It’s a time of very new beginnings. As an attending physician supervising learners it is a time of heightened stress. However, I think it’s also a time of when you get to see new baby doc spread their wings for the very first time. This is the first time they are addressed as “Doctor.” These are the first orders they will write as a physician. This is the beginning of the rest of their professional careers.

The transition is defintely not always smooth-sailing. But it is definitely worth the trip.

Filed Under: After Residency, My Life Tagged With: , , , ,
post

Doctor, Please Explain…

January 6, 2017 by Leave a Comment

Recently I have been thinking about communication.

In my short career so far, I have realized that there is often a huge chasm between what we (physicians) think we have explained and what patients understand.

As a general rule, I try to take the time needed to talk to patients and answer all their questions. Sometimes I think I do an adequate job. And patients have voice appreciation for it before. I have been thanked for actually taking the time to explain my thought process and my plan. But I’m sure there are other times when I my question-answering leaves something to be desired.

Unfortunately, time is a luxury. Sometimes things get rushed. Sometimes there are patients who need more attention because of their condition so we spend a shorter amount of time talking to the more stable patient.

I’ve also had nurses tell me that they care for patients who ask them all sorts of questions about their medical care but when the physician comes in to see them, the patient either forgets or chooses not to pose the question to the physician. Sometimes they get overwhelmed. Sometimes they are intimidated. Nurses tell me that sometimes after the doctor leaves the room, the patients will ask their questions to the nurses.
Most of my work caring for patients involves residents/interns and medical students. I try to emphasize the need for clear and accurate information each time I work with a new group. Nevertheless, miscommunication happens. We aren’t perfect. We operate in a flawed and broken system that expects perfection and efficiency from medical providers.

If you’re reading this post, I’d love to hear about your experience as a patient. Are there still things that confuse you about that experience? Are there things that you wish your doctor had taken more time to explain? Are their topics or diseases that they sped through while talking to you? Do you wish they’d have slowed down and spoken in plain English? I want to know what the confusing topics are! I want to know where we, as a profession, fall short!

Filed Under: After Residency, Other Tagged With: , ,
post

Parenthood Thus Far

December 22, 2016 by Leave a Comment

It’s now December. I went back to work in mid October after approximately 6 weeks without a shift. During those six weeks I had the occasional meeting to attend and other administrative responsibilities. But I had no 12 hour shift to fulfill. After feeling like I’ve been going non-stop throughout medical school and residency, it felt weird not to have any clinical duties for so long. At the same time, however, it wasn’t a vacation.

Prior to my 6 weeks off, I thought I would be able to stay at home, take care of the baby, and take time to read. I had hoped to have this time to catch up on much-needed reading. I soon learned that a newborn takes a lot of time. Despite both me and the wife being off work, we frequently found ourselves getting behind on things we had to do because, well, we were trying to keep this new creature alive.

During residency I had my share of on-call shifts that lasted over 24 hours. The newborn period soon came to feel like a prolonged call shift lasting days. Our nights were split into shifts where we would take turns taking the baby and making sure she was clean, dry, and fed.

We were lucky that Faith, our baby, was quick to take the breast or bottle. She wasn’t fussy and she didn’t need much coaxing to eat. But let me tell you, this little one can go from 0 to ‘hangry’ in no time at all. It’s as if she finally has the realization that, “Oh, I actually AM hungry.” This is usually followed by immediate wailing and crying.

They say that parenthood changes you. They say that having a child shifts your own priorities. I wonder how she shifts mine. I suppose only time will tell.

Oh well. It’s December. It’s baby’s first Christmas. And I will try to enjoy it while it lasts. In a few days the baby turns 4 months. I can’t believe it’s been 4 months already. It’s been crazy watching her grow so much in such a short period of time.

 

Filed Under: After Residency, My Life Tagged With: , , , , ,
post

Back To Work

October 9, 2016 by Leave a Comment

I go back to work this week. It’s the first time I have been on a shift since mid August. My wife and I recently celebrated the birth of our first child, a baby girl. I was fortunate to be able to arrange my schedule in order to accomodate this time off.

It’s odd going back to work after a long time. Part of me welcomes going back. Part of me wants to hang out with this brand new, little human being.

They say that having children changes your priorities and perspectives.

Personally, I think its’ too early for me to say what, if anything, has changed.

Sure, I wish I could spend a ton of time with the little one. But I also have gotten antsy and wanted to get out of the house.

If it were an option or possiblity, I wonder how I would do being a stay-at-home dad/husband. I would probably have to be intentional about being active and doing things out in the community with the baby. Needless to say, I’ve got tons of respect for men and women who are full-time caregivers with their children at home.

We’ll see how it goes.

Filed Under: After Residency, My Life Tagged With: , , , ,