Sunday, April 25, 2010

A HOSPITALstyle Guide for a Successful Med Student Rotation

Been there. Done that. Every attending, resident, and intern has at one point in time been a medical student. After the second year of medical school, third year med students cautiously jump into their clinical roles on various required rotations. At this time step 1 has been passed and the science behind the medicine is in your brain..somewhere. The transition to clinical practice is a big step and all of the realities that we face in medicine (insurance companies, low reimbursements, defensive medicine in the face of litigation) all collide with the idealistic and altruistic reasons of why we all chose to go to medical school. However, this is also a huge time of learning and the excitement of the medical student's opportunity to finally participate in patient care. This new role in patient management trumps it all. I have included a few comments on how to be an effective, efficient, and helpful medical student on any hospital rotation.

-Read about the specialty before beginning the rotation (this is the time when you figure out what you want to go into).

-Always be on time.

-Ask a lot of questions, this is your time to learn (and you are paying a lot for it).

-Know your role (and if you do it well, people will notice).

-No job is too small, no task too mundane (you learn something from everything) so... be familiar with laboratory values, how to dip urine, where to get supplies, how to do a rectal exam, how to do an ekg.

-Stop by and talk with your patients, get to know them, they are your best teachers in medicine and in life.

-Take every opportunity to discuss your seniors specialties with them (to know what surgery, emergency medicine, ob, peds is really like).

-Think 2 steps ahead of the resident working with you. get lab values without being asked, have materials ready without being asked, print off CT reports without being asked.

-Never do any sort of procedure without asking permission, reading up on it, and having supervision.

-Understand that it is OK if you do not know something. Show motivation to learn it.

-Do reading on your own time. hospital time is reserved for participating as a team member.

-Always know that we need and depend on your help.

-Smile. be patient. be courteous. make friends.

-Go to the bathroom on your own. no need to ask permission.

-Attitude is everything.

-Do not check your style at the door. wrinkle free scrubs. clean white coat. notebook to write down little things you learn.

Follow these rules and you will find success, find friends, learn much, and find the value of the hard work needed in any field in medicine. Good Luck!

The Quintessential Doctor's Bag

On any given day we doctors need to carry many things with us. Some we stuff into the pockets of our white coats, some into our scrubs, and even around our necks. However, as we are attending to our patient's needs and the situations that arise in front of us, many things tend to get lost or displaced in the process. Our mobility is essential to our scope of practice in traveling to different floors of the hospital, to many different rooms, to the cafeteria, to our offices. This creates an organizational challenge. And what happens if we forget something like a tuning fork, a reflex hammer, or even a pen? It slows us down. So my proposal is that we bring back the doctor's bag.

There are many options out there and your preference can dictate which might be best for you, I use a Land's End bag during my shifts in the emergency department. It is large and I leave it in my locker when I am away and it houses books, notes, my stethoscope, a head lamp for foreign body removal, my pharmacopeia, and my procedure log among other things. Overall, I love having a carry-all that creates space for anything I might need throughout a shift.

Here are some other options-

S25214 QTVR

(The Specialist Bag 127.50)
For the old school classic go to

(Jack Spade, Linen Plaid York Brief 192.50)
For stylish totes for the adventurous and fashion savy doc go to

(L.L. Bean Signature Bag, 189.00)
For a more rustic leather style visit
(Land's End Tote, 20.50)
For a functional yet stylish bag go for the very basic (can get your name monogrammed on the bag for an additional 5.00)

Just a few ideas to create more organization, more flare, and more old-school charm to your HOSPITALstyle.

Thursday, April 22, 2010

Turning Doctors into Leaders

I just read a fabulous article in this month's issue of The Harvard Business Review entitled 'Turning Doctors into Leaders" by Thomas H. Lee that gave a lot of insight into the future of medicine and our role as physicians in that future.

Here are a few highlights-
  • There is a transition happening from ART to FINANCE in the practice of medicine
  • Performance and outcomes matter
  • Focus on Teamwork
  • Peer Pressure as an impact on performance of colleagues

The same issue includes "Fixing Health Care on the Front lines" by Richard Bohmer.

The author delves into what it will take to redesign the industry. His argument points to applying scientifically established practices for diagnosing and treating diseases (with flow-charts), fine-tuning those processes for diseases we still do not fully understand, and ultimately making strides in improving patient outcomes. This also includes eliminating waste as illustrated by the recent success in some hospitals through application of the Toyota Production System.

Can we be turned into these kind of leaders? Change in our field is inevitable and actually happening very rapidly as we speak. We as doctors have a responsibility to ourselves and our patients to be open to ways that ultimately benefit the patient. This means involvement with quality assurance issues within our own institutions. This also calls for putting individualistic tendencies aside and communicating more efficiently with our colleagues to ensure the BEST outcomes for our patients. Can health care be fixed on the front lines? It is up to us.

Check out these articles online....

Monday, April 12, 2010

Style in Medicine?


From Wikipedia, the free encyclopedia

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Style may refer to:

  • Design, the process of creating something
  • Fashion, a prevailing mode of expression, e.g., clothing
  • Style (fiction), an aspect of literary composition
  • Format, various terms that refer to the style of different things
  • Genre, a loose set of criteria for a category or composition
  • Human physical appearance
  • Typeface, style is one of the three traditional design features along with size and weight: either regular, italic or condensed

Style, in specific fields, may also refer to:

  • Style (visual arts), in art and painting style can refer either to the aesthetic values followed in choosing what to paint (and how) or to the physical techniques employed
  • Style (botany), a stalk structure in female flower parts
  • Style (manner of address), titles or honorifics, including Chinese courtesy names

This is the multi-faceted definition of style according to Wikipedia. Where does style fit into medicine? We begin the road of training at various stages, but at some point we are taught about the art of medicine. It is through teachers, parents, friends, and books that we first come to realize and appreciate the complexities of the human body and more importantly the human spirit. Medicine is a unique field that mixes science and standards of practice with ethics, communication, and people skills. We are at the forefront of the extremes of life on a daily basis. One moment we are delivering a new baby and the next we are speaking to a patient about a new diagnosis of cancer, or possibly to a family of a patient that has recently died. This environment calls for stability and strength of character, but it also calls for style. How do you introduce yourself to a patient? How do you dress? What facial expression do you put on? How do you ask the most intimate of questions to someone you just met? How do you handle their trust? How do you interact with your colleagues? How do you take your coffee? How do you manage stress? The answer to all of these is with style (or so we hope).

Style is the format by which you live your life and how you make your decisions. Style in Medicine incorporates your professional persona, how you speak and act, how you embrace each new situation and how you deal with the collision of science, art and the human heart that we deal with every day. What is your style?