OK… Today’s a very special day for me. (Actually yesterday, but the idea came to me when I was way to tired to carry it out.)
Yesterday afternoon, my wife gave birth to my 5th child… yes, 5th… that’s not a typo. Many of you know from my stories of raising kids during internship and residency, that (a) I have 4 girls, and (b) my wife was pregnant with #5.
Well, it turns out that #5 was an 8lb 12oz baby boy
Now… with all of these kids, what’s a guy to do, but hold a baby sale? Check out this video for details.
Click here right now to see what your RookieDoc Membership will do for you.
Although it’s great that so many people are joining RookieDoctor.com’s Exclusive Membership Program with such enthusiasm (and jitters about starting internship), it’s not so great because some people will have to be left out. I may have to close the membership program to new members, so that I can continue to concentrate on the existing members.
The questions and worries and concerns pick up around this time of year (for obvious reasons). For me that translates into more time with members.
Plus, as I write this, my wife’s contractions are 15 minutes apart (not sure if tonight’s the night for baby #5 or not, but I wanted to get this message out before that).
So here it is… Check out this video… If it looks like something you might be interested in, click the link below it. But do it now, while this is still available.
Click here right now to see what your RookieDoc Membership will do for you.
I’ve started a Residency Horror Stories series. The point is not to get you nervous about your training or being on-call or anything like that… In fact, it’s quite the opposite.
Most people think they learn best through experience. That’s true, for the most part… but there’s another piece of “experience” that is even more important than the experience itself… and that’s “the story”. We remember things as stories. We further ingrain the memory by retelling that story. And each time we retell it, there’s an opportunity to extract new insights from it and an opportunity for the listener to benefit from your story.
Now some of the medical establishment (the Old Boys Network) may be a little upset with me for saying this, but… the dry, factual version we often present on rounds is not always optimal.
Which one are you going to remember?:
THIS?:
49 year-old obese female with a history of type 2 diabetes and smoking who presented to the ER with severe chest pain, hypotension, and diaphoresis. Her EKG demonstrated 3mm ST segment elevation inferiorly. Cardiology was consulted and she was emergently taken to the cath lab. After a brief Vtach arrest requiring 260 Joules for return to sinus rhythm, her right coronary artery was successfully stented with two Taxus stents with good angiographic results. She was transferred to the CCU in stable condition with an intra-aortic balloon pump, IV heparin, Plavix, and aspirin.
OR
THIS?:
It was my first week as a second-year resident and I was on-call in the CCU. I was called stat to the ER for a CCU admission that was described as a “49 year-old obese female with a history of type 2 diabetes and smoking who presented to the ER with severe chest pain, shortness of breath, and diaphoresis.” I was told that cardiology was consulted via phone & they recommended transfer to CCU after a VQ scan.
I went to see the patient & there’s a morbily obese lady lying in Trendelenberg, IV fluids wide open, heart rate in the 40s, and huge “tomb stone” STs on the monitor. I introduced myself and told her that we would take good care of her. She looked up at me and said, “Son, I’m gonna die tonight if you don’t do somethin’.”
I went to the ER doc and said, “This lady’s clearly having a huge RCA MI! She’s bradycardic, hypotensive, complaining of chest pain, & her EKG… well, look at it! We can’t send her to the unit with a VQ scan.”
He responded, “Well, I talked to the cardiologist on-call.” And I asked, “Well, are sure he understood what we’re looking at here? I mean, no offense, but sometimes it’s all in how we say it. I think you should call him back.”
Well, he did… the ER doc called back the cardiologist on-call and got screamed at… loud enough for me to hear it through the phone from about 4 feet away. “I said!… Admit to CCU and get a VQ scan!”.
He hung up. There I am, a new second year, one of my first nights with any kind of real responsibility and I’m disagreeing with the ER attending and the subspecialist. What should I do?
Well, there was no question… that lady said to me, “Son, I’m gonna die tonight if you don’t do somethin’.” So I did… I firmly asked the ER doc, “I’m not comfortable with this! Are you comfortable with this?!” He said, “No… No, I’m not.” So, I asked, “Well, how about TPA?” He paused… so I snatched the EKG out of his hands and ran 3 floors up to the telemetry floor. There was a cardiologist (from a competing group) and I shoved the EKG in front of him and said, “49 year old lady in Room 8 in the ER, tons of risk factors, heart rate in the 40′s, telling me she’s going to die… no labs back yet.”
He said nothing to me. He picked up the phone and called the cath lab. Together he and I wheeled her into the lab. While we were lifting her to the table, she arrested….
So which one are you going to remember? Which one will give you strength to do the right thing when the time comes. Both of those versions are true. I lived through it. More importantly, so did the patient, but not before her night got much, much worse. I’ll tell you the full story and the lessons learned in the second video for “Residency Horror Stories”… the first video will be in the next few days.
Do you have a story we can all benefit from? Tell us. Here’s the link again:
I need to apologize for the brief blog post hiatus. My daughter’s basketball team is in local championship game, I’ve been ultra-busy opening a new unit at the hospital, and I’m planning a trip to San Diego… plus my wife is pretty far along (pregnant) with number 5. But, in the midst of all of that, I’ve been working on several awesome things for the site…
The next video for Fiscal Therapy Rounds is about something I call, “The Doctor Tax”. Basically it covers why prices are inflated for doctors and how to resist it. I’ll try to post it in the next day or so.
I recently finished an awesome interview with a co-author of the book Write Your Way to a Residency Match and I’m preparing a surprise for members before releasing the interview. It’s chock full of great information, so you won’t want to miss this. It applies to residency and fellowship applications. Awesome stuff. (RookieDoc Members: don’t buy this book yet. Trust me. The surprise I’m going to offer you with this book is worth the wait. I just need to get approval first.)
Next week, I am conducting more interviews for you. The interview I am most excited about is actually with a VP from a malpractice company that is run by doctors. It’s one thing to learn how to do stuff right the first time… but when you hear how some people go wrong… you’ll never forget it.
I’ve received a massive influx of questions in the Ask RookieDoc question section. Be patient with me as I try to get to them. I’ve already emailed a couple of you directly. But the other questions are going to be answered in one of two ways – (a) in the next FAQ call (more info coming soon), or (b) in upcoming videos. (see the next bullet)
Residency Horror Stories. Although she may not know it, a RookieDoc member (Trish) answered a survey question about the Pager Module that sparked a whole new line of RookieDoc videos. They’re not just horror stories… they are real-life stories from med school, internship, and residency, that have important lessons for your training. Be on the lookout for these. They’re going to be priceless. Thanks Trish
Got any other ideas, questions or needs? Let me know. Post a comment below, or just ask.
After a great response from those of you on my “new release priority notification list”, the RookieDoc Membership program is being opened to anyone that is interested. Here’s a short intro video to show you some of the things that are part of membership. If it sounds interesting or useful, click the link below the video to find out more.
If you could sit down with me and ask me any question about being successful in your internship or residency, what would it be? The RookieDoctor.com Members area opens up to new members tomorrow at noon.
I may not get to every question directly, but may be able to post important answers here, in special RookieDoc reports (PDF), on the RookieDoc Squidoo lens, or in the Audio Tips series.
Since the last video, many of you asked to see a sample of the imaging tips from Radiology Rounds in the members area. Well, here’s a sample. It’s under 4 minutes and goes over a finding often missed by med students, interns, and residents when reading chest X-rays. Click this image to get started.
Want more videos like this one? You can get these regularly as a part of the RookieDoc Radiology Rounds Modules in the Members area. I will be accepting new members starting Tuesday 1/27/09 at 12 noon EST.
I made a short 7 minute video as a quick introduction to Twitter and how you can use it to get tips and strategies for your med school rotations, internship, and residency. Just click on the video image below to get started. You will need the most up-to-date QuickTime player (free version).
I posted a blog post a couple of weeks ago, just after the American Board of Internal Medicine (ABIM) issued a press release warning about scam certification boards. In that post, I mentioned that I was working on an identity theft report for Rookie Docs – medical students, interns, residents, fellows, and new attendings.
Well, the report is done… all 40-some pages of it. And you can get it free. “Free” meaning no money, but not entirely free. It will “cost” you three short questions.
Now, I can sit back and write random post after random post, not having a clue if you find them interesting and helpful… OR, I can ask you what you want me to write about. So, that’s what I’m doing. That’s the catch…
You anonymously answer three short questions about your financial fears and concerns, and I give you a free 40-page ebook on protecting yourself and your patients from identity theft. Sound fair? Here’s what I want you to do:
Keep in mind, I am not a lawyer (thank God), I am not a financial planner, I do not know your particular circumstances, and my advice does not substitute for a qualified professional in these areas. You can take my tips or leave them. In general, it is solid advice, but it may or may not apply to you.
And, as always, I want your feedback. (And a quick thanks for all of you who gave such good reviews of the CXR Mistakes report in the Members Area… keep it coming)
Doctors and nurses often have an “alphabet soup” after their names, representing certifications, memberships, and/or degrees. While many physicians are well-acquainted with the organizations in their particular discipline, patients usually are not. Patients, then, are at significant risk for being treated by frauds claiming to be “board certified” simply because they have a certificate from one of these “organizations”.
Already targets for identity theft by virtue of their high-paying jobs, doctors and nurses are at significant risk by these fraudulent organizations too. If they are so unethical as to pose as legitimate organizations and companies, what makes you think they would treat your sensitive personal and professional information as private and confidential?
The ABIM is asking that anyone who is contacted for joining such a group to notify them immediately. You can email them at security@abim.org. Certainly, if you know of someone using fraudulent credentials, you should report them to the appropriate authorities. In your residency program, you would probably report it to Risk Management and the hospital’s credentialing officers.
Identity theft and fraud are huge. And unfortunately, our residency programs do not teach us enough about them- how they happen or how to recognize them. As such, within the next few weeks, RookieDoctor.com will be releasing information on identity theft and what you can do o protect yourself.
