Twitter-thumb : Social media-induced DeQuervain's Syndrome

As I type, my extensor pollicis brevis tendon is screaming for mercy. I am forced to take several (unwanted) breaks to ease the uncomfortable mix of pain and weakness that is sometimes accompanied by the uncanny twitching of my thumb and fingers. I am suffering from a terrible case of twitter-thumb. Bilateral twitter-thumb.

The Hidden Power of Health Fairs

There is nothing like a good community health fair (HF). Away from the formal, detached sterility of the office this is an opportunity to meet patients on their turf. No longer adorned with white coat, power outfit and accompanying entourage, physician meets patient as just another member of the community, an equal almost. With a backdrop of blaring music, sweltering heat and flavorful eats people young and old gather, eager to commune in the name of health. Meeting in this context fosters rapprochement between patient and doctor. The once hierarchical encounter is no more. In this habitat, doctor and patient are in fellowship.

I enjoy health  fairs because they provide the perfect merger of public health and medicine. At one instant I am advising a patient on her individual health needs; in another instant I am addressing a group  on health topic salient to the community. At health fairs doctors, nurses, community organizers, nutritionists, peer educators, farmers, pastors, teachers work in tandem for the community's improved health. At these events I see my work as integrally woven into the fabric of the community's identity and goals and there are few things more powerful than the feeling of contributing to a much larger whole.

The (FM) Revolution Will be Tweeted!

If you're in medicine and on twitter and haven't come across the #FMRevolution hashtag, you must be, like the Geico commercial says, living under a rock. Since March 2011, Family Medicine has been taking the twitterverse by storm. What first started as the "Family Medicine T-shirt Revolution" at a California Family Medicine summit in 2010 has now turned into a fulfledged campaign to debunk misconceptions about the specialty, dispel misgivings about pursuing the field and to advocate for primary care as a cost-effective specialty with proven results in improving health outcomes . The revolution has been rallying physicians, residents and students nationwide to the cause.

...and mentorship

Harvard MSIV, Nate Favini, did an excellent commentary on Dr. Pauline Chen’s NY Times article entitiled, “The Hidden Cost of Medical Student Debt”. Mr. Favini aptly added lack of economic diversity and personal motivation as key elements that affect medstudents’ desire to pursue primary care, in addition to debt. Both articles made strong cases and I suggest we add another to the list of factors contributing to med student interest in primary care -- mentorship.

Memories

I recently rediscovered some of my clinical rotation musings. Enjoy...

||||4.7.10||||

Since my last writing I've moved from no longer wanting to be a surgeon to falling in love with pediatrics. I often wonder to what extent students' specialty decisions are influenced by their rotation experience. My pediatric experience was phenomenal. The most organized rotation I have seen yet. But more than the syllabus and organization of the rotation, were the people. For the first time, I saw myself in these attendings and residents. I saw qualities that are dear to me being reflected in these individuals -- advocacy, service, compassion. I saw an environment where residents and attendings shared mutual respect, not chilling fear or measured disdain. The atmosphere was one where I was always excited to be there, where I welcomed the challenge. Had I done my rotation elsewhere, would I have felt the same way about pediatrics?

Do As I Say, Not As I Do

I’ve heard patients say, “How could she smoke and she’s a doctor?” Alarmed and bewildered by the fact that an agent of health could partake in one of the most harmful acts of bodily destruction. In medical school, a sizable number of my classmates smoked and I always found it so counter-intuitive, mind-boggling that they would be learning about smoker’s lung in pathology and on class breaks would huddled outside the lecture hall sucking on their cancer sticks. These same colleagues would then be encouraged to exhort smoking cessation in our clinical skills session while we all sit, simulated patient included, in a room rife with the heaviness of second hand smoke. One would assume that there should be a direct correlation between knowledge on a topic and healthy decision-making but we know all too well that that is not the case. As Thomas Goetz states, fear of illness is not sustainable motivator for positive change in health behavior and that is true even if you’re a physician. It has certainly been true of me.

Yes! Take notes at the doctor's office.

As a recently minted physician, I am often on the receiving end of the gripes and grouses about the medical profession. Often I get complaints of office visits that are too short, doctors who seem too preoccupied to hear their patients' complaints, medical bills that are too high and medications that do nothing but cause adverse effects. On the other hand, I can't count the number of times I have left the exam room, convinced I have gotten the most complete and accurate information from the patient only to be confronted by the attending on something I had 'missed'. Really?!?!? I just asked her that and she denied having chest pain one week ago! The truth is, patients are often intimidated and confused by the whole medical experience and in this state are even more likely to forget the details of their medical history, thus creating a less than ideal environment for optimizing health.  Something needs to be done to improve the doctor's visit, both for patients and for physicians.