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Baby Got Back

A 2-year old boy is brought in by his parents because they are worried that his wrist hurts. When they got home from work that evening, the parents noticed that he was refusing to use his right arm. The boy had been in the care of his grandmother all afternoon, who did not recall any specific injury. On exam, he is comfortable and in no acute distress, exploring the exam room and cautiously hiding behind his mother when he sees you approach. You notice that he is holding his right wrist with his left hand, and cries with any palpation or movement of the right arm. It is unclear to you Read more [...]

Congratulations! Pediatricians Are The Least Paid Physicians!

Recently, a relative approached me regarding her choice to pursue pediatrics as a career choice. We had an extensive discussion about how fulfilling this specialty is and how healthy its population is compared to adult specialties. Yet our discussion took a different turn when we addressed salaries and compensation. As most of us know, pediatricians are the least paid physicians. A few weeks ago, Medscape published its 2015 report of physicians' compensation. They surveyed more than 19,000 physicians across 26 specialties between December 2014 and March 2015.  9% of the respondents were Read more [...]
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Doctor Cents: Something I hope to Never Use Part 2–Some Things Are Worse Than Death

In our last post we discussed life insurance and how most of us need this type of insurance. Today’s post will focus on a type of insurance that EVERYONE reading this blog needs—disability insurance. No matter whether you are a medical student or a PEM attending of 30 years, a 25 or a 60 year old you need this type of insurance. Although I hope to not use life insurance, I won’t know if it gets used because I won’t be around to see it used. With disability insurance, I really hope to never use it because that will mean that I can’t practice medicine but I will still be breathing and not Read more [...]

Promotions and Academic Scholarship, Part IV – Allocating Your Time

Ok, quick raise of hands:  How many of you are happy with the amount of time provided to you to accomplish your clinical and non-clinical roles?  Hello?  Anybody around? We're all faced with the finite resource of time.  And in addition to the typical forces of work-life balance and time management, let's discuss your academic time allocation.  Because unlike your University tenure-track colleagues in schools outside of your hallowed School of Medicine, you have this thing called clinical work, where you do shifts. At the 2015 Pediatric Academic Societies meeting in San Diego, Mark Gorelick Read more [...]

Doctor Cents: Something you hope you never have to use…part 1

What is something you hope you never have to use in your life?  For me things that fall in this category include my car’s airbag, a malpractice lawyer, my emergency cash fund, and my life and disability insurance. On to today’s topic of something else you hope you never have to use---life insurance. This is the first in a two part series on different types of insurance I hope you never use. (The second is disability insurance and the next topic I’ll post on.) Life insurance is usually thought of as something you only need if you have a family or someone that depends on your income. Read more [...]
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Helping fellows bring angry parents back from the brink

Suppose that you are a PEM fellow precepting a group of residents and your shift has been going well. You supervised a first-time LP—only 2 RBCs (Chardonnay tap?)—and helped with a patellar reduction. With your fellow mojo at an all-time high the last thing you want is a "social disaster." Unfortunately, a resident comes out of the exam room and says that the mom wants to speak with his supervisor. When you ask why, the resident says, "I don't know..." and shrugs. Whether you’re the fellow about to walk into this potential minefield—or the attending who might inherit the situation depending Read more [...]
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Making the Most of Academic Conferences

The Pediatric Academic Societies meeting is this weekend in droughty San Diego, California. These  academic gatherings are opportunities to learn, share ideas, and meet people.  But if you focus on the wrong things, they can also be a big waste of your time and money. For example, before going to my first academic conference many years ago, I remember focusing on getting to as many lectures as possible. Years of formal education had taught me that if lectures were available, you should go. “These lectures will transform my practice,” I thought. Now I realize that while some of those lectures Read more [...]
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Answer: “Lung Ultrasound: Has it gone viral?”

This post is in response to the post “Lung Ultrasound: Has it gone viral?” To summarize, this was an 8-month-old girl who presented in respiratory distress. Point-of-care ultrasound was used to help determine the etiology of her symptoms and the following image was obtained:     Thank you to everyone who took the quiz! 19% of you guessed correctly that this video clip was consistent with a bronchiolitis/viral pneumonia. 41% guessed that this was a bacterial pneumonia, which is also potentially correct (as described in more detail below). The remaining 40% guessed Read more [...]