Category Archives: the business of health care

5 women physicians, multi-ethnic

Discover women physicians, the future of medicine

September is Women in Medicine Month.

Why celebrate women physicians?

In 1860 the United States had 200 women physicians.

By 1900, there were 7000.

Since 1975, the number of female physicians has grown more than six-fold, from 35,626 to 333,294 in 2013. Women physicians comprise 35% of actively practicing physicians. Follow this link for a detailed timeline of

A PROFILE & HISTORY OF WOMEN IN MEDICINE

Last year, for the first time since Elizabeth Blackwell was the first woman  in the U.S. admitted to medical school in 1849, more women than men entered U.S. medical schools and approximately half of all medical students are now female. This trend will likely continue, as fewer men are applying to medical school and more women are.

My medical school graduating class of 1978  at our 30th reunion; the original class was larger, 150 students, but the percentage of women was the same as in this photo. (I’m in the pink dress)

(This post contains commission earning affiliate links to help fund this blog)

Why are more women entering medicine?

In general women still lag in entering the STEM fields– science, technology, engineering, math. But I think the most important factor spurring  more women to enter medicine is the powerful example set by previous women physicians who have paved the way for us who entered medicine later. These include

Dr. Elizabeth Blackwell

The first woman graduate of a United States medical school was born in Bristol England in 1821. (thank you, UK readers). Elizabeth Blackwell came to this country as a child and originally had no interest in medicine. But when a dying friend told her, “I would have been spared suffering if a woman had been my doctor”, she found her calling.

She was denied admission to multiple medical schools. The Geneva Medical College of New York submitted her application to the student body for a vote, and, as a joke, they voted to admit her. Well, the joke was on them as she enrolled, completed medical school and graduated in 1849.

Read more detail about How Elizabeth Blackwell became the first woman doctor in the United States

With her sister, Emily Blackwell , who also  graduated from medical school, and a German physician, Marie Zakrzewska, they opened and ran the New York Infirmary for Women and Children in 1857.

Dr. Emily Blackwell  managed the Infirmary for 40 years. Dr. Marie Zakrzewska moved to Boston when she founded the New England Hospital for Women and Children, which trained  women physicians and cared for the poor.

Due to failing health, Dr. Elizabeth Blackwell retired from practice in the 1870s.

The Physicians Mom Group (PMG) declared Dr. Blackwell’s birthday February 3 as National Women Physicians Day. This day celebrates all the significant contributions that women physicians make daily, none of which would have been possible without Elizabeth Blackwell.

Dr. Blackwell embodied the ABC characteristics of extraordinary women physicians-

Attentive, Brave, Compassionate

Women physician members of CMDA providing medical care in Ecuador

Dr.Rebecca Lee Crumpler

Prior to founding her hospital, Dr.Zakrzewska served as professor at the New England Female Medical College. That school produced another notable women physician, Dr. Rebecca Lee Crumpler.

Dr. Crumpler graduated in 1864, becoming the first African-American woman to earn the M.D. in the United States.  After practicing in Boston, she moved to Virginia where she and other black physicians cared for freed slaves, who otherwise would have had no access to medical care. In 1883 Dr. Crumpler wrote a book of medical advice for women and children, titled A Book of Medical Discourses, one of the earliest medical publications by an African American.

Dr. Virginia Apgar

More recently, a woman physician’s work has impacted the lives of countless babies and their families. If you have had a baby, or been born within the past 60 years, you benefited from the work of Virginia Apgar, M.D.

She was neither an obstetrician or a pediatrician, but an anesthesiologist. As she observed deliveries of infants she proposed a scale to rate how well a newborn was adapting to life outside the mother.

crying baby

courtesy Pixabay

She considered 5 factors:

  1. heart rate
  2. respiratory (breathing) rate,
  3. muscle tone,
  4. reflexes, and
  5. color-pink (warm) or blue(cold)

And assigned each a score- 0, 1, or 2, at 1 minute of age, and again at 5 minutes.

So a newborn had a potential score as low as 0 and as high as 10.

The higher the score, referred to as the Apgar score, the more likely the baby was healthy and would do well. The lower the score meant the baby was in trouble, and needed intensive medical attention.

After testing the use of the rating scale over several years, doctors starting using it routinely; so for the past 50-60 years almost all babies have been “graded” with an Apgar score at birth. The Apgar score  is used widely throughout the world.

Dr. Apgar, who played violin and cello in her college orchestra, was appointed the first full professor of medicine at Columbia University and also was a director for the March of Dimes.

 

Dr. Laurel Salton Clark

More recently, Dr. Laurel Clark served her country as a flight surgeon with the U.S. Navy. She along with her husband Dr. Jonathon Clark joined NASA as astronauts.

Clark made her first space flight on Space Shuttle Columbia during STS-107 as a mission specialist. The extended-duration mission was dedicated to scientific research. The STS-107 crew successfully conducted more than 80 experiments.

On February 1, 2003  Clark and the STS-107 crew perished during re-entry as Columbia broke up over Texas en route to a landing in Florida. She amassed 15 days, 22 hours and 20 minutes in space.

During a memorial service at Johnson Space Center in Houston, Texas, on Feb. 4, 2003, President George W. Bush emphasized Clark’s love for her family and her work.

“Laurel Salton Clark was a physician and a flight surgeon who loved adventure, loved her work, loved her husband and her son,” he said.

“A friend who heard Laurel speaking to Mission Control said there was a smile in her voice. Laurel conducted some of the experiments as Columbia orbited the Earth and described seeing new life emerged from a tiny cocoon. ‘Life,’ she said, ‘continues in a lot of places and life is a magical thing.'”

 

In this emotional interview, Dr. Jonathon Clark remembers his wife, who “sacrificed her life for space research.”

 

 

 

Please see these related posts about women physicians who are Changing the Face of Medicine

The surprising new doctors caring for you

Today is Armed Forces Day

 

 

Thanks to the American Medical Association for this post’s featured image.

Thank you for joining me to celebrate women physicians. If you haven’t met me already, please visit my bio page here-

Meet Dr. Aletha 

 

Please continue to follow this blog as we explore

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How a woman doctor finds joy in an unexpected way

When I finished my family medicine residency many years ago, I was excited to start practicing medicine for real. I joined the staff of a small town hospital (the only female doctor by the way) and soon was busy treating patients in the clinic, rounding on hospital patients, delivering babies, and covering the emergency room.  I enjoyed doing what I had dreamed of and trained for, but eventually found I spent more time there than with my husband and toddler son.

Since we were planning on adding a second child, I knew I could not sustain that pace. Fortunately I found a position with a medical group in a nearby city where my schedule would be more predictable, with no obstetrics or ER responsibility.

I’m sharing with you a guest post from another woman doctor who faced a similar dilemma (most of us do) . She solved her problem in an unconventional creative way. I think you will enjoy meeting Dr. Joanne Jarrett, who blogs at Creating Cozy Clothes .

My Unexpected, Crazy Journey from Medicine to Fashion

By Joanne Jarrett MD

woman in an apron holding a wooden sign-

Dr. Jarrett enjoys cooking too.

 

Hi! My name is Joanne Jarrett, and I am a retired family physician. Not the “golden years” kind of retired, but rather the “retired sounds better than I quit” kind.

 

a career in the making

If you’d told me in my twenties that I would be designing loungewear for women and preparing to move to a farm in rural Montana in my mid-forties, I’d have said you had the wrong girl. I was a determined, sharp, ambitious, successful medical student and resident, and I was planning to have it all.

My husband and I wanted kids, but that would have to wait until all of our training was complete. We took turns going through our residency programs, and we moved home to Reno, Nevada from a two year stint in Lincoln, Nebraska with 24 weeks of my first pregnancy under our belts and a new practice to run.

Needless to say, my being a stay-at-home mom was not plan A for our family.

 

a fast track career

When I became pregnant, I was working a full time family practice, seeing patients at 3 hospitals before and/or after my full day, doing urgent care some nights and weekends, and taking call for our large group a week at a time every 7 weeks. I knew that schedule was completely incompatible with motherhood, but we thought I’d work 2 or 3 days a week and have my mom nanny while I worked.

Then Delaney was born, and reality set in.

I realized that I didn’t have room inside of me to be the physician my patients deserved and to be the wife and mother I wanted for my family. I already knew that during those 6 years of marriage before kids I worked hard all day, gave every bit of myself away piece by piece, and then came home and offered my husband the crappy leftovers. He knew how hard I was trying and didn’t complain much.

It worked, but a baby tipped the scales. We couldn’t both work jobs where emergencies make the schedule predictably unpredictable. I was exhausted and knew there was no way I could face the emotional lability and intellectual demand of being a physician in my state. And I loved being with that baby girl. When I was away from her I felt an undeniable tug back.

Then Bailey arrived less than 2 years later and it was decided. I was staying home. For good.

a career crossroads

At first, I was in survival mode and didn’t care about the changes I saw in myself. I just wanted sleep and ice cream. But eventually I started to wonder if who I used to be would ever matter again and how to find her.

Over a decade in, that woman is back. But she’s better than she used to be. More patient. More settled. More fulfilled. Less scared. Looking back, I’ve transitioned from professional to harried new mom to seasoned household CEO, self respect and vigor for life mostly intact!

a woman walking with two girls on sand

Dr. Joanne’s grand mother  with her daughters

 

Running my family has been pretty much all consuming, but I’ve always had a creative side and, through the years, I have developed hobbies that foster that. Scrapbooking made sense when the kids were babies. Combining creativity with a means of wrangling the millions of photos we were taking was a win win.

A limited decorating budget and a very picky décor taste lead to me borrowing my mom’s sewing machine and making an entire house worth of curtains, learning on the fly.

 

 

 

And I have always had a thing for wrapping a beautiful gift. To the point where I have a whole wall full of paper, ribbons, and other do-bobs to help me wrap a stunner at a moment’s notice.

Sewing flat, square things like curtains and pillow covers slowly evolved into kids’ costumes and then street clothes. I have a thing for fabric, and the combination of creativity and precision that following a pattern requires satisfies my creative flair and my bent towards the analytical.

I began altering clothes in my closet to better fit my (ever varying, eye roll!) shape and began seeing the potential in clothes instead of the mere reality of what was on the hanger.

I also have a passion for downtime. This wasn’t always the case. Scott and I have been married 20 years, and at first I had no idea how to relax. Saturday would come and I’d say, “What do you want to do today?”

From the couch, he’d say “this!”

My skin would crawl .I just didn’t know how to have a recovery or leisure day.

Well, I’ve learned well! You’ll never catch me hanging around at home in my jeans and underwire bra. Huh-uuuuh! As soon as I get home at the end of the day, I head straight to my closet to get into my cozy clothes. I live in them when I’m home. Even if I’m busy with this and that, I like the psychological change triggered by putting on those comfy clothes.

But those clothes aren’t perfect. I’m setting out to change that! We need a little coverage and support despite that fact that the bra is off the team at home. I discovered shelf-bra camis and began wearing them as loungewear and pajamas. I could never figure out why this concept wasn’t expanded into other pieces.

 

a career changes directions

After years of googling “shelf bra pajamas” and “shelf bra nightgown” and coming up with nothing except slinky lingerie (get real!!), I decided to design a line of cozy loungewear for women who want to be comfortable at home in something soft, cute, flattering and supportive. Something that feels and looks great to wear in the “no bra zone” but that is fit for public consumption should the need arise. I figured if I couldn’t find them, I’d make them and maybe other ladies will like them too.

And not all shelf bras are created equally, if you know what I mean. I set out to design the perfectly soft but flattering shelf that has enough thickness for coverage and enough separation to look great. I embarked upon a know-nothing journey into apparel production and have learned an entirely new industry over the last year.

I call the line “Shelfies.” Shelfie Shoppe launched on May 8th , taking preorders as part of a Kickstarter campaign to fund the first production run. I’d be honored if you’d click the link and check it out!

And because life is crazy, on June 20th my entire extended family is making a northerly migration from Reno to rural Montana. We are moving to the town of Huson, 20 miles outside of Missoula, to a farmhouse on 20 acres with a river running through it (no, really!). The four of us will live in the house, my parents and two aunts are building a barn residence next to the house, and my sister and her family have purchased a home a few miles away.

So we don’t have much going on!

What are you doing with your life that you could never have predicted a decade or two ago? Leave a comment and let me know!

a shirt with a tag-shelfie

 

update June 15, 2018

I’m happy to report that Joanne’s Kickstarter campaign is complete and Shelfie Shoppe is fully funded! I committed and will receive one of her “cozy” dresses as my reward.

 

Whether  you need “cozy clothes” or not, I think we can all learn a lesson from Joanne’s life.

When the circumstances of life leave us feeling

  • impatient

  • unsettled

  • unfulfilled or

  • scared

 we may need to evaluate if change is necessary.

It may not be as drastic a change as she made, but even small steps can get us to a place where we can use our talents and passions to create a life that satisfies us and blesses others.

Please  spend some time on Joanne’s blog. She has a variety of posts on health, family, kids, food, and humor. Here’s a sample of a hilarious but thoughtful post about

Why I’m glad I got toilet paper stuck to the seat of my pants

 

a wooden door with a heart shaped hold

 

And please follow watercress words and me on social media, and explore the

                   HEART of health with me.                 Dr. Aletha stethoscope with a heart

a medical person holding a stethoscope

The surprising new doctors caring for you

Who will be your next doctor? What will your future doctor look like?

Your doctor within the next 10-20 years is likely in medical school or a residency program in a United States medical center right now. Within 1-10 years, they will join the ranks of practicing physicians, while some doctors currently in practice will change to a non-clinical job, retire, or die.

More women physicians are coming

For the academic year 2016-2017,  83,000 students, attended United States medical schools ,  slightly more males than female. However, in 2017, the entering class of medical students was slightly over 50% female, for the first time ever.

CELEBRATE WOMEN IN MEDICINE MONTH#WIMmonth

According to the Association of American Medical Colleges, since 2015 the number of women students has increased by 9% while the number of men has decreased by 2 %.

And already, the majority of  young practicing physicians-under age 40 years old-are female.

So you are likely to be treated by a female physician eventually, if you haven’t already,  especially if you go to a primary care doctor. Gynecology and pediatrics  residency programs are now overwhelmingly comprised of female residents.

Ethnic diversity is sadly lacking

Ethnically, medical students and residents, both male and female, are still predominantly white. The ethnic cpercentages of most other students is far below their representation in the general population. Based on self-identification, race and ethnic origin of medical residents includesa male doctor holding a tablet

  • White-60%
  • Black- 7%
  • Hispanic(any race)- 6%
  • Asian-26%
  • Multiracial- 3%
  • Unknown/other-7%
  • Native American/Alaskan/Pacific Island -less than 1%

Are many physicians foreign born ?

Will your physician come from another country?

70% of  U.S. medical residents are native citizens,  8% are naturalized citizens and 6% are permanent residents. ( adds to less  than 100% due to some status’ unknown.) Female doctor looking at an xray

Credentials

The average grade point of entering medical students was 3.56.

77% had done some type of volunteer medical service .

77% have experience in medical research.

These statistics gleaned from JAMA, December 19, 2017 

The specialization of medical care- the good and the bad

March 16 was Match Day. Not a match as in color choice for an outfit nor a match as in finding a spouse, but the concept is similar.

On Match Day,  graduating medical students learn which  residency program they will enter through the National Resident Matching Program , which “matches” them with available positions in residencies at medical centers all over the United States. A kind of medical “matchmaking” you could call it.

Why should you care? This matching process determines who will care for our medical needs in the next 30-40 years; our family physicians, internists, pediatricians, general surgeons, obstetricians, and the multitude of other medical specialties. Most doctors will continue in the same speciality their entire career, although some  switch after a few or many years.

doctor talking to a woman

Ted Epperly, M.D., consults a patient at his practice in Boise, Idaho.photo compliments American Academy of Family Physicians

Some medical students know what speciality they want to pursue before they enter medical school, while others decide after trying the different types of medicine while students. We still have the traditional specialities that most students enter- (there are also many subspecialities under each of these categories.)

 

 

Primary care 

  • Family medicine
  • Internal medicine -(adult medicine)
  • Pediatrics-children and adolescents
  • Obstetrics/Gynecology- care of women’s health and pregnancy

Surgical specialities

  • General Surgery-  surgery on skin and internal organs
  • Orthopedics-bones and joints
  • Otorhinolaryngology- ear, nose, throat
  • Ophthalmology-eyes
  • Neurosurgery-the brain, spine, nerves
  • Plastic and Reconstructive surgery
  • Cardiac and vascular surgery

Others 

  • Dermatology-skin
  • Psychiatry-mental health
  • Anesthesiology-surgical sedation and pain relief
  • Emergency medicine- emergencies and trauma
  • Radiology- xrays and other imaging-CT, MRI, US
  • Pathology-laboratory medicine
  • Allergy
  • Physical medicine and rehabilitation
  • Oncology-treatment of cancer
  • Integrative and complementary medicine

As medical care has become more complex and technological, so have the specialities of physicians. This has produced a plethora of new highly specialized fields of practice.

  • Sleep medicine
  • Medical genetics and genomics
  • Pain management
  • Geriatrics- care of the elderly
  • Palliative care-managing diseases that cannot be cured and are likely terminal
  • Hospital medicine-care of patients admitted to a hospital
  • Critical care medicine-care of patients in an ICU (intensive care unit)
  • Aerospace medicine
  • Wound management
  • Medical informatics – use of computers and medical software in medicine
  • Bariatrics- treatment of obesity with or without surgery
  • Sports medicine-treatment of athletic injuries and fitness training
  • Transplant medicine- surgery to transplant organs and after care
  • Addiction medicine

A recent viewpoint in JAMA suggested that we need a new specialty, virtual medicine, to describe physicians who treat patients through a virtual medium, telemedicine or  web based, on a computer or a mobile app.

Consider that in the early 1970s, there were only 20 medical specialties !

THE SURPRISING NEW DOCTORS CARING FOR YOU

photo from Lightstock.com(affiliate link) graphic created with Canva

 

 

 

What this means for you as a patient

According to the New England Journal of Medicine,

“the progress of biomedical science is a major factor in the emergence of new subspecialities. There are some patients who benefit from highly focused knowledge and skills.”

All of these specialities mean more medical  knowledge and experience will be  available to both treat and prevent a diverse and growing  variety of disorders.

Today’s new specialist will have a high degree of expertise in their field, making them better able to treat your problem in the most efficient, effective, safest way.

You may find your doctor recommends more testing which may lead to more treatment than might otherwise have happened; some of which may not necessarily improve outcomes. More specialized testing and treatments may increase the cost of medical care.

Dr. Sandeep Jauhar addresses this issue in this article

One Patient, Too Many Doctors: The Terrible Expense of Overspecialization

 

 

With a more narrow focus of experience, that doctor may be less familiar with other aspects of your medical status.

So, to close this gap, primary care physicians have become increasingly important to oversee and coordinate care, especially for complex patients.

So there was good news in the Match this year. The upward trend in students matching into family medicine continued for the ninth consecutive year . In 2018 more students matched into family medicine than in any  previous year, 3,535 compared to 3,237 in 2017. 

“The number and proportion of U.S. medical graduates going into family medicine is the strongest indicator of the future of the primary care workforce because family medicine is the only specialty completely devoted to primary care,”

said Michael Munger, MD, president of the American Academy of Family Physicians.

Michael Munger, M.D., consults a patient at his medical office in Overland Park, Kan.

Michael Munger, M.D., consults a patient at his medical office in Overland Park, Kan. Photo compliments of American Academy of Family Physicians

 

 

 

 

 

 

 

 

I’ve often been asked ,”Why didn’t you specialize?” My answer, “I did. I specialize in Family Medicine.”

Once called “general practice”, Family Medicine is now a recognized specialty, requiring a residency and certification by  the American Board of Family Medicine.

 

 

 

Dr. Sandeep Jauhar wrote about his first year as a resident in

Intern: A Doctor’s Initiation

“In Jauhar’s wise memoir of his two-year ordeal of doubt and sleep deprivation at a New York hospital, he takes readers to the heart of every young physician’s hardest test: to become a doctor yet remain a human being.” ― Time

 

 

 

 

Unless otherwise stated, the doctor photos in the post are from the Lightstock.com collection . Get 5 free downloads at this affiliate link. (This blog can earn a commission if you buy photos which helps support the mission of Watercress Words.)

 

Thank you for joining me to explore the HEART of health. I hope you’ve learned something. Please contact me about topics you want to read about.

Share this and other posts on social media and consider my affiliates and ads that will fund this blog and support projects to deliver the HEART of health around the world.

my regards, Dr. Aletha 

"I have a dream" by Martin Luther King, Jr.

King, Obama, and Healthcare

 

Dr. Martin Luther King, Jr. Day 

The  United States observes the third Monday of January as a federal holiday in honor and memory of the birthday of the late Rev. Martin Luther King, Jr. (January 15, 1929)

The Reverend Dr. King led the Civil Rights Movement in the United States from the mid-1950s until his death by assassination in 1968.

First African-American President- Barack Obama

In 2008 Democratic candidate Barack Obama ran for President of the United States and won, becoming the 44th President  and the first African-American to win the office.

Former President Obama running with his dog

President Obama kept fit exercising with his dog- photo compliments Pixabay 

 

Candidate Obama  pledged to enact universal health care coverage for the country, a promise President Obama fulfilled with the support of a Democratic Congress. The Patient Protection and Affordable Care Act, often shortened to the Affordable Care Act (ACA) or nicknamed Obamacare, is a United States federal statute enacted by the 111th United States Congress and signed into law by President Barack Obama on March 23, 2010.

 

 

First Universal Healthcare Coverage -“Obamacare”

The term “Obamacare” was first used by opponents, then embraced by supporters, and eventually used by President Obama himself. Together with the Health Care and Education Reconciliation Act of 2010 amendment, it represents the U.S. healthcare system‘s most significant overhaul and expansion of coverage since  Medicare and Medicaid in 1965. (source Wikipedia) 

 

Is ObamaCare doomed?

Donald Trump’s presidential campaign platform included health care reform, a plan he labeled “repeal and replace” for Obamacare. Thus far, as of January 2018 , President Trump has not convinced Congress to abandon Obamacare, but it will change under the recently passed tax law which has abolished the individual mandate  requiring all persons to either buy health insurance or pay a penalty. Premiums are predicted to increase significantly, making it more difficult for people to afford coverage.

 

 African-American Health- Progress Made, More Needed

 

The death rate for African Americans dropped 25% from 1999-2015, but they are still more likely to die at a young age than white Americans.

African Americans in their 20s, 30s, and 40s are more likely to live with or die from conditions that typically occur at older ages in whites, including

  • heart disease,
  • stroke, and
  • diabetes.

African Americans ages 35-64 are 50 percent more likely to have high blood pressure as whites.

African Americans ages 18 to 49 years are 2 times as likely to die from heart disease as whites.

Social and economic conditions, such as poverty, contribute to the gap in health differences between African Americans and whites.

 

Public health agencies and community organizations should work with other community resources , including

  • education,
  • business,
  • transportation, and
  • housing,

to create social and economic conditions that promote health at early ages.

Consumers can prevent disease and early death by

 

Dr. Ben Carson- “Gifted Hands”

Ben Carson, M.D., renowned neurosurgeon, also ran for President in 2016 , leaving the campaign during the Republican primary.

 

President Trump appointed him to his Cabinet where he serves as the 17th Secretary of the U.S. Department of Housing and Urban Development.

 

 

 

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This blog receives support from your use of the affiliate links in this post , other affiliates, and  visiting the advertisers. Profits will also support various health and relief related  organizations.

I invite you to  follow Watercress Words for more information and inspiration to help you explore the HEART of HEALTH.

Thanks for your time and interest.  Dr. Aletha 

 

EKG tracing

Reliable keys to identify a medical emergency

A larged medical insurance company received criticism for its handling of some emergency room (ER) claims recently. If, after review of an ER visit the company determines the condition was not a true emergency, it will deny payment for the visit, making the patient responsible for the full amount.

Critics, including patients, doctors, and hospital administrators fear this endangers patients , who may be harmed by avoiding  emergency room care for financial reasons.

You may consider an  emergency to be any medical condition which 

  • is new , sudden, and/or unexpected,
  • worse than usual or uncontrolled,
  • of unknown origin,
  • not responding to treatment,
  • not improving or resolving,
  • interrupts normal life.

However, to physicians and other health care personnel, the definition of an emergency is more specific.

An emergent medical condition is one that, if not treated promptly 

  • Threatens life
  • Threatens one or more limbs
  • Threatens vision/hearing/speech/mental function/ function of any major internal organ or organ system
  • Threatens long term and/or permanent bodily harm
Minutes matter with heart emergencies

Minutes matter with heart emergencies

In the United States, a federal law known as EMTALA defines a medical emergency as

“a condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in placing the individual’s health [or the health of an unborn child] in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of bodily organs.”

Some examples of emergent conditions include 

  • Sudden or new  changes in heart function, like a myocardial infarction (heart attack), arrhythmia (abnormal heart rate or rhythm) or congestive failure (poor pumping capacity)
  • Brain conditions including stroke, head trauma, seizure, psychosis
  • Pulmonary (breathing) dysfunction including pulmonary embolus (blood clot), severe pneumonia, asthma or COPD
  • Multiple trauma, including extensive burns , multiple fractures, or trauma to any major organ like the liver or kidneys
  • Chemical changes in the blood; for example high /low blood sugar, low blood potassium, low platelets,
  • Severe depression and/or anxiety
  • Drug and alcohol overdoses

a person having blood pressure measured

SYMPTOMS of an emergency  include

  • Shortness of breath, or difficulty breathing, especially if not associated with exertion
  • Uncontrollable bleeding
  • A seizure, especially in a person with no previous diagnosis of seizures
  • Sudden or severe loss or difficulty with vision, hearing , speech, or other functions such as swallowing, thinking, walking, passing urine or stool
  • Fainting, passing out, loss of consciousness, severe dizziness
  • Hallucinations, confusion, thoughts or threats of harm to self or others
  • In a pregnant woman- any of the above plus loss of fetal movement
  • Persistent/severe nausea/vomiting/diarrhea
  • Severe pain, especially if it prevents or inhibits body function

Certain groups of people are more at risk of significant illness with any of these symptoms, so emergency care should be sought sooner than later. They include

  • infants up to age 2
  • elderly-most medical references still call this over age 65
  • pregnant women
  • people with suppressed immune systems as from cancer chemotherapy, HIV, malnutrition, other drugs

Chest pain must always be taken seriously, even if mild.

Although in persons under 40 years old it is less likely due to a heart attack, there are other life threatening conditions that can occur in this age group. Again, especially if it is associated with any of the other symptoms, it is emergent.

Learn more about common heart diseases at this previous post

Exploring -when HEARTS break

While on a mission trip to Panama, my husband had a near emergency when a board flew into his leg causing a deep gash; our medical team members took care of the injury right on the clinic site, and he recovered without permanent damage

While on a mission trip to Panama, my husband had a near emergency when a board flew into his leg causing a deep gash; a local surgeon was working with our medical team , and with their help he sutured the wound at the small rural church where we were holding clinic; his leg has healed well, just a scar to remind us of the adventure.

IN AN EMERGENCY  CALL 911!

Helicopters transport of emergency patients can make the difference between life and death.

You should not call your doctor’s office or answering service, your mother, your best friend, or post a question on social media (which I have seen done!)

If it’s not an emergency but is urgent, then the next best options are calling your doctor’s office or going to an urgent care clinic. Posting on social media is still a bad choice. Do you really want your “friends” giving you medical advice about something they know nothing about?

We doctors don’t expect you to diagnose your condition before coming to the ER or the office, and insurance companies either. With using the above guidelines, if you even suspect your problem is an emergency, you are wise to seek help.

Dr. Esther Choo, an ER physician shares

6 Tips for Getting the Most Out of Your Emergency Room Visit

 

 

Hospital sign- 5 miles to help.

Is it an emergency? Insurer makes patients question ER visit

 

 

 

 

 

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Helicopter landing at a hospital to deliver a critically ill person.

 

Surprising lessons you will learn waiting at the ER

Vietnamese people with bicycles, standing outside a clinic

People waiting to enter a medical clinic in vietnam.

 

I have waited for medical care too, from both sides, as a patient and as a doctor. Physicians also wait-

  • for lab results
  • for xray and scan reports
  • for consultants to call or send evaluation findings
  • for insurance companies to pay claims
  • for prior authorizations for surgery and medications to be approved

 

We all have to wait and it usually isn’t by choice or pleasant.

clinicsign

People waiting at a medical clinic in Panama.

 

 

The Bible talks about waiting in this passage –

Isaiah 40:31, NKJV

But those who wait  on the Lord shall renew their strength;
They shall mount up with wings like eagles,
They shall run and not be weary,
They shall walk and not faint.

 

 

 

I think it’s easier to wait when you expect, hope and, trust that waiting will lead to a good outcome, your problem will be solved, your illness will be successfully treated, your pain eased, your sorrow resolved.

Sometimes waiting teaches us valuable lessons that we might otherwise not know.

group of people sitting under a tree

People waiting at a clinic in Zanzibar.

 

 

Please read this poignant post from Martin Wiles about how visits to  hospital emergency rooms changed his perspective on waiting.  It might change yours also.

Lessons from a Waiting Room  by Martin Wiles

 

“Waiting rooms have taught me life is unfair. When I see people who don’t have and can’t afford insurance. When I see people who’ve been abused by others or who’ve had crimes committed against them. And when I see people addicted to drugs who are making a visit to get a pain fix. Or when I see bodies mangled by wrecks.”

 

those who hope in the Lord will renew their strength, they will soar like eagles Isaiah 40:31

Isaiah 40:31 graphic from the Lightstock.com collection

 

 

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March 30 is Doctors' Day

Why women physicians are good for health care

As Women in Medicine Month concludes, let’s take another look at women physician pioneers. And remember- not all beautiful women are models; some are doctors.

By the most recent statistics published by  the Kaiser Family Foundation, 48% of United States medical school graduates  are women; in some states, over 50% are women. If that trend continues, eventually at least half of all practicing physicians in the United States will be women. Currently about one third are female.

My medical school graduating class at our 30th reunion; the original class was larger, 150 students, but the percentage of women was the same as in this photo. (I’m in the pink dress)

(This post contains commission earning affiliate links to help fund this blog)

Dr. Elizabeth Blackwell

The first woman graduate of a United States medical school was born in Bristol England in 1821. (thank you, UK readers). Elizabeth Blackwellcame to this country as a child and originally had no interest in medicine. But when a dying friend told her, “I would have been spared suffering if a woman had been my doctor”, she found her calling.

She was denied admission to multiple medical schools. The Geneva Medical College of New York submitted her application to the student body for a vote, and, as a joke, they voted to admit her. Well, the joke was on them as she enrolled, completed medical school and graduated in 1849.

Read more detail about How Elizabeth Blackwell became the first woman doctor in the United States

With her sister, Emily Blackwell , who also  graduated from medical school, and a German physician, Marie Zakrzewska, they opened and ran the New York Infirmary for Women and Children in 1857.

Dr. Emily Blackwell  managed the Infirmary for 40 years. Dr. Marie Zakrzewska moved to Boston when she founded the New England Hospital for Women and Children, which trained  women physicians and cared for the poor.

Due to failing health, Dr. Elizabeth Blackwell retired from practice in the 1870s.

The Physicians Mom Group (PMG) declared Dr. Blackwell’s birthday February 3 as National Women Physicians Day. This day celebrates all the significant contributions that women physicians make daily, none of which would have been possible without Elizabeth Blackwell.

Dr. Blackwell embodied the ABC characteristics of extraordinary women physicians-

Attentive, Brave, Compassionate

Women physician members of CMDA providing medical care in Ecuador

Dr.Rebecca Lee Crumpler

Prior to founding her hospital, Dr.Zakrzewska served as professor at the New England Female Medical College. That school produced another notable women physician, Dr. Rebecca Lee Crumpler.

Dr. Crumpler graduated in 1864, becoming the first African-American woman to earn the M.D. in the United States.  After practicing in Boston, she moved to Virginia where she and other black physicians cared for freed slaves, who otherwise would have had no access to medical care. In 1883 Dr. Crumpler wrote a book of medical advice for women and children, titled Book of Medical Discourses, one of the earliest medical publications by an African American.

Dr. Virginia Apgar

More recently, a woman physician’s work has impacted the lives of countless babies and their families. If you have had a baby, or been born within the past 60 years, you benefited from the work of Virginia Apgar, M.D.

She was neither an obstetrician or a pediatrician, but an anesthesiologist. As she observed deliveries of infants she proposed a scale to rate how well a newborn was adapting to life outside the mother.

crying baby

courtesy Pixabay

She considered 5 factors:

  1. heart rate
  2. respiratory (breathing) rate,
  3. muscle tone,
  4. reflexes, and
  5. color-pink (warm) or blue(cold)

And assigned each a score- 0, 1, or 2, at 1 minute of age, and again at 5 minutes.

So a newborn had a potential score as low as 0 and as high as 10.

The higher the score, referred to as the Apgar score, the more likely the baby was healthy and would do well. The lower the score meant the baby was in trouble, and needed intensive medical attention.

After testing the use of the rating scale over several years, doctors starting using it routinely; so for the past 50-60 years almost all babies have been “graded” with an Apgar score at birth. The Apgar score  is used widely throughout the world.

Dr. Apgar, who played violin and cello in her college orchestra, was appointed the first full professor of medicine at Columbia University and also was a director for the March of Dimes.

The National Library of Medicine profiles

these and many other women physicians at

 Changing the face of Medicine –

celebrating America’s women physicians.