A Hundred Words for “Tired”

Posted on March 1, 2023 by marylbrandt

It has been said that the Inuit people have a hundred words for snow. When you live in a dangerous environment, it’s important to learn the variations of snow to survive. But, when you look into the origin of the “hundred words for snow”, it turns out it’s not exactly true – Inuits don’t have more words for snow than other languages…Their detailed understanding of snow is a lived, not spoken vocabulary.

The same is true for those who spend nights awake working in a hospital. We, too, have a lived vocabulary that includes hundreds of subtle variations of fatigue, even though we don’t have words to describe them. (The closest I’ve come to being able to describe this fatigue is in “sleep equivalents”, specific events or things that makes you feel like you have had more sleep than you actually did. For example, a shower after being up all night can give you the equivalent of anywhere from 20 to 60 minutes of sleep depending on how tired you are. Brushing your teeth after a hard night of call is usually 5-10 minute sleep equivalent. A good strong cup of coffee can be as much as 45 minutes of sleep equivalent – although it’s important to titrate it so you don’t end up with anxious jitters instead of just being awake.)

Knowing how to manage this level of fatigue it is part of medical training. (Don’t get me wrong… I’m not advocating that trainees must get tired on a regular basis to “learn how to manage it”) Learning to successfully manage the fatigue of long days and nights on call hinges on two things and both have to do with deliberate choices.

Learning not to trust your first instinct if you are sleep deprived is the first important lesson. Even if it’s a drug you know well, or the chest x-ray looks ok, stop and be deliberate. Consciously review the data, look at the options and, for really important decisions, ask someone to look at the situation with you.

The second lesson in managing fatigue is maybe even more important. The bone deep fatigue of medical training is not solely the result of sleep deprivation. When you stay up all night you also lose the liminal spaces of waking and falling asleep, the threshold between night and day. In scientific terms, this means there is a major disruption of your circadian rhythms. But it’s more than just physiology. The drowsy moments between sleep and being awake take place in the liminal spaces of dawn and dusk. We lose more than orientation to daylight when we lose this liminal space. The Irish poet and priest John O’Donoghue, teaches that liminal spaces are moments and places where the spiritual touches the finite. By losing the profoundly important rhythm of rest – including these liminal spaces – we end up physiologically, psychologically, and spiritually unmoored.

You have to be deliberate here, too. By trial-and-error work to find the things that ground you, the things that help you recover in a deeper way than just catching up on the sleep. Make lists of anything and everything that helps you recover from call for the times you are too tired to remember or choose. Look at those lists before you leave for your call day and choose something to do for yourself when you leave the hospital the next day. It might be going to the gym for a light workout, having a great cup of coffee in a cafe, a slow, grateful walk outside, playing with a pet, a hug from a loved one…or finding a way to “play” outside.

May the sacrifice of time and sleep you make for others come back to you as joy … and may you find deep rest in knowing you make a difference in so many lives.

Hate cooking but want to eat better? (By the end of this post I bet you buy this app!)

Posted on January 21, 2018 by marylbrandt

It is hard to eat well when you are a medstudent, resident or busy doc (also true for busy people not in medicine The key to eating well if you are busy is planning.. but it takes time. As I’ve written before, here are the basic steps that you need to follow to eat well if you are “too busy to cook”.

Use a calendar to organize which days you need to have dinner ready
Find the recipes you want to cook
Fill in the calendar with what you will take to work for lunch and your planned dinners.
Make a shopping list.
Shop once, then follow your plan

To follow these steps, I’ve used the internet to find recipes, Evernote to map out the week, and Grocery IQ for the shopping list. I’ve gotten pretty efficient, but it’s still takes a non-trivial amount of time… and who has that kind of time, right?

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And then I read Jane Friedman’s post “My Must-Have Digital Media Tools: 2018 Edition” and I saw this…

I was skeptical, but I downloaded it.

Here’s the bottom line… this app is “expensive” ($25). But I promise, even if you are medical student without much money, it will be the best $25 you’ll spend this year.

Here’s why – this app takes the five steps listed above and puts them all into one place. It not only makes it easy to choose recipes, plan your week and shop, it almost makes it fun. Here’s how:

Use a calendar to organize which days you need to have dinner ready.

Start on the “meals” tab and put notes in for your week. If you share cooking with a significant other or roommates, you can share the account with them so everyone is (literally) on the same page.

Find the recipes you want to cook and put them in the calendar for the week

Click on the browser tab to find new recipes. As you gather recipes in the app, it becomes your own personal “cookbook” which is searchable by category, name, or ingredients.

Fill in your calendar with what you will take to work for lunch and your planned dinners.

This was the first moment I knew I was really hooked. All you do is drag and drop the recipes you want into the appropriate day. Wow.

Make a shopping list and go shopping.

This is when I was completely sold. When you pull up the recipes you’ve chosen, there is a little “hat” icon at the top:

When you click this icon EVERYTHING IN THE RECIPE appears in a shopping list. Unclick what you don’t need and repeat for all the recipes.

Because this app is on your computer and your phone, just take your phone with you to the grocery store. As you pick up the item, click the box next to it and move on to the next item. If you are sharing the app with your significant other or roommates, anyone can add to the grocery list or unclick things they have bought.

Here’s the official website for Paprika: https://www.paprikaapp.com/. Enjoy your healthy eating!!!! Try this plan (instead of the bagels, pizza, peanut butter and other “free” foods in the hospital) for a week or two. I promise you’ll feel better, learn better and have more energy to take good care of your patients.

Eating Well at Work

Posted on December 26, 2015 by marylbrandt

It’s hard for those that haven’t been there to understand how medical school, residency and/or long hours in the hospital changes what and how we eat. There isn’t time to sit down to eat, there aren’t good choices and often, the only thing to eat is the “free” food at conferences. But…. Free food isn’t free. There’s a reason it’s cheap (poor ingredients) and that it “tastes good” (lots of fat, sugar and salt)… but it makes us feel terrible after we eat it. (Beware the middle of the night french fries!) More importantly, we aren’t providing the nutrients we need to take care of other people and ourselves. So, what’s the answer?

Spend the money and the time to invest in your health! Grabbing donuts or bagels in the surgeons’ lounge in the morning, pizza at noon-day conference and a hamburger at MacDonald’s in the middle of the night is terrible. (You know it’s true).

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So what’s the alternative? Here’s a five-step, easy plan that will let you eat better, feel better and avoid gaining weight in medical school and residency. This is predicated on cooking your own food but you can use this plan if you don’t cook by buying prepackaged foods. But really…. If you can learn how to take out a gallbladder or care for ill patients in the ICU don’t you think you can learn how to sauté a few vegetables???

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Make a plan
Make a shopping list
Shop once for the week and (when you can) prep ahead
Use your day(s) off to cook things that might take a bit more time and freeze some for other days
Keep a few “instant” healthy meals in your pantry

Make a plan

Map out your week’s meals and snacks using the “pizza rule” (nothing you cook should take longer to cook than it takes to order a pizza). Pay special attention to call days. It’s important to have really delicious food which can be grabbed in a minute when you are on call. I use Evernote to make my list for the week so I can share it with my family:

If you like to cook, you probably already know where to find recipes you’ll like. If you don’t cook regularly, I post recipes on @drmlb with #CallFood that meet the “pizza rule” and would be delicious on call. Here are few other sites I use regularly: Eating Well, Cooking LIght, My Recipes, Food Network, Kayln’s Kitchen, Skinny Taste. If you use Evernote to organize your list, it gives you one other advantage – you can download their add-on and clip recipes from the internet directly to Evernote. Each “note” (i.e. recipe) in Evernote can then be shared with whoever you cook with (i.e. whoever gets home first can start dinner!). It also lets you search all your notes so you can easily find your recipes in the future.

Make a shopping list

I use Grocery IQ for my shopping list. This app lets you organize your grocery list by the aisles in your favorite stores to make shopping faster. It also allows you to share the list with your significant other which means that whoever is able to get to the store first has the updated shopping list! I don’t really use the “coupon” feature or the barcode scanner, but if you choose to use these functions, please use the FoodEducate app with it to make sure your choices are healthy!

There are other apps for shopping which come recommended by others which, to be fair, I thought I should share: Any List, Pantry Manager, Paprika

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Shop once and (when you can) prep ahead

Planning lets you spend less time in the grocery store and absolutely means less food wasted. When you get home from the store think about the meals you are going to cook later in the week. If your carrot soup on Tuesday calls for sliced carrots, diced fennel and chopped onions, chop them when you get back from the store on Sunday and put your “mise en place” in baggies or containers in the refrigerator. Cooking is not that time consuming…. but prepping is!

One other good trick is to make “mirepoix” on the weekend for the week. Diced onions, carrots, celery, bell peppers, etc can be prepped and put in a bag. It can be an instant stir-fry on nights when you need something fast. You can also put a handful in soups, omelettes, or wraps to get extra vegetables in your day. Mix it with leftover rice or other grains to make an instant salad (you can add tuna, if you want, too).

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Use your day(s) off to cook things that might take a bit more time and freeze some for other days.

You need good “comfort food” when you are working hard, but it can be both comforting and healthy. For example, this recipe for spaghetti squash lasagna. The preparation for this recipe isn’t that hard (you can steam the spaghetti squash in the microwave instead of roasting it in the oven, for example) but it’s a little too long for nights when you get home late and are really tired.

Learning to use a pressure cooker (my favorite) or a slow cooker like a crock pot is a great way to cook up a batch of something when you are home and doing other things without spending a large amount of time in the kitchen

No matter what you make or how you make it, make enough to freeze individual portions and then store them so they will stay fresh. Don’t forget to mark the containers with a Sharpie and eat them within 3-4 months!

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Keep a few “instant” healthy meals in your pantry

Despite my best efforts to plan, there are weeks when I’ve miscalculated amounts, don’t have enough time or just don’t want to eat what I had planned. When that happens, it’s great to have a go-to “instant” meal, which usually comes out of the freezer and pantry. Here are some to get your list started!

Moroccan Lentil Stew – (particulary good with harissa and served over couscous)

Quick meals from frozen ravioli

Shrimp fried rice

Fast, Easy Recipes: Naturally Ella

Posted on September 11, 2014 by marylbrandt

I’m always looking for websites with great recipes that meet the “pizza rule” for medical students, residents and busy docs. (Food that takes take less time to prepare than it does to order a pizza).

Naturally Ella is a website by Erin, who “grew up on fast food” but, along with her family, made significant changes when her father had a heart attack at age 45. Her blog has healthy vegetarian recipes that are easy to prepare and make great #callfood*. Even if you aren’t a vegetarian, these recipes will convince you to join the Meatless Monday movement!

Avocado Chickpea Salad

Hummus and Grilled Cheese Sandwich

Sweet Potato Sriracha Noodle Soup

*Search for #callfood on Twitter for other “pizza rule” recipes that are great to take to the hospital for call!

Fast and Easy Recipes – Protein Bars

Posted on June 15, 2014 by marylbrandt

The senior class ends their formal education at Baylor with a capstone course called “APEX”. In addition to reviewing critical medical information, communication skills and other important aspects of becoming an intern, there are also wonderful lectures from faculty on “how to be an intern”.

One of the APEX speakers this year was Dr. Sally Raty, who stressed how important it was to take time to care for yourself.. but that you had to look for efficient ways to do it! She promised to share recipes that are easy and take very little time to cook. I’ll share the rest of the recipes on future posts… but here is the first one (which she adapted from this recipe).

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These bars have a ton of ingredients, but they are easy to find, and this bar is way better for you than those processed, chemical blobs you’re spending $2+ on. I keep all of the dry ingredients for these bars in a basket in my pantry. I just pull the basket out and make the bars. The crumbs are amazing on vanilla ice cream….not that I would ever do that, but I’ve heard it is good.

3 cups raw oats (nothing fancy. Quaker 3 minute (not instant) oats are fine)

1/2 cup whole sesame seeds, or shelled sunflower seeds

1/2 cup shredded coconut (unsweetened is best, but sweetened is easier to find)

1 teaspoon ground cinnamon

1 teaspoon salt

1/4 cup brown sugar

1 cup vanilla Greek yogurt

1/4 cup + 2 tablespoons pure maple syrup or honey

1 cup peanut or almond butter

1 teaspoon vanilla extract

1/4 cup coconut oil, liquefied if solid (or just use canola oil)

1/2 cup chopped chocolate chips (> or = 70% cacao is best)

1/2 cup chopped nuts (almonds, walnuts or pecans)

1/2 cup chopped dates, raisins, figs or other dried fruit–optional (I don’t typically add these)

1 cup vanilla or chocolate whey protein powder– Garden of Life Raw Protein is a good one and is available at Whole Foods Market

2 eggs

½ cup egg whites (or add a 3^rd egg)

Heat oven to 350F. Spray an 11 X 7 inch glass baking dish with nonstick stuff. Throw everything in a big bowl. Mix well with your hands. Place in the baking dish, press into the pan to eliminate bubbles and try to get it level. Cook for about 20-25 minutes. Let cool completely to room temp. Refrigerate for a few hours before cutting into bars. Cut into about 48 bars. Refrigerate the cut bars.

Top 10 ways to survive (and maybe even enjoy) being on call

Posted on June 10, 2014 by marylbrandt

Like our residents (but not nearly as frequently), my group has started taking “in house” call. For every one who is currently or has been a resident, this is an experience we all know…. and one that’s hard to describe to those that haven’t experienced it. Spending 24 hours on call in the hospital can be emotionally and physically draining, but it has moments that make it a special experience, too.

There are ways to make the experience easier. Here are my top 10 ways to survive (and maybe even enjoy) being on call:

1. Drink water. Put a water bottle in the lounge refrigerator, drink from every water fountain, put your water bottle next to your computer, or come up with other ways to stay hydrated. If you want more flavor, bring a zip-lock with cut up lemons or limes to put in your water or add a splash of fruit juice.

2. Be kind. No matter how stressed or busy you are, knock on every patient’s door and enter their room with the intention to help. Sit down or put a hand on their arm when you are talking to them. Smile.

3. Take breaks. On purpose. No one really expects you to work non-stop for 24 hours and it’s not good for your patients. Deliberately stop to do something else every few hours, even if it’s just for 5 minutes. Go outside for a few minutes for a short walk to catch some natural light and breathe some fresh air. Get a good cup of coffee or tea, listen to some music or just sit. If you want something more active, climb a few flights of stairs, stretch, or even do a light workout.

4. Eat well and eat often. Do not rely on fast food or the hospital cafeteria. By far the best plan is to bring really good food from home. You need to have “comfort” food on call. If you don’t cook, buy really good prepared food that you can look forward to. Make sure you have “plan B” ready if your call day gets completely out of control by having an energy bar (my favorite is Kind bars), peanut butter sandwich or other “quick” food in your white coat pocket.

5. Be part of the team. Notice and encourage the unique camaraderie you share with everyone else who is on call. It’s a small “band of brothers” who find themselves in the hospital at 3am. Be kind to each other, help each other, and use this unique opportunity to get to know someone you might otherwise not get to know.

6. Wear good shoes. If you are in house for 24 hours, bring a second pair that’s completely different (clogs and running shoes for example). Ditto socks. Buy really good socks and change them after 12 hours if you can.

7. Use caffeine wisely. It’s practically essential for many of us at the beginning of the day, but beware trying to “wake up” with caffeine after 2pm. Not to mention that if you “caffeinate” all night, you’ll have that sickly post-call-too-much-caffeine feeling in the morning.

8. Take naps. Any sleep is good sleep on call. If it’s possible, 20 minutes will make you more alert and effective in your work.

9. Make your beeper a “Zen bell”. Use your pager or phone as a tool for mindfulness. When it goes off, take a deep breath, relax the muscles in your face and shoulders and be present. This is a proven practice to decrease stress – try it, it works!

10. Learn. Take advantage of the unique educational opportunity of being on call. The fact that there are fewer people around at night and on the weekends has a real impact on how and what you learn on call. If you are a student or junior resident, you are more likely to be the first person evaluating new consults and admissions. You are also more likely to have one on one time with your senior resident or faculty as you care for patients together. If you are further along in your training, the “down time” on call (if there is any!) is a great time to catch up on reading.

Fast Food for Call Nights

Posted on May 24, 2013 by marylbrandt

It’s 2am on call. All of a sudden you are starving, not to mention craving comfort food. The only thing available is MacDonald’s or (on rare occasions) the leftover pizza from the noon conference. It’s a problem. Eating that kind of food at 2am will almost certainly result in food coma, not to mention that you really know it’s not healithy or what you would recommend for your patients.

Here’s the answer.

These tacos are a great breakfast on the run, afternoon snack or 2am call food. It takes ~15 minutes to make 10 of them on the weekend – which is enough to last for several weeks.

Start by chopping up the veggies you want to put in the tacos. My “go to” is one red bell pepper and a poblano pepper. Corn and rice work well, too. You can change the taste by using different cheese and different veggies (broccoli, carrots etc with Monterrey Jack, for example).

Buy the cheese you want already shredded. Lowfat Mexican is my usual choice, but any cheese is fine. I’ll often cut up a block of 50% Cabot cheddar cheese which is a great tasting low calorie cheese.

Put 10 whole wheat tortillas on the counter and divide one can of refried beans between them. Use nonfat if you are watching calories. Black beans, pinto beans, spicy or not – your choice!

Divide up your veggies and cheese onto the 10 tacos.

Roll them up and put them in snack size plastic bags.

Put the little bags in a gallon freezer bag (important to prevent the bad taste of freezer burn) and put them in the freezer. They last for weeks.

Two minutes in the microwave directly from the freezer gives you a great breakfast, snack, or middle of the night comfort food!

Duty Hours, Interns and Training Doctors

Posted on March 27, 2013 by marylbrandt

For most people, talking about a 16-hour workday is outrageous. For doctors in training, it may not be enough.

Training doctors is not easy. It’s not just a matter of learning what is in the books or latest articles. Under the supervision of attending physicians, young doctors learn the art of doctoring by staying with and caring for their patients. Because of the work they do while they are learning, resident salaries are supported through Medicare… mostly. That’s another issue, but not unrelated to the issue of duty hours.

Twenty years ago, it wasn’t unusual for an intern to arrive at 5 or 5:30 in the morning, work all day, stay up all night on call, and then work the following day until evening rounds were finished. That meant 36-hour shifts and many weeks with more than 100 hours in the hospital. It was clear that this wasn’t sustainable, nor was it safe.

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After much debate, in 2003, the initial duty hour regulations were put into effect. In a nutshell, residents couldn’t work over 80 hours a week (on average) and they weren’t allowed to stay longer than 24 hours. If they worked all night, they had to go home the next day. In 2011, the regulations were revised. The major change was that interns (residents in their first year of training) could only work 16 hours in a row instead of 24. On the surface, this made sense. Fewer hours should mean more sleep. More sleep should mean rested interns and fewer mistakes.

I wasn’t surprised to read the article published by Time magazine entitled “Fewer Hours for Doctors-in-Training Leading To More Mistakes.” This report, summarizing the on line JAMA Internal Medicine article from this week, noted that “interns working under the new rules are reporting more mistakes, not enough sleep and symptoms of depression.” In the same issue, authors from Johns Hopkins reported the results of a prospective, randomized crossover trial comparing the new regulations (16 hr work day) to a 24 hours work day with the next day off. They showed no significant difference in the number of hours the interns slept per week between the 16 hour and 24 hour shifts. However, there was a marked decrease in educational opportunities, a significant increase in the number of handoffs, and less resident satisfaction with the 16 hour work day. Most importantly, both the interns and the nurses caring for patients felt that the quality of patient care was decreased by the 16 hour duty hour regulation.

Why would there be more mistakes? Patient care is usually transferred in the morning (to the entire team) and in the evening (to the resident covering the patients at night). That’s roughly every 12 hours. When a portion of the team is rotating on a 16-hour schedule, it results in more handoffs (usually to fewer team members). Increasing the number of times information is transferred between doctors means increasing the risk of communication errors.

If they are working fewer hours why are they not more rested? The new regulations almost require a “night float” system to insure that the patients are taken care of. Working nothing but nights for one week a month followed by 16 hour days is not conducive to being rested.

Why are interns depressed? Remember, decreasing intern work hours didn’t change how much work there was to do in a day – and most hospitals didn’t respond by hiring more people to help. Interns worry that they are “dumping” on their colleagues because they are being required to leave earlier than the other residents. Less obviously, they are learning to be professionals but are being treated like they can’t “take” the hours of the residents one year above them. The message is subtle but real. There’s also a perception that the quality of patient care is decreased by the new system – which is reason enough for a young doctor to feel bad.

Education is clearly impacted. These studies document what we have all observed on the wards. Interns working 16 instead of 24 hours admit and follow fewer patients. In the surgical specialties, they participate in fewer cases. They also attend fewer teaching conferences.

The solution to this complex problem isn’t going to be easy. It’s an ongoing struggle to balance service vs. education, fatigue vs. experience and, maybe most importantly, how we pay for the incredibly important mission of training doctors.

I’m working hard to be part of the solution – along with everyone else in medical education. We owe it to the future physicians we will train and the patients they will take care of.

Starting Internship (I know what you are worried about)

Posted on June 24, 2012 by marylbrandt

I sat at the table this week with our new interns and the outgoing chief residents. Listening to our new interns as they asked questions, I realized everyone starting their internship has the same fears, whether or not they express them: Will I kill or hurt someone? Will I look stupid? What if they find out I’m not as smart as everyone else? Will I get divorced/separated/alienated from my friends? Will I gain weight? How am I going to find time to take care of myself?

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What you are feeling is normal. Every doctor who ever started an internship felt exactly the same way. The best way to manage your (healthy) fear is to have a strategy. I’ve written in the past about how to succeed as an intern. But if I were going to condense that advice into three easy rules (for every day except your day off) it would be these:

1. Read at least one section from a textbook in your field every day

2. Learn something (in detail) from at least one patient every day

3. Do something to take care of yourself every day

Read at least one section from a textbook in your field every day.

Your goal for the year should be to read a major textbook in your field cover to cover. You don’t have to buy the physical book. It’s fine if it’s on line or downloaded onto your iPad.

Once you have the book, make a list or spreadsheet of all the sections in all the chapters. For most textbooks, it’s probably going to be a list somewhere between 150 and 200 topics. When you look at the 48-50 weeks you will be working this year, it works out to basically a topic a day (with some days for review).

The real goal is not just to read these topics, but to really learn them. So, when you read, don’t just skim. Read to learn. That means taking notes – and reviewing them.

Put a chart on the wall with the list and give yourself a gold star when you finish a topic if you have to, but find a way to make sure you cover all the topics (at a steady pace) during the year.

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Learn something (in detail) from at least one patient every day.

It’s really easy, as an intern, to get caught up in the work and forget that you are fundamentally here to learn – not to provide service. Make it a daily habit to learn in detail about one patient in your care. It will overlap nicely with your goal to read a complete textbook. When you admit a patient with pneumonia, read the section (and make notes) on pneumonia and then check it off your list.

One other important point (that none of us like to hear) – You will make mistakes. Be humble, be honest, and learn from your mistakes. The mistakes you make (and maybe more importantly your “near misses”) are absolutely your most valuable teacher. When you do make a mistake, use it as the topic you will review for the day. You are going to be really upset but be easy on yourself. Being upset is the mark of someone who cares, but don’t let it escalate beyond a healthy response. Talk to your mentors and senior residents. They’ve been there.

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Do at least one thing to take care of yourself every day.

This may sound trivial, but it’s not. If you can, try to eat well, get some exercise and be social every day. At a minimum, though, pick one specific thing you are going to do for yourself and then do it.

Eat well

Get Some Exercise

Be social

Beepers and Pagers and Phones… Oh, my!

Posted on April 1, 2012 by marylbrandt

I was looking at my beeper then other day and realized it looks exactly like beepers looked 25 years ago. Think about it.

Here is what mobile phones looked like 25 years ago…

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Who invented beepers?

There are some conflicting stories about who invented the first “beeper” (because they only made a noise)

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“More than 20 million people in the United States today are connected by an invisible, ubiquitous wireless link, originally developed in 1949 by a hospitalized radio engineer. Charles F. Neergard was annoyed by the constant, loud voice paging of doctors on his hospital floor, and reasoned that there must be a way to quietly inform only the intended recipient that a message was waiting. The first commercial pagers were deployed in St. Thomas Hospital in London England and were the approximate size and weight of today’s two D-cell Mag-light.” from llinoissignal.com

“In 1921, the first pager-like system was in use by the Detroit Police Department. However, it was not until 1949 that the very first telephone pager was patented. The inventor’s name was Al Gross and his pagers were first used in New York City’s Jewish Hospital. Al Gross’ pager was not a consumer device available to everyone. The FCC did not approve the pager for public use until 1958.” from inventors.about.com

Timeline of history of the pager

In the era of nothing but landlines, pagers were necessary to contact people who were moving around. Which leads to the next obvious question:

Why do we still have pagers in medicine?

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Most physicians preferentially use texting as a method to communicate with each other (when we can). But, we all still have pagers, too. There are several reasons:

1) You can turn off a pager (when you aren’t working). It’s harder to turn off your cell phone.

2) Pagers don’t interfere with medical equipment. (Unlike some cell phones). (Although there are some who feel that the benefit of improved communication outweighs the potential risk of interference. )

3) Pagers work in the basement and in steel reinforced buildings (like hospitals), places that limit cell phone reception

4) You can dial one number to reach a group of people (important for codes, etc)

5) The battery life is much better than a cell phone

6) In a disaster situation (like a hurricane) pagers still work when cell phones don’t

Where are the new solutions?

There are systems now that allow you to use special mobile phones within the walls of the hospital. Some systems, like Spectralink, use proprietary phones that work only within the hospital. Others, like Vocera, use software to allow the use of iPhones for the same purpose. Apple has acquired a patent for a similar system which suggests they may be working on new technology.

Making a new product for the almost 1,000,000 physicians in the United States would seem to be a market big enough to warrant some creative ideas! How about the most obvious one – Why can’t the full function of a pager be added to a cell phone?

Any engineers and/or entrepreneurs looking for a new product to develop?

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