Laura Vater, MD, MPH @doclauravater Twitter profile | Pikagi

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Laura Vater, MD, MPH

@doclauravater

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GI oncologist @IUCancerCenter | Writer (narrative med, fiction) | TEDx & commencement speaker. Writing about humanism in medicine, for patients & clinicians.

Indianapolis, IN

https://t.co/AhCShWkAsR

Joined March 2017

Don't wanna be here? Send us removal request.

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@doclauravater

Laura Vater, MD, MPH

6 months

Only as an attending do I appreciate all the doctors who took time to teach me in my training. I didn't realize they probably had notes to write, meetings to attend, research papers to submit, and patients waiting in the clinic. Instead, they took time to teach. What a gift.

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@doclauravater

Laura Vater, MD, MPH

1 year

Being awake for 24 hours is the equivalent of having a blood alcohol content of 0.10%. This is higher than the legal limit for driving. If doctors aren’t fit to use their driver's license after 24 hours awake, should they be asked to use their medical license?

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Laura Vater, MD, MPH

1 year

I’m an odd oncologist, maybe. When my patients opt for no chemo, I keep seeing them if they wish. I help w/ symptoms, follow scans over time, & help interpret data about alternatives. A doctor is a guide. We should continue to guide, even if a person opts for a different path.

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Laura Vater, MD, MPH

1 year

Sleep deprivation kills compassion. Without sleep, we can’t process emotional information. The parts of our brain where we feel empathy don’t work as well. If we look at MRI scans of people after a night of no sleep, they have far less activity in empathy parts of the brain.

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Laura Vater, MD, MPH

7 months

Once, a woman stopped me in the lobby. "I'm sorry, I can’t find the ICU.” I showed her where to go. An hour later, I was called to the room—her husband was dying from cancer. That was the day I decided to treat every person in the hospital as if it were their hardest day.

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Laura Vater, MD, MPH

1 year

In the 1890s, Dr. Halsted created the model for residency training as we know it today. Residents worked long hours with little sleep. Sadly, we now know he was using cocaine to stay awake & morphine to sleep, and relied on residents working nonstop to cover up his addiction.

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Laura Vater, MD, MPH

2 months

Today we honor Dr. William West, who died by suicide. His family writes, “We hope systemic changes can be made to support aspiring medical professionals better. This is critical. We don’t want any other families to experience tragedies like this.”

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Laura Vater, MD, MPH

6 months

We need to stop shaming doctors & nurses for: - Seeking mental health care - Crying if a patient dies - Needing time to sleep - Taking vacation What did I miss?

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Laura Vater, MD, MPH

1 year

I became a mom in med school, & many people told me I shouldn't do it. To anyone being told they have to put their parenting plans on hold until training is done, don't listen. This narrative is not helpful. We need more representation of parents in training & more support.

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Laura Vater, MD, MPH

7 months

My grandma went to nursing school when she was 46, with 4 kids, and became a NICU nurse. My mom went to medical school at 37, with 3 kids, and still practices primary care in an underserved community. It’s not too late for you. It’s never too late.

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Laura Vater, MD, MPH

1 year

In med school, a patient with cancer was lying on the table before surgery, visibly scared. Everyone was busy doing their tasks. I wanted to go to her and hold her hand, but I thought it would make me look soft. So I stayed back. These are the moments I regret the most.

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Laura Vater, MD, MPH

1 year

A resident and a fellow died by suicide this week. We must do a better job caring for our medical trainees as human beings. We must protect their mental health. We must improve the working conditions for all trainees. #meded

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Laura Vater, MD, MPH

1 year

This just in: Congress has EXPANDED residency slots for only the second time in 25 years. Congress has approved 200 additional residency slots for 2023. This is progress, but we still need a lot more. It’s projected we’ll be short 124,000 physicians by 2034. Data: @AAMCtoday

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Laura Vater, MD, MPH

3 months

Dear partners of medical people: Thank you for supporting us. Know that decision fatigue is real & after a busy day of work we often can't make another decision at home... it's not because we don't love you or don't care, we are just mentally spent. Thanks for loving us anyway.

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Laura Vater, MD, MPH

1 year

While Dr. Halsted was a brilliant surgeon, this model of training is deeply troubling. Doctors are not superhuman. Or superheroes. We’re just human beings, caring for other humans. Sleep is not optional for any of us, including doctors. #meded #residentwellness

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Laura Vater, MD, MPH

7 months

Why do residents work so much? Tradition. In the 1890s, Dr. Halsted created the model for residency training--residents worked 24/7 with little pay. Sadly, he was using cocaine to stay awake & morphine to sleep, relying on residents working nonstop to cover up his addiction.

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Laura Vater, MD, MPH

1 month

I’m working on a keynote speech while my husband does the dishes… I’m utterly convinced that one of the biggest predictors of career success (especially as a woman in medicine) is who you marry and how much work at home they’re willing to share.

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Laura Vater, MD, MPH

11 months

Four years ago I had suicidal ideation due to repeated sleep deprivation. I was a resident working long hours, including 28-hour calls. Sleep deprivation is an independent risk factor for suicide. Any discussion about resident wellness is wholly inadequate if it excludes sleep.

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Laura Vater, MD, MPH

1 year

Now 130 years later, rather than using cocaine to stay awake, doctors are encouraged to use prescription stimulants. And despite the data that sleep deprivation is truly terrible for our health and for patient safety, we are still depriving doctors of sleep.

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Laura Vater, MD, MPH

1 year

Dear incoming interns: Remember that your attendings have been practicing medicine for years, while you're essentially getting a new job every 4 weeks. Know that your job is not to know everything. You job is to show up, ask questions, & care deeply for your patients.

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Laura Vater, MD, MPH

1 year

I developed anxiety in med school, and I thought this meant I was weak. Everyone around me seemed to be doing just fine. Later, I learned that many of my peers were going through the same thing. In medicine, we learn to hide how we’re really doing—to the detriment of us all.

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Laura Vater, MD, MPH

7 months

Dear interns: Its okay if you don't remember that allopurinol inhibits xanthine oxidase at 6 a.m. Remember your attendings have been asking the same questions of learners for years, while youre hearing them for the first time. Be kind to yourself, & keep learning.

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Laura Vater, MD, MPH

1 year

Only as an attending do I fully appreciate all the doctors who took time to teach me. I didn’t realize they probably had notes to write, research papers to submit, patients waiting in the clinic. Instead, they took time to teach. What a gift. #meded

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Laura Vater, MD, MPH

9 months

How good of a doctor you are depends a lot more on how you listen to patients, search for answers, & continue to learn throughout your career than the grade you got on an organic chemistry exam when you were 19.

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Laura Vater, MD, MPH

1 year

Med students: Hold the hand of the patient who needs you. Trust your instincts, even when those around you don't respond in the same way or understand. Hold onto your empathy with both hands.

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Laura Vater, MD, MPH

1 year

I started my intern year in the ICU, and I was terrified… What if I didn’t know enough? To all the new doctors: Your job is not to know everything. Your job is to show up, to ask questions, to learn something each day, & to care deeply for your patients. You will be okay.

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Laura Vater, MD, MPH

1 year

We as a body of physicians must take a hard look at the data on sleep & do away with the archaic model of medical training that sleep deprives & dehumanizes young doctors. Sleep deprivation should not be seen as a rite of passage of training, but as a violation of human rights.

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Laura Vater, MD, MPH

8 months

It’s National Physician Suicide Awareness Day, and 4 years ago, I was at a very low point. I had SI due to repeated 28-hour calls for many months in a row. The only thing that kept me going was the mental image of my daughter’s face (she was 3 at the time).

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Laura Vater, MD, MPH

6 months

A student told me, “I was so nervous presenting during rounds. My hands were shaking & I felt so inadequate.” Remember that we were all once beginners. Learning takes practice. And courage. If you’re feeling “inadequate” today, remember you belong here as much as anyone else.

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Laura Vater, MD, MPH

1 year

New data: Long hours (≥60 per week) & extended shifts (≥24 hours) pose a danger to patient safety & to residents. The combination has a synergistic effect, amplifying medical errors, car crashes, and needle sticks. It’s time to rethink the way we’ve always done things.

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Laura Vater, MD, MPH

10 months

It’s critical we support the mental health of all doctors, especially those who are postpartum. This week, Dr. Krystal Cascetta, an oncologist, died by suicide & took the life of her 4-month-old daughter. She was likely experiencing postpartum psychosis, according to experts.

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Laura Vater, MD, MPH

6 months

Just a reminder that someone may look “fine“ & yet be facing anxiety, depression, or thoughts of suicide. At my lowest point, I still showed up to work. I wrote the notes & orders. I didn’t tell any of my peers I was struggling, because I thought it would make me look weak.

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Laura Vater, MD, MPH

3 months

On Thank a Resident Day, here are a few things you may not know: 1. Residents work 60-80+ hours/week & make around $12-18 per hour. They get no extra pay for extra (residency) shifts. 2. They often work 28 hours straight & can be sleep deprived for much longer on “home call.”

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Laura Vater, MD, MPH

9 months

One year as an attending (!) and here are 5 things I’ve learned: 1. Deep connection with patients will sustain you. It makes the work worth doing.

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Laura Vater, MD, MPH

9 months

This week, Dr. Corban Caldwell, an Emergency Medicine resident, died in a car crash, leaving behind his wife and five children. Per police reports, around 2:45 a.m., his car left the interstate and struck several trees. We don’t fully know the factors that led to his death.

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Laura Vater, MD, MPH

2 months

Dear patient I had to share awful news with today: When I close my eyes tonight, yours will be the first face I’ll see. I’ll wonder how you’re doing. I’ll wonder if I said the right words. I’ll keep hoping right alongside you & then pray for you, in this moment you’ll never see.

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Laura Vater, MD, MPH

8 months

Just a reminder that burnout in healthcare is not due to a lack of resilience. It's caused by overwork, sleep deprivation, staffing shortages, excessive charting demands, not enough time with patients, dealing with insurance denials, & lack of adequate support... to name a few.

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Laura Vater, MD, MPH

1 year

We know that doctors low on sleep have less empathy for a patient’s pain. Tired doctors prescribe less pain medicine. When we take away something as essential to our humanity as sleep, everything erodes: Our thinking. Our coordination. Our health. And sadly, even our empathy.

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Laura Vater, MD, MPH

1 year

Clinicians don’t need more training on how to be resilient. They are already highly resilient. Instead, they need more support. More advocacy. More people seeing them as whole human beings.

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Laura Vater, MD, MPH

1 year

One day you’re the third year med student on the team and your hands are shaking presenting the SOAP note, then you blink and you’re the attending on the inpatient service leading the whole team. To the med students out there, trust that you belong here as much as anyone else.

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Laura Vater, MD, MPH

1 year

It’s ironic that we bring bright, altruistic people into the field of medicine and then systemically dehumanize them (by pretending they shouldn’t be affected by death, and that they don’t need sleep, breaks, or time off). Then we wonder why empathy levels decline in training.

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Laura Vater, MD, MPH

1 year

Things I needed to hear before Match Week: 1. You are more than a match result. 2. Your worth goes far beyond where an algorithm sorts you. 3. No matter the result, you’re still a worthy human being. 4. No matter what, take this moment to celebrate how far you’ve come.

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Laura Vater, MD, MPH

7 months

Students are often told they aren’t “good enough” for something. Not “smart enough” for medicine or engineering. Not “strong enough” for orthopedics. Not “tough enough” for trauma surgery. Don’t underestimate the power of the words: “You’d be a good fit for this field.”

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Laura Vater, MD, MPH

7 months

In medical training, we get so accustomed to working all the time that a weekend off is a "golden weekend" and working 40 hours per week is "part time.”

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Laura Vater, MD, MPH

1 year

Women in medicine need to hear that we can still have fulfilling, successful careers even if we have children during training. We don't have to wait until our training is over to start our families. Thanks for publishing my writing, @medpagetoday

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Opinion | Why Can't I Be Both a Good Doctor and a Good Mother?

You don't have to put your parenting plans on hold

www.medpagetoday.com

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Laura Vater, MD, MPH

1 year

Without sleep, our empathy fades. Real stories: “I’m happy when a patient leaves against medical advice, so I have less patients to round on.” It looks like, “Feeling anger towards a patient who presented to the ER at 3 am while on a 24-hour call.”

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Laura Vater, MD, MPH

1 year

Having cancer is hard enough. The words we use shouldn’t make it harder. While the battle analogies may energize some patients, for many others they lead to blame and shame.

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Laura Vater, MD, MPH

11 months

Celebrating 10 yrs of marriage today & this advice has helped us: 1. Share inside jokes. Lots of them. 2. Don’t make big decisions or argue when you’re hungry or tired. 3. Celebrate your partner’s wins. 4. Support their interests as they evolve over time. What would you add?

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Laura Vater, MD, MPH

7 months

With adequate sleep, people are less irritable, more generous, and have higher levels of empathy. Imagine if healthcare workers weren't sleep deprived throughout the year. How would that transform healthcare?

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Laura Vater, MD, MPH

2 months

On this doctors day, if you feel deficient as a physician and mother, please remember that your kids love you. They are proud of you. They are lucky to be raised by a strong, successful person. My mom went to med school at 37, and I was 9. She finished residency when I was 16.

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Laura Vater, MD, MPH

4 months

You are not “just” a medical student. Not “just” an intern or resident. The way you care for others with patience, non-judgment, and deep presence makes an impact on patients at every level of your training. Don’t forget this. #meded

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Laura Vater, MD, MPH

1 year

A message this week: “We're working way over 80 hours but can’t report it. My voice is so small." Residents have little to no negotiating power & few alternative options. Their careers often depend on staying silent. And for these reasons they're exploited.

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Laura Vater, MD, MPH

1 year

Just a reminder that patients on ventilators can often hear us. Talk to them how you would if they were awake. Introduce yourself. Be kind. Explain what’s happening (before you examine them or do a procedure). They deserve this. #meded

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Laura Vater, MD, MPH

11 months

One of the most important phrases I’ve learned to say in my first year as an attending physician: “I don’t know, but I’ll find out.” Honesty and trust building outweigh pretending every time.

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Laura Vater, MD, MPH

7 months

While Dr. Halsted was a brilliant surgeon, this system of training is troubling. Doctors are not superhuman. When we take away something as essential to our humanity as sleep, everything erodes: Our ability to think. Our mental & physical health. And sadly, even our empathy.

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Laura Vater, MD, MPH

3 months

I'm on my way to practice medicine today, more than a decade after a pre-med advisor said l'd never get in. When someone evaluates you, it's just a single moment in time. It's not the last word.

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Laura Vater, MD, MPH

3 months

One day you're crying over a test score in physics, the next day you're working in your dream field. Hang on. It gets better.

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Laura Vater, MD, MPH

6 months

Here’s a basic truth: Physicians cannot provide thorough, compassionate care if we don’t have time with our patients.

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Laura Vater, MD, MPH

1 year

A fellow reached out to me. “I’m working 80+ hours a week & running on little sleep. They’re telling me to ‘Just be more resilient.’” Clinicians don’t need more resiliency training. Instead, they need more support. More advocacy. More people seeing them as whole human beings.

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Laura Vater, MD, MPH

10 months

4 phrases to repeat to yourself as a new school year begins: 1/ I am not stupid, I’m just learning something new. And learning takes time. I will be kind to myself along this journey.

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Laura Vater, MD, MPH

1 year

Sleep is not optional for any of us, including doctors. Without it, our mental and physical health erode. Sleep deprivation should NOT be viewed as a rite of passage of medical training, but as a violation of human rights. #meded #residentwellness

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Laura Vater, MD, MPH

1 year

Everyone in healthcare would benefit from therapy. We regularly witness illness, trauma, & death. We make complex decisions that affect human lives. We have a close-up view of the unfairness of our healthcare system. If you’re in healthcare, this is your sign to go to therapy.

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Laura Vater, MD, MPH

2 months

One day you're the intern just learning to replace potassium, then you blink & you're the attending on service making complex decisions & leading the whole team. To the trainees out there, trust that you belong here as much as anyone else.

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Laura Vater, MD, MPH

1 year

No matter what happens this week, remember this: You are more than a match result. You are more than a residency slot. You are more than where an algorithm sorts you. #Match2023

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Laura Vater, MD, MPH

7 months

A CDC report this week on burnout in healthcare concluded with this: Solutions should emphasize “improving the work environment to support mental health, rather than asking workers to be more resilient…” Resilience isn’t the issue. The environment is.

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Laura Vater, MD, MPH

9 months

The chance of getting in a car crash increases w/ sleep loss & when a sleep-deprived resident drives home after a long shift, the chance increases by 168%. If you’re ever finishing a shift after little sleep, please consider taking a nap before driving or getting a ride home.

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Laura Vater, MD, MPH

3 months

Emotions I often felt as a med student: - Nervous talking to patients & presenting SOAP notes - In the way on a team - Awkward during procedures & examining patients - Lost throughout the hospital - Not good enough Med school is hard. Hang on.

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Laura Vater, MD, MPH

7 months

One day you're interviewing for residency with a newborn & uncertain where life will lead or how you'll survive. The next you're a practicing oncologist & your kiddo is thriving. To anyone in this season: Keep going. You will make it through.

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Laura Vater, MD, MPH

1 year

Just a reminder to be kind to the primary teams calling for a consult. They aren’t experts in your field. You are. That’s why they‘re calling. Each interaction is a chance to teach. #MedEd

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Laura Vater, MD, MPH

1 year

@ChrisStump327 Also recommend Why We Sleep by Matthew Walker - there’s a whole chapter on doctors in training

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Laura Vater, MD, MPH

6 months

To anyone in healthcare being labeled as "inefficient" for providing thorough, compassionate care and making patients & their families feel heard... I see you. Thanks for all you do.

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Laura Vater, MD, MPH

4 months

I’m convinced that the most important thing we can give another person is our undistracted, unhurried presence. Thank you for giving this to others today.

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Laura Vater, MD, MPH

1 year

Create the environment of medical training you wish you’d had. If you were bullied, create a bully-free culture. If you were sleep deprived, normalize rest. If you were ignored or discounted, make your learners feel valued. This is how we change the culture. #meded

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Laura Vater, MD, MPH

4 months

My mom went to med school when I was 9, & she used to take me to round in our small, rural hospital. She listened to patients’ stories, cared about their families, & treated them with kindness. I’m still grateful my first formative clinical experience was with her. Happy #nwpd !

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Laura Vater, MD, MPH

5 months

Officially board certified! So glad to have passed my oncology boards — this final step of my training. Sending a huge thanks to the physicians who took time to teach me not just the nuances of oncology but how to deeply care for human beings.

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Laura Vater, MD, MPH

1 year

You are worthy of the time it takes to: Go to the dentist Get regular check-ups Get your cancer screenings Go to therapy You deserve the health you strive so hard to give to others.

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Laura Vater, MD, MPH

11 months

To anyone transitioning into a new role this month (intern, upper level resident, fellow, or new attending), please remember to be kind to yourself. Learning takes time.

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Laura Vater, MD, MPH

2 months

Dr. West was finishing his ophthalmology residency. At his family’s request, please consider donating to the Dr. Lorna Breene Heroes’ Foundation. We must continue to protect the wellbeing of doctors by ensuring they have reasonable hours, adequate sleep, & mental health support.

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Laura Vater, MD, MPH

1 month

One of my favorite parts of working with residents in clinic is the look on their faces when I say, “Take an hour for lunch to decompress, go for a walk, or just breathe.” Give your learners breaks when you can, even if your own schedule doesn’t allow for them.

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Laura Vater, MD, MPH

6 months

Not sure who needs to hear this but you can work in healthcare & not work 24/7. You can say no. You can carve out time for patients & your family. You may sacrifice money, prestige, & your need to please the boss, but it’s possible. Keep making choices that are right for you.

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Laura Vater, MD, MPH

8 months

Nurses are not our subordinates but our partners in caring for patients. Their training, experience, and insights complement and strengthen ours. We are equals in this work we do.

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Laura Vater, MD, MPH

1 year

Dear incoming interns: You are capable. You are competent. You are qualified. You are ready for this next step (even if it doesn’t feel that way).

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Laura Vater, MD, MPH

20 days

A friend of mine is being constantly told to “move faster” & see more patients. Let’s be clear: It is impossible to provide high quality of care to patients if we don’t have time with them. Listening takes time. Building rapport takes time. Making complex decisions takes time.

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Laura Vater, MD, MPH

1 year

@Outdoorbrit1 We absolutely have to take a hard look at the ethics of continuously sleep depriving doctors. With all we know about sleep loss and how it destroys our mental and physical health (and increases risk for suicide), this model is in many ways inhumane.

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Laura Vater, MD, MPH

7 months

In training, I'd often drive home in silence, wondering if I made the right decisions or said the right words. Years later, I still have those thoughts. Caring for patients is hard, complex, & emotionally challenging. Thanks to those of you doing this work.

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Laura Vater, MD, MPH

1 year

Dear residents, You are good enough. You are capable. And you are much more than any career. If your mental health has declined, you are not defective. You do not lack resilience. Find a virtual therapist. Call this physician support line (888-409-0141). Reach out to someone.

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Laura Vater, MD, MPH

9 months

I love my job. But wow do I hate prior auths. Why must we have an inefficient middle man dictating the care we provide, and taking our precious moments of time off in the process?

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Laura Vater, MD, MPH

1 year

Just a reminder to attendings, fellows, & residents: Let your med students leave early if you can. Give them time to study, to exercise, to be with family, or to simply rest. They need that.

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Laura Vater, MD, MPH

1 year

A resident reached out to me: “We had a lecture on sleep deprivation and modafinil was recommended.” To be clear: This is a prescription stimulant that’s potentially habit forming. Prescription stimulants aren’t the solution for resident fatigue. Sleep is. #residentwellness

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Laura Vater, MD, MPH

4 months

If we mistreat & dehumanize young doctors--essentially teaching them that human life is not of value--they may learn to dehumanize patients. Not only do our patients deserve our respect and kindness, so do our learners: our students, residents, and fellows.

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Laura Vater, MD, MPH

3 months

You may have seen a hundred heart attacks, or a thousand diagnoses of cancer, but for the person experiencing illness, their life has been turned upside down. Our normal days are their most difficult. I try to remember this even as I’m zooming in and out of patient rooms.

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Laura Vater, MD, MPH

1 year

Eliminating sleep deprivation in medical training & practice is not just about patient safety. It’s not just about the health of clinicians. It’s also about empathy. We should prioritize sleep for all clinicians. Have you experienced compassion fatigue when exhausted?

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Laura Vater, MD, MPH

10 months

I’m convinced we can be equally exhausted by our work & fulfilled by it. We can love a job that makes us weary. It doesn’t mean it’s the wrong fit or the wrong work. It’s a reminder that we need space and time to unwind, decompress, and restore ourselves.

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Laura Vater, MD, MPH

1 year

@BobbySlaterMD Some thoughts I’ve shared on IG:

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Laura Vater, MD, MPH

3 months

Never underestimate the value of turning to the person sitting beside your patient and simply asking, “How are you?”

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Laura Vater, MD, MPH

2 months

If you’re in a hard season of studying, may these words encourage you: 1. You do not study in a vacuum. Your time and effort are not wasted. Push through self-doubt & keep working hard, because your future patients will benefit from what you learn today.

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@doclauravater

Laura Vater, MD, MPH

10 months

One of the greatest challenges in healthcare today is simply trying to be present with a patient. Not being distracted by the computer, the phone chiming, the tasks yet to be done. If you can simply be present with another human being, this is an accomplishment. Celebrate this.

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@doclauravater

Laura Vater, MD, MPH

7 months

When you're in a hard season of studying in medical training, remember that there are real people on the other side of this. You may not meet them for a year. Or a decade. But there are patients who will benefit from what you learn today.

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Laura Vater, MD, MPH

2 months

Things I needed to hear on match week: 1. You are much more than a match result. Your worth goes far beyond where an algorithm sorts you. 2. Whatever the result, you're still a worthy human being. 3. No matter what happens, take this moment to celebrate how far you've come.

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Laura Vater, MD, MPH

4 months

Just a reminder that you can be both emotionally exhausted from your work and fulfilled by it. Feeling this today. Make sure to give yourself space to process, cope, unwind, laugh, & play.

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