How can there be joy in medicine if there is no joy in Mudville?

Physician
May 29, 2023

The following article is part satire and part imagination.

The classic poem “Casey at the Bat” delves into the dashed dreams of 5,000 frenzied fans who gathered to watch the “Mudville Nine” play baseball, pinning their hopes on their star player, Casey. Do they have unrealistic expectations of Casey, or is his prowess over-hyped? And what implications does this time-honored poem have for medical practice?

Parables – short stories that teach a …

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Unveiling the intricate link between housing costs and health care

Policy
May 29, 2023

While housing costs have escalated, health care costs have not been left behind. According to the National Health Expenditure Account (NHEA), health care spending grew 4.6 percent in 2019, reaching $3.8 trillion or $11,582 per person. The correlation between these two factors is multifaceted.

When housing is unaffordable, it consumes a large chunk of a household’s budget, leaving little for health care. This can lead to skipped doctor appointments, unfilled prescriptions, …

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Physician entrepreneurs offer hope for burned out doctors

Physician
May 29, 2023

As I leave a conference organized for a group of physician entrepreneurs, I have so many thoughts running through my head. Some of these thoughts revolve around making my small, fledgling medical practice run more smoothly, reaching more people (and serving them better), and always remembering my why. These are the “business mastermind” skills I signed up to learn at the conference. But I may have come out of this …

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Uncovering the truth about racial health inequities in America: a book review

Policy
May 29, 2023

When I started my intern year, that is my first year of training in medical residency, I noticed something peculiar about the epidemiology of disease in our hospital. The Black patients on the medical wards would often present with the morbidity of their diseases almost ten to twenty years earlier than their white counterparts. A Black person with leg swelling and shortness of breath who presented with advanced heart failure …

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Why electronic health records are failing patients: the dark side of copy and paste [PODCAST]

Podcast
May 28, 2023
YouTube video

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Join us for an insightful conversation with Erica E. Remer, a physician and clinical documentation specialist, as we explore the challenges and pitfalls of electronic medical records (EHRs). Erica delves into the impact of copy and paste …

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The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

Physician
May 28, 2023

Anyone who practiced medicine in the past decade will be well acquainted with the myriad discussions about epidemic of burnout and the eroding of well-being among health care providers that has accelerated with the pandemic. With 63 percent of physicians having at least one symptom of burnout and professional fulfillment dropping from 40 to 20 percent in 2021, there are no shortage of culprits. Increased workload, documentation, and administrative …

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The power of coaching for physicians: transforming thoughts, changing lives

Conditions
May 28, 2023

Upon reading numerous articles referencing physician coaching, most have been written by physicians who were transformed by coaching and then became coaches themselves. (Thank you.  Your work is so needed in this area!) At least once or twice, I’ve seen coaching referenced in a derogatory manner or deemed unnecessary. In those instances, the premise was that “the system” is the problem and coaching is not the answer. In reality, this …

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Raw humanity on night float: inspiring patient encounters and overcoming challenges

Physician
May 27, 2023

Night float had always been this mythical monster to me, an intimidating prospect that conjured up some of my greatest fears about a residency rotation – jetlag, nocturnal clock, lack of continuity with patients or a day team, multiple pagers and multiple admissions every night. Maybe it was the uncertainty of the unknown that had seemed so daunting.

Somehow, after three admissions on my first night, I found myself still awake …

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Is AI the solution for the shortage of nephrologists? ChatGPT weighs in.

Tech
May 27, 2023

As I’m sure you know, nephrology is the branch of internal medicine that deals with the kidneys. And in the U.S., young doctors are quite unlikely to choose this path.

Why? The combination of long hours, chronic illness, and (relatively) unimpressive pay has proven deadly to the field. In fact, around 30 percent of training (fellowship) positions go unfilled each year.

To stay afloat, the nephrology community has turned to …

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Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

Conditions
May 27, 2023

“One should . . . be able to see things as hopeless and yet be determined to make them otherwise.”
– F. Scott Fitzgerald

I’m in a massive ballroom with numerous tables and promotional placards lining the walls and center. In attendance are every pharmaceutical manufacturer and their sales reps. All the biggies are here; Pfizer, Merck, Novartis, and AstraZeneca, to name a few. Their drugs are household names because they advertise …

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Why HIPAA is failing and what you need to know to protect your data [PODCAST]

Podcast
May 26, 2023
YouTube video

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Join us in this episode as we discuss the limitations of HIPAA and U.S. law in protecting health information privacy with our guest, Brian R. Jackson. As a pathologist, Brian provides a unique perspective on the challenges …

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Revolutionizing emergency medicine: Overcoming long-term challenges with innovative solutions for physicians and patients

Physician
May 26, 2023

My previous post on this topic described long-term cultural and organizational challenges facing emergency medicine (EM) that pose greater threats to the specialty than temporal challenges (e.g., overproduction of emergency physicians (EPs)). Some challenges are not remediable; they are inherent to the specialty:

  1. short-term patient relationships
  2. unpredictable workload/intensity
  3. frequent, rapid fluctuations of stressful and less-stressful periods

However, many detrimental aspects of EM can be substantially …

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An obstetrician-gynecologist reveals the truth about reproductive planning and how to navigate society’s expectations

Conditions
May 26, 2023

Judging a book by its cover is easy. I just did it. There was a title at my library last week, So When Are You Having Kids?, and I judged it. That’s a loaded question: Am I even able to have kids? Do I want kids? If I do, when is a good time, personally or professionally? Who could ever be ready? Yet, how many times a day do …

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Why affirmative action is crucial for health equity and social justice in medicine

Policy
May 26, 2023

Harvard and the University of North Carolina at Chapel Hill are among the higher ed institutions involved in a U.S. Supreme Court battle over affirmative action that is expected to be decided this spring or summer. As a former appellate defender in the Gratz v. Bollinger affirmative action case in 1993, as well as an emergency medicine physician serving under-insured patients, I know firsthand how affirmative action …

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Overcoming stigma and finding hope in infertility, pregnancy loss, and childlessness [PODCAST]

Podcast
May 25, 2023
YouTube video

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Join us for a thought-provoking episode as we sit down with life and wellness coach Gail Miller, a maternal-fetal medicine physician. We dive into a topic that is often kept silent but affects so many – infertility, …

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The pediatric health care system tested to the limits: an inside look at the “at capacity” period during the tripledemic

Physician
May 25, 2023

Where should I begin when describing a period that seemed to have no end in sight? When we, as pediatric emergency department (ED) providers, felt like we were drowning in a tsunami of pediatric patients coming from every direction – from adult EDs needing to transfer seizing children for a higher level of care, from EMS coming in with apneic neonates, and from the endless supply of those from the …

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Nose-brain connection: The surprising link between allergies and mental health revealed

Conditions
May 25, 2023

Artificially separating the body from the mind has been one of the biggest missteps of modern medicine. Over the last few years, we have increasingly read studies confirming the mind-body connection, the gut-brain axis, and now we are learning more about the nose-brain connection.

Given the direct proximity between our nose and our brain, this connection shouldn’t be much of a surprise. The olfactory nerve, cranial nerve 1, wires directly to …

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Is the rise in mental illness due to greater awareness or a true increase in incidence?

Conditions
May 25, 2023

Someone asked me recently if there is a significant increase in the prevalence of mental illness since it seems everyone is in treatment somewhere. It was a good question and got me thinking.

The prevalence of mental illness has been increasing in recent years, but it is unclear if this is solely due to more people seeking treatment or if there is a true increase in the incidence of mental illness.

In …

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