Don’t hold your breath: Non-competes are unlikely to disappear for physicians
Physician non-compete clauses have been a controversial topic for many years. These clauses within contractual agreements prevent physicians from joining or operating a competing practice within a certain distance or timeframe. With the Federal Trade Commission (FTC) looking into non-compete clauses, many people have wondered whether the FTC will finally end physician non-compete clauses.
On January 5, 2023, the FTC proposed a new rule that would ban employers from imposing …
The power of a simple form: a doctor’s experiment in building trust with patients
While we appreciate the importance of trust, not all patients have the same windows of opportunity to establish it with their physicians. The nature of each specialty and the severity of the patient’s condition influence how quickly and deeply trust can be created and maintained. The STEMI patient will quickly learn to trust the interventional cardiologist, and the trauma victim, and the surgeon.
Not surprisingly, it’s very challenging for physicians …
Patients vs. customers: the ethics of health care as a business
Medicine is both a business and a profession, with the business aspect being the provision of health care services for a fee and the professional aspect being the delivery of medical care for the patient’s benefit.
The business of medicine refers to the broader economic and political systems that shape the health care industry, such as government policies, insurance regulations, and the influence of pharmaceutical companies and other industry stakeholders.
The terms …
The hidden consequences of portal message fees
As the health care industry continues to evolve, many practices and hospitals have turned to electronic portals to communicate between patients and their providers. However, some practices have begun charging patients a fee for responding to messages sent through these portals. While this may seem like a viable solution for increasing revenue, it could ultimately have negative implications for the care of patients.
One major issue with charging patients for portal …
Navigating the complexities of academic medicine contracts [PODCAST]
From patient-centered care to paperwork-centered practice: the decline of primary care
A lot has been written about physician burnout, often it is attributed to the administrative burden, with some estimates that U.S. physicians spend an average of 1.84 hours a day completing documentation outside work hours. I’ve felt for some time that the administrative burden in primary care is increasing, but not due to the commonly cited endless EHR clicks or the burden of insurance companies’ forms and prior authorizations. It’s …
Equalizing the future of medical residencies: standardizing work hours and wages
In the United States, work hours are traditionally recorded on a weekly basis, and salaries are paid every two weeks. However, full-time employees (FTEs) work for a full year and receive a W-2 annually. FTEs are usually hired based on an annual wage divided into 26 bi-weekly paychecks. Tracking weekly work hours can lead to inconsistencies in time recording, so it might be better for both employers and FTEs to …
Uncovering the overwhelming impact of the advanced maternal age patient on nursing
Imagine you have a busy full-time job. You get married at age 31. You and your new partner travel to Italy, Ireland, and Hawaii before settling with the kids. You both make pretty good money, so you buy a house. Of course, it needs furniture. And you have to have the new I-phone that just came out. You’re finally ready to get pregnant, but after two years, it hasn’t happened. …
Celebrate Banana Cream Pie Day with your friendly hospitalist
I am smart, I swear.
I graduated near the top of my class in medical school, I swear.
I kicked butt on the Step exams, I swear.
But ask me to manage someone’s diabetes or hypertension; No, thank you!
Thank God for hospitalists, a set of remarkable physicians that allow me to do my job effectively. Without them, I would be lost. Would you really want me, an orthopedic surgeon, to manage complex medical …
A human’s a human, no matter how small
Theodore Geisel, known by his pen name Dr. Seuss, wrote hundreds of children’s stories that continue to shape young children’s development to this day. Dr. Seuss was a lifelong Democrat and favored many of FDR’s New Deal policies. However, an NPR article notes his widow mentioned that she did not like it when his characters were used to push particular political points of view. The book …
TikTok takeover: How social media consumed my life [PODCAST]
The vital importance of climate change education in medical schools
I may have less direct patient interaction as a radiologist than in other medical specialties. Still, I have a unique vantage point from which to observe the overall picture of the hospital. I see the prevalence of diseases affecting our patients and their demographics. While working at a children’s hospital in the Pacific Northwest, I have repeatedly witnessed the devastating effects of wildfires over the past few summers, interpreting and …
Retiring from medicine: the good, the bad, and the ugly
I retired as a physician at age 70, when COVID-19 came to town and the clinic I was working closed. During these past three years, I have had the luxury of a long view of my career. Every now and then, I feel the urge to pick up my stethoscope again and return to the practice of medicine. I’m tempted by the several good aspects of being a doctor.
The good
The conversations …
The unpredictable wave: a physician’s journey through seizures
The first seizure I remember was like a wave in the ocean. Over my head, sudden dizziness, ready to go over the crest, then down into the dark. The dark was just not there. Or anywhere. Coming up was like being thrown out into the flotsam and jetsam, not knowing which way was up—seeing but not. A slow coming to the shore, a slow return. I knew I was there, …
Size-inclusive medicine: a response to AAP’s guidelines for the treatment of children and adolescents with obesity
We are a grassroots advocacy organization of medical students across the country, focused on making health care more equitable for patients in larger bodies. We join the physicians, eating disorder professionals, and community members who raise concerns regarding the AAP’s most recent clinical guidelines, “Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents with Obesity.”
The new AAP guidelines are based on science that grossly misrepresents the …
Addressing disparities in gynecological care for women with physical disabilities
I recently read a story in which a woman named H. Lee, who has muscular dystrophy, details a decade-long struggle to receive adequate cervical cancer screening. Providers have been unable to find her cervix due to the curvature of her spine, examined her in her wheelchair because there were no height-adjustable examination tables, and outright turned her away for “liability reasons.”
By the time she finds an accessible provider, she …
From suffering to healing: the role of trauma in chronic pain
“Trauma is perhaps the most avoided, ignored, belittled, denied, misunderstood and untreated cause of human suffering.”
– Peter Levine, PhD, Developer of Somatic Experiencing Therapy
One frequent cause of treatment-resistant chronic pain is unresolved trauma, yet few health care providers and patients are aware of the connection, and, as a result, it is rarely addressed. This leads to considerable unnecessary suffering and misguided attempts at pain treatment that often do more harm …
Good doctors vs. bad hospitals: the battle for patient care
The public and the politicians may be missing the boat when they do not question the role of hospitals in the present health care debate. The hospitals have hung themselves out to be the “good guys” who hire and keep good doctors and promote the practice of good medicine. They portray themselves as the pillars of communities.
But in 1999, the Institute of Medicine reported that 98,000 deaths occurred in hospitals …
The physician-patient connection: Ensuring mutual understanding
Do patients truly understand?
The question is not meant to be rhetorical. I have many conversations throughout the day with patients across all socioeconomic backgrounds and with varying levels of education.
The discussions include details surrounding their disease-specific particulars, treatment options, and surgical protocols. Patients digest my thoughts and then respond with specific questions of their own. They ask for instructions as well as the nuances of the healing process.
I confess that …
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