“It feels different down here,” she said. I had just approached a young woman in our ED waiting room to apologize for the seven-hour wait to be seen. She looked at me with bloodshot, dark brown eyes and continued, “It feels like … the lower decks … Do you know what I mean?” I placed my hand on her shoulder, acknowledging her analogy with a shudder of complete understanding.
She was …
A voice from the lower decks of health care
The doctor you are seeing may have already left medicine.
Yes, you still have an appointment.
Yes, they are still in the room, taking your history and performing a physical exam.
But inside their mind, they have already decided.
They haven’t said it out loud.
There’s been no official resignation letter.
But it’s a done deal.
It may be six months from now or ten or twenty-four.
It doesn’t matter because the decision has …
Your doctor may already be gone
As a practicing ophthalmologist, I saw many patients who had developed blurred vision, glare, or trouble reading. These patients needed to understand that cataracts were the cause of their vision problems and how the cataracts developed and how they should be treated. I would begin the explanation by using a large, plastic eye model to show the lens’s position and how a clouded lens would affect vision. I would then …
The dichotomy of patient needs and patient wants
All medical professionals are familiar with the jargon: quality metrics, P4P, low-cost/high-value care, PQRS, and meaningful use. We see these terms in multiple emails, staff and clinical meetings, and organization-wide initiatives. These measures and guidelines will significantly impact the type and quality of care we provide to our patients and how we are paid for it. This movement is not necessarily detrimental and could lead to improved health among …
When quality measures interfere with good care
“If I make a mistake, my patient could go home in a body bag.”
I don’t recall whom I first heard this from, but it stuck in my mind as terrifying thoughts do. And we wonder why burnout in medicine is a thing.
Mistakes in medicine can cause mortal consequences. They can harm another human being. We can’t escape this reality. We can’t undo it. We don’t get “three lives,” as in …
Why is it hard to find grace in medicine?
The levels of physician burnout which are a constellation of symptoms including feeling apathy, fatigue, depersonalization, and detachment are a group of feelings that have plagued health care.
But within the last two years, burnout has exploded to upwards of 65 percent in specialties like emergency, critical care, and infectious disease. It is not surprising, as these specialties have been on the frontlines of COVID care.
Why does this matter?
Because — we …
Shame, guilt, perfectionism and ego: a terrible combination
“Mycelium is ecological connective tissue, the living seam by which much of the world is stitched into relation.”
-Merlin Sheldrake
Merlin Sheldrake invites us to see the world from the point of view of mycelium. He coaxes the reader to “[i]magine that [they] could pass through two doors at once. It’s inconceivable, yet fungi do it all the time. When faced with a forked path, fungal hyphae don’t have to choose one …
Whether we are considering a new job or up for review at our current place of employment, there are several things we should negotiate. Many of us focus solely on salary, but there are other things we should be sure to negotiate as well:
1. Benefits and insurance. One of the first things to consider besides salary is benefits. For physicians and other young professionals with college degrees, student loan forgiveness …
8 things to negotiate besides salary
After I passed my emergency medicine oral boards in 2019, I learned that the American Board of Emergency Medicine was implementing MyEMCert modules, an alternative means of maintaining certification. I was so excited never to have to take a multiple-hour board exam again. However, now that I have become a holistic coach, I find myself preparing for the National Board of …
What it means to be board certified in health and wellness coaching
In the early days of the COVID-19 pandemic, governments and communities had to take rapid and decisive action to protect their citizens against this novel virus. While it was yet unclear how dangerous the COVID-19 infection may be to children, their teachers, and their families, governments quickly shut down schools and activities to slow the spread among the population at large.
Before the pandemic, childhood obesity was already a crisis with …
Reversing the impact of the pandemic on childhood obesity
In his bestselling book How Not to Die, physician Michael Greger described how his grandmother, diagnosed with advanced heart disease at 65, transformed her health and lived for many years after switching to a whole-food, plant-based diet.
It was a seminal event for Dr. Greger that inspired a career dedicated to promoting the impact of lifestyle behavior on health. As lifestyle medicine-certified clinicians practicing in a palliative medicine …
The surprising role for lifestyle medicine in palliative care
If my mother gave birth to me today instead of over 60 years ago, she would probably be dead based on her risk factors. She was Black, had gestational diabetes, and gave birth to a 9-pound 4-ounce baby girl via C-section. She would have been discharged from the hospital on post-op day four rather than post-op day seven. But, thank God, my mother, unlike her mother, lived. I never knew …
If my mother gave birth to me today, she would probably would die
“COVID has brought us new challenges and a genuine opportunity to be part of the critical response to optimize the care we deliver not just to our patients but also to their families and caregivers. I am lucky, blessed to do this work every day and carry such a deep passion.
We are …
A deep passion for palliative medicine [PODCAST]
There are no two ways about it: The health care system in the United States and Canada is failing. Few want to talk about a dirty little secret, but the facts are clear. Health care costs are rising at an unsustainable rate, and millions of Americans are uninsured or underinsured. The system is not accountable to the people it is supposed to serve.
Having experienced both the Canadian and United States …
The health care systems in the United States and Canada are failing
There are times in medicine when the focus is on how hard it is to be a doctor in these uncertain times. We focus on patient care demands, reimbursement challenges and financial instability, and the general lack of feeling rewarded. And that can keep physicians stuck in a cycle of comparing what’s possible with the present circumstances.
Hey, I get it. I’ve been there. I’ve looked at senior attending physicians and …
Unlock the power of comparison for more clarity in your career
After years of searching for answers to my pain, I was finally diagnosed with endometriosis during my second year of medical school. However, the joy of finally having a diagnosis quickly became overshadowed by the knowledge that I was now a part of the 1 in 4 female physicians who suffer from infertility. As a married 27-year-old future doctor with at least six more years of training, …
The hidden costs of fully covered infertility treatment
I am almost divorced.
I thought about staying private about this. And I mostly have over the last nine months. But here’s the thing — this decision is one of the best ones of my entire life.
I have not been at all immune to the roller coaster of emotions. The last few months have brought me peace and happiness. And as I have shared my story with more friends, I recognize …
I am standing before a team of fellows, residents, medical students, and pharmacists on Monday morning about to start rounds on the oncology service. And as the intern is about to dive into the first patient presentation, I take a moment to ask a question: “Is anyone here into aviation?” This context is met with an awkward pause, people’s eyes looking down, and a bit of confusion. I make an …
10 ways medicine is like the airline industry
Maintaining a relationship during nursing school takes some effort. Your time is taken up by studying, classes, clinicals and labs. Oh, did I mention studying? At the end of the day, there is just not much time left for significant others. Now, I am referring to romantic relationships here, but the same concept also applies to friendships.
I’ve put together a list of tips from my own experience to hopefully give …
How to maintain your relationships during nursing school
Back on the internet, you are looking for something to make you angry. It’s a habit you picked up as a researcher, stuck in your lab until sunset, walking home to those empty walls. It’s one you’ve kept as a medical student.
It’s always the most belligerent takes that ignite you. The ones that leap to the front line, waving old middle school science like it’s pure, unshifting truth. It needles …
On the internet, you are looking for something to make you angry
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