If we better manage diabetes, can we better manage COVID?  

Conditions
April 1, 2022

Over their lifetimes, adults in the United States have a 40% chance of developing type 2 diabetes. And the likelihood for Latino adults is 25% higher. Even worse, Latinos develop type 2 diabetes when younger, and experience more severe complications and higher hospitalizations.

The stark disparities of type 2 diabetes reveal how cultural and social factors affect disadvantaged populations. As a case in point, managing diabetes is more difficult for patients …

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If we better manage diabetes, can we better manage COVID?  

I left medicine. Then I found meaning.

Physician
April 1, 2022

Many years ago, doctors were relied upon to care for the health needs of their local communities. They were trusted fixtures relied upon to diagnose and treat whatever the ailment. They spent time interacting with patients, not paperwork or screens. There was no bureaucratic red tape or a long list of administrative procedures. It was pure medicine.

I think it would be safe to assume that burnout barely existed. These doctors …

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I left medicine. Then I found meaning.

I gained weight and, with it, I gained life

Physician
March 31, 2022

First, this article is not to discredit or compare to anyone. This article is not to take away the celebrations of those whose behavioral changes have made them feel more healthy and fulfilled in their lives — though I will challenge the emphasis on the number on the scale as an outcome measurement to use for such celebrations. This article is to shine a light on a less commonly discussed, …

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I gained weight and, with it, I gained life

Going mobile: an antidote for career regret

Physician
March 31, 2022

This year, the National Resident Matching Program provided matching services to more than 42,000 applicants. A medical student’s choice of specialty is one of the most important decisions they will ever make. But deciding which medical specialty to enter can be difficult. The majority of medical students are indecisive about their intended area of practice. Over the course of medical school, only a quarter (26.1 percent) of …

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Going mobile: an antidote for career regret

What does Will Smith’s facial expression at the Oscars tell us about our patients?

Physician
March 31, 2022

Will Smith’s Oscar smackdown of comedian Chris Rock proves one thing: violence should never be a response to insults – or any other inciting factors – in the heat of the moment. Will Smith knows it, and so do the millions of television viewers who witnessed the assault. Yet, despite Smith’s written apology to Rock, Smith may likely believe his actions were justified. Why do I say this? Because if …

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What does Will Smith’s facial expression at the Oscars tell us about our patients?

How doctors can ensure their Latinx patients receive the best medical care

Physician
March 31, 2022

“Any questions?” I asked one of my patients, Dona Maria, for the third time.

After her prolonged silence, I asked again, almost in despair, “anything else? Anything that you don’t like about what I have said? Or anything you don’t like about the medications I am recommending?” Dona Maria sees my disappointment and tries to smile at me. Then she shares some stories about her great-grandson, who just turned three.

It is …

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How doctors can ensure their Latinx patients receive the best medical care

Mental health issues and the African American community

Policy
March 30, 2022

Death is a topic that most people try to avoid. Death by suicide is also something that that remains rarely discussed. This is probably because suicide is scary, particularly if we have thoughts of being the loved one left behind. People considering suicide don’t take the time to let people know that they are considering suicide; they tend to keep all these things bottled up to themselves.

As one writer Read more…

Mental health issues and the African American community

Will Smith’s slap is a trauma response

Conditions
March 30, 2022

This is what the result of unresolved trauma looks like.

What we witnessed Will Smith do in assaulting Chris Rock during the Academy Award ceremony was a trauma response.

While I am in no way condoning violence, this is a very public and important opportunity for us to understand what a trauma response can look like.

A trauma response can take many forms and look like:

  • Slapping someone for saying “the wrong” thing.

    • …

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Will Smith’s slap is a trauma response

Why this medical school is doing it right

Education
March 30, 2022

It’s been shown that patients can benefit from a satisfying medical experience and the actual clinical treatment. The satisfying medical experience in and of itself leads to trust, follow-through, and health improvements.

Medical school is the optimal time to learn how to deliver a great patient experience. In med school, one develops formative views on the culture of medical practice. Knowing this, we looked at an institution that …

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Why this medical school is doing it right

Death of a nurse: a soliloquy

Conditions
March 29, 2022

It’s not what you think. It’s not my actual mortality.

It’s that emotional death.

Of being a nurse.

If you’ve never been a nurse. Then you will never know.

It’s that’s giving of yourself: heart and soul.

Constantly and forever.

It’s not being with your family for Easter or Thanksgiving or Christmas.

It’s not being able to go to the bathroom or even take a 30-minute break in 12 to 13 hours.

It’s being surrounded by bully nurses …

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Death of a nurse: a soliloquy

2 insight-provoking questions when starting over

Physician
March 29, 2022

“Peace is your home, integrity is the way to it, and everything you long for will meet you there.”
– Martha Beck

In 2017, the blueprint I had crafted for my life evaporated before my eyes.

Up until that point, I had systematically checked off the steps to becoming an Air Force oral and maxillofacial surgeon. I was in the Air Force, and I was in oral and maxillofacial surgery (OMFS) residency. I …

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2 insight-provoking questions when starting over

A physician was bullied and fired by the bully

Physician
March 28, 2022

I don’t think I became a whole person until my mid-30s. When you spend the majority of your life in school, training, and building a practice, everything else goes on hold, or autopilot. There are very few things that I made conscious decisions about. Becoming a doctor was something I decided in childhood, and then it was a mission that I felt I needed to achieve. Every action in my …

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A physician was bullied and fired by the bully

Those with the power to reform our system have little incentive to act

Physician
March 28, 2022

It is no surprise that burnout is surging along with this latest pandemic wave. Exhaustion—both physical and moral—is the ashen heart of burnout. Even as the flood of patients recedes in some areas, health care operations are hardly back to normal as many systems struggle with staffing shortages. In the hospital where I work, nurses have carried up to double their normal patient load, while the remaining phlebotomists on staff …

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Those with the power to reform our system have little incentive to act

The center of gravity in health care and the role of primary care

Physician
March 28, 2022

I’ve been as guilty as anyone of leaving my patient out on a limb. As a practicing primary care physician, I’ve had patients with diabetes who observe Ramadan, but I had no idea how to support them during their fast. I’ve had transgender patients yet didn’t have the right language to talk about their health, and nothing in the electronic health record (EHR) seemed designed to support them. I’ve sent …

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The center of gravity in health care and the role of primary care

A full-time equivalent is 2,080 work hours annually

Physician
March 27, 2022

The magical number for one full-time equivalent (1-FTE) professional is 2,080 work hours annually — 40 work hours per week for 52 weeks in a year.

Professionals can work extra hours during non-vacation weeks to make up for opportunities lost during vacation weeks. For example, 1-FTE can work 52 work hours per week for 40 weeks in a year to accrue a 12-week annual vacation, while 0.5-FTE will need to work …

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A full-time equivalent is 2,080 work hours annually

Gender disparities in medical leadership and entrepreneurship

Physician
March 27, 2022

Listen up, ladies. All of you strong, brilliant, and deserving women in medicine. The physicians, NPs, PAs, nurses, and other women currently in or thinking about future leadership roles in health care.

Listen. Up.

Are you aware that male physicians make up to $2 million more than female physicians over their medical career?   If not, I suggest you read more here: “Women Earn $2 Million Less Than Men in …

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Gender disparities in medical leadership and entrepreneurship

A critique of interoperability, big data, and AI in medicine

Tech
March 27, 2022

Today medical records are developed for a single encounter (an outpatient visit or hospital stay). The medical records for an encounter are signed off at the end of the encounter and cannot be changed. An addendum medical record can be added later to correct misinformation in the encounter medical records, but this is seldom done.

This process enables medical documents to be legal recordings of what happened during each encounter. But …

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A critique of interoperability, big data, and AI in medicine

The true story of morphine milligram equivalents

Meds
March 26, 2022

They are the foundation of the CDC’s 2016 opioid guidelines, resulting in legislation limiting opioid prescribing in 36 states. Morphine milligram equivalents, or MMEs, are used to set arbitrary prescribing limits for opioids by physicians since many state legislators fail to understand — and translate into policy and law — the ’16 guidelines. If we had all known the history of MMEs, perhaps we would not have been so eager …

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The true story of morphine milligram equivalents

Doctor, why don’t you care?

Physician
March 26, 2022

“Doctor, why don’t you remember when I was last hospitalized? I told you about that two months ago. You obviously don’t care if you can’t remember. Is all of psychiatry like this? Maybe I need to see someone else. Why won’t you prescribe Ambien for my insomnia during pregnancy along with all the other medications I am on? My last doctor had no problem giving me Ambien during pregnancy.”

This was …

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Doctor, why don’t you care?

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