For years, I hated when patients would ask if I had children. I consider myself to be a good pediatrician and trained at a highly rated medical school and residency. I work hard and I care for my patients. I can, however, be socially awkward and did not start dating until later in life. At its most innocent, the question triggered inadequacies about my social and personal life. At its …
How becoming a mother made me a pediatrician
It should come as no surprise that primary care physicians are looking for careers outside of medicine. That 40 percent of primary care clinicians are concerned their field won’t exist and that 21 percent plan to leave primary care in three years.
Doctor burnout has reached epidemic levels. Primary care physicians feel like mice on a wheel, running faster without gaining ground. If …
As doctor burnout climbs, can we save primary care?
I left my primary care practice earlier this year to focus on life coaching. Why did I leave? Because I wanted to do more and make a bigger impact. I remember how eager I was to complete medical training as I approached the light at the end of the tunnel. I thought I could finally relax and enjoy life as an attending after all the delayed gratification from becoming a …
Should you stay or leave medicine?
Prevention
Our most effective weapons are lockdowns, masks, distancing, ventilation and vaccination, but we can also protect close patient contacts pharmacologically. Subcutaneous REGEN-COV (Regeneron’s monoclonal antibody combo, casirivimab plus imdevimab) lowers the rate of illness by a whopping 81.4%. This has been known since April and blessed by the FDA in July, but has yet to catch on.
Outpatient therapy
A year and …
A summary of state of the art COVID treatment
Wood art
The taxing journey of going through an illness often has the turning point of hearing a “diagnosis.”
Diagnosis locks a person inside a sick body. Diagnosis is a label that dictates certain behavior in an individual and the whole circle of people around that person, including family members, workplace, health care providers, and insurance companies. Diagnosis is a journey from diagnostic …
An excerpt from Physician Betrayal: How Our Heroes Become Villains.
A mass casualty event begins with one act of betrayal. By one person. A person with power. In medicine the assault weapon—doctor’s orders.
One act of betrayal by one doctor may lead to an unstoppable cascade befalling all colleagues downstream in rapid succession.
Physician betrayal always begins with self-betrayal—the act of …
Medicine’s culture of betrayal
As a pulmonary and critical care doctor and the mother of three children too young to receive a COVID-19 vaccine, life has been harrowing. At the beginning of the summer, however, I was beginning to breathe a sigh of relief. My children had been in school last spring, and by the heroic efforts of their amazing teachers and staff, completed the school year free of sickness or quarantine from COVID-19. …
Clearing the air our kids share: a prescription for healthy schools
As third-year medical students, we recently stepped out of the classroom and onto the wards, eager to provide the quality care we had been working towards for the better part of the last decade. We were, however, quickly met with a stark reminder of how climate change can jeopardize our ability to do so. We entered the ER in the midst of a blistering heatwave to find two patients waiting …
What the latest IPCC report means for physicians: There is no time for climate despair
“Are there specific ways empathy will be tested in the standardized patient exam?” a medical school classmate of mine earnestly asked following a lecture years ago. I laughed, thinking that teaching empathy was impossible. As an optimistic and naive medical student, I had thought of myself as naturally empathetic. During those days, I was able to spend hours with patients, gaining their confidence while hearing their stories and concerns. I …
My journey to the root of empathy and why we must try to teach it
Americans are dying in ICUs in far greater numbers than would otherwise be if not for a newly misapplied 57-year-old rule banning the only American board-certified ICU doctors available in many cities from providing critical care, leaving only nurses to do the doctor’s job in treating ICU patients.
There is a severe national shortage of only 25 percent of the needed board-certified intensive care unit doctors — known as critical care …
Millions of Americans without ICU doctors due to the “Biden ban”
One day, a primary care physician located about two hours away called my office in a desperate attempt to find a rheumatologist. His lovely 64-year-old patient, very healthy otherwise, recently developed a severe and disabling inflammatory arthritis. After conservative treatments failed, he tried to refer the patient to the traditional medical system. However, they could not get a sooner than six months appointment. This is a symptom of a broken …
The emergence of direct specialty care
In June 2020, I wrote a short piece about the COVID vaccine that turned out to be prophetic. I said that the vaccine’s immunity might wane over time, that there might be bothersome side effects immediately, and that the public might ignore social distancing and mask-wearing once they were vaccinated. I worried that there would be political pressures to focus more on the economy than on public health.
And I wrote, …
A person-to-person strategy is needed in the pandemic war
When you enter medical school, you put your trust into an unspoken promise: Work hard, pass all your classes, and you’ll come out as a doctor after four years. While mostly true, this perception doesn’t take into account the residency application process and the possibility of graduating without a position as a physician-in-training. This thought didn’t cross my mind until I decided to apply for otolaryngology, one of the most …
Unsolicited advice from unmatched residency applicants: Hope for the best, plan for the worst
Unfortunate outcomes are inevitable even when practicing quality medicine. Most are random events, but some are medical errors. The majority of physicians have been sued and those, who have not, will be. Common to all defendants is that the lawsuit is totally fallacious.
To be fallacious, the outcome of a medical intervention must be an unpreventable random mal-occurrence. This is the only alternative to a medical error. Nevertheless, there is a …
Your best defense? Don’t play by the rules in a medical malpractice case.
By now, many of you would have read my article, “Who needs scientists? It’s not like we listen to them anyway.” So, let me tell you another fiction story. But, first, I need to give you some background to this story.
Many of you would know about the theory of evolution by natural selection and how it explains the diversity we see today. It’s an excellent idea, and …
Obi-Wan Kenobi and Charles Darwin have a COVID conversation
“In times of uncertainty, human behavior often makes people resort to less-than-stellar behaviors; unhealthy personal environments can become manifest as well. Often, these coincide with health care being used more frequently and the safe haven of health care delivery being sought. With all physicians being leaders, it is incumbent …
All physicians are leaders [PODCAST]
I am exhausted.
Mentally, emotionally, physically.
I fear we are reaching our breaking point. We have run a marathon, hoping that we were nearing the finish line as we saw numbers decline in June, only to be told to lace up our sneakers and start over.
Work in outpatient pediatrics is always busy in the summer – seeing our patients for school and sports physicals, marveling at how much they’ve grown since we …
Physicians have gone from being heroes to villains
“F—- you! I won’t do what you tell me!” the lyrics blare into my teenage ears, as I lip-synch to the rock band Rage Against the Machine’s song Killing In the Name. It’s 1992, and my Walkman is attached to the waistband of my Seattle Blues. It would take at least a decade to fully understand the meaning of those lyrics. Nearly thirty years later, this line …
Rage Against the Machine: This song is mine, and it’s how I heal
I am a board-certified pediatrician, wife, mother of four, and host of a podcast. I have been interested in nutrition and feeding practices for as long as I can remember. In my practice as a pediatrician, I was constantly bombarded with parent concerns about children’s eating habits. Commonly parents worried that their children were not eating enough, were eating too …
The surprising power of family meals
Ask any physician how they are doing today, and you’ll probably hear some version of frustrated, tired, and sad. It’s not the lump-in-your-throat type sadness. It’s that my-mind-and-soul-are-tired sadness. The feeling you have when all you can see is the conflict and the angst that seems to fill the world right now. The feeling that the world is burning and we are powerless to stop it.
I am a physician who …
From advocate to adversary: How COVID-19 has changed the doctor-patient relationship
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