I had just received a call that I had been accepted to medical school, and I had immediately pulled up a Google search: “best time to have children in medical training?” I was certain that this was not how most people celebrated news of their acceptance to medical school, but this was a priority for me. A quick scan of the results of my Google search was clear, “Don’t do …
So, are you committed to medicine — or your baby?
In any industry, there will always be unhappy customers. Having a formalized method of dealing with complaints is absolutely necessary to protect consumers and patients. What isn’t discussed enough is the severity of these complaints’ psychological repercussions on physicians and other medical providers.
Most providers spend years of their lives in school, sacrificing family plans, social events, and sometimes their own well-being, all on a mission to care for others. Despite …
The psychological repercussions of patient complaints
The health care crisis is a difficult one to face. Health care budgets have skyrocketed, and rates of chronic illnesses have increased much faster than before. As physician leaders, what if we each took personal responsibility for the crisis? Perhaps it all boils down to how many people trained in health care know what is necessary for living healthy lifestyles. Yet, that knowledge often doesn’t materialize in excellent health outcomes. …
A holistic approach to health and wellness requires openness and vulnerability
“American medicine is facing an identity crisis. The COVID-19 pandemic brought renewed attention to socioeconomic health disparities and turned up the heat on the question of whether health care is a right or a privilege. The financial strain on hospitals resulting from the temporary postponement of scheduled surgeries exposed a vulnerability caused …
Is health care a right or privilege? The economic consequences of that answer. [PODCAST]
Before I walk into clinic, I already know their response if I submitted my resignation letter today.
I hear it monthly from multiple patients who have no reason to believe I’m leaving: “You aren’t going to leave too, are you?” “It took us years to get here after the last doctor left.” “Please promise me if you move on, you will let me know where you go.”
They have baseline trauma from …
A resignation letter to my patients: How do I leave you well?
Own it.
People sometimes say, “Own it.” Own your mistake. We use it less frequently to say own reactions or actions instead of blaming others and external forces for our actions. Life coaches call it being in a state of “emotional childhood.” It means that instead of saying you are responsible for your thoughts, feelings, and actions, you blame others for these.
“The situation is bad.”
“I am angry because it is not …
Stop blaming others. You need to own your actions.
I am sitting in hot springs deep in the dark and crisp air woods – naked. It has been a day of lectures and workshops at a retreat with my fellow physicians. We are all naked in the effervescent, warm bubbles of the springs. In the dark, I can recognize who people are by the fluorescent necklace each wears. You know, the kind that you crunch and shake to activate …
The profound experience of being naked with other doctors
When plastic surgeon Dr. Robert Pearl published his Los Angeles Times op-ed, “How Doctor Culture Sinks U.S. Healthcare,” a polemic essay critical of primary care physicians like me, he set off a firestorm. While he made some valid points, Dr. Pearl also blamed many of the preventative health failures in the U.S. squarely on the shoulders of primary care physicians without acknowledging that our health care …
The unfair blame on primary care physicians
My phone rings.
“Namaskar! My cough is really bothering me. What should I do?” says a middle-aged man.
“Namaskar! I am Astha Prasai. I am here to help you. Please bear with me while I ask you your problem in detail,” I answer.
Mr. Kafle from Kathmandu is worried about this nagging cough he has, and it has been a month since he has tested positive for COVID- 19. After talking to him …
Telemedicine in Nepal during COVID-19
“When I was diagnosed as gene-positive for HD, just over ten years ago, there wasn’t anything promising on the horizon in terms of a cure. It has only been since new clinical trials were announced in the past few years that I have allowed myself to feel a tiny bit of …
Huntington’s disease and a patient’s perspective on genetic testing [PODCAST]
Even though I completed residency almost 15 years ago, it is easy to remember the dread I experienced before taking hospital call. The sinking feeling in my stomach as the call date loomed near, the hypervigilance and terror every time my beeper went off in the middle of the night, the fear of imagined catastrophes that would by necessity be my fault.
My anticipation of call was usually worse than reality. …
Physicians: Stop dreading call
July 1 is a day that marks the new era when student truly becomes doctor, where hundreds of residency programs start day one of the three-year or longer residency, a life-changing rite of passage. Where the initial hours start the tens of thousands of hours of experiential full immersion training. Looking back, intern year was one of the hardest years of my training and definitely one of the hardest years …
Reflections from a former intern
Value-based care (VBC) continues to be a popular expression across the health care landscape, but the challenges and opportunities it offers are quite different across specialties. Behavioral health (BH) providers are an important case in point. The opioid epidemic combined with increased recognition and prevalence of mental illness secondary to the pandemic has brought behavioral health to the forefront, but for BH providers, the transition to VBC continues to present …
Behavioral health providers face challenges in value-based care
I’m not an organizational leader, a member of the C-suite, a department chair, or a VP of anything. I’m a coach who guides physicians as they try to provide exceptional care and actually have a life. But I know a lot about setting goals, executing on priorities, and inspiring through vision statements.
Here’s the thing. This is not a successful long-term strategy:
Hello, health care organization leader, are you listening?
I am a first-generation Chinese American. And amidst the complexity of the pieces that form my identity (mom, wife, daughter, woman, doctor), it is the piece I have often prized the least.
In one of my earliest memories, I am riding a crowded bus in Beijing. My aunt and cousin are pointing out the American tourists as we pass, commenting on their high nose bridges and round eyes and how these …
It’s time to rethink the model minority
Most physicians have been defendants in lawsuits. Plaintiff experts almost always have a feeding frenzy. In truth, expert witnesses are held to codes of conduct about remaining objective and avoiding partisanship or advocacy. Yet, should the verdict favor defendants, these experts, except for deserving the term “hired guns,” are rarely, if ever, held accountable for their feeding frenzy, which conflicts with their ethical obligations.
I want to share my experience. I independently …
A counterintuitive strategy when you are sued for medical malpractice
The Food and Drug Administration (FDA) negated the recommendation of its expert panel and approved Aduhelm to treat Alzheimer’s dementia (AD), contending that the possible benefit trumped the lack of evidence of efficacy. The FDA was inexcusably in error in making this decision. Aside from the likely lack of benefit, the use of this drug can result in many negative consequences that make its use ethically questionable.
The manufacturer submitted two …
The FDA was wrong about Aduhelm
A rough career transition in 2019 followed by the pandemic highlighted how I was still financially tethered to my job — after 10 years of practicing as a subspecialty trained radiologist, saving, maxing out my retirement accounts, and investing in the stock market and in real estate. Looking around, I saw other physicians in a similar predicament. After years dedicated to rigorous training, we were still trapped by “golden handcuffs.” …
How doctors think about financial independence is dead wrong
Nurses are an essential component of the American health care system and are continually in high demand nationwide. For years, nurses have elected to leave the field or have sought alternative professions instead of working in a traditional nursing role full-time. The pandemic brought into focus the need for work-life balance across professions. Whether strained from high-stress levels, financial upset, demanding hours or an overwhelming workload, nursing …
The rise of non-traditional nursing
Amidst beeping monitors, I sat holding my mother’s frail hand in mine with tears rolling down my face and an eerie silence within my soul. I was trying to make sense of the last 24 hours.
My mother had migrated to Houston after an early retirement at 55 to spend time with her granddaughter and me. But life had other plans, as she was diagnosed with breast cancer a year into …
Culture and end-of-life caretaking
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