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Telemedicine reduces the stigma in substance use disorder patients

Physician

December 16, 2020

“The patient is 15 minutes late. Can you still see her?”

“He missed an appointment yesterday because the bus ran late, and he’s out of Suboxone. He’s getting agitated in the waiting room, and other patients are complaining. Could you see him right away?”

“Therapy group has already started. Is the facilitator willing to let one more patient in?”

In the halcyon days before COVID-19, these questions plagued the …

Medical residents signed up to live in the hospital, not to die there

Anonymous

Physician

December 16, 2020

I saw a tweet recently from a medical resident training at another hospital that really hit home for me: “In response to a rumor that health care workers who treat COVID patients will be prioritized for vaccination in our health system, one of my co-residents asked unironically, ‘Does that include us?’”

“Resident” is a word coined in the twentieth century when physicians in training often physically lived (“resided”) at the hospital. …

What worries this physician about the COVID-19 vaccine

Dalia Saha, MD

Conditions and Diseases

December 16, 2020

Over coffee and the usual banter in the doctor’s lounge, a group of physicians takes a break from seeing patients after donning off their PPE. The TV is blasting the news, largely ignored, until the focus turns to the COVID-19 vaccine. The newscaster announced that the first group to receive the vaccine would be health care workers. Everyone stops talking; all gaze at the wall-mounted screen. And it …

This physician is retiring. Here’s his most valuable lesson.

Mark Lopatin, MD

Physician

December 15, 2020

In a few weeks, I will be retiring. After 31 years and more than 100,000 patient visits, I will be hanging up my stethoscope. Over the years, there have been tremendous highs but also horrible lows. The latter includes having been victimized by a frivolous lawsuit where my patient suffered injuries attributed to a medicine prescribed by another doctor. I was named in the suit, simply …

COVID, paternalism, and the death of patient autonomy

Garrett Jensen

Medical Education

December 15, 2020

A year ago, if you had asked me if most doctors respected their patients’ wishes, I would have answered with a resounding yes. If you had asked me if medicine had divorced its paternalistic roots when physicians trampled over ideals like patient autonomy and non-malfeasance, I would have said yes. But that was last year, and in this new world of COVID, panic, hysteria, and ever-present claims of just “following …

Misinformation is endemic in our society, but it is not a new problem

Samoon Ahmad, MD

Physician

December 15, 2020

Misinformation is endemic in our society, but it is not a new problem. Misinformation passed along with or without an ulterior motive has been around for as long as humans have been communicating. What is new is that digital media allows expertly designed misinformation to spread quicker and more ruthlessly exploit individuals’ preconceived notions through confirmation bias.

While the latter is most certainly a hot topic, this post is not about …

Understanding the business of medicine: How to pursue excellence in the medical field

Todd Skertich

Physician Finance

December 15, 2020

Your success in the medical field is not solely contingent upon your clinical dexterity but often results from the mastery of various industry aspects. What separates a great doctor from a good doctor is their cognizance of both the clinical and business sides of medicine. The market, risks, and trends of medical businesses are a great resource for residents as they establish their place in medicine. Business management is a …

How to make peace with purpose

Kara Pepper, MD

Physician

December 15, 2020

“Tell me, what is it you plan to do with your one wild and precious life?”
– Mary Oliver, The Summer Day

Ikigai is a Japanese concept that means “a reason for being.” The word “ikigai” is usually used to indicate the source of value in one’s life or the things that make one’s life worthwhile. The word translated to English roughly means “thing that you live for” or “the reason for …

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How to make peace with purpose

During the pandemic, many health care workers won’t be home for Christmas

Debbie Moore-Black, RN

Conditions and Diseases

December 14, 2020

He was a healthy 36-year-old paramedic with a loving wife and an adorable little boy.

Jim loved his job. The rush, the adrenaline, the blaring lights through downtown hurrying to get to the major hospital. Cardiac arrests, gunshot wounds, tragic auto accidents, respiratory arrests, CPR, compressions, starting IVs. Speaking to the ER physician en route to the hospital to give stat meds for V-tach, SVT, delivering a baby. Anything and everything. …

Why can I trust the COVID vaccine?

Alexandra Fairchok

Conditions and Diseases

December 14, 2020

Many friends have asked for my perspective on the COVID vaccine. Answering this requires both an explanation of clinical trials and an understanding of what normally slows down pharmaceutical development.

Importantly, COVID vaccines are required to go through the same process as every other pharmaceutical. These include the following:

Preclinical trials. In this stage, researchers conduct animal testing to see if the vaccine can produce an immune response. If the vaccine is …

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Why can I trust the COVID vaccine?

Primary care faces a very difficult winter

Ken Terry

Health Policy

December 14, 2020

Primary care is in trouble again. Last summer, as government assistance programs expired or wound down, primary care practices across the country were struggling to stay afloat because of lost business. By October, patient visits had rebounded in most specialties. But by mid-November, as COVID-19 surged everywhere, primary care physicians reported that they faced critical staffing shortages and limited resources, Read more…

Primary care faces a very difficult winter

New Medicare documentation and payment changes starting next year that deliver relief for clinicians

Seema Verma, MPH

Health Policy

December 14, 2020

Starting on January 1, 2021, clinicians across the country can expect new Medicare rules on billing, documentation, and payment for evaluation and management (E/M) services — or common office/outpatient visits – to go into effect. These historic changes will give clinicians more flexibility in how they document visits in their patients’ medical record, reduce their paperwork burden and give them more time to spend with patients. With over 750,000 clinicians …

What to consider before becoming a medical power of attorney

Miles J. Varn, MD

Conditions and Diseases

December 14, 2020

If a family member or friend asked you to serve as his/her medical power of attorney, what would your answer be? Many people agree to assume this role without a second thought, but you should take some time to understand what your responsibilities as a medical power of attorney would be, why the person has chosen you to do this, and what potential complications and conflicts may arise. With that …

Vaccinating the entire U.S population: Health information technologies are positioned to help

Betty Rabinowitz, MD

Conditions and Diseases

December 13, 2020

The mammoth task of vaccinating most of the world’s human population against COVID-19 is before us. Several viable, highly effective vaccines have been developed at record speed. The pharmaceutical industry will now be called upon to meet the next challenge of producing the vaccine at scale by manufacturing the billions of required doses. A distribution and logistics challenge follows: how to equitably coordinate and execute the widespread distribution and administration …

Why eliminating health care disparities is easier said than done

Martin Lustick, MD

Health Policy

December 13, 2020

Those of us in health care understand that the pandemic represents just one more example of the disproportionately negative impact of health issues on people of color. As stated in a 2017 National Institutes of Health report, “For racial and ethnic minorities in the United States, health disparities take on many forms, including higher rates of chronic disease and premature death compared to the rates among …

COVID-19 and The Queen’s Gambit: What will be the pandemic’s endgame?

Robert Pearl, MD

Conditions and Diseases

December 13, 2020

The Queen’s Gambit, a seven-part Netflix series, has been the darling of streaming television during the coronavirus pandemic. Seen by more than 60 million people, the story chronicles the life of fictional chess prodigy Beth Harmon, who grows up in a Kentucky orphanage and goes on to win a world championship.

With its three-dimensional characters and fresh spin on the coming-of-age plotline, the series has captivated the …

As COVID worsens, don’t forget about the opioid crisis

Vishal Khetpal, MD and Nishant Shah, MD, MPH

Conditions and Diseases

December 13, 2020

For the past seven months, an epidemic in our country has spiraled out of control, claiming thousands of lives that could have been saved. It has been met by an inadequate, meandering national response that has often lacked urgency. It has disrupted families, and at times has overburdened our health care system grappling with limited resources.

This assessment undoubtedly describes the COVID-19 pandemic that is now resurging in many communities across …

What this medical epidemiologist learned from prior pandemic vaccination efforts

Tista S. Ghosh, MD, MPH

Physician

December 13, 2020

It was the fall of 2009. I was a medical epidemiologist at the largest local health department in the state of Colorado, in charge of coordinating the area’s H1N1 pandemic vaccination efforts. The CDC was distributing vaccine to state and local health departments, and we were in turn responsible for getting it out to our citizens. It was a daunting task – we were exhausted from months of dealing with …

What is the physician’s greatest gift to patients?

Andy Lamb, MD

Physician

December 12, 2020

I stood inside the door of “una chosa,” Spanish for “a hut” — the walls bamboo and sunbaked mud; a broom-swept dirt floor; two open windows partially covered by tattered cloth; no running water, no electricity. The acrid smell of smoke from the wood fire in the open brick oven permeated the air. Then I saw her. Lying on a bed made of wood and rope was a young woman. …

8 things physicians should know before they’re interviewed by the media

Tyeese L. Gaines, DO

Physician

December 12, 2020

Lights, camera, action!

You get a call from your hospital’s public relations office asking you to speak to the local news. Even though this isn’t your first time, your heart is pounding, with a mix of nerves and excitement. You start doubting whether you have anything valuable to say about the topic, even though, yes – you went through many years of medical school and residency before this moment. You are …

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