With the news that nearly 6 million Americans have lost their employer-sponsored health due to COVID, it is finally time to ask ourselves: is the “American Model” of health care working?
The “American Model” is a system of fragmentation: one in which changing jobs can mean lapses in insurance, moving to a new state can mean losing Medicaid eligibility, and getting a raise can mean financial ruin …
Is now the time for single payer?
The NBME has announced that the USMLE Step 1 exam is changing from graded on a curve to pass/fail no earlier than Jan 1, 2022. This announcement came before the coronavirus pandemic took hold and significantly disrupted pretty much everything, including medical education. Since then, given widespread Prometric center closures, study schedule disruptions, altered medical school curricula, and a whole host of other unexpected challenges, many …
Coronavirus takes a toll on IMGs: anxieties over USMLE Step 1 becoming pass/fail
This is the million-dollar question that I’ve been asked over and over again by distraught parents wanting to do right by their children.
Parents want to have their children stay home so they can keep them healthy and safe. At the same time, they are worried about the far-reaching consequences of them not being in school. School is not just about academics but also about social and emotional wellbeing. For some …
Should I send my child back to school? A letter to parents.
I recently saw a powerful video about an amazing nurse who is a foster mother to children dying of cancer. She lovingly cared for them no matter the circumstance, the difficulties, or the heartbreak that came with each and every death of one of these precious children. It broke my heart to see and hear. It caused me to reflect on how fortunate we are to have people with hearts …
To all who care for patients: Thank you for the many sacrifices you make every day
After many years of training, I have graduated from residency and am now a board-eligible general surgeon. I was one of more than 1,000 candidates who attempted to take the American Board of Surgery (ABS) Qualifying Examination on July 16, 2020. What should have been a major milestone rapidly devolved into a nightmare, as examinees were locked out of sessions, falsely accused of violations, and unable to attain certification due …
The 2020 American Board of Surgery Qualifying Examination: failure, backlash, and response
Prevention is the best medicine. But when you’re already sick, what you really want is an effective treatment. When the level of contagion is high, and the likelihood of contracting a disease is great, you want to know that there are options available to support you when you inevitably get sick. If herd immunity is the most effective means of eradication, you want to do your part and hope others …
How coaching prevents and treats physician burnout
The ongoing COVID crisis in the U.S. has highlighted our broken heath care system. And with it, has come an opportunity to begin to fix the system. Some touted mindfulness as a panacea pre-COVID – suggesting that if clinicians reframed the situations around them, they could better cope and continue. This backward argument echoes the idea that clinicians should redouble their resilience rather than address the core drivers of their distress. …
Mindfulness as a diagnostic tool, not a treatment
I held back my tears as I headed home that day from work. A sense of impending doom and fear of the future was clutching my heart, something like I have never experienced before. For the first time in my medical career, my mind was preoccupied with thoughts about my own safety and how it could be at stake. What had started off as a regular day at work, had …
What it’s like to be pregnant in a pandemic
A lifetime ago, when we first heard of a novel virus making the rounds in China, I was added to several physician groups on Facebook. The discussion surrounding the virus was academic; the distance made it easy to be objective, speculation on how severe it was, and how widely it would spread was casual and detached. Terrible what was happening in China. Those lockdown measures were so draconian. If only …
The virus takes and it takes. Physicians give and they give.
Writing a pandemic novel is sort of like running a mock code. You may feel a tinge of fear as you work through the actively changing scenario, but mostly you feel the excitement of the challenge. Yet when an actual patient is deteriorating before you, all you feel is terror.
In 2007, as I was traveling daily between Washington, DC and Baltimore on a commuter train, I read an …
Imagining a pandemic as a physician novelist
Five years ago, if you asked oncologists at my practice to name the list price of a given chemotherapy agent, most wouldn’t have known–unless they were executives, maybe. Pharmaceutical reps rarely talk about costs. The EMRs don’t give list prices. And when we input drug orders back then, no cost analyses were offered.
These days, those same oncologists can quote efficacy and cost data chapter and verse for a variety of …
Driving culture change in the pursuit of oncology value
Walking into the COVID ward in the children’s hospital, those words seemed etched on an invisible wall, a wall that I wanted to choose to stay behind. It was a wall I could stay behind for the first couple months of the pandemic where multiple studies touted how children weren’t getting sick, and my hospital had seen very few mild cases of the virus in children manifesting from a fever …
“COVID doesn’t affect children.” You may want to rethink that.
He shoved the paper with the address in his pocket. Then he found his little black bag with the oils and other implements for giving what once was called the last rites of the church, but were now termed the sacrament of the sick, and headed off in the direction of the Flats. Sixty-six Center Street. He’d been there before, he was sure. Only the week before, the adjoining block …
A priest, a police officer, and tragedy
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As a medical student, I have discussed with classmates and faculty how to handle a potential patient interaction on vaccinations. Learning how to handle a patient who may be misinformed may be best through experience rather than lectures. During the COVID-19 pandemic, this experience may come sooner and be more commonplace than I previously expected.
While anti-vaxxers currently make up a small percentage of the United States, their Read more…
COVID-19 misinformation is a public health crisis
A few weeks ago, I was delighted when KevinMD accepted an opinion piece I’d submitted. But I withdrew it just before publication because, on reflection, I realized that I’d been wrong.
While sheltering in place during the COVID-19 pandemic, I’ve become an avid consumer of medical podcasts, such as those presented by JAMA and the New England Journal of Medicine. The opinion piece …
Is upspeak really that bad for women in medicine?
As we all grapple with what it means to live in society battling a global pandemic that is so fundamentally altering the way we interact with one another, we are faced with several questions we haven’t faced before in our lifetime: how are we going to move forward from this? What does a post-COVID-19 world look like? When will we be able to go back to “normal”?
While all of these …
COVID-19: Here’s how to gain the public’s trust
As protests broke out on the streets of downtown Cleveland and the National Guard camped outside the hospital, I delivered a beautiful, Black baby boy. In some ways, that night was like any other night. Another vaginal delivery, another moment filled with love and joy that I had the privilege of sharing with a family. But this delivery felt different.
Medically, the patient was fine. My checklist of assessments after the …
An OB/GYN resident’s perspective on Black Lives Matter
“I absolutely insist that you accept this 5-dollar bill,” said the slightly hunched, distinguished-looking Caucasian man in khaki shorts and a T-shirt. He held my big brown hand firmly open with the fingers of one hand while placing a five-dollar bill in it with the other. He looked into my eyes gently but firmly.
I looked down at Abraham Lincoln on the currency bill and instantly felt devalued. My brain went …
This physician decided not to get offended and started a healing interaction
“Where were you born?”
“Here!” Yousef (not real name) with happy, gleaming eyes excitedly pointed at Algeria on the laminated world map hanging on the bulletin board in the exam room.
“And Dad was born here,” pointing to Morocco with mom nodding approvingly.
Who knew that an inexpensive, laminated map could be such an icebreaker for families? Simply sharing immigration stories and experiences living abroad created a wonderful way for families to engage …
A simple act to help families struggling to find their way in a foreign culture
I’m an obesity medicine specialist who is frustrated. I keep running into the same issue, and it’s time we start discussing the elephant in the room: the need we all have to show love and appreciation with food, especially sugar. It’s never been more problematic than it is right now. As our patients with obesity are sick and dying from COVID-19, we are honoring the front line workers caring for …
Stop honoring health care workers with sugary treats
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