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A physician is on the scene in the Bahamas after hurricane Dorian

Physician

September 26, 2019

The water continued to rise as the rain pounded Marsh Harbor, a town on Abaco, one of the 700 islands of the Bahamas archipelago. Hurricane Dorian plodded along, nearly slowing to a stop directly over their meager homes. The rain and wind continued to lash their wood and aluminum dwellings, but the real threat came from the sea. Changes in climate mean the ocean started higher than it did only …

Doctors, do you really understand?

Michele Luckenbaugh

Patient

September 26, 2019

There is a haze lurking overhead clouding rational thinking. Thoughts wander back to times when my body was unencumbered, and I felt nothing was out of my grasp. Maybe that was an unrealistic thought, but it is how youth and inexperience protect one from the somewhat harsh realities of growing older.

Coming to terms with chronic health conditions is perplexing. There are days when everything goes just right. The sun is …

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Doctors, do you really understand?

Here’s why health care innovations stay secret

Neil Baker, MD

Health Technology

September 26, 2019

Having been an improvement advisor with many quality improvement initiatives and collaboratives, I have observed that stories about successful initiatives too often leave out major relational barriers that got in the way as well as the critical interventions necessary to overcome them.

That important details about relational challenges so often remain hidden is not a small problem. Evidence points to relational issues as a major cause of lack of expected success …

Who actually owns your medical records?

Linda Girgis, MD

Physician

September 25, 2019

I was in a discussion with a group of patients about how difficult it is for patients to get access to their own medical records. It was initiated after one of my patients was refused copies of her recent hospitalization. There is much confusion out there about who actually owns the record and how it is allowed to be accessed. Most people are aware of HIPAA, the regulation set into …

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Who actually owns your medical records?

Black market pharmaceuticals target immigrants

John M. Glionna

Health Policy

September 25, 2019

The bootleg medications were smuggled across the border and sold to mostly Latino immigrants in public spaces throughout Los Angeles — at swap meets, parks, beauty salons and makeshift stands outside mom-and-pop grocery stores.

The drugs were cheap, and the customers — mostly from Mexico and Central America — did not need prescriptions to buy them. Some of the products featured brand names and colorful packaging that immigrants knew well from …

In medicine, find the beauty in what is common

Andrew Ross, MD

Physician

September 25, 2019

“The value of experience is not in seeing much, but in seeing wisely.”
– Osler, “Aequanimitas”

Recently, my family and I were leaving a restaurant, and in so doing, we crossed a large parking lot filled with a seemingly endless number of pebbles. My youngest daughter, whose hand I was holding, suddenly pulled away from me. I stopped short, about to reinforce with her the importance of holding hands in the parking …

An important health care safety net is at risk

Mark Pappadakis, DO

Health Policy

September 25, 2019

EMTALA is born

The machine beeps alarmingly as it breathes for your child. The various numbers on the monitor are foreign to you, but you know something isn’t right because the nurse briskly walks away from the stretcher to grab the doctor, who then orders more medication and makes adjustments to the machine. The beeping stops, and the anxiety eases from the staff.

The official in business clothes — standing next to …

Your bone fracture, my cash flow: the consequences of private equity in health care

Michael L. Millenson

Health Policy

September 25, 2019

A recent article in Modern Healthcare describes how private equity firms are starting to snatch up specialist physician groups that promise rich revenues, such as orthopedists, dermatologists, and ophthalmologists.

Naturally, this is about adding value, not adding to bank accounts. Because whether it’s physicians or hospitals, health insurers or drug companies, no one in health care ever does anything except in the best interest of patients.

The Modern Healthcare …

How emotional intelligence makes you a better physician

Johanna Vidal Phelan, MD, MBA

Physician

September 25, 2019

In the early evenings after work, I thoroughly enjoy taking brisk walks. Walks are a great opportunity to exercise, of course, but I also cherish making time for myself to process the many thoughts that can occupy the mind of a busy physician. My walks are typically the only time of the day when I can quietly meditate, ruminate, prioritize concerns, or simply restore my soul.

As I walk, I get …

When patients die, physicians mourn as well

Don S. Dizon, MD

Physician

September 24, 2019

I was driving to work one morning, and as part of my new routine, I listen to The Moth podcast. If you do not know it, it’s a wonderful community of storytellers — compelling stories, told by people from every walk of life. I often find myself drawn into the program (like a moth …

How pneumatic tubes symbolizes our health system

Fred N. Pelzman, MD

Physician

September 24, 2019

About once or twice a day, everyone on our hospital’s computer network gets an emergency message that scrolls across the bottom of our screens, highlighted in the colors of danger and warning.

They include things like a notification that a particular data system is down and that a backup on paper will have to be used for documentation, or the hospital …

Let’s end surprise billing without a Trojan Horse

Damian Caraballo, MD

Health Policy

September 24, 2019

With August recess at a close, Congress has yet to find a solution to end balance (or “surprise”) billing, where patients are charged the remainder of their medical bill for out-of-network (OON) expenses not reimbursed by their health plan. About the only compromise for-profit health insurers, hospitals, and physician groups can agree on is that patients should be taken out of the middle, but they can’t agree on how.

Physician groups …

It’s time for AI-enabled solutions in health care to live up to their buzz

Chris DeRienzo, MD

Health Technology

September 24, 2019

Artificial intelligence is incredibly buzzy in health care right now, and for a good reason. Other industries are already experiencing AI-enabled radical transformations, like real-time fraud monitoring and detection in banking and finance and instantaneous image recognition across the web and social media. Health care now stands similarly positioned to capitalize on the transformative power of machine learning, and the massive potential is driving levels of investment expected to Read more…

It’s time for AI-enabled solutions in health care to live up to their buzz

To extinguish burnout, bring back physician autonomy

Christina Dewey, MD

Physician

September 24, 2019

In his article, “Medical education needs to stop burning out students — now,” Augustine Choi suggests the culture of medical education is responsible for increasing numbers of depression and burnout among medical students, and suggests that more programs are needed to address self-care and wellness in order to build resilience.

While I agree that mental health treatment should be readily available and easily accessible to those in …

Made mistakes? How to spin them for your medical school applications.

Michelle Finkel, MD

Medical Education

September 24, 2019

Despite more than a dozen years in medical school admissions consulting, I still clearly recall a bright advisee who had improved her grades considerably throughout her college career. But I, unfortunately, had a less than stellar freshman transcript. After calculating her AMCAS GPA with me, she lamented, “I feel like my grades are a criminal record.” In a twisted way, she was right — she couldn’t erase the grades.

But she …

The unexpected people who’s listening to your conference speech

Anne Katz, RN, PhD

Conditions and Diseases

September 23, 2019

Do you ever wonder what the staff in hotel conference rooms think about what we talk about in presentations and lectures? I talk about sensitive stuff — sexuality, fertility, etc. — and I use words that many people have not said out loud in front of hundreds or thousands of people. I’m used to the words, of course, and they …

Seniority is the worst metric for health care leadership

Travis Bias, DO and Ashley Ramirez, CPNP-AC

Physician

September 23, 2019

Health care delivery in the United States is being led by practitioners who have ascended to leadership roles primarily through years of loyalty to their organizations. But as burnout worsens and affects the youngest clinicians to the detriment of the system, is this the appropriate cadre to shepherd us towards necessary system transformation?

We share two stories that …

Fact-checking faces steep challenges in health care

Gary Schwitzer

Conditions and Diseases

September 23, 2019

Fact-checking has become one of the buzziest buzzwords in journalism. There are more than 100 fact-checking projects around the world. It’s been trotted out to counter alleged “fake” news. And to monitor the accuracy of political leaders who stretch the boundaries of believability. April 2 has been proclaimed International Fact-Checking Day.

Indeed, genuine fact-checking may play an important role in political news coverage. FactCheck.org has been working in this space for 15 years. The …

Modern health care and the Burger King mentality: Sometimes you can’t “have it your way”

Jeffrey McWilliams, MD

Physician

September 23, 2019

It’s difficult to put into words the honor I feel as an emergency physician. Strangers invite you into their lives, trusting in your training, knowledge, and compassion as they battle crisis. We are involved in intimate details of triumphs and loss on a daily basis, sharing in tears of joy and sorrow as we fight and advocate for our patients. It’s a humbling calling that I’ll never take for granted. …

Wonder about each patient outside the exam room

Alexander Rakowsky, MD

Physician

September 23, 2019

I pass by one of our local parochial schools on the way to clinic two mornings a week. With the school year in full swing, each Friday I see the children lining up outside to go to weekly Mass. With the girls in their grey tartan skirts and blue vests and the boys in their blue shirts and pants, they form a colorful, large nameless entity to which I don’t …

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