I am a psychiatrist living in El Paso. My husband was the orthopedic traumatologist on call at the academic center last weekend when 22 El Pasoans were murdered and 26 wounded in a mass shooting at a busy Walmart in town. The rest of this week has been oddly surreal for me or maybe numb. Until this afternoon. Something happened while I was getting my hair done that made me …
The powerful, surreal scene in an El Paso hair salon
As the fall approaches, medical schools across the country are preparing for the arrival of a new crop of medical students. The primary emphasis of medical school is to teach technical competencies so that students graduate with the medical knowledge and know-how to diagnose and treat disease. Recognizing the health care is getting more and more complex, schools are also introducing new and evolving fields like health systems …
Medical students creating their own oaths: Is that the best way to enter the profession?
As a doctor that specifically deals with brain and spine surgeries, I have adopted a No Room for Error mentality in the operating room. I believe this same mentality can be helpful in making the best possible life decisions.
What do I mean by No Room for Error?
It is natural to visualize the successful achievement of a goal. For instance, prior to performing the most common surgery I perform, resection of …
How a neurosurgeon uses a No Room for Error mentality when making life decisions
The team stood around the older woman’s bedside. As one of the medical students, I prepared to meet my assigned patient. While being assigned to me, Mrs. R yelled, I’m not letting that n***** take care of me!
As the only Black person in the room, her words meant for me hung in the air. Frozen in place, my heart racing, I fantasized walking out of the room. Without a break …
Veronica Kelley was working at an office building across the street from the Inland Regional Center in San Bernardino, Calif., in December 2015 when a county employee and his wife entered with semiautomatic rifles and opened fire, killing 14 and wounding 22. Most of the victims were co-workers of the gunman.
The couple went on to wound two police officers later that day before being fatally shot by …
The lingering effects of a mass shooting
Hey there, Dr. Brown.
Just wanted to send a little note to warn you that I’m coming to see you soon for my yearly “checkup.” You and I both know that this is my annual opportunity to spew all of my worries on you and for you to reassure me that I’m not dying. Have you blocked at least an hour for me? I’ve got a boatload of random symptoms that …
A letter before the yearly checkup
“It is high time for us to recognize that the physicians who spend so much of their lives caring for us are often suffering in silence, and effective interventions would be good medicine for all of us.”
– Joan M. Anzia, MD
On February 4, 2007, I attempted to take my own life.
It was Super Bowl Sunday, and the Colts were playing the Bears. My wife Charlene and I were home, and …
The deadly silence of physician depression and suicide
Keeping tabs on the sheer volume of medical drugs and devices on the market is nearly impossible – the FDA approved a record 105 novel medical devices and 59 new drugs in 2018 alone. At the same, hospitals and physicians face ever-growing pressure to cut costs while improving quality. Many physicians make patient treatment decisions based on their own expertise and/or limited review of the readily accessible information, the processes …
5 ways to lessen the physician burden in the product evaluation process
My niece, whom we will call Anne, recently completed her residency. I remember Anne as a child: always smiling, always happy, idealistic. She excelled academically and chose medical school despite my reservations. I watched Anne proceed through medical school and residency, transforming before my eyes into an anxiety-riddled, sleep-deprived, irritable, and jaded physician. She said to me late in her residency, “I’m afraid I am becoming an asshole.”
This is ironic …
The System has a tremendous advantage over physicians
Many years ago, it was called the emergency room. Now we call it the emergency department. However, unlike so many departments in the world, the emergency department has almost too many purposes, duties, and mandates to number.
However, in the process of being the under-funded safety net for American health care, it has also become a place of remarkable danger where medical and nursing staff, support personnel and even patients face …
ER staff deserve a safe place to do their jobs
When PDL BioPharma’s $40 million blood-pressure medicine faced the threat of a generic rival this year, the company pulled out a little-known strategy that critics say helps keep drugs expensive and competition weak.
It launched its own generic version of Tekturna, a pill taken daily by thousands. PDL’s “authorized” copycat hit the market in March, stealing momentum from the new rival and protecting sales even though Tekturna’s patent ran out last year.
PDL’s …
How drugmakers became masters at producing authorized generics
On March 11th and 12th, representatives from the NBME, AMA, AAMC, Federation of State Medical Boards and the Educational Commission for Foreign Medical Graduates gathered in Philadelphia for InCUS — the Invitational Conference on USMLE Scoring — to discuss potential changes regarding how Step 1 is scored. InCUS came about as a result of a wave of student frustrations over the pressure from the increasing importance of this exam in …
Should USMLE Step 1 be pass-fail?
Everyone knows someone today who’s dealing with dementia. And as a geriatrician — that means a lot of questions come my way. Questions about parents who recently had cognitive testing, about the role of assisted living, about prevention — you name it. Dementia is out there in a way it never was before. People have questions, and they need answers.
Dementia is not a normal part of aging
This is where I …
Arm yourself with new dementia information
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On a beautiful spring morning, I found myself in an outpatient OB clinic, ready to begin the last rotation of my third year of medical school. My attending physician greeted me and patiently (but quickly) showed me the ropes. I spent the better part of the day using a doppler to detect fetal heart sounds, measuring fundal heights, reading ultrasounds, and learning how to do pelvic exams on my incredibly …
Want resilience? Look to your patients.
Pharmacy benefit managers (PBMs) including Express Scripts, CVS Health, and OptumRX are the subject of intense criticism by virtually everyone in medicine and politics. While the purpose of PBM’s group purchasing business model was intended to contribute to lower drug costs and premiums, many of their customers have not experienced these benefits. Instead, many patients are choosing not to take their medications or take …
While pharmacy benefit managers are watching cable, patients are streaming Netflix
The decision seemed straightforward. Bob McHenry’s heart was failing, and doctors recommended two high-risk surgeries to restore blood flow. Without the procedures, McHenry, 82, would die.
The surgeon at a Boston teaching hospital ticked off the possible complications. Karen McHenry, the patient’s daughter, remembers feeling there was no choice but to say “go ahead.”
It’s a scene she’s replayed in her mind hundreds of times since, with regret.
On the operating table, Bob …
The questions surgeons need to ask their seniors before surgery
Let’s get right to it: This is an apology letter to frontline clinicians. And a call to action.
I’m a patient advocate, and I’ve spent most of the last 20 years fighting for patient- and family-centered care in national laws and regulations, and in local practice. Prioritizing the needs of patients and families above all else. It is meaningful work to which I feel deeply called, and it is hard work …
As a patient, I never understood the heartbreakingly human toll our system takes on clinicians
Here are some specific ways for medical trainees to save on their move.
Timing is everything
When is the exact timing of your move? Are you flexible? Think about your situation: you graduate medical school, pack up, and then move for residency. Right?
Most moving companies are busiest (read: most expensive) between May and September when they know you are likely to move. With Match Day in mid-to-late March, getting an early start …
How to save money when moving for residency
Perfect nurse.
Perfect manager.
Perfect puppet.
An ICU physician once told me: Nurse managers have a life cycle of a mosquito.
Fast and furious
And then gone.
Deleted until the next one shows up.
It was the perfect ICU.
Twenty-five beds.
Dynamic intensivists. Phenomenal.
And they respected us nurses and collaborated with us. We had perfect cerebral perfusion together.
Experienced ICU nurses who knew what to do like clockwork — teaching the younger new nurses. Teaching them the facts of ICU. …
Perfect nurse. Perfect manager. Perfect puppet.
It’s a widely held belief that eventually all living human doctors will be replaced by robots. Some say as soon as 2035.
I say, “Why wait? Replace me now!”
If the idea of a robot diagnosing and treating — and examining — you and your loved ones seems objectionable, please reconsider.
There are actually several advantages of robots over so-called “human” doctors:
Doctors are prone to burnout. If a robot burns out, just replace …
Replace doctors with robots now, please
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