Between leaving an emergency department where I had been working for nine years and starting in a new one, I had the luxury of having two months off, from May to July. This meant that I would get to really enjoy an extended summer break and recharge my batteries. It is fair to say that some degree of burnout and moral injury contributed to this change, and this was a …
What this clinician learned from a whale watching tour
For the last three decades, the numeric pain score has been the go-to assessment for acute pain in the hospital setting. Since this methodology was developed for research purposes to see if drug “A” had an effect on patient “A,” its clinical utility is not just worthless but dangerous.
Let’s look at a simple example of a pain order set that is commonly used across the country. If a patient says …
When the standard of care is bad medicine
Though the news at first stayed local in Philadelphia and the northeast, it’s gaining traction nationwide. ZDoggMD is on it. Bernie Sanders held a rally.
What happened? The venerable Hahnemann University Hospital, the main teaching hospital for Drexel University College of Medicine in Philadelphia, is bankrupt and will soon close its doors after more than 170 years as a safety-net hospital serving inner-city patients.
Why should we care? After all, there …
The disaster at Hahnemann University Hospital
Hitting a roadblock in your life and career? Don’t get frustrated. Use the resources that are readily available to you.
Not sure what they are? Think about it. You have had access to them all the time.
The moment you decided to become a doctor, you became unstoppable. You may have followed the traditional path and went from college into medical school and then residency. Maybe your path took a few turns before medical …
The experiences in medicine shape your future
As he stuck his ungloved finger on the parched tongue bearing the color of pale salmon, he called out for the visiting medical student. It was my first official medical rounds in a university hospital in Khartoum as a Sudanese-American medical student, visiting my “native” country, an experience afforded through a global health project spawned in Farmington, Connecticut. The sea of wide-eyed Sudanese students parted, and I found myself floating …
A physician’s call to action from Sudan
As physicians, we face the formidable task of working with patients who appear angry, never content with care or “made better” by anything we do. They may be known as “difficult,” unpleasant, or demanding. These patients are the most challenging and often the least rewarding to care for. But does it have to be that way?
A number of years ago at my first post-residency job in an urban safety-net primary …
How trauma-informed care promotes healing
The recent Boeing 737 airline crashes have left a scar on the American (and worldwide) psyche regarding air travel. Boeing, an iconic brand, prestigious in history and talent, neglected to update and formally educate pilots regarding an essential software update which ultimately contributed to two fatal crashes, killing 346 people in total.
Recent audio between an American Airlines pilot and Boeing’s leadership offers some insight — and lessons — into this …
What health care can learn from the Boeing 737 Max tragedies
I am a physician who was born and raised in Puerto Rico. I confess that since I was a child, I have always wanted to visit Roberto Clemente’s statue in Pittsburgh, Pennsylvania. Recently, my dream came true when a meeting I attended in the city allowed me to see it for the first time. I was overjoyed to personally witness how Pittsburgh had honored Roberto’s memory. There I was, standing …
A physician’s reflection on Roberto Clemente and his leadership legacy
When I was on staff at a large medical center, the CEO established four core values for the institution which he arranged in a diamond pattern: safety at the apex — think of yourself as a patient expectedly at the bottom.
While it seems hard to assess how seriously this widely displayed mission statement was taken, or if anyone really remembered which value went in which corner, the institution expanded. Thinking …
When a physician becomes the control subject in a study
A young man’s life is over too soon. He had been seen more than four times by more than ten different physicians and in four different clinical settings in the two weeks leading up to his death. Each time he was accompanied by a concerned loved one. Each time his depression was discussed in detail. Each time a medical professional determined that it was safe to send him home. Yet, …
A physician’s role in enlisting help to prevent suicide
An excerpt from Understanding Medicines for Anxiety.
Although the SSRIs (selective serotonin reuptake inhibitors) are among the most widely prescribed medicines for depression, they also have a useful role to play in treating anxiety disorders. In this article, we will look at their benefits and limitations when used in this …
Think beyond benzodiazepines for anxiety
Physicians and health care providers across the world are trained to treat disease processes and disease states. Often, this approach becomes technical. And while directed towards the patient, it paradoxically distances itself from the patient. The distance created between the patient and the physician through diagnostic and therapeutic approaches is related to the patient’s dissatisfaction with their medical journey.
Being sick and ill, whether it is a major or minor illness, …
5 things I learned from being a “high-maintenance” patient
Have you heard of the book The 5 Love Languages? My wife will tell you my love language is “words of affirmation,” and I agree. I feel most appreciated when I’m told that I’ve done something well or when my hard work and efforts are recognized, as is the case with most of us.
Gary Chapman, author of The 5 Love Languages, also wrote a book called The 5 Languages of …
Show your staff you care. Here’s how.
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Literature surrounding the effects of social isolation and loneliness for older adults is no longer lacking. Studies and articles outlining the dreadful consequences of these epidemics have even pierced large media outlets like Time magazine, where they emphasize how one in three older adults are lonely.
While any attention brought to the fact that the age group containing people age of 85 and up is …
The suffocation of social isolation
Each of us has limited time, resources, knowledge, and experience. As physicians, the majority of our time, along with our resources, has been devoted to our medical education and clinical practice.
Real estate syndications can be an attractive investment vehicle for busy professionals who do not have the time or experience to actively manage real estate. As an investor in a syndication, you can put your capital to work for you. …
The benefits of passive over active investing for busy professionals
The World Health Organization (WHO) recently announced the 11th revision of the International Classification of Diseases will have a new code: gaming disorder.
For those who eagerly await play-by-play updates to ICD codes, this may be old information. Others may have noticed the brief, but sensational media blip created in June after a few news outlets tasked their hippest interns to tackle the insurmountable task of educating the world on what …
Understanding the backlash to gaming disorder
When a patient seeks the care of a professional, they expect that person to be well trained, experienced, and constantly continuing their education. As an ophthalmologist, I completed a 4-year undergraduate program at Virginia Commonwealth University, 4 years of medical school training at The University of North Texas Health Science Center, a year of a rotating internship, and a 3-year residency program in ophthalmology at Tulsa Regional Medical …
Scope of practice expansion: Patient safety is sacrificed for greater access
Street medicine is a small niche, but it’s not new. Dr. Jim Withers and Dr. James O’Connell began the pioneering in the United States in the 1980s, and it’s not just a local practice; the Street Medicine Institute is a global organization made up of fifteen countries across five continents. When preceptors or other physicians ask me what field I want to go into, I tell them “street medicine.” Almost …
Street medicine: You don’t know about it, but you don’t care to
This time of year, I like to walk down memory lane. I remember my first rotation in the neonatal ICU. I was up all night doing heel sticks on preterm neonates, only to have to repeat them when the results came back because the K’s (potassium levels) were elevated from squeezing the heel. The life of an intern and resident on a NICU rotation has changed since I trained. We …
Plan for your life and medical career with these 3 steps
Incontinence is hard to talk about — many women choose to suffer in silence, finding it too embarrassing to talk about it with friends, family or a doctor. The truth is urinary incontinence affects millions of women — you’re not alone and there are several treatment options available to significantly improve quality of life.
To educate women about this prevalent issue and the many ways to address it, here’s a list …
5 misconceptions about incontinence
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