The main character in the popular film Groundhog Day is caught in a time loop where he must repeat the same day over and over again.
The U.S. Senate is now having its own Groundhog Day moment as it debates (yet again) a law to replace the Affordable Care Act. To add to the drama, Senator Bernie Sanders (I-Vt.) is promoting his single payer alternative popularly branded as “Medicare for All.” In a recent …
What’s the greatest threat to health reform?
As someone who talks to many physicians about burnout and life in medicine, I find myself having a lot of discussions about the circumstances of people’s jobs. Almost inevitably, there comes a point in the conversation where someone expresses dissatisfaction about an aspect of their contract or an additional responsibility that was placed on them.
As physicians, we’re groomed to take care of patients. During training, we don’t talk about compensation, …
5 things physicians can do to protect themselves
Replace like with like — that is the basic principle of reconstructive surgery since its conception in the mid-1500s. Borrow from the healthy part of the body to rebuild the damaged part … But what do you do when you have run out of places to borrow? What if there simply isn’t anything like it anywhere else on the body? How do you reconstruct something as complicated as the human …
Face transplantation is the new frontier of plastic surgery
RRegardless of specialty, no physician can truly provide patients with the care they deserve if they practice in isolation. In recent years, the health care system has acknowledged this reality by embracing greater collaboration and team-based care. With an aging population increasing the prevalence of chronic disease and life-threatening conditions, the timing couldn’t be better.
For the field of dermatology, the American Academy of Dermatology’s recent Burden …
It’s time for teamwork in dermatology
A few weeks ago, my program hosted a lecture series that focused on patient safety. One lecturer truly caught my attention. He chose to highlight the fact that medical professionals have been trained since medical school that perfection, as a practicing physician, is necessary. We have been held to high expectations during our training, and we hold ourselves to these impossible standards as we continue our courses in residency and, …
Dismiss the ideal of perfection
As many was in the health care world, I was shocked by the unlawful arrest of nurse Alex Wubbels. In health care, there is a brotherhood and camaraderie between our law enforcement officers and health care workers, especially nurses. We all are literally on the front line of public service on a daily basis, making this story even more disturbing.
Although the situation initially happened on July 26, …
Here’s how the unjust arrest of one nurse inspires all nurses
Quality-based Medicare payment is far from a new concept. However, the Quality Payment Program (QPP), created by the Medicare Access and CHIP Reauthorization Act (MACRA), introduces a new vocabulary, complex requirements and fast-approaching deadlines. Physicians have little time left to successfully navigate the program and avoid penalties for 2017.
A recent survey by the American Medical Association (AMA) …
Last call for MIPS reporting: 6 steps to be prepared
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 57-year-old woman is evaluated in the emergency department for an episode of hematemesis that occurred 1 hour ago. She had previously felt well except for a recent knee injury, for which she has been taking ibuprofen. She currently is experiencing lightheadedness and weakness. Medical history is otherwise unremarkable. She does not …
MKSAP: 57-year-old woman with hematemesis
Although I am now working part time, I still get my academy’s monthly newsletter. I pretty much ignore the ads and any clinical studies that do not directly affect the work I am doing now, but I still find myself drawn to stories with a political bent. Namely, those stories that reflect the latest health reform controversy. The vast majority of these stories do not mention anything really new, just …
9 reasons you shouldn’t expect health care to change
With summer vacations over and school back in session, I should have gotten up earlier. The usually tough morning commute into Columbus was downright brutal, and I found myself getting repeatedly annoyed as I rushed to make it to clinic on time. Somehow, legally, I managed to make it right at 8 a.m., the start of my weekly asthma clinic. Though I arrived a bit later than usual, I still …
Don’t to forget to walk in your patients’ shoes
1. This is a calling. Physicians do not typically start out undeclared, drink through a couple of semesters and randomly apply to med school. For many, they started dreaming in grade school. They started pushing themselves for straight A’s in third grade, fought for valedictorian, turned down frat party invites to study, and then essentially gave up four years of their lives to med school incurring an average debt of …
10 things a doctor’s spouse wants you to know
What is a doctor? Technically speaking, a doctor is a person that dedicates his or her knowledge and skills to the prevention and treatment of diseases, while maintaining and even enhancing human health.
The majority of physicians enter into the profession of medicine because they are committed to helping others. It is this mission-driven spirit and dedication that makes us grateful for the opportunity each to care for others during a …
Here’s what happens when the doctor becomes the patient
Health care is falling apart. We all know it, we can feel it, but it’s hard to say why it’s happening or even what is happening, we just know that it is true. And as bad as it is for patients, it’s even worse for providers. We know that there is something wrong. We want to help people. We are busy all day long seeing patients. Why doesn’t it feel …
Physicians have the power to save our health care system
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I am sitting in my hospital room in a bone marrow transplant unit in a European city. I am a patient who has recently received a stem cell transplant. I am U.S. citizen, but I am a resident of a country with a single-payer health system. The insurance system here covers 85 percent of the population. And participation is mandatory, although high earners can opt out by purchasing private insurance. …
A first-hand account of single-payer health care
With clinician burnout, depression, resilience and joy in practice so prominent in the primary care literature lately, I have been reflecting on my own career, and the times I experienced the most joy professionally. Looking back, I think it was the years I worked with Chris (not her real name).
Chris, a home health nurse, was at first simply a bubbly voice on the other end of the phone. She had …
How a nurse helped this doctor find joy in medicine
Although my medical school created many opportunities for clinical exposure during the first two years, none of it compared to the immersive experiences that were to follow. Textbooks, PowerPoints, and lectures galore were supplanted by hundreds of patient interactions in my rotation months. Here are four patient communication tips that have served me well, and that I wish I knew from the outset of my rotations.
1. Build rapport with the …
4 tips for better communication with patients
How often have I heard those words or some version of them? The location of the conversations varies. I might be standing outside the curtain of an emergency room bay or sitting on a worn chair inside a cramped waiting room adjacent to the ICU. Possibly on the phone in the dark of my bedroom at some pre-dawn hour. Those words, coming from the mouth of a spouse, a child, …
What does it mean to say, “We want to live?”
How many times have you heard resident physicians say that they do not have time to exercise and get in shape? When looking at the numbers, it’s hard to blame them. An 80-hour work week is enough to make anyone realize that time is a precious commodity.
Take away six-to-eight hours for sleep each day, plus a couple of hours for eating, showering and studying, and you are left with approximately …
Want to stay in shape during residency? Here’s how.
Twelve years ago on August 29th, Hurricane Katrina ruined our childhood home in New Orleans. My parents evacuated last minute and were not allowed back for an entire month while standing water remained in our house, rotting away all our childhood memories. They rebuilt, sold the house and eventually moved to Texas.
This year on August 27th, Hurricane Harvey destroyed my husband and our young girls’ family home and cars and …
Even after Hurricane Harvey, laughter is the best medicine
The national debate on health care is moving into a new, hopefully bipartisan phase.
The fundamental underlying challenge is cost – the massive and ever-rising price of care which drives nearly all disputes, from access to benefit levels to Medicaid expansion.
So far, policymakers have tried to reduce costs by tinkering with how care is delivered. But focusing on care delivery to save money is like trying to reduce …
Want to fix America’s health care? We need to focus on food.
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