As a physician, I often forget how much I know. But there are things that remind me just how different our own experience as doctors is from those who don’t spend their days and nights taking care of the ill.
I do a lot of work for television, helping writers and directors to create medically plausible stories and scenes. I used to get worried that I might get the dose of …
It’s time to advocate for our patients to politicians
A new study about the best place for babies to sleep — in their own rooms, or sharing a room with their parents — contradicts current AAP guidelines. But hopefully, in the long run, it will help more parents and babies get a better night’s sleep overall.
The most recent “safe sleep” guidelines were published in 2016. They stressed evidence-based recommendations for the safest way for babies …
Where should babies sleep? A pediatrician responds.
Medical school prepares physicians to prescribe medications for prevention and treatment of disease, but little to no time is spent teaching something just as important: de-prescribing. In our current system of auto-refills, e-prescriptions, and mindless “checkbox” EMR medication reconciliation, patients may continue taking medications years after their original prescriber intended them to stop. There is no doubt that many Americans are over-medicated, and the problem Read more…
To solve the overmedication problem, follow the physiatrists
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I recently read a post by oncologist Dr. Stephanie Graff on the experience of blame, from self and others, that people with cancer are subjected to:
The talk about risk factors and early detection makes us think we can achieve perfection, and that cancer is somehow a personal fault … let us stop making accusations and blaming persons diagnosed with cancer. They are blameless.
Her post, “Read more…
There is no place for blame in cancer
The Senate version of the Republican health care bill lays bare the priorities of America’s current political leadership. It is not pretty. The new bill demonstrates the Republicans’ entirely unbalanced view of government and fiscal policy, where monetary value trumps all other values, and where only the wealthy are worthy of a helping hand.
These are the new values of the Republican leadership as evidenced by the new bill. We once …
What the Better Care Reconciliation Act says about America
School’s out! This time of year is met with great expectation in children all over the country. However, another unwelcomed guest, hunger, comes along with the summer break. Over 30 million children qualify for the National School Lunch Program which provides free or low-cost meals to children daily during the school year. When classes are out over the summer months, the food availability lessens for many children as parents aren’t …
Summertime is no fun when you are hungry
Computers, more specifically, electronic health records (EHRs), will someday revolutionize the practice of medicine. In fact, successful computerization of medical care is the most critical step necessary to transform the American health care system from its current sorry state to the 21st-century system of our dreams. It is ironic, then, that today EHRs represent one of the worst problems plaguing medical professionals. At this point, many physicians would say that …
How to fix the EHR mess we’re in
Two hours of administrative tasks for every hour with patients. A proliferation of non-physician administrators deciding how the day is going to run. Little in our training about how to cope with uncertainty and change. It’s no surprise that burnout rates are approaching 60 percent. Despite being so common, when we see a colleague struggling with physician burnout, we may not know what to say. Responding appropriately can bring someone …
How to respond to physician burnout in a colleague
Your brain is a three-pound hunk of biological tissue. And though it’s nothing more than a conglomeration of specialized cells, it generates the taste of cheesecake, the ecstasy of enchantment, and the misery of suffering. Amazing, right? I certainly think so, though I find myself among a shrinking minority. Whereas the eyes of our medical forefathers were turned toward the heavens in search of answers to seemingly unknowable questions — …
Toward the stars: On humility and pain in medicine
Once during my TV news days, I was feeling pretty good about myself during a three-hour drive to the Mayo Clinic. “I am so glad I don’t practice!” I crowed to my photographer. “Practicing physicians are so sad. They’ve lost their income, their autonomy, and the public’s respect.”
My photographer didn’t miss a beat. “Yeah,” he replied. “They sound just like you.”
By which he meant that as a journalist, I’d lost …
The striking parallels between doctors and journalists
I see them every time I wait in the inescapably long lines at the grocery store. They’re offering me so much. Fat-melting foods that “work like gastric bypass.” Sleep masks that prevent breast cancer. One day diets. And, of course, the perennial “medical miracles.” All these revelations can be mine with a simple magazine purchase.
It’s easy to dismiss the medical advice being propagated through the supermarket checkout aisle. Who would …
Doctors should fight fake health news at the checkout aisle
President Trump told a group of Republican Senators that the House-based American Health Care Act is “mean” — and on this he surely called it right!
How else would one describe a bill that would take health insurance away from 23 million people, allow states to waive rules requiring insurers to cover people with preexisting conditions at no extra charge, and raise premiums and deductibles to the oldest and …
The ACP leads the charge against the Better Care Reconciliation Act
In my last year of training, I came to realize the difference between doctors who felt successful and those who didn’t. From the beginning, I had always been hard on myself. I always thought about the decisions I made for every patient in detail, played them over and over in my head, and wondered what I could have done differently for each one. Whether or not their outcome was satisfactory, …
How to maintain a sense of accomplishment as a physician
Dear Senators,
I know that the plan is to meet soon to pass the latest GOP health plan. The Affordable Care Act (ACA), also known as Obamacare, failed with a price tag of over a trillion dollars. Yes, this faulty plan is not sustainable as is. Yet, your proposed plan is just a rehashing of the failed elements.
While you look at the economics and short-fallings, I look patients in the eye …
If you want to truly fix a broken system, look at the patients
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 28-year-old pregnant woman is evaluated for a cardiac murmur identified on examination by her obstetrician. She is asymptomatic. She is in her 24th week of pregnancy. Medical history is unremarkable, and there is no family history of heart disease. She takes prenatal vitamins and no other medications.
On physical examination, she is …
MKSAP: 28-year-old pregnant woman with a cardiac murmur
Any physician who firmly believes in the ethical principles of beneficence and justice will recognize the legislation recently passed by the United States Congress known as the American Healthcare Act (AHCA) as a moral travesty. The bill’s provisions to shift costs from the wealthy to the impoverished, diminish protections for individuals with pre-existing conditions, and strip away essential health benefits for patients are cruel measures that run directly counter to …
Residency programs and medical schools must prioritize advocacy training
Pain is not a vital sign. It cannot be measured objectively, nor does an extreme value portend crisis as in the case of pulse or blood pressure. The myopic focus on pain in recent decades has been misguided and deleterious, and the opioid crisis is the result. Now, like ostriches with our heads in the sand, we are again playing victims instead of wielding power when we allow customer satisfaction …
The myopic focus on pain has been misguided
As a pediatric allergist, I treat several conditions that commonly affect children, including asthma, food allergies, eczema and allergic rhinitis. Almost everyone knows someone affected by some form of allergic condition, which makes for frequent questions from families, referring providers, and the public at large.
Early in my career, I noticed that many patients (and even colleagues in other specialties) were asking me questions that were either outdated or born entirely …
Searching online from a patient perspective can make you a better doctor
My hospitalist medical group consists of as great collection of atheists, agnostics, and skeptics as you will ever find. But we all agree that quality is our religion. We believe to our last breath that patient care is sacred and an invaluable gift. And so, as with all faith, there is no halfway. You believe, or you stand around scratching your head asking what those other fools are worshipping. Just …
Quality is this physician’s religion
I read an article by Dr. Jarret Patton that reminded us that “Cops and doctors have the same problem: People don’t trust them.”
I remember thinking to myself that I had to do something to help clarify the source of this age-old problem and also to help improve the situation. It is important for us to remember that our past life experiences, diverse cultures, goals and …
Doctors and cops can fight mistrust the same way
