Physician

Inside the system that’s costing health care billions every year

Physician
December 31, 2024

It all begins with a political movement for national health in the 1970s. There are no “health systems,” just doctors and hospitals. Fee-for-service is determined by conventional principles of cost accounting, in which payment for services compensates for overhead and leaves enough profit to remain in practice and enjoy the American dream.

There are health insurance companies. The purpose of health insurance is to protect patients against medical expenses, not to …

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How a mid-flight emergency taught me to put myself first

Physician
December 30, 2024

It’s crack-of-dawn early, and I’m on a flight. Working swing ER shifts has left me exhausted, barely packed, and running on fumes. But hey, as long as I’ve got my passport and clean underwear, I’m good to go. There’s a mall in every city, right?

I settle in, headphones on, ready to dive into the latest episodes of The Lincoln Lawyer. I’m beyond tired – there aren’t even words for this …

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What your clothes say about love and loss

Physician
December 30, 2024

I have an eye for finding beautiful clothes. Though I find jeans and shirts/kurtas comfortable, I’m not sure why I adore the shalwar kameez so much! Perhaps it’s because it’s my national dress, and I adore everything that connects me to my homeland. Secondly, I’ve been wearing it since I was a child. My mother was an expert at sewing clothes, and she made all of my dresses.

Jeans and shirts/sweaters/kurtas/tops …

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Jimmy Carter’s final act: What America’s seniors can learn from his health care choices

Physician
December 29, 2024

With Jimmy Carter’s passing, many will reflect on his impact at home and abroad. Yet, one his most personal acts will also stand as one of his most enduring legacies.

At 100, not only was our 39th president the longest-lived president, he was also to first to publicly elect hospice care, prioritizing the quality of his last days over simply being alive.

When he first enrolled two years ago, the family’s announcement …

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The potency of purpose: Merging corporate values with business success

Physician
December 27, 2024

“People don’t buy what you do; they buy why you do it. And what you do simply proves what you believe.”
– Simon Sinek.

Business is equated with money—dollars, profits, ledgers, etc. But there is much more to business than finances. At the end of the day, you don’t take profits or losses home—you take home values. You rake in integrity. You create a playground of ethics for people. There are certain …

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How innovative partnerships are transforming patient safety in health care

Physician
December 26, 2024

As health care leaders and providers, our ultimate mission is to provide safer care for all—but there’s a flaw in our system. Today, as many as 4 in 10 patients are harmed in primary and ambulatory health care settings, and up to 80 percent of this harm is avoidable. Patients should feel safe when they receive health care. Unfortunately, the pervasiveness of medical harm across all health care settings and …

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The rise and fall of telepsychiatry

Physician
December 25, 2024

Telepsychiatry is a private audio (telephony) or video (video with sound) conference connection through which most psychiatric services can be provided to patients. I have been an early adopter and advocate for providing services, through telepsychiatry, to our patients who are experiencing mental health issues and psychiatric illnesses. The road leading to where we are right now in the field of telehealth has been treacherous and filled with regulatory landmines …

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Christmas in a children’s hospital

Physician
December 25, 2024

In December, the questions parents ask in the hospital are different. Instead of “Will my child be OK?” we pediatric hospitalists hear:

“We have plane tickets to go skiing for Christmas. Will he be well by then?”

“She’ll be home for Christmas, right? We’ve never been away from home for Christmas.”

“It’s his first Christmas. He’ll be discharged by then, right?”

And every other variation you can think of. The hospital for Christmas is …

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Rethinking shift work: Why “job sharing” is the key to happier, healthier doctors

Physician
December 25, 2024

In the realm of shift-based health care, the term “job sharing” doesn’t technically exist—after all, shifts aren’t a single continuous job to split. Yet, still, a full-time workload is considered the norm, and the concept of dividing the workload among multiple physicians rather than relying on one overburdened individual feels revolutionary in a field where burnout is rampant.

For independent contractors, who often enjoy the flexibility to choose when and how …

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The oxygen mask principle: a critical lesson in health care self-preservation

Physician
December 24, 2024

In the high-stakes world of health care, medical professionals are renowned for their selfless dedication to patient care. They work long hours, navigate complex medical challenges, and consistently prioritize the needs of others. Yet, within this culture of compassion, there exists a profound and often overlooked truth: to provide optimal care, health care workers must first care for themselves.

The oxygen mask principle, famously demonstrated during pre-flight safety instructions on commercial …

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Beware of these talking points in medical malpractice litigation

Physician
December 24, 2024

A medical liability litigation industrial complex manipulates medical liability litigation with three talking points. As a result, 85,000 lawsuits are filed per year. Of these, 56,000 are summarily dropped; 28,000 are settled; 300 are plaintiff verdicts, and 700 are defense verdicts. The cost of health care is $60 billion per year, and the medical liability litigation industrial complex takes a chunk of the action. There is considerable uncertainty. Facilities close …

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Emergency medicine: Balancing challenges, rewards, and well-being

Physician
December 23, 2024

Emergency medicine is one of the most challenging and rewarding specialties in health care. We are required to be clear-headed enough to make quick decisions while sleeping when we can, hugging our families while we can, and forming unshakable bonds with our colleagues over shared triumph and tragedy.

For many emergency physicians, these challenges come at the expense of their own health and well-being, yet we don’t see it. At least …

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Forgiveness: Why it’s the hardest and most rewarding act of humanity

Physician
December 23, 2024

I believe in forgiveness and not hating anyone, no matter what. But, ultimately, we are all human. I believe in karma, and we should not hurt or push people to their limits so much that they become damaged beyond repair. I’ve seen cruel people end up in miserable lives. Some people excel at concealing their sorrows, while others struggle. But we indeed reap what we sow. Those who are cruel …

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How a doctor’s clever approach restored a life—and a marriage

Physician
December 22, 2024

An excerpt from Yankee Doctor in the Bible Belt: A Memoir.

Doctoring in the mountains of Eastern Kentucky, I met Mrs. Snoop, a new patient at the clinic. She is 38 years old. Her chief complaint, according to her husband, is “not wanting to have sex.” He speaks on her behalf, sitting in the corner in grease-spattered overalls and heavy work boots.

On examination, Mrs. Snoop …

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Society is obsessed with weight loss

Physician
December 21, 2024

Society is obsessed with weight loss. Part of my brain is, too, albeit I am well aware that there will be no number low enough on the scale to satisfy that part of me.

Anorexia nervosa is a poorly understood and mismanaged condition from my perspective as a health care professional and patient with lived experience. Society seems to glorify anorexia, and people compliment what may often be maladaptive behaviors (such …

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Long-term impacts of physician suicide on patients and doctors

Physician
December 21, 2024

Kim Downey:

Pulling into my driveway, I grabbed a handful of envelopes from the mailbox, one of which was from my doctor’s office. I could tell it wasn’t a bill, and I became anxious. Upon opening it, I was relieved to find that it wasn’t about my doctor leaving his practice or that anything had happened to him. Rather, it was a notification that another doctor I’d seen once was leaving. …

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How a psychiatrist rebuilt trust with a patient in crisis

Physician
December 19, 2024

An excerpt from Unlike the Rest: A Doctor’s Story © 2024. Published by HarperCollins Publishers Ltd. All rights reserved.

I was trained in my first month of residency, during onboarding, to always position myself closest to the door when interviewing a patient, as situations can escalate quickly and become potentially dangerous. “If a patient stands, you stand,” my preceptor said to me during safety training. Her words came back to …

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Why the U.S. health care system is failing patients—what every American should know

Physician
December 17, 2024

I’m a semi-retired cardiologist. I currently volunteer at a free community health clinic for individuals who do not have health insurance. Many of these individuals are undocumented foreign workers, yet we care for them seamlessly, without the restraints of our bureaucratic billing system and the burdens and restrictions promoted by the insurance industry.

As I age, to my chagrin and utter dismay, I have also unfortunately become a patient. I have …

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