I spent a year as a UCSF postdoc with the leaked tobacco documents. And this article is taken directly from the tobacco-control playbook. In the tobacco wars, we learned that: when a disease is caused by a for-profit industry, the only successful approach is regulation first, followed by treatment.
Here is exactly how and why doctors should regulate EHR and regain control of their cognitive …
I didn’t know her name until it was over, much too late. What I knew was she was thirteen and that on this winter day, someone in her family had been pulling her behind their car on a sled. No doubt laughing and looking in the rear-view mirror, the person driving had whipsawed around a corner, and the young girl — probably screaming (fear? delight?) — held onto the sled …
Would you expect the chef at a restaurant to be told that they are not only required to prepare the food in the kitchen but also deliver it to each of the tables and manage the billing? What about sorting out the restaurant’s finances or understanding the number of patrons that need to flow through per night to optimize income? If this sounds unreasonable, how did we end up asking …
Lawsuits are conventional in medical practice.
An unhappy patient hires a malpractice attorney, who hires a medical expert, who interprets the standards of care and generalizes a departure from the standards of care and proximate cause. The preponderance of evidence is 50% certainty plus an ill-defined scintilla, which needs to be only 0.01% to be good enough.
The lawyer sues the doctor, who notifies the malpractice carrier, hires a defense counsel, and …
I always think of the beginning of July as the New Year in medicine. It’s when medical students become interns, interns become residents, and residents become newly minted attendings. With each change is an increase in responsibility.
I remember paying even more attention to the history and physical each time I crossed that threshold. With an increased sense of purpose and responsibility. This was true in the office and during admissions …
An excerpt from Boundaries For Women Physicians: Love Your Life And Career In Medicine.
My story is similar to that of countless other women who have chosen careers in medicine. I am a pediatric hematologist/oncologist. A few years ago, I was driving home one afternoon after having spent several hours with …
The majority of people who donate money don’t research or compare charitable organizations. Only 1 in 3 research before giving, according to one of the biggest charity ratings websites, Charity Navigator. Giving 2.0 author Laura Arrillaga-Andreessen says only about three percent compare charitable organizations.
These numbers were both surprising and not surprising to me. I have done most of my donating with no more than a cursory …
“You should prepare for the future. Your son will never be independent.”
I do not recall hearing those words at their source, but I was only eight when they were relayed to me by my parents. At the time my diagnosis, now characterized as juvenile myoclonic epilepsy, was poorly understood and often confused with more virulent disabling neurological conditions. Despite this fact, I have used the doctor’s prediction as fuel for …
I understand it’s been over two years since the World Health Organization announced the coronavirus pandemic, and we are tired.
I speak for the thousands of health care workers and frontline workers: We are exhausted, we feel taken for granted, and for many of us, we are leaving the industry. In some cases, we went from health care heroes being villanized as if we somehow benefited from the pandemic. So many …
Medical mistakes are as old as the practice of medicine itself, but it wasn’t until 1999 that the United States started paying more attention to them.
Over twenty years later, we may be reducing medical errors — a recent study published in the Journal of the American Medical Association found significant decreases in mistakes in cases of pneumonia, acute myocardial infarction, heart …
Fear. It means something different to each person, but collectively we can all agree that fear can be something that drives us to succeed (fearing failure), causes us to take care of ourselves (fear of poor health), and can even promote experiences that wouldn’t otherwise be pursued (fear of missing out, affectionately known by the acronym FOMO). This isn’t the kind of fear I had this past Sunday sitting in …
I started my hospitalist shift like any other day. I arrived at 5:30 a.m. for shift hand-off at 7 a.m. A full hospitalist load and endless administrative tasks to complete, the duality of both roles punctured me like a venomous snake bite. I had two full-time jobs to complete in 12 hours. Impossible! Or was it? I added one and one-half hours to my shift at the beginning–time hidden behind …
Get off the field.
Go back to the dugout and rally your team.
Create your rules of engagement.
The structure and hierarchy of medicine teach doctors to compete with one another. From the beginning, we’re told there are a finite number of acceptance letters sent to aspiring physicians. In medical school, we compete for one of a limited number of slots in highly selective and competitive training programs. And as attendings, we have …
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It’s been two and a half years post-pandemic, and I still don’t feel normal.
There’s a dark veil hanging over my life. I feel oppressed, unable to practice the way I want, unable to live and think in ways other than this abnormal new biological pseudoscience I’m not expected to question so that I’m more inclusive.
There’s a sense of lost purpose like I no longer work to feel fulfilled. Instead, I …
Imagine that you are a brand-new attending in a hospital. You have your new starched white coat and stethoscope around your neck. Before you enter your patient’s room, the nurse says, “Whew! Good luck! The patient’s dad is really angry! He’s been yelling for the last ten minutes!”
Are you prepared? Do you know what to do?
The boundaries of unacceptable behavior have eroded in the past few years. Politicians, law enforcement, …
A recent JAMA article showed that starting salaries for female physicians were lower than that of their male counterparts in most subspecialties.
New physicians are not expected to have many differentiating factors besides gender, yet the starting salaries differ. It is important to note that specialties with a higher percentage of women also have lower salaries for bother men and women. As the percentage of women physicians in a given …
I lay on an examination table while a plastic surgeon surveyed my skin to determine if a suspicious mole should be excised. I joked with him that I had once considered plastic surgery as a career. I knew he still worked at the hospital and fired a rhetorical question at him, enquiring if the hospital was still as busy as it was two years ago when I had worked there? …
“You’re my last hope.”
The words come from a patient I have no prayer of helping. He has had decades of back pain. He has had several surgeries, injections, hardware in, hardware out, but nothing has helped. He is unable to work. His struggle with back pain has ruined relationships, ruined his financial stability, ruined his mental health. His goals and mine are aligned. We both want to make his life …
What they want is power, control, and to take all the credit. In short, they want what you have.
Vision. Even more so, the ability to manifest a vison. Even more so, they want your energy. Your passion.
“Candy Everybody Wants” by 10,000 Maniacs is an epic song. I know every word.
Hey hey give ‘em what they want
If lust and hate is the candy
If blood and love taste so sweet
Then we give …
I left practice 25 years ago when I saw portents of clinical practice as it exists today: impersonal, with electronic records and assembly-line labor heralding the movement to institutional employment over private practice.
But it was also my genuine interest in population health and pharmaceutical medicine that propelled me into a nonclinical career. The jobs I chose in this millennium were with health insurance and pharmaceutical companies, …
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