My introduction to health insurance companies was very abrupt and simple.
I received my medical training in the U.S. Navy and served three years after that. Then, I was finally discharged. I had treated thousands of patients as a Navy doctor, but I had never charged one, nor did I even know how to charge for services.
My partner in the civilian practice I joined made the transition easy: “Sign this contract …
The toxic doctor-insurer relationship
One recent afternoon in the GI endoscopy suite (not my favorite place to work, but that’s a topic for another day), I walked up to the bedside of my next patient and introduced myself as I always do.
“Hi,” I said, holding up my name badge for the patient and his wife to see. “I’m Dr. Sibert. I’m with the anesthesiology department and I’ll be looking after you today.”
The patient was …
You’re a doctor when you’re not giving anesthesia?
Norman Grant was a new patient. He had chronic back pain, not helped by surgery or a dozen injections after that. It all started with an industrial accident in 2001. He had settled his case and was on chronic OxyContin, which far from kept him functional. But as of January 1, his insurance was no longer covering that drug. He only had two weeks left of it.
He told me he …
The art of asking where it hurts
When I was young, my father told me that baseball is a metaphor for life. As a lifelong fan, I’ve found professional inspiration and valuable lessons in this game, time after time after time.
This year was no different. Throughout the 2021 MLB playoffs, and amid an exciting World Series between the Houston …
The troubling similarities between primary care physicians and MLB relief pitchers
It was as if my four-day-old daughter’s condition was not critical. It was as if I was not a clinician who could confidently assess and identify seizure episodes. It was as if there were no monitors blatantly showing critically low oxygen levels.
Nine long hours and still no response. I felt like I was begging for eternity. I had repeatedly approached the nurses’ station to get their attention and assess my …
The unique agony of being a Black female doctor
What can we learn as we experience turmoil, change, or as we grieve a loss? Is there something we can focus on to help us go through difficult times in our lives? This can be a minor occurrence in our life, or it can be what we have all lived through collectively during a global pandemic.
What can help us see what is beyond what we are experiencing now and let …
Grieving our collective loss with compassion
March 11, 2020, my nightmare began.
“Ready to switch?” asks my American Sign Language interpreter during an all-day virtual conference. Switching from speaker view to gallery view, I search for a different speaker’s interpreter among numerous attendees, pin her video, and switch back to speaker view. This interpreter updates me on what I missed during the transition.
I do this every half hour throughout the conference, peering through my reading glasses while …
Practicing medicine as a Deaf physician is an uphill battle. COVID makes it worse.
I was asked this question at least three times this week, so I think there must be something going around. It doesn’t help that a Kardashian with 140 million Instagram followers recently signed a deal to become an equity partner and global spokeswoman for a company selling collagen supplements. The global market for collagen-containing products was estimated at $300 million last year, and is projected …
Are collagen supplements good for you? A physician’s deep dive answer.
While the pandemic sparked a renewed (if only temporary) appreciation of the medical profession, this alone wasn’t enough to induce change in the system overwhelming them – a fact blatantly revealed to me this year at the annual conference of the American Academy of Family Physicians. I admit I was a little disappointed when the pandemic forced the location to be changed from sunny California to virtual. But, since I’d …
America is failing primary care doctors
This article was written before COVID-19 social distancing recommendations.
I want to start off by saying that I fully know my breastfeeding journey is a success story. There are so many women who struggle with medical illness, latch issues, an unsupportive workplace, milk production, and more. I had initial struggles; but, largely, these were not my issues. In that way, I was fortunate. Mine is the story of learning to become …
An un-apology: a physician’s breastfeeding isolation
Medicine is not a business
You fools.
Healing is your blueprint, activated
to complete itself.
A doctor does not broker it,
The best anyone can do is align you
With what you should be,
And stay out of the way.
(Like a teenager setting off an illegal firecracker.)
Mostly, you pay the doctor for the alignment,
And the nurse
To keep the doctor out of the way.
If you’re not ready,
to get on with the business of what you should be,
You come …
Medicine is not a business: a poem
People often say health care professionals are often the worst patients. As health care professionals, we are well versed with what is needed to be healthy, but we struggle, like many other people, to consistently apply these principles.
Some reports indicate that as many as 50 percent of doctors experience symptoms of burnout, including emotional exhaustion, feel less enthusiastic about work, and lack personal accomplishment at some point during their career. …
If the healers are sick, what happens to the rest of society?
We went into medicine to help people, and now we struggle with feelings of betrayal. We sacrificed so much. While our cohort in college went on to graduate and earn an income and start families, we continued with medical school, an all-in venture financially and personally, demanding all of our time, efforts, and attention. Then we trained. And trained some more. And then, finally, we went to work. We took …
Physician struggle with feelings of betrayal
The journey to becoming a physician is generally a linear path. Sure — there are exceptions, but for the most part, you can accurately predict what you will be doing in the future. For example, when you are in high school, the next step is college, then medical school, residency, possibly a fellowship, and finally your first job. (That’s approximately 16-18 years of your life!)
But what happens when things don’t …
How to navigate residency probation
At the very start of the pandemic last year, I met with a couple of patients in the office while we wore masks. Based on that limited experience, I quickly concluded that seeing each other’s faces was of paramount importance, even if over video. That, plus the infection risk, led me to close my office to in-person appointments. For more than a year, I exclusively conducted …
Which is better: Psychotherapy using video or in-person while wearing masks?
Remember the dark days of the pandemic, when the true risk of caring for COVID patients started to become clear? Remember when you could be censured by a nursing supervisor or administrator for wearing a mask in public areas lest you frighten patients or visitors?
Right around then, a third-year resident at UCLA decided to wear a mask wherever he went in the hospital, as testing wasn’t readily …
Why it may be time for doctors to unionize
Recently, I solved a medical dilemma by changing the medication that seemed to have nothing to do with my patient’s problem.
Ethan Blake is a thin-boned, soft-spoken man with atrial fibrillation and a history of high blood pressure. He lives alone and prefers to shovel his own driveway. He also loves to walk his springer spaniel in the woods behind his house. He is in great physical shape.
At his routine follow-up …
Thinking like a plumber when adjusting medications
When I decided to leave practice and explore non-clinical career options, I found no shortage of opportunities, ranging from the pharmaceutical industry to the health insurance industry and many points in between. I chose to work in the health insurance industry because jobs were plentiful, and the focus of work remained on the patient.
A typical entry-level job in the health insurance industry is that of utilization …
For doctors leaving clinical practice: Do not consider utilization review jobs
My Tuesday out of clinic started off like any other Tuesday. I got up (sluggish, still chronically sleep-deprived), scrubbed my face and brushed my teeth, slipped into workout clothes then set to getting my two girls ready for school. After packing lunches, brushing hair, and waiving to the bus, I sat down to do what most of us do on our days out of clinic: check the dreaded inbox. Who …
I’m your primary care doctor. May I take your order?
We have been walking down a long hallway for many, many months. We left the room we resided in pre-COVID, but we have not yet found a room to rest. We are in the liminal space of COVID. This is unsettling and unnerving — liminal space often is.
Liminal space in architecture is the area between discrete, functional spaces, a way of passage, but not the place where beds are placed, …
Crossing the liminal space of the pandemic
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