"I don't think I am the right doctor for you." In over 20 years of practice, I had never uttered those words before this year. Now, as my medical assistant of 20 years remarks, almost two years into the pandemic,…
“I don’t think I am the right doctor for you.”
In over 20 years of practice, I had never uttered those words before this year. Now, as my medical assistant of 20 years remarks, almost two years into the pandemic, I say it almost daily.
I like to think I am a good physician and listener, spending most of the outpatient visit time trying to understand what it is that the patient …
It was dark as we entered a crumbling stone building, a one-room 15’ x 15’ structure. No electricity, no running water, no amenities, we assume “we all have.” I was leading a medical team to the poorest country in Europe,…
It was dark as we entered a crumbling stone building, a one-room 15’ x 15’ structure. No electricity, no running water, no amenities, we assume “we all have.” I was leading a medical team to the poorest country in Europe, Moldova, a country I had come to know and love well. The team had finished a busy day in the clinic. Before going to dinner, I wanted to make a …
A record number of Americans are choosing to quit their jobs. This phenomenon has been termed The Great Resignation by economists. The reasons for the Great Resignation are multifactorial and a subject of great debate, but some insight can be…
A record number of Americans are choosing to quit their jobs. This phenomenon has been termed The Great Resignation by economists. The reasons for the Great Resignation are multifactorial and a subject of great debate, but some insight can be gleaned from the rise of a movement that has been called ‘antiwork’. This movement is probably best embodied by the immensely popular /antiwork Reddit forum, where aggrieved employees share stories …
I'm writing this case report to raise awareness about a condition plaguing the health care system. The condition is Prior Authorization Fatigue Syndrome (PAFS). This condition is the direct result of the circuitous process of prior authorization (PA). I am…
I’m writing this case report to raise awareness about a condition plaguing the health care system. The condition is Prior Authorization Fatigue Syndrome (PAFS). This condition is the direct result of the circuitous process of prior authorization (PA).
I am the physician owner of a medium-sized allergy practice in Southern Colorado. In our clinic, we spend many hours navigating the PA system to obtain approval for a range of health conditions. …
Even though COVID infection rates are decreasing, health care providers are still struggling with how to handle unvaccinated patients. Last month, a Colorado hospital system, UCHealth, stated it won't provide transplants to patients who choose to remain unvaccinated. In August,…
Like any stressor, COVID-19 has revealed great strengths in science and medicine. But it exposed weaknesses that could have been tolerated before but now are untenable. Perhaps the best example of both is COVID vaccines — the success they have…
Like any stressor, COVID-19 has revealed great strengths in science and medicine. But it exposed weaknesses that could have been tolerated before but now are untenable.
Perhaps the best example of both is COVID vaccines — the success they have had against the COVID pandemic and the fuel they have provided for an equally dangerous pandemic: the misinformation pandemic.
There was no guarantee that a COVID vaccine would even be possible, and …
Recently I have been more quiet than usual. Less writing. Less fire and brimstone. Quiet, at least for me. But anyone who is paying attention knows that when the most passionate and the most invested get quiet, something is truly…
Recently I have been more quiet than usual. Less writing. Less fire and brimstone. Quiet, at least for me. But anyone who is paying attention knows that when the most passionate and the most invested get quiet, something is truly amiss. Whether it be a looming threat or a very real and present crisis is unknown, but the fact remains that in that silence lives the very real possibility of …
An excerpt from Physician Underdog. When investors make the decision to invest, there is something deeper that occurs outside of the capital. A foundation of empowerment is built, and the founders have an edge now over others that didn’t get…
When investors make the decision to invest, there is something deeper that occurs outside of the capital. A foundation of empowerment is built, and the founders have an edge now over others that didn’t get investment. This comes back to how powerful venture capitalists can be, because they have the ability, through their endeavors, …
Recently, I finished reading a book about Dr. D.S. “Doc” Ping titled The Legend of Doc Ping. Doc, a former United States Marine and Vietnam veteran, mentored me for a near-decade from my adolescence through early adulthood. As I was…
Recently, I finished reading a book about Dr. D.S. “Doc” Ping titled The Legend of Doc Ping. Doc, a former United States Marine and Vietnam veteran, mentored me for a near-decade from my adolescence through early adulthood. As I was reading this book, I could not help but reflect on my time training with him, and the lessons I learned from “Ping’s Dojo,” especially as they pertain …
My 13-year-old daughter inspired this article. If you parent a middle school volleyball player, you know that overhand serving is the holy grail of the game at that level. My daughter has a solid underhand serve that works well for…
My 13-year-old daughter inspired this article. If you parent a middle school volleyball player, you know that overhand serving is the holy grail of the game at that level. My daughter has a solid underhand serve that works well for her, but a consistent overhand serve would give her a big boost. To my consternation, she prefers to practice passing, i.e., bumping the ball back and forth. Why would she …
One patient down. Nine more to go. My attending politely closed the door behind him and walked back to his computer to chart his patient. His pen crossed off a line from the list that he pulled from his pocket.…
One patient down. Nine more to go.
My attending politely closed the door behind him and walked back to his computer to chart his patient. His pen crossed off a line from the list that he pulled from his pocket. His schedule was listed in 15-minute intervals.
As we got to the workroom, he sat down, and under his breath, I heard him sigh. It was barely ten o’clock in the morning. …
For the last couple of decades, I was trained to save lives. I sat shoulder to shoulder with others who drilled this in me when I was green, sometimes even through humiliation. I learned to perceptively read patient cues, develop…
For the last couple of decades, I was trained to save lives. I sat shoulder to shoulder with others who drilled this in me when I was green, sometimes even through humiliation. I learned to perceptively read patient cues, develop quick reflexes, and think on the spot in critical moments, wherever and whenever life was compromised. I always threw lifebuoys into the ocean when I was called into action. This …
Once again, at 1 a.m., I was knee-deep in patient charts and the cacophony of messages that our "user-friendly" EHR employs to allow various staff members to reach us. One of these was about a simple, inexpensive radiologic test I…
Once again, at 1 a.m., I was knee-deep in patient charts and the cacophony of messages that our “user-friendly” EHR employs to allow various staff members to reach us. One of these was about a simple, inexpensive radiologic test I had ordered which the insurance company denied for my patient. Not surprisingly, I was exhausted, and I lost it.
With some minor edits, I wrote the following in response to this …
This article is satire. As an orthopedic surgeon, it has always been clear that our specialties benefit from a somewhat symbiotic relationship. We feed you patients, and you often return the favor by providing us with the needed confirmation to…
This article is satire.
As an orthopedic surgeon, it has always been clear that our specialties benefit from a somewhat symbiotic relationship. We feed you patients, and you often return the favor by providing us with the needed confirmation to operate. However, I feel as though there is a deepening rift between our two specialties. It has been developing gradually, almost imperceptibly, over time. Perhaps it is perpetuated by the belief …
"No matter how extensive or well-developed your capacity for empathy may be, you cannot feel empathy for everyone all the time. Whether we’re talking about doctors who have never been patients, or clinicians who have never faced discrimination, we know…
“No matter how extensive or well-developed your capacity for empathy may be, you cannot feel empathy for everyone all the time. Whether we’re talking about doctors who have never been patients, or clinicians who have never faced discrimination, we know that people’s ideas can change, when properly educated and …
I’ve been struggling to find the right way to highlight how relentlessly misinformation is killing us. I could say that another World War II would only be 60 percent as deadly for Americans as this misinformation-fueled pandemic. I could say…
I’ve been struggling to find the right way to highlight how relentlessly misinformation is killing us. I could say that another World War II would only be 60 percent as deadly for Americans as this misinformation-fueled pandemic. I could say that if the deceased victims of COVID-19 were their own state, they’d have a larger population than Wyoming, Vermont, or Alaska.
But these examples fall short in two important ways.
There are several major transitions in a person’s medical career. The first occurs when you leave behind undergraduate life for medical school. The first term as a medical student will test your resiliency and confirm whether you are prepared to…
There are several major transitions in a person’s medical career. The first occurs when you leave behind undergraduate life for medical school. The first term as a medical student will test your resiliency and confirm whether you are prepared to make the necessary sacrifices to be a physician. The next transition occurs as you leave the academic portion of medical training and enter clinical rotations. This process culminates with the …
How do you learn to deliver the worst news anyone will ever hear? And equally important, how do you find the resilience to go on when difficult conversations don’t go well? My profession for the past 15 years has been…
How do you learn to deliver the worst news anyone will ever hear?
And equally important, how do you find the resilience to go on when difficult conversations don’t go well?
My profession for the past 15 years has been to train the next generation of physicians as an inpatient clinician-educator. A key piece of my work revolves around communication with patients and their families. On each new resident team, I coach, …
It felt like watching a train go by with no control over its destination and no way to stop it. We simply had to watch our loved one as he made his way towards death. The doctor said he had…
It felt like watching a train go by with no control over its destination and no way to stop it. We simply had to watch our loved one as he made his way towards death.
The doctor said he had a traumatic brain injury with herniation. His pupils were fixed and dilated on arrival to the emergency department, which meant that he was not a candidate for any neurosurgical intervention. And …
I had surgery recently, and as most physicians do at some point, I found myself on the other side of the bed. Definitely not the side where I have the most experience or feel most comfortable, but it is what…
I had surgery recently, and as most physicians do at some point, I found myself on the other side of the bed. Definitely not the side where I have the most experience or feel most comfortable, but it is what it is. The whole process makes a person feel vulnerable and out of control: not a feeling most doctors are accustomed to. But I knew the procedure, so I peed …
