During my internal medicine internship in 1980 a professor chided our team because housestaff no longer prepared and interpreted peripheral blood smears. He scoffed that they don’t make doctors like they used to. I have heard similar lamentations through the years. I imagine that millennia ago Galen griped that his apprentices did not examine phlegm and feces closely enough. I noted that I should not become a crotchety critic when …
It is said that everything that moves has a breaking point. Engineers understand this concept, and they have developed intricate methods to understand when metals will reach their breaking point if they sustain repeated back and forth stress.
It becomes crucial to understand that when metals break, the consequences have substantial implications as many industries rely on machines to be efficient and safe. If a machine shuts down due to the …
Physicians are hurting. This is what makes them human.
I’ve always had a strong sense of justice. I think that’s what attracted me most to superheroes as a child. Growing up, my favorite by far was Spider-Man.
Many people think it’s because of his superpowers, but for me, it was always about Peter Parker, the man behind the mask. Peter Parker is a nerdy guy who loves science and makes inappropriate jokes all the time. He has this immense personal …
You don’t belong here. You’re not good enough. You’re no superhero.
I went to replace four hanging plants at a nursery this past weekend because they all died once the Texas heat made its appearance, despite being watered, placed in the shade, and talked to by my daughter and me.
While I was looking for plants that will hopefully survive the Texas summer, I was chatting with my husband, who cheekily said, “Those plants weren’t resilient.”
He, of course, knows my disdain for …
I recently heard an interview on NPR about the author Yusef Salaam that wrote a book called Better, Not Bitter, and the title just blew my mind. I had to repeat it a few times in my head. Better — not bitter.
It made me think of everything that happens to us and how we all have a choice to turn any small interaction up to every major trauma into an …
Become an ambassador of joy and movement
The regulation allowing full reimbursement for telehealth visits in the setting of the pandemic was a wise and compassionate decision. As more doctors participated, many thousands — likely millions — of sick and susceptible elderly were able to access needed care without exposing themselves to COVID-19. It was a double-edged sword, however, and we are now seeing the downside of continuing such a policy beyond pandemic concerns. The problem: Everybody …
The telehealth problem: full pay, but less value
I’m currently reading What Happened to You by Oprah Winfrey and Bruce D. Perry, MD, PhD, and being reminded that I react rather than respond when I am in a trauma activation. When that happens, I don’t have access to higher cortical functions like critical thinking. And as Gabor Mate, MD, would say, I don’t respond to what’s happening; I respond to my perceptions of what’s happening. And actually, I …
How a physician learned to stop reacting to overnight calls
On April 5, 2021, the federal government mandated that health care providers provide free electronic access to patients’ clinical notes, as part of the 21st Century Cures Act. This includes 8 types of notes spanning outpatient and inpatient arenas. If providers/organizations do not comply with this mandate, they will be subject to fines due to “information blocking.”
This was borne from the OpenNotes movement – which declares itself to promote and …
How medical notes will change if patients get to see them
As a parent who also happens to be a hospital-based pediatrician, lots of people have asked me my opinion on back to school and/or daycare.
I am sharing my thoughts. I’m only one person. These are just my thoughts. Feel free to take what is helpful to you and trash the rest. It won’t hurt my feelings.
I think it’s important to frame this conversation by stating loudly and clearly that there …
Putting my kid back in school: the right decision for this pediatrician
First, you turn off your phone. You can’t have any interruptions. As you walk to your patient’s room where the family is waiting for you, pick up a box of tissues and put it in your back pocket. Don’t hold it in your hand as you meet them. It’ll betray their new reality.
When you enter the room, you introduce yourself to everyone as the doctor. You find a seat to …
How to tell someone their loved one died
“We can’t sit in the stands – we have to get messy and play on the field.”
The casual observer, the season ticket holder, the player, and the coach have very different levels of knowledge, skill, and passion for a professional sport. The casual observer may be confused, not even understanding the fundamentals of the game. The season ticket holder likely has some experience with the sport, possibly playing as a …
Getting messy in the game of health care
But seriously, who needs scientists? It’s not like we listen to researchers or pay attention to the warnings. The world is burning up with record ground-breaking temperatures. These so-called scientists predicted these warnings decades ago, with great details. Who do they think they are? They got lucky! They are fear mongers and not to be believed. Look at the fake media! Landslides, earthquakes, fires, flooding, drought, and the list goes …
Who needs scientists? It’s not like we listen to them anyway.
For most care providers, having conversations about end of life comes with certain challenges. Most medical education prioritizes diagnosis and treatment of illness with the goal of extending life; therefore, it can be quite difficult to acknowledge when curing illness or prolonging life are no longer achievable goals. On top of that, it’s certainly not easy to witness the pain and sadness of families when their loved ones are nearing …
Why it’s important for physicians to talk about death
ADVERTISEMENT
Pick out any company’s mission, vision, and value statement, and you are very likely to find a call to innovate. Companies understand they must produce more high-quality widgets, ideally at a lower cost. Adherence to the status quo will only get in the way of this pursuit: Innovation is the name of the game.
Consider a company that makes cake, and the current version of the cake isn’t selling as well …
What has leadership accomplished by asking for innovation?
My husband and I recently had a bit of a wobble in our marriage. In truth, it was more than a wobble, and it had been building for years. I am pleased to say that we have traversed the turbulence. Not only are we once again sailing in smooth waters, but we are sailing in more idyllic waters than ever before.
Why did it happen?
For so many reasons, but I need …
Why this physician and her husband almost divorced
We in Southern Oregon saw how the pandemic raged in other areas of the country. We were waiting. It would hit here, eventually, we knew it. It came to our city slowly, and then we had a spike. Still, it was much milder than many other places, and we were grateful to be spared the worst of it.
People started getting vaccinated. It was like a baptism of sorts, and the …
We are all out of ideas for how to convince you to get vaccinated
Last March, I was working in a small primary care practice on the west side of Denver. COVID-19 came to town. On Thursday, March 12, we were told the schools would be closing. On Friday, we were told that clinic staff had to wear masks — and the clinic had to start testing patients for COVID-19.
The only problem? There were no medical-grade masks to be had. Not through the state …
I was thinking about retiring, and COVID-19 gave me a push
You are 19 years old, standing in the mud and mire that are the trenches of World War I. You are cold, hungry, filthy, emotionally, mentally, and physically exhausted. You stare straight ahead, eyes vacant, not revealing deep inside you a visceral fear that defies description; a fear that only those who have faced the horror of combat know. This is your reality. You know what awaits when the order …
Surviving the first 100 yards: How do you do it? Why do you do it?
When I started my career 15 years ago, I naively said I would like a job where there aren’t a lot of politics. Little did I know that my job and profession would be so strongly affected by national politics a decade and a half later.
I study human behavior and can usually conceptualize behaviors fairly easily. I have been stumped in the past four months. Truly stumped. Four months ago, …
I am not asking you to do anything my family and I haven’t done
Four years ago, I was ready to throw in the towel. I practiced for 22 years in a large metropolitan hospital, became very involved in resident education, clinical program directorship, medical staff affairs, in addition to a busy hospital-based surgical practice. I watched as the environment of care for clinicians and the quality of the relationship between the medical staff and system administration steadily deteriorated.
My small, single-specialty surgical group merged …
Ageism and the mid-career physician
Get free updates delivered free to your inbox.
