Consuming too many potato latkes and Christmas cookies has left its mark on our waistlines. Unfortunately for Americans and their medical care, the seasonal overeating seems to last all year. Indeed, the American Medical Association has declared that obesity is…
Consuming too many potato latkes and Christmas cookies has left its mark on our waistlines. Unfortunately for Americans and their medical care, the seasonal overeating seems to last all year. Indeed, the American Medical Association has declared that obesity is a disease.
It may be more accurate to describe obesity as a contributor to certain diseases. Obesity raises the risk of premature death, heart disease, high blood …
First, you have to call up your daughter to pick you up and take you to the lab. It’s hard for the nurse to find your vein. The pain from his fishing around in your arm is not nearly as…
First, you have to call up your daughter to pick you up and take you to the lab. It’s hard for the nurse to find your vein. The pain from his fishing around in your arm is not nearly as bad as the pain you always have in your hip, and back, and shoulders, but it’s the straw that breaks the camel’s back, and you cry a little bit. The …
I knew Friday was not going to be a good day. A leak in the ceiling of my family room. A pet who would need surgery. I was already stressed well before Friday. But at work, the issues started on…
I knew Friday was not going to be a good day.
A leak in the ceiling of my family room. A pet who would need surgery. I was already stressed well before Friday.
But at work, the issues started on Thursday with an osteoporotic patient for whom I had recommended Forteo, six weeks earlier. It was denied by her insurer who wanted Tymlos instead. No big deal. We simply precerted Tymlos, but …
One of the largest problems in our ER, it seems, is that there is a subset of patients who visit us on a routine basis. Commonly known as "the regulars," these familiar faces are sprinkled throughout our day between all…
One of the largest problems in our ER, it seems, is that there is a subset of patients who visit us on a routine basis. Commonly known as “the regulars,” these familiar faces are sprinkled throughout our day between all our other patient visits. Whether it be for chronic pain, for chronic illness, for companionship, simply to have a place to hang out for a few hours, or to get …
"Aren't you happy for me?" asks the patient smiling from the exam chair in my office. I say yes, but that's not entirely true. Happiness isn't the right word. Conflicted might be it. How do I reconcile my feelings when…
“Aren’t you happy for me?” asks the patient smiling from the exam chair in my office. I say yes, but that’s not entirely true.
Happiness isn’t the right word. Conflicted might be it. How do I reconcile my feelings when this patient, who I am not sure is deserving, reports that he was awarded Social Security disability?
Sure, he has severe arthritis, wildly uncontrolled diabetes, and a massive skin breakdown of his …
Egotism is a common trait among doctors, although most of us keep it under adequate control when dealing with patients. The ideal doctor-parent encounter has been described as a collaboration among equals, each of which brings expertise to the exchange;…
Egotism is a common trait among doctors, although most of us keep it under adequate control when dealing with patients. The ideal doctor-parent encounter has been described as a collaboration among equals, each of which brings expertise to the exchange; the doctor knows medicine, the parent knows the child. This is the ideal, although sometimes the reality falls short of it. The way our medical system is now structured gives …
My uncle died last year. As physicians, we are all too familiar with death. Even if we are practicing primary care, we are touched by death and the line between life and death. That patient who had what statistically should’ve…
My uncle died last year. As physicians, we are all too familiar with death. Even if we are practicing primary care, we are touched by death and the line between life and death. That patient who had what statistically should’ve been acid reflux, but who you found to have stomach cancer. That breastfeeding mom who thought a little lump was a clogged milk duct, when it actually turned out to …
If you asked me five years ago what my career goals were, I may have said something about getting more grant funding and writing more manuscripts so I could eventually become an independently funded physician-scientist. But honestly, at that time,…
If you asked me five years ago what my career goals were, I may have said something about getting more grant funding and writing more manuscripts so I could eventually become an independently funded physician-scientist. But honestly, at that time, I had no concept of the nitty-gritty details and emotional support that it would take to accomplish those goals. My primary research mentor was a notable figure in our field …
Experience and skills are not enough to assure the highest levels of success and sustainability with improvement initiatives in healthcare. The reason this is true has to do with ... quicksand. When I was a kid, quicksand seemed to show…
Experience and skills are not enough to assure the highest levels of success and sustainability with improvement initiatives in healthcare. The reason this is true has to do with … quicksand.
When I was a kid, quicksand seemed to show up in movies quite a bit. People would be on the beach or in the jungle walking on what seemed like solid ground and suddenly get stuck. In quicksand, you lose …
When I first saw Jea-Hyoun, in a medical meet-cute straight out of a romantic comedy, she was being evaluated for thyroid cancer. I was an allergy/immunology fellow harried by a pile of paperwork. She was a patient, in the same…
When I first saw Jea-Hyoun, in a medical meet-cute straight out of a romantic comedy, she was being evaluated for thyroid cancer. I was an allergy/immunology fellow harried by a pile of paperwork. She was a patient, in the same building where she saw patients of her own as a psychiatry and family practice resident, preparing to see the specialist. We made awkward small talk in the hallway before she …
You’ve seen the ads, and you may have even gotten a flyer in the mail directly from your insurance company. Use an app to make a quick video call to get the medical care you need. No waiting rooms, no…
You’ve seen the ads, and you may have even gotten a flyer in the mail directly from your insurance company. Use an app to make a quick video call to get the medical care you need. No waiting rooms, no appointments, no having to be touched, or even sit in a room with a physician – just the magic of the internet, and you’ll get what you want.
I think it’s time for physicians to end the assault on the clinical practices of PAs and NPs. Are you worried about PAs and NPs taking your job? If you’re a good doctor, you should stop worrying. Great PAs and…
I think it’s time for physicians to end the assault on the clinical practices of PAs and NPs.
Are you worried about PAs and NPs taking your job? If you’re a good doctor, you should stop worrying. Great PAs and NPs are everywhere, and I think it’s time physicians embraced them.
PAs and NPs have excellent skills
My first rotation as a third-year medical student was in the emergency department. There was a …
If physicians are “muggers” and co-conspirators in “taking money away from the rest of us,” then journalists and economists are pontificating parasites who produce no goods or services of any real value. I don’t think either is true, but the…
If physicians are “muggers” and co-conspirators in “taking money away from the rest of us,” then journalists and economists are pontificating parasites who produce no goods or services of any real value.
I don’t think either is true, but the recent attacks on physicians by economists Anne Case and Angus Deaton, and “media professional” Cynthia Weber Cascio, deserve to be called out. You …
I sometimes work as a church security volunteer. And when I do it, I get to simply stand and watch. Watch for someone sick or injured (we have defibrillators and wound care equipment). Watch for someone coming to cause harm.…
I sometimes work as a church security volunteer. And when I do it, I get to simply stand and watch. Watch for someone sick or injured (we have defibrillators and wound care equipment). Watch for someone coming to cause harm. Watch in order to call the police. Watch to keep the children safe.
And it occurs to me, when I do it, that watching is incredibly important. I know this as …
The start of a new decade seems more meaningful than the beginning of other new years. I tend to think more long-range at these mileposts. For 2020, I've made three resolutions that I hope will have a positive impact on…
The start of a new decade seems more meaningful than the beginning of other new years. I tend to think more long-range at these mileposts. For 2020, I’ve made three resolutions that I hope will have a positive impact on my life for years to come:
1. Ramp up reading
Starting now, I intend to consume more books on a regular basis. Crucial to meeting this goal will be diverting my gaze …
Stress is one of the epidemics of modern-day living—especially work-related stress. At a basic fundamental level, it’s just simply a chemical reaction. Your adrenaline and cortisol levels shoot up in response to a stressful stimulus, the primitive “fight-or-flight” response kicks…
Stress is one of the epidemics of modern-day living—especially work-related stress. At a basic fundamental level, it’s just simply a chemical reaction. Your adrenaline and cortisol levels shoot up in response to a stressful stimulus, the primitive “fight-or-flight” response kicks in, and your brain and emotions go into overdrive. The problem with this acute response, is that it tends to lead to illogical thinking and an inability to really find solutions. Research also confirms that having chronically elevated stress hormones is very detrimental for your long-term health and …
It’s been liberating and eye-opening and sometimes a pain to have all three of my kids in grade school. The benefits of one drop off and not paying for daycare do outweigh the downside of figuring out what to do…
It’s been liberating and eye-opening and sometimes a pain to have all three of my kids in grade school. The benefits of one drop off and not paying for daycare do outweigh the downside of figuring out what to do with the kids when they have days off. Usually, I plan my schedule accordingly, but I still have to fit in the requisite number of shifts for my
The physician burnout crisis and a national provider shortage have fueled a growing trend in health technology focused on better utilizing physicians and reducing administrative burdens. I became a surgeon because I wanted to help people, not because I had…
The physician burnout crisis and a national provider shortage have fueled a growing trend in health technology focused on better utilizing physicians and reducing administrative burdens. I became a surgeon because I wanted to help people, not because I had a strong desire to push paper. The high volume of administrative tasks increasingly consumes a physician’s time that could be better spent with patients. For example, primary care physicians …
If my hypertensive patient develops orthostatism and falls and breaks her hip, I fully expect the orthopedic surgeon on call to treat her. I may kick myself that this happened, but I’m not qualified to treat a broken hip. If…
If my hypertensive patient develops orthostatism and falls and breaks her hip, I fully expect the orthopedic surgeon on call to treat her. I may kick myself that this happened, but I’m not qualified to treat a broken hip.
If my anticoagulated patient hits his head and suffers a subdural hematoma, I expect the local neurosurgeon to graciously treat him even though it was my decision and not his to start …
The recent pardon of a convicted child rapist by the ex-Kentucky Governor has sparked a lot of controversies. The basis of the pardon was- “the victim’s hymen was noted to be physically intact.” Evolving studies have continuously shown that the…
The recent pardon of a convicted child rapist by the ex-Kentucky Governor has sparked a lot of controversies. The basis of the pardon was- “the victim’s hymen was noted to be physically intact.” Evolving studies have continuously shown that the hymen is not a reliable or accurate means to conclude sexual assault.
But if physical damage is the only criterion used to assess …
