I learn all manner of interesting things from the information sheets posted on the walls of the employee bathrooms at my hospital. I learn, for example, about upcoming CME offerings for advance practice providers, how many seconds one has to scrub the hub of a central line, and what the new process is when nurses need to call in sick. They call a specific phone number and state that they …
Why doctors can’t take sick days
“I want answers!” My mother was upset over the care for her ill husband. Previously able to converse normally, he was now incoherent and disoriented. The recent recipient of a bone marrow transplant to treat his advanced leukemia, he probably experienced a brain infection because of the immune suppression therapy needed to accept the marrow. The marrow transplant didn’t work. He was sent home from the hospital on hospice care …
100 percent satisfaction doesn’t work in our health system
When I became a physician years ago, the idea of telehealth had barely taken hold among doctors or patients. Today, as we bask in the passage of the CHRONIC Care Act of 2017, we’re seeing dozens of use cases in stroke, emergent care, psychiatry and more that underscore telehealth’s potential.
Consumers are becoming increasingly digitally savvy too — and not just the millennials. Today, about one in five adults Read more…
What physicians need to make a telehealth program stand out
Life is short. We always hear that phrase but really don’t know what it truly means. What I mean is that life doesn’t feel short; we complain of our days being too long, or weeks too busy and dragged out. The only thing that feels too short in my life are weekends. There comes a point in life where I think you figure out what it means, you look back …
Doctor, when is your next vacation?
Both in and outside of health care certain buzz words and phrases become so ubiquitously used that a shared understanding is assumed despite conflicting perceptions of what these sentiments actually mean. Examples in health care include: shared decision making, quality of life, professionalism, patient-centered care, and evidence-based. Each sounds positive and intuitive — what health care provider perceives her/himself as not professional and patient-centered or not providing shared, evidence-based, quality …
The hazard of the health care common is communication
When I was 20 years old, I boarded a flight from St. Louis, Missouri to Houston, Texas. It was Fall and the temperature had begun dropping. That being the case, I was dressed like a typical college student at that time of year: sweatpants and a hoodie. After taking my seat, a middle-aged white woman sat next to me. Little did I know what I was in for.
Over the course …
Why your child should have a black, male doctor
There are so many things that I could tell you to be. Be brave. Because change and opportunity are scary and fear is a natural precursor to achievement. Be kind. Because there are fewer things in life that will bring such natural and unadulterated joy. Be humble. Because the first sign that you are plodding off in the wrong direction is the undying certainty you feel in the rightness of …
The act of sharing vulnerability creates incredibly profound experiences
I just heard.
A colleague, a man of integrity and warmth, a hard-working physician with ideals, ethics and many valued contributions, has taken his own life. His perspectives may have differed from mine at times, but every interaction was infused with respect. He was a good man.
Much has been written about the rate of suicide of physicians. One million Americans lose their doctors to suicide each year. Normally …
Reach out to your colleagues: This can have more impact than you can imagine
My patient
The day I met you was early in my second year of internal medicine residency. After much of my internship had been spent on arduous inpatient rotations, I was finally ready to lead my own team of young doctors and students on a high-acuity wards service. Yet, in my continuity clinic, I was still fresh, insecure, and naive. The day I met you, your abdomen was swollen, your eyes …
Primary care uniquely positions us to be our patients’ best allies
When I’m working in a hospital setting as a physician, part of my everyday job duties involves going over consent forms with patients. I am of course a medical physician, rather than a surgeon, so generally don’t have to go over them as often. But I do have to take consent regularly for certain interventions including blood transfusions and minor procedures. The process of getting consent is something everybody is …
The trust patients place in their doctors
There’s an ugly undercurrent that sometimes shows up in the emergency department: indeed all over the world of medicine. I’ve seen it in doctors and nurses alike. It’s a meanness, a smallness, a kind of moral judgment that can lead us to make poor medical decisions. Or it can simply make us poorer in spirit.
I remember the day I had a young man who was in custody. He was 18, …
Physicians need to learn to avoid moral errors
How many physicians know how many visits they are approving when referring to a specialist?
This was a germane question posed to me today. I first asked this question of myself as a junior faculty member, while busting the residents’ chops over the egregious numbers of referral visits they were approving. You see, as any good resident knows, being proactive in the referral department demonstrates skill in the art of “avoiding …
Attention PCP colleagues: We can do better with referrals
During my first pregnancy, I frequently dreamt of my baby. I couldn’t remember the details of facial features or hair color, but I always knew that I was going to have a girl.
Three years passed after Claire was born, two more heartbeats were identified and then lost somewhere deep within my abdomen. On two occasions, I watched blood seep from my body and stain my clothing, realizing that I didn’t …
Perils of a postpartum pediatrician
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It was 4:30 a.m. on a freezing cold winter morning when I dragged myself to my car and started down the street to the hospital. I was working in the ICU for the month, and sleep had become a commodity I no longer enjoyed. I tried to shake my brain out of the dense fog it seemed to always be in lately.
I looked up in time to see my car …
A resident physician’s story of depression
The process of setting up a new pain management clinic has allowed me to critically consider the role of patient intake forms, an area that has traditionally been ignored by technological advances and institutional innovation.
Health care must empower patients to conveniently complete intake forms digitally — whether at home, en-route to our clinics, or in our waiting rooms. When done correctly, the forms can greatly enhance the patient …
It’s time to upgrade the outdated intake forms at health care clinics
“What do you want to be when you grow up?” I see their eyes light up as they smile, and get prepared to answer this very important question. For some of them, it is the only smile I have seen during the entire visit. And for me that makes the entire visit worth it.
I move my eyes away from the computer and solely focus on their face as I hear …
Inner-city teens still have a dream
A good friend of mine, B., once told me a few years ago that before her divorce, her husband was verbally and occasionally even physically abusive toward her. Somewhat shocked by this news, I expressed how glad I was that she had gotten out of that situation.
I did not think that B. would be a typical victim of domestic abuse. Coming from an affluent background, we met as co-workers in …
Domestic abuse can affect anyone, even physicians
Being a hospitalized patient is perhaps one of the most disempowering experiences an individual can face (besides being in war, or a prisoner). Patients face constant uncertainty; having no idea what time their physician will visit, when they will be taken for their tests, or who will suddenly interrupt them again with a demand – perhaps an early morning blood draw, or yet another round of interrogation and uncomfortable examination …
Patients need an advocate at the bedside
Time is our most valuable resource. It’s nonrenewable — once spent, you can’t get it back. We all understand this logically to varying degrees. But many of us feel the compulsion to manipulate time, to restructure it to fit our lifestyles. “Make the time,” is the common expression, as if we could create something out of nothing. You can’t. You can’t change the laws of nature and “make” time, no …
We need more unstructured time for doctors
Hippocrates wrote the Oath for Physicians about 2,500 years ago, and numerous translations and variations have emerged for medical students to take, usually at graduation time. That era of Western medicine had great changes so that an oath appeared necessary to protect the patients in those ancient times. The thrust of the Hippocratic Oath included not only the physician’s competence and dedication but also the critical needs of each patient. …
The impact of the Hippocratic Oath in 2018
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