As a gynecologist, I not only witness new love but have to regularly ask about it because it can impact my patient’s health. They may need birth control, STI screening and counseling, or pre-conceptual counseling. Then there is one of my favorite group of patients: those that are “older” and entering into new relationships either for the first time or following a divorce or loss of a spouse. The balance …
I burned out early. I was done being a doctor at the end of fellowship. Although I took a job as a critical care physician, I desperately sought to alter my career somehow. I looked into website development, something I had been good at in high school. I took a few refresher classes on my days off and started coding my own sites. Luckily, my first job out of fellowship accepted many …
I was done being a doctor at the end of fellowship
Having recently returned from a medical mission to the Syrian refugee camps in Jordan, I have become consumed with advocating for the rights of the children outside of our borders. All the while the children I have spent the last five years caring for have been fighting for themselves in this changing political climate. As a pediatrician for an underserved immigrant population, I have seen first hand how a simple …
How an executive order can erase an entire childhood
Long ago, before our hospital changed over to a nearly complete hospitalist model, the faculty at our internal medicine practice served as the attending of record for all of our own patients, as well as the patients of the residents we supervised, when those patients were admitted to the inpatient services across the street.
When we would arrive in the morning, we would look at the admission list, note that one …
Let primary care doctors practice more outpatient medicine
I’ve always wanted to be a pediatrician because I love kids; if you ask most people who work in pediatrics whether nurses or physicians they may say that. It’s a very common response to the question “Why pediatrics?” Or how can you do pediatrics?” when students and physicians are asked. Yes, we love working with children for many reasons. Some love the unexpected unrehearsed things kids say; they will shock …
When healthy children die: Pediatricians are not superhumans
After eight years of practicing obstetrics and researching childbirth in the United States, I know as well as anyone that the American maternal health system could be better. Our way of childbirth is the costliest in the world. Our health outcomes, from mortality rates to birth weights, are far, far from the best. 
The reasons we fall short are not …
Childbirth in the U.S. and India: How it falls short and why
Telemedicine is often in the news and until recently I had only casually glossed over the latest articles. The details I paid little attention to, but the headlines I would remember. “Great for rural areas” I would read! “Extend physician reach!” “Get specialists to greater numbers of patients with unique conditions!”
As a nearly graduated anesthesia resident in a large city with an abundance of doctors, I didn’t think telemedicine would have …
Will telemedicine take your job?
I met a man recently who had wandered about life dragging the rotting corpse of his arm barely attached to the rest of his body for over a year. His limb carried such a pungent malodor he stopped eating months ago because the noxious stench of his own dripping pus made him perpetually nauseous. A former handyman, he had jimmied up a poor-man’s sling with a tattered Hanes undershirt. It too …
How the ER touches the untouchables in society
Recently, I wrote a letter to hospital executives, urging them to deliberately invest their own personal time and effort in fostering hospitalist well-being. I suggested several actions that leaders can take to enhance hospitalist job satisfaction and reduce the risk of burnout and turnover. Following the publication of that post, I heard from several hospital executives and was pleasantly surprised that they all responded positively to my message. Several execs …
How hospital executives wish their hospitalists would act
The frenetic pace and chaos of working in an urban trauma center are addicting — at least for a while. Interesting, unusual, and tragic patients test the mettle of even seasoned physicians. For some, the lure is too strong to step away.
For others, the attraction of a quieter life and promise of a more sane existence is too powerful to resist.
My story
After training in one of the busiest level 1 …
Finding contentment in rural emergency medicine
I swear by Epic, by eClinicalWorks, by Allscripts, by AthenaHealth, and by all the coders and accountants, making them my witnesses, that I will carry out, according to my ability and judgment, this oath and this indenture.
To hold my mouse in this art equal to my own hand; to make it right-click as well as left-click; when my ACO is in need of money to share an “at-risk” portion of …
Today’s version of the Hippocratic oath
To be clear, this is about one person. It warms my heart to know that people want to come and start new lives as Americans. Some of the best doctors got their education and training overseas. Not only have I worked with many of them, I’m related to three by marriage. Most people have heard of Mr. Andrew Wakefield. He used to be a British doctor before being stripped of …
The one immigrant who has nothing good to contribute to the American story
“I attribute my success to this-I never gave or took any excuse.”
-Florence Nightingale
I was publicly thanked today for doing my job. No, really. By two of my coworkers, actually. It sort of took me aback just a bit.
Over the past Christmas holiday a couple of patients, being human as we all are, forgot to get their medications squared away before the clinic was going to close for a total of …
It’s 2017. There’s no excuse to be disconnected.
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Wellness. It’s all the rage these days as we try to manage our crazy work schedules while still maintaining balance in life. We have wellness committees, wellness workshops, wellness coaches, and wellness apps for our smartphones.
So, then, what does it mean to be well?
To the average person, and to the dictionary, to be well is to be “in good health” or “in a good or satisfactory way.”
However, to those suffering …
What does it mean to be well? Ask an opiate addict.
So, how do you do it all?
It’s a Monday morning. After a flurry of activities, I am walking into the office at 8:00 a.m. I think back to the past 2 to 3 hours. I was up at 5:30 a.m., and in my workout clothes soon after. I managed to squeeze in a 20-minute workout, thanks to a video on YouTube. I then reviewed my schedule and patient charts for …
How do physician-mothers do it all?
I knew the moment when my career in pediatrics was over. I was in the fourth year of my med-peds residency, taking overnight call in the pediatric ICU. Nights were busy, stressful and I was alone. A young boy came in as an unrestrained MVA after his father hit another car. Dad was OK (although severely distraught), but the five-year-old towhead boy in front of me was not, with his head immobilized in …
The decisions that changed this physician’s career
“Too many times I feel
We are losing time once shared
And only when you’re in ecstasy
You seem to really care”
I recognize the song immediately — Chuckii Booker’s “Turned Away.” Not the regular version, but the extended one. As the words rush over me, caressing my nostalgia, a memory, a moment comes back.
I was standing behind the counter at Homer’s Ice Cream on a brilliant summer morning before the doors opened. We …
This the one thing that makes me feel like everything is OK
How do you describe the feeling when you are at a restaurant, and the waiter sees your coffee cup at less than half full (never half empty) and without asking they refill the cup or better yet, bring you a fresh cup of coffee? If you are like most customers, you have a nice feeling about the restaurant and the waiter as they have anticipated your needs. Usually, this anticipatory …
Improve the patient experience with anticipatory patient service
Recently, one of the biggest mistakes ever observed on live television occurred when Warren Beatty and Faye Dunaway, presenters of the award, announced the wrong film as winner of the Academy Award for best picture. Not since Janet Jackson’s costume malfunction has, live television caused such uproar.
How could this have happened? How could it have been prevented? Moreover, what can this error teach us about how we care for patients?
A …
What the Oscars can teach us about patient safety
Sometimes it feels like the great unspoken secret between doctors and nurses. The words that we dare not utter to patients and families. Perhaps it is our hope that we’re wrong. Perhaps, we dread providing unwanted news. Perhaps, we don’t want to face reality or extinguish our patients’ hope.
As a daughter, I felt that sense of sadness and dread, waiting to hear the news that would not be told. It was September …
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