Physician

When medical malpractice is not medical malpractice

Physician
November 1, 2024

In medical malpractice, inductive reasoning regards the standard of care as the duty to do no harm. If there is a complication from a medical intervention and the medical intervention differs from the standard of care in any conceivable way, the difference alone is sufficient to conclude that the medical intervention departs from that duty.

However, unanticipated threats require nimbleness. This is a calculated risk. It causes a difference, but it …

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Why this doctor stayed stuck in a job for years and how she finally broke free

Physician
November 1, 2024

My work was draining. The joy was no longer there. Sure, I loved caring for patients, but the schedules, the call, and missing my children’s life events were all catching up to me. It all was too much. After two decades at a Level 1 hospital, I was the epitome of a “burned-out” physician. My mind would harken back to the Clash’s famous song from the 1980s—”Should I stay or …

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Why the RVU system makes attaining the quadruple aim laughable: a deep dive into a broken health care model

Physician
October 31, 2024

The quadruple aim represents an ambitious, holistic vision for the future of health care: improving population health, enhancing the patient experience, reducing per capita costs, and improving the work-life balance of health care providers. While many health care systems have adopted this framework, the widespread use of the relative value unit (RVU) system fundamentally undermines these goals. Far from facilitating the quadruple aim, the RVU system creates a chasm between …

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How Betty Ford’s breast cancer battle revolutionized health care in the 1970s

Physician
October 30, 2024

It is rare that an ABC movie of the week endures. Buzz Kulick’s 1971 Brian’s Song is the notable exception. IMDB describes the movie as a “beloved tearjerker,” which portrays the friendship between Chicago Bears teammates Gale Sayers and Brian Piccolo in the mid-1960s. Central to the plot is not only the race-based prejudice that existed in professional football at the time but also the public depiction of cancer in …

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What would we do if we weren’t doctors?

Physician
October 30, 2024

I have often wondered where I would be if I had never been accepted to medical school. After all, I got in by the slimmest of margins. I even failed at one application round, finally matriculating at Boston University after an icy post-college winter delivering UPS packages through the snow-covered streets of Cambridge and a depressingly lazy summer punching receipts at the exit to BJ’s Wholesale Club. Now, thirty years …

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Toward a work-life compass: Work-life balance doesn’t exist

Physician
October 30, 2024

A four-day workweek is being touted as better, especially for jobs that are cognitively oriented. The brain needs more time for rest and relaxation than a five-day workweek allows, so four days of work and three days for everything else will provide a work-life balance.

For more than two decades, particularly after I had my first child 17 years ago, I’ve been trying to achieve that elusive work-life balance. I …

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How a single act of kindness can transform the world

Physician
October 28, 2024

Since I was a child, I have despised the words “May you live long.”

I felt like it was a curse.

My younger brother, who knows my thoughts, used to joke, “Allah kre tumhari itni lambi umar ho, tum marne ko tarso!” (May Allah bless you with such a long life that you will pray for your death.)

He still wishes the same for me. (He wants me to suffer.)

I used to say …

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How the DEA’s use of predictive algorithms is worsening crises in urban communities and raising suicide rates among African Americans

Physician
October 28, 2024

The true definition of criminal behavior has always been problematic. Are we criminals because we break the law or because we have been convicted? Famous and revered people throughout history have clearly broken the law but are almost never defined as criminals. All the founding fathers of the United States self-admittedly committed treason against the crown, a capital offense. In contrast, others, like Stalin and Hitler, had every legal right …

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Why good doctors are being jailed—and what it means for you

Physician
October 27, 2024

Today, in America, if you are suffering from certain medical conditions, physicians are being taught that you cannot be trusted or even treated. This results from a decade of law enforcement targeting physicians, pharmacists, and nurse practitioners for making medical judgment calls the police don’t agree with when it comes to the treatment of certain conditions. I use the term “police” here to include federal agencies, knowing that, while policing …

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Most medical school students are being seriously compromised in their future medical careers

Physician
October 27, 2024

The mythical belief that almost 100 percent of medical school students have accepted over the last century—that one can practice medicine without the need for a business education—has contributed not only to the crisis in health care and the physician attrition crises we see today, but also to the rapid disintegration of private medical practice in our nation.

The confusion covertly introduced into medical students’ minds stems from the missing segment …

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The maternal and child health crisis in Sudan: a call to action

Physician
October 25, 2024

The war in Sudan, which began in April 2023, has created one of the world’s largest displacement crises, forcing more than 10 million people to flee their homes. The warring sides, the Sudanese Armed Forces and the Rapid Support Forces, are inflicting horrendous violence on people across the country. Hospitals have been attacked, markets bombed, and houses razed to the ground, leading to a catastrophic toll on the health of …

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How flawed legal reasoning can tilt medical malpractice cases

Physician
October 24, 2024

A quote by Sir Winston Churchill: “However beautiful the strategy, you should occasionally look at the results.”

Actually, Churchill never said this. It may have been Ian Gilmour, a member of Margaret Thatcher’s Cabinet, years after Churchill’s death. Nevertheless, this quote is often cited in the context of risk management. It is as relevant in a medical malpractice lawsuit as it is a warning to malpractice attorneys. No matter how elegant …

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As a doctor, what I learned from knocking on doors for the presidential election

Physician
October 24, 2024

When I’m not knocking on exam-room doors as a pediatrician in New York City, I’m knocking on voters’ doors in Northampton, Pennsylvania—a small county that could determine the outcome of this year’s nail-biting presidential election.

Each time I walk up to a voter’s front door, my heartbeat quickens. You would think a doctor who talks to total strangers every day would be immune to such jitters. But even with a door-knocking …

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From darkness to empathy: How one ICU patient transformed my perspective

Physician
October 24, 2024

My first ICU rotation of intern year was filled with great darkness. It was dark outside as I walked from my car into the hospital each morning before sunrise, and it was again dark when I walked to my car at the end of the day. Less than one hour into my first day in the ICU, a patient’s weak and ineffectual heart stopped beating, and CPR was swiftly initiated. …

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Nurses sue over trans colleague’s actions

Physician
October 22, 2024

Eight female nurses at a United Kingdom hospital are suing their employer for not assuring their psychological and physical safety. The nurses work in specialized areas that require their changing uniforms once daily. There is a trans-female nurse, similarly specialized, who changes with them. He wanders about the locker room in briefs or nude, the women report, ogling them as they exchange clothing. It has also been related that he …

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Physician gaslighting looks like this

Physician
October 22, 2024

As physicians, we are often collectively gaslit—made to believe that somehow, we are responsible for system failures. Many physicians are brainwashed to “drink the Kool-Aid” and accept phrases like, “This is the way things have always been done.” We are made to feel inhuman when we advocate for ourselves as if we are somehow to blame. The system uses terms like “unprofessional,” “unable to cope with the rigors of being …

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Medical crisis or government overreach: How misguided policies are destroying lives

Physician
October 20, 2024

A million vulnerable patients have died in the last decade, and while I have no doubt the rate of overdose and poisoning will drop nationwide—killing a million vulnerable patients has that effect eventually—I choose not to contribute to that death rate. This decision is in accordance with my deeply held beliefs. In 2014, Governor Asa Hutchinson signed the Arkansas Conscience Protection Act into law, supposedly protecting health care professionals who …

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The role of social credit scores in the enforcement of health care regulations

Physician
October 19, 2024

As health care predictive algorithms, including the Prescription Drug Monitoring Programs (PDMP), expand their reach beyond traditional enforcement of health care regulations, the concept of a social credit score has emerged as a powerful but controversial tool. Like predictive policing, social credit scores use an individual’s behaviors, online activity, and social interactions to assess their perceived trustworthiness and risk to society and are used as fodder for the prosecution of …

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Why in-person care still matters in the age of telemedicine

Physician
October 19, 2024

There’s a patient who comes to see me every week. Every time we part ways, I say, “OK, Susan (name changed)! See you in a month!” But inevitably, she’ll call on a morning when she knows I’m in the office, and my staff will fit her in. She likes to tell me about what she did with her granddaughter that week. She doesn’t have anything terribly wrong with her; she …

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