Physicians have no autonomy. Here’s how to change that.

Physician
September 27, 2023

“Physicians have no autonomy.” I read and hear versions of this every day, expressed with anger, resignation, or both. It’s also called agency, control, and power (as in feeling empowered).

I’m the first one to admit that physicians have way less autonomy than in the ten decades that preceded this one. Moving from private practice to employed models, heightened focus on productivity, compensation via RVUs, and mergers have shifted the power …

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Understanding intersex health care [PODCAST]

Podcast
September 26, 2023
YouTube video

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Join Rosemary Eseh-Logue, an internal medicine physician, as we delve into the often-overlooked topic of intersex variations in sexual development. We explore the importance of understanding intersex identities, breaking down misconceptions, and improving health care experiences for …

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The erosion of patient care

Physician
September 26, 2023

The Black Eyed Peas asked, “Where is the love?” and that’s what I wonder, too. As medicine – oops, I’m supposed to say “health care” – has become more and more corporate, what has been slipping away is the love. What do I mean by that? There were specific ways we old docs were trained to care for patients.

Let’s start with bedside manner. We were trained to sit with the …

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Debating the role of psychiatric assessments in medical decisions

Conditions
September 26, 2023

I recently had an incident involving a long-time patient. This particular encounter proved to be challenging. The patient had chronic pain for years and had already exhausted all conventional treatment options. Ironically, he was otherwise healthy and fit. His recalcitrant condition made him a prime candidate to be treated with a spinal sord stimulator (SCS).

An SCS is an implantable device with two electrode leads connected to a battery-powered pulse generator. …

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Navigating adulthood in the digital age

Physician
September 26, 2023

When my parents were 22, they were two years out of college. My mother was married and commuting from Dallas to graduate school in Houston, on the verge of another cross-country move and a metaphorical world away from her New York City upbringing. My father was the officer running the kitchen on a United States Navy frigate somewhere in the Mediterranean Sea, a literal world away from his Brooklyn childhood.

When …

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5 things to know about weight from a bariatric surgeon

Conditions
September 26, 2023

You’ve probably had friends and family corner you to look at a rash or talk about medications. With social media exploding about Ozempic, these questions and even curbsides from physicians have boomed. We all want to know more about weight.

As a bariatric surgeon, here are five things every physician should know about weight:

  1. How to start a conversation with a patient about weight
  2. When to refer a patient to a …

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Out-of-office infusions in oncology care [PODCAST]

Podcast
September 25, 2023
YouTube video

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Join Banu Symington, a hematology-oncology physician, as she shares her expertise and insights on the topic of out-of-office infusions, discussing patient safety, experience, and the potential impact on cancer care.

Banu …

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The power of business knowledge for medical professionals

Physician
September 25, 2023

My own hundreds of medical articles floating around in the media today about business education being the rigorous standard for profitable and successful businesses, such as private medical practice business, seem to be unworthy for consideration by the dominant leadership in medical school education.

But when I find myself being sucked into reading deep thoughts uttered by world-renowned business experts such as Dan S. Kennedy, Peter Drucker, Maxwell Maltz, MD, Michael …

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Using the language of art to create work-life balance

Physician
September 25, 2023

Most physicians cite work-life balance as a top priority. Yet there is little clarity on what exactly work-life balance means.

Some prefer the term work-life integration, suggesting that work and personal life should be intertwined. Work-life integration is a common buzzword in managerial circles. However, for most physicians, this way of life is already a reality. Taking calls, working late, and keeping up with CME and recertification already mean that much …

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Levamisole is good for your dog, but bad for your cocaine

Meds
September 25, 2023

In recent years, public attention has been focused on the presence of Fentanyl-laced cocaine. It has overshadowed another new threat just as heinous yet relatively unknown – that of levamisole. Since the turn of the century, the use of levamisole has grown as a “filler” to cut or increase the amount of cocaine sold. Other than for veterinary use, this compound has been largely abandoned by human medicine due to …

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Physician autonomy and patient interactions in corporate health care

Conditions
September 25, 2023

Have you noticed that when you try to make an appointment with your primary care physician, you have to wait much longer these days to be seen? And when you do finally walk into the exam room for the appointment, it seems the countdown clock is already in motion. Have you also noticed that the face you last saw opposite you for your previous check-up is not necessarily the same …

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PSA screening: What you need to know [PODCAST]

Podcast
September 24, 2023
YouTube video

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Join Stephen Lieberman, a urologist, as we navigate the nuances of prostate care, discussing the evolution of PSA screening, the controversies it has sparked, and the crucial insights that can empower individuals to make informed decisions about …

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Vague criteria can lead to misdiagnosis and prison

Conditions
September 24, 2023

The definition of addiction, now called substance use disorder, has varied greatly over time. The first edition of the Diagnostic and Statistical Manual, from 1952, didn’t include specific diagnostic criteria for this condition. Over the next sixty years, the DSM went through six revisions, with a slow evolution of the terms “substance abuse” and “dependence.” The first was limited to substance use causing social and occupational problems, while the last …

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U.S. maternal mortality crisis: a deep dive

Conditions
September 24, 2023

Our increasing maternal mortality rate is gathering attention both nationally and internationally. The U.S. is 33rd among developed nations, and the rate is increasing. Indeed, as Neel Shah notes:

Americans today are 50 percent more likely to die in the period surrounding childbirth than their own mothers.

In 1974, the U.S. maternal mortality rate was 9 per 100,000 live births. By 1980, the rate was 8 maternal deaths per 100,000 births. …

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Lively communication in the service industry

Physician
September 24, 2023

Gaining insight into the customer’s perspective often occurs when one steps into the customer’s shoes, even if it’s in a different service industry. However, it’s crucial to remember that employees are individuals with their own needs. This brings us to a significant question: Should employees engage in lively and perhaps even boisterous conversations while confined to their workplace, where they might be the only sources of human interaction in an …

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Contemporary weight loss: Unveiling the quest for elusive elixir

Conditions
September 24, 2023

Recently, I received a call from an old friend. We had drifted apart over the years, but his purpose in calling wasn’t rooted in a desire to rekindle the embers of yesteryears. No. Rather, it was an explicit inquiry into whether I could assist him in obtaining the elusive elixir of contemporary weight loss. In revealing tones, he shared that the specter of obesity loomed heavily in his family lineage, …

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Balancing efficiency and compassion [PODCAST]

Podcast
September 23, 2023
YouTube video

 

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Join Scott Abramson, a neurologist, as he explores the delicate balance between medical efficiency and genuine compassion in the fast-paced world of health care. Discover practical insights and strategies to nurture empathy, enhance patient care, and find …

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Reigniting after burnout: 3 physician stories

Physician
September 23, 2023

What is working?

I often encounter variations of this question on social media. The response is frequently met with silence or lackluster positivity.

I’ve engaged in conversations with numerous inspirational physicians who have shared their tales of burnout and recovery.

As part of their healing journeys, in addition to their active medical practices, the physicians below have all obtained coaching certifications. These doctors are now even busier than before, but they find fulfillment …

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Why patients write: stress relief, self-care, and sharing experiences

Conditions
September 23, 2023

To compliment and complement the KevinMD article “Why physicians need to write,” by Dr. Louise Aronson, I’ll share why patients, at least this patient, write. I wrote What Patients Want: Anecdotes and Advice because I had been “adrift in a draft, if you get my drift,” in doctors’ offices, and I thought I could share the perspective of the patient in the white paper sack, with health care …

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Inside the grueling life of a surgery intern

Physician
September 23, 2023

One day, you find yourself on the edge, peering into the abyss. Then someone pushes you in. Welcome to the first day as a surgery intern. Few folks outside of medicine fully fathom the rigors a doctor must endure during post-graduate training. From the get-go, we were thrown into the fire, responsible for complicated, sick hospital patients, in what felt like a prolonged boot camp, where ridiculously long hours, horrid …

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