For over twenty years, I’ve had a recurring nightmare: I’m back in medical training, and my patient is crashing. To save them, I must enter my medical orders into the electronic health record (EHR). The only problem is, there are no open computers. I could give a verbal order in a real-life emergency, but those aren’t the rules in this nightmare world. I go from computer to computer, begging for …
The emotional toll doctors face: a book review
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We dive into the powerful story of a physician-mother whose world changed with the onset of COVID-19. Our guest, Arian Nachat, a palliative and emergency medicine physician, shares her journey through the pandemic, …
Mother, doctor, CEO: one woman’s journey to reshape health care [PODCAST]
Primum non nocere, “first, do no harm,” is the prime directive of medical ethics for all physicians. It is also the first thing that comes into question when maleficence by a doctor is suspected.
The standard of care is how any prudent and competent practitioner should exercise their duty to, “first, do no harm,” when managing a specific medical condition. The standard of care is empirical and adjusts to circumstances that …
How doctors can minimize harm: the essential duties of patient care
According to the National Institutes of Health, the majority of individuals experience several traumatic events in their lifetimes, but do they all develop post-traumatic stress disorder (PTSD)? If you question the general populace or the media, they would indicate that PTSD is extremely common. Although it varies by sub-population, for the general populace, 13 and above, the rate of diagnosed PTSD is 4 percent to 8 percent. It is highest …
PTSD: Why trauma’s impact is more complex than you think
“Do any of you have children?” the patient’s mother asked each of my team members during rounds. I (STG), as the attending, quickly jumped in and mumbled, “Yes, I have (as a foster parent),” and redirected the conversation back to the medical management of her child.
It was not until a week later, when I was attending a talk on microaggressions, that I realized my team members may have perceived the …
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We discuss the growing challenges within the U.S. health care system, from long wait times and fragmented care to the corporatization of medical services. Our guest, patient advocate Michele Luckenbaugh, shares insights on …
Patients vs. profits: Examining the real cost of the health care industry boom [PODCAST]
Recently, I encountered a stark reminder of the challenges facing our mental health care system. A 16-year-old Black boy came to us at Boston Community Pediatrics (BCP) in a state of crisis, expressing suicidal thoughts and a deep sense of fear. As part of our integrated behavioral health model, my mental health colleague and I immediately recognized the urgency of his situation. We arranged for an Uber to transport him …
The urgent need for equity and accessibility in pediatric mental health care
I recently encountered a new patient, a seemingly healthy 25-year-old man who had just graduated from college and was working his first job. He was not a tobacco user and had no medical diagnoses, but shoulder and abdominal pain brought him to Mass General Brigham. After a series of tests, the diagnosis was clear: stage IV lung cancer.
As a lung cancer oncologist who has treated patients for 20 years, I’ve …
Why rethinking cancer risk is critical to addressing rising cancer rates in young adults
In the weeks after her mother died, Stacy’s mind was filled with thoughts about things she believed she’d done wrong and ways she’d let her mother down. “I shouldn’t have gotten so impatient with her”; “I should have been kinder, should have spent more time with her.” She was even tormented by the inaccurate belief that she had caused her mother’s death by failing to “try harder to get her …
The dangerous impact of cognitive distortions on grieving
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We dive into the essential skills every physician needs to master in contract negotiation. Internal medicine physician Miguel Villagra offers practical advice on navigating the complex clauses and legal language, sharing key strategies …
Essential negotiation tips every physician should know [PODCAST]
An excerpt from Disabled Ecologies.
The multicolored poisonous waste disposed of by Hughes Aircraft Company was never just TCE, the most infamous ingredient. It was always a toxic soup: dozens of volatile organic compounds and heavy metals, contaminants with names like dichloroethylene, chromium, cadmium, and benzene. The chemicals were used in the early 1950s in the manufacture and cleaning of missiles that would travel thousands of miles overseas to …
Toxic waste disaster: How Hughes Aircraft poisoned Tucson’s environment and people
I have found that many physicians are not happy. I wanted to share with them some ways to find “amrita” in life. Then we can face life with joyful countenance, ready to receive the Maker when we hear the knock, as described in Revelation 3:20. It is important to associate with virtuosity. La Chaim!
The excitement: Albert Camus said that the “struggles that one encounters in life are by themselves the …
Finding happiness in the challenges of neurosurgery
As a patient advocate, I have witnessed firsthand the devastating effects of policies leading to untreated and undertreated pain. As a mother who has lost a child to drug poisoning, I have also witnessed how drug policy is driving an increasingly lethal street drug supply. With overdose deaths rising, well-intentioned policies have left many suffering without the medications they need for quality of life. Tragically, some patients, overwhelmed by unrelenting …
Restoring compassionate pain care: a call to action
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We dive into the personal and professional journey of Ben Reinking, a board-certified pediatric cardiologist, medical educator, and certified physician development coach. We explore the importance of maintaining hobbies, finding balance, and how …
Why having hobbies can save your medical career [PODCAST]
Dr. Peter Onorato, an accomplished anesthesiologist, found himself at a crossroads. With a lucrative career and a substantial income, he was eager to grow his wealth. Like many high-income earners, Peter believed he could outsmart the market. Despite his wife’s concerns, he decided to invest over $300,000 in a tech startup after several days of online “research” and hearing from several colleagues in the doctor’s lounge about the expected 25-30 …
Behavioral finance: your mood and your money
After more than a decade in private practice, taking care of tens of thousands of patients—everything from preconception to hospice care—I’ve learned how important it is to set and protect your boundaries. I’ve worked in various environments throughout my career, from running my own multidisciplinary medical center to being part of other practices. If I had to choose, I would prefer to be part of an established practice. Running my …
Protecting boundaries in private practice: a vital key to sustainable success
For years, the U.S. public has been hearing that prescription opioid pain relievers are always and forever a bad thing—and that doctors and big pharma companies are supposedly responsible for an epidemic of addiction and drug overdose-related deaths. However, these assertions are outright lies. Both the U.S. Centers for Disease Control and Prevention and the Veterans Administration know it.
The recent national opioid settlement is as bogus as a three-dollar bill—and …
The real cause of the opioid crisis isn’t what you think
The journey of electronic health records (EHRs) mirrors my own professional transformation. As a practicing anesthesiologist at Moffitt Cancer Center in the early 2000s, I handwrote paper charts in an era when computers were already integral to other parts of the hospital.
Relying on manual notes was frustrating and inefficient, so I jumped at the chance to help implement Moffitt’s anesthesia electronic record system. This effort sparked an interest in health …
From handwritten notes to digital solutions: a journey in health IT
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We sit down with Rebecca Arnold, an author and certified executive leadership coach, to explore the emotional challenges faced by physicians experiencing disillusionment in the health care system. Rebecca shares insights on how …
How to survive the modern health care system without losing yourself [PODCAST]
Automation and artificial intelligence (AI) have been advancing steadily in health care, and anesthesia is no exception. A critical development in this area is the rise of closed-loop AI systems, which automatically control specific medical variables using feedback mechanisms. The primary goal of these systems is to improve the stability of key physiological parameters, minimize the repetitive workload on anesthesia practitioners, and, most importantly, enhance patient outcomes. For instance, closed-loop …
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