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We sit down with Nicholas Rosenlicht, psychiatrist and author of My Brother’s Keeper: The Untold Stories Behind the Business of Mental Health―and How to Stop the Abandonment of the Mentally Ill. Nicholas unpacks …
From patients to clients: the tragic business of mental health care explained [PODCAST]
The World Health Organization (WHO) reports that 4.5 billion people do not have access to primary care. In the US alone, the American Medical Association (AMA) claims 83 million Americans do not have access, and the National Association of Community Health Centers (NACHC) puts the number even higher at one-third of the US population or over 100 million, including many children (NACHC).
Since losing my brother, a cardiologist, to a misdiagnosis …
Towards a future for semi-autonomous AI-powered primary care providers
An excerpt from My Brother’s Keeper: The Untold Stories Behind the Business of Mental Health―and How to Stop the Abandonment of the Mentally Ill.
Throughout history, civilized societies have recognized the vulnerability and suffering of the ill and accordingly granted them special rights and protections, as well as a unique designation: “patient.” This is changing. In the 1990s, when I was involved in negotiating managed care contracts for a community …
The dangerous shift in mental health: Are we clients or patients?
At the doctor’s office, in the ER, in the hospital, how many times are you asked about your drug allergies? A lot! And, as a common practice when in the hospital, you’ll even get a red bracelet or something to indicate such. There are strict rules around allergies; from techs to transport to MDs, hospital staff are well-trained to look for these bracelets and to make sure that you don’t …
The hidden medication putting Parkinson’s patients at risk
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Join Manuel Arango, the director of Health Policy & Advocacy at the Heart and Stroke Foundation of Canada. We dive into the pressing issue of food marketing to children, exploring how these strategies …
How food marketing to kids is harming their health and what we can do [PODCAST]
For an introduction to SPR, click here. For a history of SPR, click here. To learn how to distinguish real vs. sham peer review, click here.
We don’t hear about SPR as often as it occurs because those who have experienced it have likely signed nondisclosure agreements or self-isolated in shame after …
Sham peer review (SPR): strategies for saving your career and soul
I’m primary care and I see a patient in a 10-minute appointment who tells me she now has a disabled daughter who is 22, had a stroke, and currently cannot cope with all that her disrupted life is demanding of her. I am also expected to fill out that FMLA paperwork for that patient and respond to 20 back-and-forth portal messages on that same patient over the next two days, …
The overwhelming reality of primary care: Why doctors still persevere
In the August 2023 issue of MD Linx, Stephanie Srakocic writes about a Philadelphia jury that awards a $1.4 million verdict against a nurse practitioner for failing to treat hyperthyroidism. The patient, who is hyperthyroid, is admitted to the hospital for acute abdominal pain, nausea, and vomiting. The patient subsequently dies. The implication is that the patient is under the care of a nurse practitioner, and there is no …
Nurse practitioner hit with $1.4m verdict: the hidden truth behind the lawsuit
Ecclesiastes was probably written by many ancient scholars, although Jewish tradition holds that it was written by King Solomon. Whatever the provenance, I think the first chapter holds a nugget of wisdom that we need to try hard to remember:
What has been is what will be,
and what has been done is what will be done; there is nothing new under the sun.
Is there a thing of which it is said,
“See, …
The enduring cycle of violence: lessons from history’s darkest moments
Today, most emergency departments (EDs) face overcrowding, high patient volumes and a strain on our increasingly limited staff and resources. As a result, the average patient experiences ED wait times of about two-and-a-half hours, with some reaching nearly four hours.
The possibility of sepsis makes these delays even trickier. More than one-third of all in-hospital deaths are attributed to sepsis, making it the Read more…
The deadliest condition in emergency departments deserves a new diagnostic approach
I had a dismal start to the second year of my psychiatric residency, and my subpar performance was noted by many faculty members. One professor approached me and told me to discuss the situation with my psychotherapy supervisor, adding, “Don’t let your supervisor sugarcoat it.” The professor knew that my advisor was an extremely kind and gentle person who would prefer to leave out the details of my performance so …
The growing discrepancy between health care promises and practice
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We welcome Ron M. Aryel, a pediatrician who shares his powerful journey through medical school and residency as a physician with cerebral palsy. Facing discrimination, ableism, and hostility from colleagues and superiors, Ron …
How this pediatrician overcame cerebral palsy and discrimination in medicine [PODCAST]
“I’m in my final year of orthopedic surgery residency and will do a one-year fellowship (I finish July 2026). I’m in the early phases of talking to potential employers, many of which say they could offer a stipend as I finish my training. Do you have any advice on how a stipend should be optimally structured?”
Stipend secrets: Navigating your final year of residency
As you approach the final stretch of your …
Navigating stipend offers: a resident’s question
I miss my stethoscope—the small black one with the tiny neonatal head. I wore it around my neck constantly while on duty in the NICU and L&D. It served as an outward symbol of my knowledge and experience. Inwardly, it reminded me of all the things I could detect about a baby by simply looking, listening, and gently touching. My little stethoscope was ready in any emergency. It helped me …
Early retirement may not be the solution to your burnout
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We sit down with Michael J. Grace, attorney and author of The Mumbo Jumbo Fix: A Survival Guide for Effective Doctor-Patient-Nurse Communication. We explore how health care communication has evolved before, during, and …
How COVID changed doctor-patient-nurse communication forever [PODCAST]
I was raised in the Catholic Church. The solemn, reserved, respectful quiet as the priest whispered out his occasional reverent chants. That’s what I knew. That was the only thing I grew to love of the Catholic faith.
This friend of mine. We met years ago by happenstance. She was a firm believer in God, her husband, her dog, her daughters, and her Christian novels that she read feverishly.
She also loved …
Why prayers alone couldn’t save my friend from cancer
Many students only learn basic health facts, like how to put a condom on a banana or that the mitochondria is the powerhouse of the cell. But when it comes to making real-life health decisions, this scarce knowledge just doesn’t cut it. Shockingly, only 12 percent of American adults have proficient health literacy skills. This gap becomes especially clear in college, where young adults face new independence and make crucial …
The health crisis no one’s talking about: Why teens need better health education
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We sit down with Audra King, a surgery resident, to explore the challenges and toxic environments that medical trainees often face during their residency. From instances of disrespect and workplace bullying to the …
Inside the toxic reality of surgical residency [PODCAST]
Hearing about the school shooting last week at Apalachee High School in Georgia, I couldn’t imagine the gut-wrenching pain that the victims and the local community felt as yet another mass shooting tore apart families.
The tragedy reminded me that no one is safe from the horror of gun violence. As a pain physician, I’ll never forget hearing one of my patients say, “If I don’t get the pain fixed, I …
We can prevent another Apalachee High School, if we have the courage to act
Continuous quality improvement undoubtedly contributes to the ongoing honing of best practices in medicine. This health care-specific parallel of total quality management programs in business helps us daily inch closer to the ultimate goal of eradicating patient harm. Health care professionals familiar with these variation-reducing processes are likely well-versed in the popular Ishikawa fishbone diagram. While the focus is intended to be spread across materials, processes, equipment, and …
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