What if we asked patients what they want?
Historically, the Canadian health care system has decided what should be done for the care of the population.
Who gets care, when and where, what is a priority, what delays are tolerable, and what degree of saturation is acceptable in a Quebec emergency room? This paternalistic approach is obsolete.
A modern service company must be interested in the needs and desires of its clientele.
Other than in the health …
Physicians: Are we still the good guys?
In the very realistic fictional world of The White Coat Diaries by Dr. Madi Sinha, a first-year internal medicine resident goes through a harsh initiation into the realities of medical training. Protagonist Norah Kapadia encounters a complication of a penile implant in an elderly patient with end-stage liver disease and dementia. Her senior resident talks her through the problem of causing hematuria as she placed a catheter through an …
The demise of primary care in America
An excerpt from Patients in Peril: The Demise of Primary Care in America.
The last 100 years have seen an astonishing drop in the percentage of American physicians who practiced primary care. In the early 1930s, 87% of private practice physicians were in general care; by the early 1960s, this percentage …
When doctors develop [patient] portal hypertension [PODCAST]
An expert’s advice about staying in private medical practice
Most physicians are aware of our nation’s disintegration of private medical practices. Bailing out of private medical practice for financial or other reasons predicts the takeover of government-controlled employed medical practice as well as the medical profession itself—including medical school education.
One world-renowned marketing and business expert offers important advice for medical care professionals who prefer to remain independent of such medical practice restrictions while we still can do so:
A lot …
A retired physician’s medical school memories
An excerpt from Fifty Years a Doctor: The Journey of Sickness and Health, Four Plagues and the Pandemic.
President Kennedy’s assassination
One cold winter morning, all the medical students had to leave the warmth of the medical school to get to Kings County Hospital across the street for “rounding” with attendings.
We didn’t …
The stigma of cognitive decline: Silence has a price
Have you ever experienced brain fog? It’s one thing to reach for an extra coffee or reflect on the vagaries of age, but growing research shows that subjective cognitive decline (SCD) is a powerfully predictive indicator that many patients either dismiss or fail to report. About one in four people who experience SCD will have further declines – which can often be mitigated if patients report …
Primary Care 2.0: new thinking and practice redesign [PODCAST]
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“When my colleagues and I visited high-performing primary care clinics across the country, we sought insights to inform a new model for providing the most efficient and high-quality care. Here’s how we’re practicing in Primary Care 2.0.”
The jobs you hold prior to medical school are important, but not for the reason you think
Most experts recommend that premed students seek medically-related jobs to gain early proficiency and support their medical school application. There is nothing like valuable hands-on experience, they say, for students to demonstrate their passion and knowledge about the field of medicine. According to the article “25 Health Care Jobs To Get Before Medical School,” written by the Indeed Editorial Team, “students who fill their resumes with volunteer work, …
Reflecting on health and wellness: Celebrating the wins and learning from the losses
The game came down to the last seconds.
Down by three, we scored on a layup. Now a one-point game. And then, it was over. A narrow 1-point loss in the championship game for our middle school boys team.
One started crying, then another. It caught on like something infectious, and suddenly parents were tearing up as well. As one of the coaches for the team, I wondered what we could have …
The promises and limits of a fentanyl vaccine
“Fentanyl Vaccine a Potential ‘Game Changer’ for Opioid Crisis,” declares a Medscape headline.
“Fentanyl Vaccine Delivers Promising Results in Trial,” reports an industry website.
“A Vaccine Against Deadly Fentanyl Might Be Near,” promises US News & World Report.
Only the fourth headline I encounter puts the news into proper perspective: “New Fentanyl Vaccine …
A letter to residents after the subspecialty match
Dear residents:
I heard the amazing news that each of you matched today. Congratulations! That is huge. You will be outstanding subspecialists!
The best part is that now you can take a deep breath and relax. The stress is over. Hopefully, you matched at your first choice, but please know that if you didn’t, it will be OK. I know the feeling. Although I was lucky to get my first choice for …
Physicians with mental illness shouldn’t hide [PODCAST]
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“Doctors with mental illness don’t need more suicide awareness — we’re aware. And we don’t need confidential treatment opportunities. What we need is assurance from all invested parties — our employers, credentialing bodies, and licensing officials — …
Balancing the roles of patient and healer
“Holly, we’re really worried about you. You’ve been sleeping for days. Let us take you to the school clinic.”
I looked up at a figure in the bedroom door surrounded by a light that hurt my eyes. It was my college roommate, a sweet girl from North Carolina who had put up with my shit for most of our senior year. I wanted to bounce up and smile, to jump into …
The Christmas miracle and the music box
She was 82 years old — sweet, frail, and maybe four feet eight inches tall.
She had many beloved children, grandchildren, and even a few great-grandchildren
They all grew up knowing that family was their core — their base, their home where love resided.
It was only a few days before Christmas, and Mrs. Mary entered our ICU.
COPD.
She lived with this for a long time. But this time, it crippled her. We gave …
Stephen “tWitch” Boss’ tragic death highlights the importance of mental health
A prominent celebrity named Stephen “tWitch” Boss of the Ellen DeGeneres Show took his life at 40. Boss’ contagious love of dancing, carefree spirit, and milewide grin brought joy to millions. From the outside looking in, we saw a gentle soul – a successful actor and dancer with a wife and three children.
Just days before his passing, Boss shared a joyful video on social media of him dancing …
Overcoming the epidemic of loneliness
As I drove home from work and turned right onto the familiar street that would eventually wind around like a smile to my home, I briefly closed my eyes and tilted my face to the sky, enjoying the butterscotch sunlight still peeking through the leaves framing the street. I noticed with contentment the various groups of people clustered alongside one another, walking at a leisurely pace on the adjacent sidewalk.
It …
What does it mean to truly be an ally? [PODCAST]
A blessing for health care workers
As winter approaches and life slows down, it’s a time to pause and reflect on all everyone has had to endure these past few years. To those involved in health care, it has been an especially difficult time… a test of both resolution and inner strength. With my hope that all will see brighter days ahead, I offer the following as my means of giving thanks to all of you …
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