A case against real estate syndications
If you like real estate, you may have heard the term “real estate syndications.” This is a fancy term for group investment, where several people get together to acquire a big asset (like an apartment complex), they form an LLC, and there are active investors who manage the property and passive investors who help with the capital for the down payment, and they get to share the profits with the …
From Uber driver to Harvard Medical School
“What happens to a dream deferred?
Does it dry up
like a raisin in the sun?
Or fester like a sore—
And then run?
Does it stink like rotten meat?
Or crust and sugar over—
like a syrupy sweet?
Maybe it just sags
like a heavy load.
Or does it explode?”
– “Harlem” by Langston Hughes
“$23.46,” the Walmart cashier distractedly mentioned to me as I got ready for my first ride. I had signed up and passed the background check. My …
Much more than simple white coat syndrome
Ongoing consultations with a new-to-me internist have raised attention to my in-office blood pressure measurements. In preparation for my next appointment, I regularly record my BP, sometimes several times a day. In other office visits, for cancer talks and such, I simply explain I regularly home and grocery store measure my BP, which always seems to be in the established normal range. I am confident that these in-office rises are …
Time constraints in physical therapy [PODCAST]
We get what we incentivize
We get what we incentivize.
This is a basic rule. I’d love to say it’s a basic rule of humanity, but unfortunately, I have a background in psychology, so I know it goes a lot deeper than that—it’s a basic rule of every living creature. Humans are, in many ways, just very big pigeons. We reliably prioritize certain rewards. We prefer smaller sooner rewards to larger later rewards; we push the …
The immediate impact of the transition to a pass/fail Step 1 exam
Historically, students’ three-digit scores on the United States Medical Licensing Exam (USMLE) Step 1 were a main factor in determining competitiveness for residency programs. In February 2020, the world of medical education shifted drastically when it was announced that the USMLE Step 1 would transition to a pass/fail scoring system. One of the main factors driving this change was that medical students and residency programs were attributing too much …
Why even doctors need regular doctor visits
After a great game of doubles tennis, a good friend brought up a recent visit with his primary care physician while sitting with friends, trying to cool down. He expressed appreciation for his position but complained about the need to see his doctor every three or six months, all the while acknowledging various medical problems being addressed.
This led to general comments by several non-physician friends about how they feel that …
Effective doctors need to be challenged [PODCAST]
Prudence and promise in psychedelic-assisted therapy
Psychedelic-assisted therapy (PAT) represents one of the most promising developments in psychiatry in decades. The treatment typically involves the infusion of a compound such as LSD, psilocybin, or MDMA during an extended therapy session with licensed professionals.
Although it lacks widespread regulatory approval or clinical use, significant advances have been made in the study of PAT in the past decade, with a pronounced increase in recent years. Recently, a Read more…
A doctor’s grief
Last evening I crumbled in the arms of my patient and wept. This was unknown territory to me, an unexpected role reversal. For three weeks after my Mom’s death, I maintained a stoic distance as patients offered their condolences, as they asked about my mother, and empathized. We doctors have been trained to do this, to face death, to keep our emotions at arm’s length. But this patient, who has …
When your letter to the editor is rejected or ignored
Dear Dr. El-Dalati,
I am sorry that we will not be able to publish your recent letter to the editor regarding the Chowdhury article of 16-Sep-2021. The space available for correspondence is very limited, and we must use our judgment to present a representative selection of the material received. Many worthwhile communications must be declined for lack of space.
The response from The New England Journal of Medicine (NEJM) seemed simple and …
Let doctors in recovery be able to recover their careers [PODCAST]
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What is cognitive load? How can we help clinicians manage it?
This article is sponsored by the Nuance Dragon Ambient eXperience. AI-driven ambient clinical intelligence (ACI) promises to help by revolutionizing patient and provider experiences with clinical documentation that writes itself.
What is cognitive load?
Cognitive load is a psychological theory that deals with how the human brain uses its working memory, how …
5 tips for treating seasonal depression during the holidays
Although the holidays are typically associated with feelings of joy and thankfulness, it is imperative that people should not automatically assume these emotions are commonly shared. Three percent of all individuals are impacted by seasonal affective disorder (SAD) during the holidays – a statistic many people are unaware of. The media promotes an unrealistic expectation that everybody should be happy during this time, but this is not the case …
The most valuable health care companies of tomorrow will be technology companies
I’ve always been curious about the top 0.1 percent.
Their mindsets, backgrounds, upbringing, perceptions, skills, and behavioral traits that got them there.
After living through the Dot-com bubble, 9/11, Enron-WorldCom, the 2008 financial crisis, the meteoric rise of technology (search, e-commerce, social media, sharing economy), and the rise of a new class of billionaires, I intuitively sensed that there was a disconnect between what was going on in the real world, and …
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A physician’s remedy for stress, anxiety, depression, and burnout [PODCAST]
The transformative power of EMDR
I became a self-involved status and achievement “junkie” in order to tune out unbearable inner voices that repeated, “You are worthless … you’re a fraud … you’re a failure.” I was obsessed with grandiosity: I owned a penthouse apartment with a landscaped terrace, a closet full of Brooks Brothers suits, a family crest ring, engraved stationery from Tiffany & Co., monogrammed dress shirts from Charvet in Paris, and towels from …
Stop calling it the good cancer
“You have the good cancer.”
These are the most common words that spill out of providers’ mouths to patients just being diagnosed with papillary thyroid cancer. However, this statement does not make this diagnosis any easier to comprehend and digest the life-altering news that has been received by the patient. The survivability rate for this cancer is a high percentage; that is good news, but not good cancer. An issue at …
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For me, COVID has a face
I’ve moved recently, and in the process of moving, invariably, one discovers old items. This had gotten shelved in the fracas of those years, work changed overnight, changing employers, moving. However, in a discussion with a close friend today, this resurfaced as she’s grappling with patients and family who are not seeing what she’s seeing.
Summer 2020
It’s another Sunday night family dinner. Conversation centers around catching up on the latest family …
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Past Week
-
What’s driving medical students away from primary care?
-
Make cognitive testing as routine as a blood pressure check
-
The hidden cost of delaying back surgery
-
The dreaded question: Do you have boys or girls?
-
Rethinking patient payments: Why billing is the new frontline of patient care [PODCAST]
-
The broken health care system doesn’t have to break you
-
Past 6 Months
-
What’s driving medical students away from primary care?
-
The silent crisis hurting pain patients and their doctors
-
What happened to real care in health care?
-
Internal Medicine 2025: inspiration at the annual meeting
-
The hidden bias in how we treat chronic pain
-
Residency as rehearsal: the new pediatric hospitalist fellowship requirement scam
-
Recent Posts
-
Does silence as a faculty retention strategy in academic medicine and health sciences work?
-
Why personal responsibility is not enough in the fight against nicotine addiction
-
How dismantling DEI endangers the future of medical care
-
Alzheimer’s and the family: Opening the conversation with children [PODCAST]
-
AI in mental health: a new frontier for therapy and support
-
What prostate cancer taught this physician about being a patient
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