All I ever wanted to be was a nurse
I am a nurse. I am tired and defeated. Thursday, I went to work at 7 a.m. after the strike, only to want to leave as soon as I walked into the hospital. We were short-staffed … again. I made an “aware” which is a hospital forum where anyone can report unsafe staffing, hospital conditions, maintenance, or security issues. My aware went to my unit manager where we had a …
The journey is to find the gift in the challenge
An excerpt from The Myth of Normal: Trauma, Illness, and Healing in a Toxic Culture.
Ours is a culture wholly averse to death and even aging; think of how many products are geared toward erasing or “reversing” the signs of oncoming infirmity, the physical reminders of life’s finitude. Here, then, …
Coaching or mentorship: What is the solution for physicians?
Over the years, I have mentored a lot of trainees. After discovering coaching and seeing my career transform after I started working with a coach, I have become a coach myself. I definitely use coaching techniques with my mentees, but the relationship I have with them is different from the one I have with my coaching clients. Coaching and mentorship are different but complementary approaches to moving your career forward. …
Insurance companies deny medical care. And that’s wrong. [PODCAST]
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“Securing prior authorizations is a daily ordeal for most doctors’ offices. Doctors report that, on average, they must get insurance company approvals 41 times every week. Of the authorization requests that are denied, fully 73% ultimately get …
It is a gift to be on a team where people think differently
You may just think differently. Not wrong.
It is a gift to be on a team where people think differently.
However, some leaders want people to all to think like them. And they become upset and frustrated when you think differently.
So we step back and observe why they may be frustrated. We may observe in ourselves why their opinion and approval matter so much.
The discomfort may push you to abort your own …
Is Elon Musk right about the future of medicine?
“Mark my words. AI (artificial intelligence) is more dangerous than the nukes.”
– Elon Musk
The other day, as soon as I walked in to work, already running my usual ten minutes late, I was hustling from my office to the clinic when I saw one of our physician assistants in the hallway. Otherwise known for her calm composure, it seemed odd that she was visibly distressed. She had forgotten her laptop …
Economic uncertainty is the new norm, but financial insecurity doesn’t have to be
I’ve lived through multiple economic downturns since 1999.
Bear markets and recessions can be scary.
The uncertainty and fear can be exhausting.
Currently we are in the midst of battling fears of record inflation, gas prices, an ongoing recession, interest rate instability, supply chain disruptions, insecurity in food, energy, and housing, along with surging debt and currency crises.
This is all happening against the backdrop of war, climate crisis, and a world recovering from …
My postpartum blood pressure spike [PODCAST]
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“I think about my preeclampsia-specific and general knowledge gaps. I could not recall learning about postpartum preeclampsia in my prenatal classes. I wasn’t given any written instructions on what symptoms to expect with my blood pressure returning …
How drug prices are manipulated
I wondered whether to recommend Nuedexta for my elderly relative with worsening Alzheimer’s disease and daily spontaneous crying. Often she would deny feeling sad and couldn’t account for her sobbing. Avanir Pharmaceuticals released Nuedexta in 2010 to treat pseudobulbar affect: involuntary emotional outbursts due to certain neurologic conditions or brain injury. I wasn’t sure if these crying bouts qualified as pseudobulbar affect. But my biggest hesitation was the breathtaking …
Physician contract horror stories
As a physicians’ attorney who focuses his practice on physician contract review, I have seen some truly horrendous results after physicians have signed agreements they did not understand. Here are just a few of the “war stories” I have experienced.
24/7 call “for a few years”
One physician employment agreement I reviewed had several points that I felt should be clarified. The employer’s attorney accommodated most of my requests for clarification in …
Social entrepreneurship: business that’s good for people
Many people assume that there is a tradeoff between making money and making an impact—that you can’t do both at the same time, or at least not to a high level. This has been the prevailing thinking, especially in the business sector.
But over the past few decades, a new field of “social entrepreneurship” has proven this assumption wrong. A spectrum of possibilities now exists for people aspiring to reap profits …
Think about genetics in heart disease [PODCAST]
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“Despite these high numbers, we cardiologists often look to genetic screening last in our diagnostic workup. But without genetic screening, we can’t always see the whole picture in our cardiomyopathy patients. Once we’ve excluded coronary disease as …
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Difficulties navigating the health care system are causing many Black and brown kids to fall through the cracks
A recent JAMA Pediatrics study confirmed what I see in practice as a pediatric primary care psychologist in Texas, one of four minority-majority states. The study reported alarming gaps between Black and Hispanic kids compared to white kids in attendance at primary care wellness visits—important appointments where children and parents can receive preventative and developmental services, timely immunizations, and answers to common questions. …
Why expand telemedicine for arthritis patients?
One in four Americans carry a diagnosis of arthritis, a significant cause of limitation from basic life activities to disability. One in ten adults has to limit their activities due to pain caused by this disease. Yet, a massive shortage of specialist physicians and geographical and licensure barriers restrict access to specialized medical care, especially in rheumatology offices. Also, the cost of arthritis is 303 billion dollars yearly …
Ending gun violence in America should be a no-brainer
Brain matter was spilling out the top of the patient’s head in the trauma bay. It doesn’t take a neurosurgeon to know that this is not normal. My pager screamed, “GSW to head – ED Room 1.” Gunshot wound to head – Emergency Department Room 1. As the neurosurgery resident physician on call that night, it was my job to evaluate this patient STAT. I wish I could say this …
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A physician’s reflections with certainty in medicine [PODCAST]
Where do trans and visibly queer people go to residency?
I came out as transgender in my post-baccalaureate years. I grew up in California and was enjoying my time in college at Boulder. Although I had been severely bullied in middle school, there were never any problems for me in the adult world.
Discrimination was not something I thought really existed because I had not seen it.
Blissfully discovering my new self, I began my social transition. I was finally coming into …
Is our health care system based on untruths?
As Americans, we live in one of the most affluent countries in the world. Outwardly, many of our citizens seem to possess the necessities of life: shelter, food, job employment, and world-class health care. But what happens when we take a closer look? Do we see cracks in the foundation?
If we are honest, the answer is a resounding yes. When one looks at the area of health care, there is …
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The slippery slope of utilization management
“The patient has a severe infection of the hand and is not improving on the current antibiotics,” I explained to the medical director at the insurance company.
“I understand. However, the patient has no elevated white count or fever, and I cannot get it to meet the criteria, so I will have to deny the necessity for the patient to stay in the hospital,” she explained.
I felt my voice rising and …
Past Week
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Internal Medicine 2025: inspiration at the annual meeting
-
Are quotas a solution to physician shortages?
-
How smartphones are stealing your focus—and what you can do about it
-
When grief hits all at once: a morning of heartbreak and love
-
Learning to trust your body again: Healing the hidden wounds of medical training
-
Why patients and doctors are ditching insurance for personalized care
-
Past 6 Months
-
How trade wars could destroy the U.S. health care system
-
What happened to real care in health care?
-
The silent crisis hurting pain patients and their doctors
-
Doctors don’t need yoga, they need time to smoke
-
Finding your medical specialty: Embracing uncertainty in clinical rotations
-
The medical malpractice system is broken: Who really benefits?
-
Recent Posts
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A doctor’s emotional struggle with a young leukemia patient
-
DSM-5 doesn’t name it, but moral distress is everywhere in medicine
-
How a restaurant principle can transform your patient care
-
The quiet segregation no one talks about in medical school
-
C. Everett Koop’s defining stand against the tobacco industry [PODCAST]
-
Not all heroes wear capes: Sometimes they just speak up in meetings
-
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Past Week
-
Internal Medicine 2025: inspiration at the annual meeting
-
Are quotas a solution to physician shortages?
-
How smartphones are stealing your focus—and what you can do about it
-
When grief hits all at once: a morning of heartbreak and love
-
Learning to trust your body again: Healing the hidden wounds of medical training
-
Why patients and doctors are ditching insurance for personalized care
-
Past 6 Months
-
How trade wars could destroy the U.S. health care system
-
What happened to real care in health care?
-
The silent crisis hurting pain patients and their doctors
-
Doctors don’t need yoga, they need time to smoke
-
Finding your medical specialty: Embracing uncertainty in clinical rotations
-
The medical malpractice system is broken: Who really benefits?
-
Recent Posts
-
A doctor’s emotional struggle with a young leukemia patient
-
DSM-5 doesn’t name it, but moral distress is everywhere in medicine
-
How a restaurant principle can transform your patient care
-
The quiet segregation no one talks about in medical school
-
C. Everett Koop’s defining stand against the tobacco industry [PODCAST]
-
Not all heroes wear capes: Sometimes they just speak up in meetings
-
