Are antibiotics too much of a good thing?
Since the development of antibiotics in the 1940s, patients presenting with an infection could be expected to respond quickly to a prescribed course of antibiotics by their physician. While the antibiotic prescription model has helped countless lives, this paradigm has degraded over time due to the emergence of antimicrobial resistance (AMR). The net impact is a global health crisis, worsened by continuing the over-prescription and misuse of antibiotics.
The more drugs …
The impact of a lack of diagnosis reaches far and wide
Getting a medical diagnosis can actually be a huge relief.
I know it may seem counter-intuitive.
Saying “I have cancer,” “I have Parkinson’s,” or “I have depression” definitely doesn’t belong in the same realm as being relieved.
Or maybe it does.
When was the last time you saw a GoFundMe for “gradually progressive neurologic symptoms for 20 years that numerous physicians in many different specialties still don’t understand”?
When did you form a Team Lucy …
Back to reality when it comes to pain treatment
Back in the 1980s, I had a longtime patient, age about 30, that came to my office for severe back pain. She previously had some mild back pain and had no orthopedic evaluation. Otherwise, she was in good health without any other health issues.
She could barely walk upright, so I sent her to the orthopedic physician I normally referred my patients to the same day. He sent her back to …
Your anesthesiologist cares for you [PODCAST]
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 …
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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 …
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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 …
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 …
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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 …
Past Week
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Do Jewish students face rising bias in holistic admissions?
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Why shared decision-making in medicine often fails
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“Think twice, heal once”: Why medical decision-making needs a second opinion from your slower brain (and AI)
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My journey from misdiagnosis to living fully with APBD
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Why we fear being forgotten more than death itself
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Bureaucracy over care: How the U.S. health care system lost its way
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Past 6 Months
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What’s driving medical students away from primary care?
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Internal Medicine 2025: inspiration at the annual meeting
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A faster path to becoming a doctor is possible—here’s how
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Residency as rehearsal: the new pediatric hospitalist fellowship requirement scam
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Are quotas a solution to physician shortages?
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The hidden bias in how we treat chronic pain
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Recent Posts
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Rethinking addiction treatment: contingency management and the future of recovery [PODCAST]
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What Adam Smith would say about America’s for-profit health care
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Why self-care must become medicine’s new standard
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How societal narratives trap us and how to escape
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How a homeless mathematician taught me the true meaning of success
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Registered dietitians on your care team [PODCAST]
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Past Week
-
Do Jewish students face rising bias in holistic admissions?
-
Why shared decision-making in medicine often fails
-
“Think twice, heal once”: Why medical decision-making needs a second opinion from your slower brain (and AI)
-
My journey from misdiagnosis to living fully with APBD
-
Why we fear being forgotten more than death itself
-
Bureaucracy over care: How the U.S. health care system lost its way
-
Past 6 Months
-
What’s driving medical students away from primary care?
-
Internal Medicine 2025: inspiration at the annual meeting
-
A faster path to becoming a doctor is possible—here’s how
-
Residency as rehearsal: the new pediatric hospitalist fellowship requirement scam
-
Are quotas a solution to physician shortages?
-
The hidden bias in how we treat chronic pain
-
Recent Posts
-
Rethinking addiction treatment: contingency management and the future of recovery [PODCAST]
-
What Adam Smith would say about America’s for-profit health care
-
Why self-care must become medicine’s new standard
-
How societal narratives trap us and how to escape
-
How a homeless mathematician taught me the true meaning of success
-
Registered dietitians on your care team [PODCAST]
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