How privileged a physician’s knowledge is
I was warned about it before we walked into the room.
So when I did walk in, I made sure my eyes stayed focused on his eyes, my gaze high and attentive. I smiled, possibly more than normal, to make sure he felt comfortable. Like a puppeteer holding up his doll, I knew it wasn’t time for me to drop down my eyes yet.
The resident with me began the routine visit …
Financial survival for physicians in private medical practice
There are two valuable reasons why all physicians, especially medical students, should obtain or demand from their medical school academic business education.
About 98 percent of physicians and medical students have never had an academic business education. About 30 to 50 percent of graduating medical students prefer private medical practice—which requires business and marketing knowledge to reach their optimal potential in private medical practice as described below.
Private medical practice is a …
A health economist acknowledges how financing experiments failed our health system
I read a superb commentary in STAT, “Value-based payment has produced little value. It needs a time-out,” that reviews the failures of “value-based care” and the failure of its promoters to acknowledge those failures. Ideas conceived, tested and found lacking, and used as the basis for more of the same. Distracting from real health system reform.
So I thought, wouldn’t it be terrific if the originators of flawed health …
A medical student’s advocacy journey [PODCAST]
How every doctor should address a patient’s pain
From medical school to residency, I’ve worked with colleagues who don’t prescribe pain medications for their patients who truly need them. Or they are just very hesitant about doing so. Some simply don’t believe in them. Others fear the legal implications like being named to a med mal or wrongful death lawsuit. And several avoid pain meds, specifically opioids, like the plague because of possible addiction risk even when their …
Academic medicine on life support: a letter to a newly appointed CEO of a leading academic medical institution
Congratulations on our leading academic medical institution (LAMI) yet again making it to the top ten list of the U.S. News & World Report!
You have taken the reins in perilous times (globally and domestically), and what you do and what you stand for will determine if this great hospital will not just survive but survive with its brand and reputation intact. Getting hired as a physician who grew up in …
Trauma and burnout among frontline health care workers
Thinking back to 2020, concerning the emergence of COVID-19 and the first hard lockdowns all over the world. Individuals from all walks of life were frightened, locking themselves in their homes for fear of being infected. Yet, frontline providers and health care workers had to carry on with their daily jobs. Were they less scared than the nonmedical layman or immune to the virus? Unfortunately, they weren’t. They were just …
Are you ready to hear the truths about perfectionism? [PODCAST]
How doctors can regain control of their software
I spent a year as a UCSF postdoc with the leaked tobacco documents. And this article is taken directly from the tobacco-control playbook. In the tobacco wars, we learned that: when a disease is caused by a for-profit industry, the only successful approach is regulation first, followed by treatment.
Here is exactly how and why doctors should regulate EHR and regain control of their cognitive …
I didn’t know her name until it was over
I didn’t know her name until it was over, much too late. What I knew was she was thirteen and that on this winter day, someone in her family had been pulling her behind their car on a sled. No doubt laughing and looking in the rear-view mirror, the person driving had whipsawed around a corner, and the young girl — probably screaming (fear? delight?) — held onto the sled …
A pervasive culture of time constraints in health care
Picture this. A patient in a hospital or rehab facility has just finished exercising with therapy. He is thirsty, and he thinks he might as well ask for a snack now because he will be hungry in 30 minutes. His therapist sets him up in his wheelchair (brakes locked), tray table with all necessities positioned in front of him, with his call bell within reach. As she approaches the door …
Preserving humanity in the ICU [PODCAST]
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Our Shakespearean love affair with BMI
I’m standing outside the exam room, reviewing Marcus, my 16-year-old patient’s growth chart, specifically his BMI. It’s up again, and my heart sinks. I feel that all too common rush of frustration and disappointment and, “Why am I here and what is the point?”
“Am I just here to document weight gain in my patients?”
Marcus has been coming to my pediatric weight management clinic for over two years and has high …
Breast implant illness: It’s not all in your head
“It’s just part of getting older.”
“Welcome to being a woman.”
“I hear this all the time from women. You just need to learn to deal with it.”
“Here’s a pill. See you in six months.”
“I have run all the labs I can think of. They are all normal. There’s nothing wrong. I’m sure it’s just stress.”
“It’s probably in your head.”
“There’s nothing I can do for you.”
Every doctor visit was the same. Each …
My high school was harder than my first year of medical school
I am a second-year medical student at the University of Texas Medical Branch (UTMB) in Galveston, Texas. In 2018, I graduated from Westwood High School in Austin, Texas. My experience at Westwood was harder than my first year of medical school at UTMB. I wrote this piece to provide some context to students like myself who struggled or are struggling with public school in Texas.
When I was 17 years old, …
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What a lifetime of gaslighting by other doctors feels like [PODCAST]
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“Ehlers-Danlos syndrome patients take an average of 10 years to be diagnosed.
In that time, the pain from microtrauma and joint instability can become unbearable. “Just exercising more” can backfire, causing injury and disability and creating a cycle of added …
Misaligned expectations lead to conflict, burnout, and disillusioned physician leaders
Would you expect the chef at a restaurant to be told that they are not only required to prepare the food in the kitchen but also deliver it to each of the tables and manage the billing? What about sorting out the restaurant’s finances or understanding the number of patrons that need to flow through per night to optimize income? If this sounds unreasonable, how did we end up asking …
When can physicians start spending money?
You may never have created a budget. Not everyone does. For many of us in medicine, our saving so completely dwarfs our spending that we’ve never needed to use a budget. We just wing it. Why do some physicians spend so little?
Spending money is hard for many people, including physicians. After years of frugality in education and training, then funneling money into investments, planning for the future, building life for …
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When a hospital unexpectedly closes
An excerpt from The Evening Hero.
This was apparently not to be a Yungman-only meeting. It was in their conference room, same one where had their monthly morbidity and mortality conferences, and it was packed with doctors. In fact, there was just one chair open, and Yungmans best friend Ken the …
Past Week
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What’s driving medical students away from primary care?
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A faster path to becoming a doctor is possible—here’s how
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A world without antidepressants: What could possibly go wrong?
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Make cognitive testing as routine as a blood pressure check
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Rethinking patient payments: Why billing is the new frontline of patient care [PODCAST]
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Why the words doctors use matter more than they think
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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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The silent crisis hurting pain patients and their doctors
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What happened to real care in health care?
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How the CDC’s opioid rules created a crisis for chronic pain patients
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Are quotas a solution to physician shortages?
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Recent Posts
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Rethinking patient payments: Why billing is the new frontline of patient care [PODCAST]
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The dreaded question: Do you have boys or girls?
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Make cognitive testing as routine as a blood pressure check
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Reimagining diabetes care with nutrition, not prescriptions
-
Why funding cuts to academic medical centers impact all of us [PODCAST]
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What’s driving medical students away from primary care?
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Past Week
-
What’s driving medical students away from primary care?
-
A faster path to becoming a doctor is possible—here’s how
-
A world without antidepressants: What could possibly go wrong?
-
Make cognitive testing as routine as a blood pressure check
-
Rethinking patient payments: Why billing is the new frontline of patient care [PODCAST]
-
Why the words doctors use matter more than they think
-
Past 6 Months
-
What’s driving medical students away from primary care?
-
Internal Medicine 2025: inspiration at the annual meeting
-
The silent crisis hurting pain patients and their doctors
-
What happened to real care in health care?
-
How the CDC’s opioid rules created a crisis for chronic pain patients
-
Are quotas a solution to physician shortages?
-
Recent Posts
-
Rethinking patient payments: Why billing is the new frontline of patient care [PODCAST]
-
The dreaded question: Do you have boys or girls?
-
Make cognitive testing as routine as a blood pressure check
-
Reimagining diabetes care with nutrition, not prescriptions
-
Why funding cuts to academic medical centers impact all of us [PODCAST]
-
What’s driving medical students away from primary care?
-
