As I finish my 21st year of clinical practice, I have been reflecting a lot about my career. Several friends asked me for advice as their children begin medical school. Instead of repeating myself, I decided to make a list. Here are the five things I would tell my younger self.
1. Just apply. Recently, I attended a luncheon and sat next to a female physician. I hadn’t met …
5 pieces of advice every young doctor needs to hear
Though celebrated by anti-abortion advocates across the country, the overturning of Roe v. Wade by no means closed the book on the abortion debate. However, it was a victory for both human rights and federalism. The decision reinforced that the U.S. is a constitutional republic composed of individual states, each with its own agenda. States are now individually empowered to enact abortion legislation anywhere along the human gestation cycle. As …
The truth about hard cases and abortion: Separating fact from fiction
According to the Centers for Disease Control and Prevention, as of 2020, approximately 5.8 million people in the U.S. were living with Alzheimer’s disease, a progressive brain disorder affecting memory, thinking, and behavior. The prevalence of this disease is expected to continue to rise as the population ages. The number of people living with the disease is projected to grow threefold to 14 million by 2060. While there is …
Advancements in technology offer hope for those with Alzheimer’s disease
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In this episode, our guest Susan MacLellan-Tobert, a pediatric cardiologist and physician coach, delves into the challenges faced by healthcare workers during the COVID-19 pandemic. Despite being …
Processing grief: a vital step for health care workers during COVID-19 [PODCAST]
It is no longer news that Silicon Valley Bank has collapsed like a pack of cards. Quite unsettling is also the uncanny way the whole enterprise unraveled like a Ponzi scheme. Faced with uncertainty and a crisis of confidence, investors went on a withdrawal binge. But how does the crash of a bank for tech startups in Santa Clara, California, that caters to extremely high net worth individuals concern an …
The butterfly effect of financial decisions: lessons learned from Silicon Valley Bank
Maybe dogs aren’t the only ones drinking water from a toilet bowl. In the United States, we have easy access to clean water. We use culinary water to do our dishes, bathe, wash our cars, and even fill our toilets. Most Americans don’t ever consider the possibility of running out of drinkable water; the same can’t be said for the friends I made in the Philippines. Let me tell you …
How lack of access to clean water is devastating developing countries
The first time I saw a preceptor use the American College of Cardiology’s atherosclerotic cardiovascular disease (mercifully, ASCVD) risk calculator, I was hooked. As a first-year medical student, data nerd, and aspiring primary care provider, I love a good diagnostic tool. Watching as he entered our patient’s pertinent medical history, I ran down the list of risk factors for cardiovascular disease we’d just learned in my …
Binary medicine harms our gender-expansive patients
This article is sponsored by Pfizer.
The diagnosis and treatment of migraine, a debilitating neurological disease that affects nearly 40 million people in the U.S. and one billion worldwide, is poised for a transformation, and primary care physicians (PCPs) hold the key.
Migraine is the most common diagnosis among patients presenting with headache in the primary care setting. More than 50 percent of all visits for migraine take place in …
A better future in migraine management: the essential role of primary care
Recently, two of my most beloved teachers came to our continuity clinic as Mrs. Melendez brought in her daughter, Maria, for her annual physical (not real names). I have known the Melendez family for nearly the entire 18+ years I have been at this clinic, at first taking care of their four older children who were at that time in early middle school through high school. At one of the …
A pediatrician’s memorable experience with a patient with Down syndrome
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In this episode, we have Dennis Hursh, a physician contract lawyer, sharing his experiences in dealing with hospitals and their tendency to condescend towards physicians and their lawyers, also known as “hospitalsplaining.” He discusses a recent example …
“Hospitalsplaining”: the condescension problem in physician employment contracts [PODCAST]
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In this episode, Yael Dreznik, a pediatric surgeon and author of the book Twenty-Six, shares her personal story and insights into the life of a surgeon. From the early morning rituals to the fear of making mistakes, …
Twenty-Six: a story from a pediatric surgeon [PODCAST]
When I was growing up, I remember my father saying the phrase, “Fool me once, shame on you, fool me twice, shame on me.” In today’s world, I find myself often recalling those words. Most of life these days should not be taken at face value.
It also appears that if you shout out falsehoods frequently enough, then it seems that members of extreme political groups will believe it as the gospel truth. …
Transparency and honesty: the keys to fixing America’s broken health care system
“What should we do?” I asked my partner. I looked down at our dog, who was limping in pain and whose treatment was just quoted at nearly $1000. Just yesterday, our brakes collapsed, and repairing our car would also be a hefty expense. He sighed, knowing we didn’t have the money for either but definitely not both. My partner and I are both resident physicians in San Francisco and here …
To improve health care, respect doctors’ humanity with a living wage
When we physicians discuss “work-life balance,” we often imply that our dedication to our work is so consuming and imbalanced that we end up sacrificing time with our families. To achieve a better balance and promote a healthier family life, we strive to limit our work hours to make more time for our home lives.
I wonder if the reverse can also be true. When our home life becomes overwhelming or …
The secret life of physicians: work, home, and the battle for balance
A letter of intent (sometimes called a “term sheet”) can be useful for physicians and those who recruit them. The purpose of letters of intent in physician contracts is simply to ensure that both parties are “on the same page” as far as the major terms of the agreement they hope to enter. For example, if you expect to be paid $300,000 a year, but the employer is expecting …
I write this letter with a heavy heart. Our story began during my sophomore year in college, but after a decade with you, I can’t help but feel our dynamic has changed. Intrusive thoughts of leaving you have etched their way to the forefront of my mind. The harder I try to quiet them, the louder they declare themselves. They’ve grown from whispers to screams, and I can’t ignore them …
Breaking up with nursing: a heartfelt letter
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In this episode, we speak with George Tewfik, an anesthesiologist, about the importance of recognizing and addressing knowledge gaps in anesthesia residents. George discusses how new residents may arrive with a sense of false confidence that can …
Empowering anesthesia residents: lessons in trust from an anesthesiologist [PODCAST]
The COVID-19 pandemic has been an unprecedented event for worldwide health care. The call to action for organizations included setting up mass testing sites to serve their communities. I helped set up multiple locations across several counties using a mobile model. We tested hundreds of patients each day in various places. Once the vaccine was approved, we began our vaccination efforts using our mobile model and mass vaccine sites, including …
Understanding the end of the COVID public health emergency
During my night shift at the emergency department, I encountered a 72-year-old decorated war veteran named Mr. Sun. Accompanied by his concerned wife, he came to address a year-long struggle with fatigue and a non-productive cough he’d been experiencing in recent weeks. Initially resistant to seeking medical attention, Mr. Sun finally gave in to his wife’s insistence.
As I entered the room to assess Mr. Sun, it was immediately apparent how …
A veteran’s battle against possible lung cancer
In theory, the widespread adoption of health information technology (HIT) and integrated applications can improve patients’ access to their health information and facilitate patient-centered care. In reality, this increased reliance on patient-facing technologies and data derived from connected devices, machine learning, and artificial intelligence can widen gaps in access, create new barriers to health equity, and generate biases that influence research and clinical decision-making that negatively impact the patient experience …
How data and technology influence health in ways that doctors don’t
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