Why HIV and COVID-19 vaccine screening should go together

Conditions
November 22, 2022

During the COVID-19 pandemic, Americans got accustomed to regularly answering a series of questions about our risk of exposure to COVID and our possible symptoms. For more than two years, our country remained laser-focused on this protection, demonstrating our health care system’s ability to mount a strong response to a public health crisis. So why haven’t we taken similar precautions in the face of other crises, particularly HIV?

For too long, …

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As doctors, caring is our poetry [PODCAST]

Podcast
November 21, 2022
YouTube video

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“The art and craft of being a physician and finding meaning in our care of others are to make poetry out of our lives.”

Steven Kamajian is a family physician.

He shares his …

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Letting grief make you stronger

Conditions
November 21, 2022

Grief is powerful and can break your heart for the rest of your life, or you can learn from it and become stronger. Losing a loved one is something that everyone will go through, but not all come out as survivors in the end. It’s part of life, but a very difficult part. Think of your loss as a lesson to help you live the rest of your life.

How do …

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Medical support staff is neglected, disrespected, and mistreated

Physician
November 21, 2022

Medical support staff is leaving in droves and leaving patients’ health at greater risk. Calls and messages to doctors’ offices have surged as patients try to access care. Wait times skyrocket to book visits.

News stories about the current state of the health care system typically focus on the plight of doctors and nurses. Studies detail the “Great Resignation” impairing the health care industry–a new report published …

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How whole-person care can make us better healers [PODCAST]

Podcast
November 20, 2022
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“My lifelong quest to become a healer — over 40 years as a family physician, scientist, and researcher with the National Institutes of Health, the World Health Organization, the Walter Reed Army Institute of Research, and the …

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The slow death of primary care: a Canadian perspective

Physician
November 20, 2022

Loss of autonomy, gaslighting, abuse, exploitation, and hypocrisy are all strong words. Just writing them brings to my mind the harsh reality of my experience and the collective experience of others who have dared to speak up. These words come to mind when I think about primary care in Canada. I recognize similar sentiments are heralded by my U.S. colleagues and those in the United Kingdom.

The system is failing. …

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Ambulatory medicine today: Focus on what you can control

Physician
November 20, 2022

Patient volume has recovered across the country, and most medical offices are back to a steady state of care delivery—but ambulatory care has changed irrevocably. We’ve entered a phase shaped by crisis and marked by even more intense cost pressure and consolidation. What steps can independent medical practices take now to help ensure stability and prosperity moving forward?

Offer employees a more rewarding work experience.

The great resignation—unprecedented turnover in the labor …

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Why is collaboration missing in health care?

Physician
November 20, 2022

An essay posted by Fareeha Kahn, MD (“A hospitalist’s struggle to find teamwork in academic medicine“), raises an important issue. The problem of lack of collaboration is not unique to academic medicine. The problem is the result of misaligned incentives.

Having read the work of Harvard Business School professor Michael E. Porter, I better understand the goals and challenges of value-based care. If we look at the premise …

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We’re confusing resilience with grit [PODCAST]

Podcast
November 19, 2022
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“It’s not that physicians need to be more resilient. We’ve failed to provide them with the goodwill to be human and embrace their “whole selves” (people who are resilient often but not always), access to safe and …

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Depriving women of this drug is good public health

Meds
November 19, 2022

It’s a public health win that on October 19th, an FDA Advisory Committee voted 14-1 to remove Makena, a drug intended to prevent preterm birth, from the market. The FDA usually follows the advice of its advisory committee, and the briefing documents it supplied the committee make it clear that the agency wants the drug off the market. As well it should. Makena doesn’t work.

After a preliminary trial showed that …

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Political creep: government intrusion in health care

Policy
November 19, 2022

The American Medical Association (AMA) would have you believe that the biggest threat to the medical profession is “scope creep” – the intrusion of advanced practice providers into medical practice.

The way I see it, this is no big deal; the movement will reach equilibrium, and everyone will play nicely in the sandbox.

In my opinion, the biggest threat to the medical profession is “political creep” – the increasing government …

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It is time that medical societies acknowledge that pro-life views are legitimate

Policy
November 19, 2022

The recent Dobbs decision has led to strong reactions from many major medical associations arguing that limiting abortion options will significantly harm women with unexpected pregnancies. This needs to be acknowledged, and the desire to do what is best for women is to be commended and shows a true passion for providing what these organizations deem to be the best possible care.

However, there are many medical providers who are as …

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Meet the doctor who had a colonoscopy without anesthesia [PODCAST]

Podcast
November 18, 2022
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“If you did not have a colonoscopy, I would still recommend that you do it in a conventional way and get that IV sedation. But if you are an adventurer as I am, I would highly recommend …

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Digital philosophy: a critical tool for the mental health of children

Physician
November 18, 2022

The precipitous decline in the mental health of U.S. children and adolescents has been meticulously cataloged in newspaper articles, books, and documentaries. In our own pediatrics clinic, the numbers have skyrocketed — a baseball player unable to get out of his car for practice, a teenager with aggressive behavior masking underlying depression and anxiety, and another 9-year-old unable to attend school due to daily panic attacks. Every day now, we …

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Why we should end gendered titles

Physician
November 18, 2022

The question of addressing physicians by name has been addressed again. Yet the question about names has not been addressed.

Before addressing the name question, I will talk about how I have evolved with time.

In India, I have been used to formally addressing everyone as either “Sir” or “Madam” during in-person meetings and in virtual communications when I have known them — “Sir/Madam” or rarely …

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I saved a baby’s life

Physician
November 18, 2022

I saved a baby’s life today.

I say that not to impress anyone or to make myself out to be some kind of deity but because it is simply true.

A three-week-old baby arrived at my office, gray and limp, with agonal respirations and oxygen saturation of 67 percent. My team of dedicated office staff worked with me rapidly and seamlessly, providing oxygen, bag-mask ventilation, and emergency medical services (EMS) activation. Together, …

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Why you should add advance directives to your college freshman’s checklist [PODCAST]

Podcast
November 17, 2022
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“Suppose you’re getting ready to send your young adult off to college for the first time. In that case, you’ve likely been spending the summer getting college dorm and apartment essentials lined up: bedding, storage cubes, first …

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Leaving The House of God

Physician
November 17, 2022

To paraphrase Fat Man’s Law Number Three, “At a code, the first pulse you take is your own.”

Enduring advice, as true today as it was in the early ’70s when Roy G. Basch, MD, and his gang of hapless interns roamed the airless wards of The House of God, the mythical hospital in the infamous novel by Samuel Shem, although almost everything else about practicing medicine seems …

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It’s time for a reckoning in pain medicine

Conditions
November 17, 2022

More than a million Americans have died since the late 1990s from drug overdoses, with the vast majority dying from an opioid overdose. This trend started with the heavy marketing of opioids to physicians as nonaddictive and effective. The number of deaths from overdose has escalated significantly in the past few years. Although many of the recent opioid-related deaths are from fentanyl, substance abuse treatment providers report that …

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