Withdrawing life-sustaining treatment over family objections

Conditions
August 24, 2022

“We can keep your loved one alive. but we won’t. Even though you think their life is worth living, we do not.”

The first time I helped a hospital convey this type of offensive message to a patient’s family, it deeply humbled me. My service on a hospital medical appropriateness review committee forged charitable respect for alternative viewpoints that now pervades my work to protect patient rights.

Hospital review committees adjudicate medical …

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When should you consider surgery for scoliosis?

Conditions
August 24, 2022

Most people with scoliosis will never require surgery. But who does need surgery, and how do you know?

Often diagnosed in childhood, scoliosis is characterized by an abnormal curve in the spine that can range from as small as 10 degrees to more than 100 degrees. In pediatric patients, this can result in pulmonary problems if the curve is severe.

However, pediatric patients’ complaints are mostly centered around their appearance due to …

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Contract advice for physicians leaving the military [PODCAST]

Podcast
August 23, 2022
YouTube video

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“Military physicians should also realize that not all employers are equal or treat their physicians equally.

Military physicians entering the civilian job market are in a ‘seller’s market.’ They should get a reasonable employment agreement. It is important …

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Advancing health equity conversations through cultural humility

Policy
August 23, 2022

In 1998, Drs. Tervalon and Murray-Garcia created the concept of “cultural humility” as a way to transcend the prevailing but limiting concept of cultural competence in teaching medical students and trainees how to respectfully deliver health care to the increasingly diverse populations of the U.S. The cultural competence paradigm leads health care professionals to assign patient group traits or labels. On the other hand, cultural humility incorporates a lifelong commitment …

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How hearing is connected to well-being

Conditions
August 23, 2022

As an audiologist, treating hearing loss is a part of my everyday life. Even still, I’m sometimes amazed at the difference hearing aids can make in patients’ lives. For example, recently, when an older patient with longstanding hearing loss was fitted with a pair of hearing aids, he was suddenly able to participate in conversation with his son again. The smile across his face said everything.

Hearing well can slow cognitive …

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Management of acute postoperative pain reveals systemic flaws in health care policy

Physician
August 23, 2022

Medical care in the United States is broken. The pandemic contributed, but we were well along this misdirected journey. There is a pathological push/pull between financial pressures applied by payors and health care systems to decrease costs, thereby generating profits versus the desire of providers to deliver outstanding care to patients. This is ingrained into our system as it is designed. The dynamic is further muddled by our unique medicolegal …

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Melting the iron triangle: health equity in innovative health care landscapes [PODCAST]

Podcast
August 22, 2022
YouTube video

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“While the technological boom in the health care field is not a circumstance of the pandemic, the accelerated roll-out and adoption of digital features certainly are. And rapid innovation in the health care technology field is not …

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Let’s address the needs of millions of students with sensory processing disorders

Conditions
August 22, 2022

As public and private schools around the country gear up for opening their doors to in-person learning later this month, it is important to acknowledge and accommodate the millions of children who deal with sensory processing disorders.

An estimated 5 to 16 percent of school-aged children have difficulties processing the senses either by overreacting or underreacting to sensory information. This includes not only the five senses of touch, …

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Patients who are openly skeptical of a physician’s science-backed advice

Physician
August 22, 2022

I’ve just passed the 15-year milestone of practicing family medicine in a small farm town in the Midwest. Knowing my patients and their multi-generational families deeply and enjoying their trust is a major part of my job satisfaction.

Unfortunately, the last two years have put a serious dent in both the trust and the satisfaction.

No one ever takes all the advice their physician gives them, at least in my experience. Until …

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Keep us safe: Stop the violence against health care workers

Physician
August 22, 2022

Violence against health care workers has escalated to unprecedented levels in the last decade. The pandemic seems to have accelerated outbursts against health care providers online, in print, and in person.

A man from Tulsa, Oklahoma, recently angry over back pain, killed his surgeon and other health care workers before ending his own life.

Many health care workers report they are used to working in environments that are …

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Non-judgmental empathy in the exam room [PODCAST]

Podcast
August 21, 2022
YouTube video

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“I think we all have an inclination—at least from time to time—to judge others. No matter how experienced, compassionate, and professional we are as physicians, we’re still human. I can admit that I have indeed struggled with …

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Not a cheater? Let’s count the ways.

Conditions
August 21, 2022

Sexual infidelity is the headline grabber when most people think about betrayals in love relationships. But, everyday breaches of trust slide under the radar and can erode even the strongest of relationships.

A small lie about a purchase, a slight exaggeration about a job promotion, a cover-up about a forgotten birthday—each takes a bite out of trust and is a form of cheating. Most of us are disappointed by a love …

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Controlling physician behavior

Physician
August 21, 2022

Some years ago, I had the privilege of serving as chief of staff of my community hospital. One of my responsibilities was to review complaints directed at doctors. Ten to twenty “occurrence reports” came across my desk every week. Most were from nurses who felt doctors had unfairly reproached them.

Hospitals are required by their deeming organizations — ours is The Joint Commission (TJC) — to adjudicate each item with due …

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Computers and your hands: Dispelling common myths

Conditions
August 21, 2022

Have you heard that computer use causes carpal tunnel syndrome? In fact, there is a near-universal belief that technology gadgets can cause all sorts of hand problems. Both the lay public and most healthcare providers believe that entities such as “Blackberry thumb” and “repetitive strain injury” truly exist and that common hand problems such as flexor tendonitis and basal joint arthritis of the thumb are caused by repetitive typing or …

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Tips for treating high-weight patients [PODCAST]

Podcast
August 20, 2022
YouTube video

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“It might seem odd to write about what high-weight patients would like when they meet with their doctors. Don’t they want what every patient wants? The answer is yes, but the fact is, they often don’t get …

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Who even reads personal statements?

Education
August 20, 2022

The following article is satire.

We’re again approaching that time of year for medical students: ERAS application season. As students whimper and wonder if they’re making the right career choice, as they set their dreams on a specialty but have been told they need a “backup,” while determining their geographical boundaries of where they can possibly think of living for the next three to who-knows-how-many-years. With all this chaos, they must …

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Doctoring in the backwoods: challenges and rewards

Physician
August 20, 2022

I worked in rural Kentucky for 20 years, all of it in poverty clinics. I suspect I got to know my patients better than someone working in a specialty clinic in a big city. The challenges and rewards of doctoring are unique to each specialty. But these are the challenges and rewards I experienced in primary care in the backwoods.

I learned that doctoring is hard. People always come in complaining …

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How the culture of health care perpetuates racism [PODCAST]

Podcast
August 19, 2022
YouTube video

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“Many health care professionals go into health care to help people, no matter their race, socioeconomic status, or other identities. Even as white health care professionals start to learn about the systemic nature of racism, something that …

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What it means to leave clinical medicine

Physician
August 19, 2022

Not too long ago, a circumstance occurred. I have experienced similar circumstances several times in my career. However, this time, my response was different.   It was like a switch in my brain flipped. I was ready to leave clinical medicine. It was time for the next chapter.

Wow! It was a moment of surprise, relief, and excitement, quickly followed by a WTF? Where was this thought coming from? There was …

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