If you don’t practice, don’t move, or you’ll probably lose your license

Physician
August 2, 2022

I left practice 25 years ago when I saw portents of clinical practice as it exists today: impersonal, with electronic records and assembly-line labor heralding the movement to institutional employment over private practice.

But it was also my genuine interest in population health and pharmaceutical medicine that propelled me into a nonclinical career. The jobs I chose in this millennium were with health insurance and pharmaceutical companies, …

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What this physician mom learned about shame [PODCAST]

Podcast
August 1, 2022
YouTube video

 

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“I cry often enough that my kids almost gleefully expect it, checking me for tears during movies or shows, shaking their heads in mock dismay when they see that their prediction is correct. I’ve cried many times at home, watching screens, reading books, …

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Make your health insurance broker a translator, not a shopper

Policy
August 1, 2022

In the unending ocean of choice and complexity of medical insurance, sailing your own ship is harder than it looks. Especially when you get a new job, age into Medicare, or turn 26 and thus can’t stay on your parent’s coverage. Every ship captain needs a helmsman—brokers are a major help for picking a health plan, but they are best used as an insurance translator rather than your personal shopper. …

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Less resiliency may heal burnout

Physician
August 1, 2022

The word “resiliency” has been lauded, applauded, and buzzed about in talks about physician burnout.

When I hear it, I tune out.

My stomach churns. I feel sick.

Why?

Because physicians are resilient.

We are, in fact, the walking, talking, breathing personification of the word.

We cannot manage to get through medical school, residency, and boards, without being resilient.

And remember, we do this by choice.

Lots of schooling and academic demands.

Inhumane hours.

Little sleep.

Extraordinary amounts of information to …

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A physician mom’s take on telemedicine [PODCAST]

Podcast
July 31, 2022
YouTube video

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“In early 2018 when I started full-time telemedicine, I was quite reluctant about losing the physical hands-on evaluation, especially the palpation, percussion, and auscultation components in the physical exam, and the holding hands, hugs, and handshakes of in-person visits.

But thankfully, I remembered one …

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Doctors need to advocate more for their patients

Physician
July 31, 2022

My first patient of residency was Mr. John. He endured life-threatening injuries that left him without speech or the ability to move his limbs. Every day had obstacles, and I met most of his family over time. Mr. John was a family man who looked after others first before himself. A self-made man. He was a man who was physically strong and dedicated to every project and goal he set …

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The role of nutrition in rheumatology patients

Conditions
July 31, 2022

Five years ago, I met a patient that changed my view on practicing traditional medicine, especially when it comes to rheumatology. For years, I was proud to be in a booming field that provided patients with a new therapy every few years. As a physician and scientist, I believe that targeted therapy offers tools to treat patients like never before, but I have noticed that results vary over time.

Daniel was …

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Don’t become a doctor?

Physician
July 31, 2022

Do not become a doctor. This was the piece of advice my parents gave me when I initially shared my desire to do so.

No, neither parent is in the medical field. As I’m finishing medical training today, I fear this will be the advice I will give my daughter one day. Once wide-eyed, I now look in the mirror and barely recognize myself. Seven years into post-medical school training, I …

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Transition planning: financial moves for medical residents and fellows [PODCAST]

Podcast
July 30, 2022
YouTube video

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“While you may not know exactly what your transition period will look like ahead of time, you can do your best to prepare for this change. By having a plan in place, you can make sure you are ready for the time between …

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A nut allergy nightmare at 35,000 feet

Conditions
July 30, 2022

A hungry college student was on a plane flying to Italy. She was alone, as her parents had bought her a ticket to join them on the trip, but their own flight had been sold out. About an hour after take-off, the flight attendants came down the aisle with their carts to serve dinner. She chose the chicken and quickly ate the entire meal. It was Indian-style cuisine, an odd …

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Denying essential medical care doesn’t save money — or lives

Conditions
July 30, 2022

That health care in the United States is wildly expensive is beyond debate — but the actual numbers are almost beyond belief. In 2010, for example, health care costs amounted to $2.6-trillion. By 2020, those costs had risen to $4 trillion — an increase of more than 50%. Worse, such increases show no signs of slowing.

Health insurance premiums, out-of-pocket expenses, and direct government expenses all add up to a nearly …

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Please stop saying “provider”

Physician
July 30, 2022

When I started my internal medicine practice in 1996, the medical arena was vastly different than it is today. Back then, having an MD after my name actually meant something.

A letter from me to an insurance company would get a needed medication covered for a patient––a time before preauthorization existed. Dr. Google was not yet born. “Provider” exclusively belonged to the insurance industry.

My patients called me “doctor” and referred to …

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Robotic interventional cardiology [PODCAST]

Podcast
July 29, 2022
YouTube video

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“In the majority of robotic-assisted cases I perform, automated movements are particularly helpful in delivering gear – I can easily get balloons and stents around the C-shaped curve in the right coronary artery from the cockpit just like I would be able to …

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Seemingly unimportant acts make a big difference

Conditions
July 29, 2022

We were reminiscing recently at a brunch we set up. It had been many years since we had seen each other. Eventually, we went our separate ways. But we reconnected once again.

Anna was one of our night shift nurses. She was bright and articulate. She eventually became a preceptor and mentor to many new ICU nurses.

The “night shifters” are on an island of their own. We form a special family, …

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Do microaggressions persist after practice?

Physician
July 29, 2022

Microaggressions are common, subtle, offending behaviors and attitudes that stem from implicit (unconscious) bias. Individuals targeted by microaggressions are different than us — different in their look, skin tone, gender, sexual preference, socioeconomic status, educational level and age.

Implicit bias refers to unconscious stereotypes, assumptions, and beliefs held about an individual’s group identity. They affect our understanding, actions, and decisions and increase Read more…

Candid about my breast cancer

Conditions
July 29, 2022

Lump

I am a pretty private person and will only disclose information with a small few I trust. However, it has been five years since my second diagnosis with breast cancer, and I felt compelled to share my journey because I’ve made it a lot longer than I thought I would.

Every day for the rest of the month, I will share what I recall, what helped, and what didn’t. My only …

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What needs to change in medicine for it to be sustainable? [PODCAST]

Podcast
July 28, 2022
YouTube video

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“A prospect seeking a career in medicine must start with their own awareness of boundaries and perfectionism before entering the field. This inner work must be indoctrinated in schools and encouraged through residencies and mentorships. Furthermore, administration must model this and valued it …

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The nurse who walked a million miles

Physician
July 28, 2022

Nurses are notoriously tough, resilient, and caring. Their ability to deliver health care with a mindful spirit is uncanny. Multitasking is soon ingrained in even the greenest of this kind.

Go ahead, inundate them with requests, some admittedly regretful, and you will witness amazing things being accomplished with few exceptions. They can be mischievous as well. After all, they’re human, right? Surely the new haughty unsuspecting intern deserves a 2:45 a.m. …

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I received a comprehensive sex education. I still chose abstinence.

Conditions
July 28, 2022

Here’s the story of a girl who got a comprehensive sex education and still chose abstinence. That girl was me.

Did I gain this knowledge from school? Heavens no. I grew up in the South at the turn of the 21st century. Abstinence-only sex education was the name of the game (still is, last I checked), especially in the school district I was in. Ironically (or maybe not so, in light …

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