Breaking the vicious cycle of medical malpractice lawsuits

Physician
August 11, 2022

Lawsuits are conventional in medical practice.

An unhappy patient hires a malpractice attorney, who hires a medical expert, who interprets the standards of care and generalizes a departure from the standards of care and proximate cause. The preponderance of evidence is 50% certainty plus an ill-defined scintilla, which needs to be only 0.01% to be good enough.

The lawyer sues the doctor, who notifies the malpractice carrier, hires a defense counsel, and …

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Learn to round on yourself

Physician
August 11, 2022

I always think of the beginning of July as the New Year in medicine. It’s when medical students become interns, interns become residents, and residents become newly minted attendings. With each change is an increase in responsibility.

I remember paying even more attention to the history and physical each time I crossed that threshold. With an increased sense of purpose and responsibility. This was true in the office and during admissions …

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Comparing charity evaluation websites: What do those ratings mean?

Physician
August 10, 2022

The majority of people who donate money don’t research or compare charitable organizations. Only 1 in 3 research before giving, according to one of the biggest charity ratings websites, Charity Navigator. Giving 2.0 author Laura Arrillaga-Andreessen says only about three percent compare charitable organizations.

These numbers were both surprising and not surprising to me. I have done most of my donating with no more than a cursory …

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

Conditions
August 10, 2022

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 aid kit, extension cords, dry erase board and other room necessities. But have you thought about what could happen should they get ensnarled in a health crisis away from home?

It’s a hard …

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Melting the iron triangle: Prioritizing health equity in dynamic, innovative health care landscapes

Policy
August 9, 2022

As a master of health administration (MHA) student completing my administrative residency in the health technology industry, I chose to dedicate my capstone project to a topic positioned at the intersection of what I had learned in graduate school and what I had learned during my residency. While administrative residencies are typically in a hospital or consulting setting, I matched with a primary-care-focused electronic health record company as the organization’s …

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The great resignation can be stopped. Here’s how.

Policy
August 8, 2022

The 2022 Top States for Business designation has higher stakes than ever, as companies compete for top talent while balancing inflation, supply chain issues, and other ongoing pandemic side effects. However, the solution to employee recruitment and retention is not an expensive corporate relocation; it is time for a corporate wake-up call. American companies must stop or re-examine existing efforts to engage with their employees and instead meaningfully adjust …

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Certainty is a fading flame in a failing body

Physician
August 8, 2022

“You should prepare for the future. Your son will never be independent.”

I do not recall hearing those words at their source, but I was only eight when they were relayed to me by my parents. At the time my diagnosis, now characterized as juvenile myoclonic epilepsy, was poorly understood and often confused with more virulent disabling neurological conditions. Despite this fact, I have used the doctor’s prediction as fuel for …

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Monkeypox and the prolonged COVID pandemic could seal the fate of the health care system

Physician
August 8, 2022

I understand it’s been over two years since the World Health Organization announced the coronavirus pandemic, and we are tired.

I speak for the thousands of health care workers and frontline workers: We are exhausted, we feel taken for granted, and for many of us, we are leaving the industry. In some cases, we went from health care heroes being villanized as if we somehow benefited from the pandemic. So many …

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Teen dies when blood culture protocol botched [PODCAST]

Podcast
August 7, 2022
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“Address the patient’s chief complaint first. In this case, the other symptoms were only side effects of the main problem.

Pay attention to lab work. In this case, the elevated white blood count and the related blood culture …

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CMS Medicare fee cuts: The altruism of physicians is used against them

Policy
August 7, 2022

It’s hard to concisely put into words how frustrated physicians are right now. How many other professional groups out there have to fight to not have their compensation cut multiple times a year? Recently, CMS released its proposed physician fee schedule for Medicare for 2023, which reduces the conversion factor by 4.42%. This compounds upon additional cuts such as the resumption …

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We’re reacting to medical errors the wrong way

Physician
August 7, 2022

Medical mistakes are as old as the practice of medicine itself, but it wasn’t until 1999 that the United States started paying more attention to them.

Over twenty years later, we may be reducing medical errors — a recent study published in the Journal of the American Medical Association found significant decreases in mistakes in cases of pneumonia, acute myocardial infarction, heart …

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Opioid-free orthopedic surgery: Why (and how) my patients go opioid free after surgery

Conditions
August 7, 2022

Primum non nocere.  First, do no harm.

All doctors are familiar with this credo. From ancient precepts such as the Hippocratic Oath promising to abstain from doing harm to the modern bioethics principle of nonmaleficence, the calling of physicians involves striving to help alleviate suffering and avoid making it worse. In our increasingly complex health care and data environment, avoiding inadvertent harm can be more difficult than one might expect.

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We must disrupt harm

Meds
August 6, 2022

In the mid-1980s, with the AIDS epidemic on the horizon, austere conservative Margaret Thatcher sanctioned the first needle exchanges in the U.K. to prevent the budgetary burden that HIV might otherwise have become on the National Health Service. Nearly forty years later, New York City opened its first supervised injection sites in November of 2021, where intravenous drug users inject their substances of choice under the watchful eye …

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As we live in fear, there is still hope

Physician
August 6, 2022

Fear. It means something different to each person, but collectively we can all agree that fear can be something that drives us to succeed (fearing failure), causes us to take care of ourselves (fear of poor health), and can even promote experiences that wouldn’t otherwise be pursued (fear of missing out, affectionately known by the acronym FOMO). This isn’t the kind of fear I had this past Sunday sitting in …

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My “dig deep button” is officially out of service

Physician
August 6, 2022

I started my hospitalist shift like any other day. I arrived at 5:30 a.m. for shift hand-off at 7 a.m. A full hospitalist load and endless administrative tasks to complete, the duality of both roles punctured me like a venomous snake bite. I had two full-time jobs to complete in 12 hours. Impossible! Or was it? I added one and one-half hours to my shift at the beginning–time hidden behind …

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