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“I smiled, put the lamb curry in front of her, and instructed her granddaughter on how much time to heat it up in the microwave.
Val wasn’t in a condition where she could have a long conversation with …
A cancer patient’s last wish [PODCAST]
One of the most radical implications of the literature on early childhood trauma is that abuse needs to be eliminated from all of our relationships: our families, teachers, colleagues, and government. When government leaders create a new policy, they can proceed in a way that disempowers constituents, or they can proceed in a way that fosters dialogue and shared decision-making. Ironically, the development and implementation of California’s policy …
Adverse childhood experiences: Can government policy reduce trauma?
I was sitting in front of a panel of six people for my psychiatry training interview in Wellington, New Zealand. Two community members, two psychiatry consultants, and a senior psychiatry registrar, all of which were of Caucasian ethnicity.
I can recall talking about cultural differences in my upbringing and how that has helped me to connect to some of the most vulnerable people in our community. Samoan culture is adherently based …
Institutionalized racism in psychiatry: a doctor’s experience
My husband’s medical school offered a “key supporters” session during his first-year orientation week. Each student’s family or significant other was invited to attend a two-hour session to learn the schedule of a student doctor and for a panel discussion from current students and their key supporters.
Most people walking out of the room afterward were really nervous. It sounded like students were studying 15 hours a day with no more …
Making it work when you’re married to a medical student
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“Health system leaders can master this ‘chess game’ by anticipating the next several moves well in advance with the assistance of AI-based predictive analytic tools. This adoption will lead to dramatically better outcomes than a purely reactive …
How AI-based technology can help improve hospital capacity management [PODCAST]
Doctors with mental illness don’t need more suicide awareness — we’re aware. And we don’t need confidential treatment opportunities. What we need is assurance from all invested parties — our employers, credentialing bodies, and licensing officials — that it will be OK if we need help, we can get what we need, and that everything for the job can be sorted out once we’re well. Because it turns out, in …
Physicians with mental illness shouldn’t hide
The announcement of the Biden-Harris Administration’s national strategy on hunger, nutrition, and health is a critical step toward building a healthier nation. For the first time in half a century, the administration announced more than $8 million in private and public sector commitments to help end hunger and reduce diet-related diseases by 2030. The focus on food security, nutrition, and health is encouraging, as public health champions have …
The national strategy on hunger, nutrition, and health offers hope
I applaud the efforts of several states that have enacted legislation to make it easier for physicians to get mental health treatment without incurring the wrath of physician health programs (PHPs). PHPs, while well-intended, are notoriously disruptive to the lives and careers of physicians struggling with depression, substance use disorders, and other mental health conditions. PHPs have a reputation for implementing unreasonable requirements and being coercive, sometimes worsening …
Mental health is a slippery slope when it comes to physicians’ well-being
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“Modern parenting comes with challenges that only a modern parent can understand. As both a pediatrician and a mother, I dispense with the advice I wish I had when my daughter was born. While there may be …
How the internet broke parenting [PODCAST]
Talk to physicians in private medical practice today, and you will discover that they will affirm that their medical practice is financially satisfactory, stable, and doing well financially.
Private practicing physicians know that they have no measurable standard to use to verify what they just told you except for their profit and loss statements from their CPA. And even if they believed they could be in a much better position financially, …
Why physicians never reach their career potentials
I just got this email from a physician: “Hi, Pamela. I wonder if I could curb you on seeking mental health services as a physician. I am not suicidal or impaired but considering a consultation with a psychiatrist for medication. Any chance you would be able to chat with me for a short bit to discuss tips for seeking consultation while avoiding stigma and labeling?”
Sadly, most medical professionals fear seeking …
13 tips for depressed doctors who need confidential mental health care
The value of empathy in medicine is seldom debated. Just as the art of medicine is taught as the balance of knowledge and application, so has empathy been recognized as both a value to be fostered and a skill to be learned. Medical curricula have reflected this, and while didactics are increasingly filled with various conversational frameworks and behaviors that convey empathy, rarely do they include specific language to convey …
Giving language to empathy: lessons from palliative care
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“I was truly gutted when watching the recent Saturday Night Live that joked about nut allergies. My son Joshua, who is 16 years old, has an anaphylactic peanut allergy. I found the …
Food allergies are not a joke [PODCAST]
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There is something to the movie The Secret Life of Walter Mitty that I just love. Every time I hear the music, I feel the sky of possibility opening as a melancholy feeling simultaneously hits. And today, while finishing my ACLS recertification, I realized another reason why: Walter Mitty finally starts designing his way forward. And you can too.
While sitting in between cases, one of my partners asked me why …
How prototyping your life can save medicine
As a pediatrician, you’d think that I’d be a pro at celebrating growth. After all, I celebrate the growth of children in the office as they meet their developmental milestones and grow physically. I celebrate their academic and social growth.
What I hadn’t celebrated: my own growth. I thought for years that I was beyond that. Even my own professional growth had become tedious: Check the boxes on CME …
A physician celebrates her growth
As we continue our third year of the pandemic, there have been reports of hostile treatment directed at public health officials and medical personnel. This is escalating a crisis of burnout among health professionals, but there is an insidious, chronic hostility that lurks within hospitals between those who are supposed to be on the same team.
Bullying within health care has been a longstanding challenge. It is pervasive enough that the …
We need to talk about the bullying in health care
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“I learned the hard way what can happen when physicians—especially women physicians—lack personal boundaries. Before hitting my low point, I had no boundaries. I had been raised to give, give, give, and, when times became tough, to …
Boundaries for women physicians [PODCAST]
Admittedly, this comes to you from a place of concussion-inducing-head-banging-against-brick-walls-level frustration.
For the past year, I have made it a personal mission to get people suffering from obesity on GLP-1 agonists. These drugs are all in the same class, have identical mechanisms, and three are the same generics. (Ozempic, Wegovy, and Rybelsus are all semaglutide.)
They are advertised as Wegovy, Ozempic, Rybelsus, Saxenda, Trulicity, and Mounjaro.
To say these are life savers is …
A personal mission to get obese patients on GLP-1 agonists
I had a fairytale courtship, engagement, and wedding to my Prince Charming. We came home, starry-eyed, ready to start our forever together. Within weeks, I began to struggle. Always an extrovert, suddenly going to my family medicine rotation took extraordinary effort. I began to worry about my every word and action. Some days, I said nothing — unsure whether I could form a coherent sentence. I decided to take time …
How major depression strengthened my practice and my faith in God
You recently told me that I have the physician’s group’s highest patient satisfaction scores. This doesn’t surprise me. I know what makes me great: I take time. I let patients tell their stories. I listen, educate and collaborate. When I don’t know something, I find the answer. I am the poster woman for “AIDET.”
Recognizing that time is finite, I strive for efficiency. I delegate. I refer. I use order sets. …
26 hours in a day: the impossible math and timing of providing quality care
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