An excerpt from On Medicine as Colonialism.
For about seventeen years, from 1991 until 2008, I lived in little Scituate, Rhode Island, where I practiced family medicine, and for about eleven of those seventeen years, I practiced out of the basement of my house. It was an older style of primary …
Primary care colonialism: the impact of profit-driven health care on communities
The skill
Patient safety, patient experience, workforce health, and cost-effectiveness are critical outcomes with an important common root. They’re all impacted by our ability to communicate effectively and respectfully. Additional terms to describe these skills include people, interaction, interprofessional, relationship, and social skills. They can even be used to describe behaviors inherent in many properties of complex adaptive systems, such as the butterfly effect, flexibility, and adaptability. The more we understand …
The hidden link between soft skills and patient safety
I arrived at my desk after a holiday hiatus with renewed energy to tackle the day. It sat there, unassuming, on my desk with a note. My heart was giddy, knowing my tea pastime would level up. Opening the letter, I realized it was from my boss. My boss had given me a tumbler, and I felt like a kid on Christmas morning. The excitement seemed out of proportion to …
Feeling valued by my boss: How a simple tumbler made my day
This time, it’s my family.
My work takes me all over the U.S., consulting on the implementation of virtual care to get the most appropriate level of care to the patients who need it. I work with teams to develop better workflows and to get more experienced eyes on patients. It’s the kind of care anyone would want for their own family.
I was flying to Utah to assist a hospital system …
The future of health care is virtual: a nurse’s perspective
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In this episode, we speak with Christopher Sayed, a dermatologist who has dedicated his career to studying and treating hidradenitis suppurativa (HS). HS is a condition that causes painful boils in areas like the underarms, groin, and …
Discover the reality of living with hidradenitis suppurativa [PODCAST]
When my kids were born (3 within 19 months), one thing became very clear: there was only one way that I could possibly accomplish all of my goals. I wanted a fulfilling, successful career, with big aspirations. I also wanted to be really happy and present in my personal life. I didn’t want to sacrifice my career and didn’t want to sacrifice my personal life. I wanted success and fulfillment …
Streamlining your life is the key to career fulfillment
A pregnant Somali woman was determined to have a vaginal delivery. Unfortunately, labor wasn’t progressing as expected, and the health care team recommended a C-section. The patient declined the recommendation and said it’s in God’s hands. After some persistence, the health care team convinced the patient to get a C-section. After the C-section, the patient felt disappointed that her wishes weren’t considered. The OB team, however, didn’t understand why the …
It’s time to ditch cultural competence
Our previous post discussed how a full-time equivalent equals 2,080 work hours annually. To further clarify, we would like to explain how work hours during federal holidays can be calculated. One approach is to offer employees an incentive by counting each work hour after-hours as 1.5 and each work hour during federal holidays as two during the calculation of payable annual work hours. This can encourage employers to expect …
Balancing employee needs and fair pay during federal holidays
It’s your first visit to a cardiologist because you’ve had occasional episodes of an irregular heartbeat. As you fill out your pre-appointment paperwork, you carefully list the symptoms you’re experiencing and the treatments your primary care physician has recommended before referring you to a specialist. You don’t mention that you recently started taking Lexapro (escitalopram) to treat depression because you’re focused on your heart issue.
But that accidentally omitted information could …
Why sharing your complete medical history with your clinicians is important
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In this episode, Nancie Wiseman Attwater discusses her husband Bill’s struggle with idiopathic pulmonary fibrosis. Despite the doctor’s advice to change his diet, Nancie realized that it was probably too late for that to make a difference. …
When the doctor’s advice isn’t enough: a caregiver’s perspective [PODCAST]
I recently watched The Color of Care, a documentary highlighting the disparate and inequitable care received by Black and brown individuals during the COVID-19 pandemic. During the movie, Executive Producer Oprah Winfrey opined that one of the primary health care issues is the “empathy gap.” Upon hearing the phrase, I shot up in my chair, as it felt eerily (and painfully) similar to what I described in …
The empathy gap: How a lack of understanding is fueling poor outcomes and health disparities
In 2020, firearm fatalities displaced motor vehicle accidents as the leading cause of death of U.S. youth (ages 1 to 19). We long ago dramatically reduced infectious deaths (though vaccine hesitancy threatens to upend this victory), and the “big five” have been auto accidents, firearms, cancer, suffocation, and drug overdose – accidental in the youngest and intentional or accidental in teens.
Between 2000 and 2015, firearm deaths remained steady at about …
Gun crisis in America: Youth fatalities on the rise
An older patient recently told me that she spent 80 days over the past year in a doctor’s office. This represented over 20 percent of her life. She was relatively well but had several chronic medical conditions that required frequent office visits. In addition to these visits, she navigated scheduling, prescriptions, laboratory testing, and copayments.
Her experience is not unusual. For example, among patients with diabetes (a common chronic medical condition), …
How minimizing treatment burden can help patients with chronic conditions
Arianna Huffington recently wrote on LinkedIn, “45% of U.S. workers wouldn’t wish their job on their worst enemy. We’re in a crisis of purpose and meaning, not just burnout.”
This occupational phenomenon has also reached crisis proportions in the health care industry. In a recent study on physician burnout, Dr. Christine Sinsky reported the highest rates of burnout (>60%), emotional exhaustion, and the …
The power of physician-administrator partnership
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In the world of medicine, job security is not a given. In this episode, we speak with Aaron Morgenstein, an orthopedic surgeon who discusses the challenges and uncertainties of being an employed physician. He explains the implications …
90 days and counting: the uncertainty of being an employed physician [PODCAST]
I was brought to tears today, suddenly, unexpectedly, by the ringing of a bell. I had passed a small sign earlier, and I knew that the ringing signified the completion of someone’s chemotherapy. As I heard cheers, I thought how amazing this group of individuals (who I could not see, closeted as I was behind a curtained space) had a shared experience of crossing the finish line.
There is a lot …
Cancer as a model of diversity: To be an ally, ask
With yet another highly contagious COVID variant sweeping the East Coast, it’s never been more clear that we need a systems approach to reforming epidemiology in the U.S. Several legislative approaches, including the PREVENT Pandemics Act and public health loan forgiveness, offer a promising start, but as a scientist who was on the ground during COVID, it is clear to me that much more is needed. Specifically, the CDC, …
Faced with yet another variant, epidemiologists must act more like silicon valley start-ups
“There are, in truth, no specialties in medicine, since to know fully many of the most important diseases, one must be familiar with their manifestation in many organs.”
– Sir William Osler, MD.
I agree with this statement to an extent. However, I wholeheartedly respect and admire many subspecialists whom we all rely on. Disease does not usually wave a red flag and manifest extravagantly in one organ system. It usually is …
Why primary care physicians should be the quarterbacks in patient care
Americans give lip service to the importance of teamwork. But most often, we credit success to individuals. Perhaps nowhere is this “MVP mindset” more apparent than in medicine.
The brilliant lone physician — gallantly battling to save a patient’s life — is the TV-inspired image most of us conjure up when we think of the medical profession. While that archetypal hero was, in fact, the best hope for patients in the …
Health care leadership: Making medicine a team sport
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End-of-life care is a crucial and often overlooked aspect of health care. In this episode, we speak with Kevin Haselhorst, an emergency physician and author who shares his insights on the challenges and opportunities in this area. …
End-of-life choices: Why Medicare needs to change [PODCAST]
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