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David Alfery is a cardiac anesthesiologist who shares his experiences in the operating room and intensive care unit. In this discussion, he reflects on the lessons he learned about life, death, and the balance in between through …
Life, death, and the balance in between: a cardiac anesthesiologist’s story [PODCAST]
I wasn’t supposed to hear this, but I did. It sealed the deal for me. It was one of the reasons I had to finally leave my true love: ICU nursing. After 33 years as an ICU nurse, I knew it was time to go.
I used to feel like I had a purpose. I used to think I was a dynamic part of saving lives in the ICU. I lived …
ICU nurse of 33 years speaks out on the harsh reality of corporate hospitals
In a medical malpractice lawsuit, your defense is completely in the hands of the malpractice carrier, and, make no mistake of it, its interests come first. However, the medical malpractice insurance contract is more instrumental in the defense of a doctor than insurance companies realize. There are clauses in the contract that, at first glance, seem to benefit carriers. However, there is a flip side to each clause.
First Read more…
“Make thorough inspection.”
– Sir William Osler, MD.
The art of the physical exam is precisely that: an art that must be practiced often, for years on end, and the one that a physician may become a great achiever or skilled but never the master.
When I trained in internal medicine over a decade ago, our program director often harped on this art. I was too naive to understand his message at the …
The art of the physical exam: the importance of returning to the basics
Not only does medical practice coaching teach you how to open your mind to who you really are, but it also allows you to bypass the dreaded $20,000 to $50,000 MBA business education that your medical school refused to teach you about.
When you recognize that many highly educated professional athletes hire personal coaches throughout their careers, you must wonder what value they find in being coached. You would think that …
How receiving medical practice coaching can multiply your income
This article is sponsored by Pattern. We simplify disability and life insurance for busy doctors so they feel confident they have the right policy and that their income is protected.
As a physician, your career is one of the most important investments you will make in your life. Not only have you spent thousands of dollars and countless hours in medical …
Why every physician needs disability insurance
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In this episode, we will be discussing the role of health system specialty pharmacies in improving patient outcomes.
Our guest, Chelsey Lindner, is a clinical pharmacist who will share her insights on the unique combination of expertise and …
Improving cancer care through integrated care [PODCAST]
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
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