Why are women leaving medicine? Gaslighting.

Physician
July 22, 2022

Not a week goes by that I don’t have a conversation with an amazingly successful women physician who states: “I’m thinking of quitting.” They are succeeding in all their goals: leadership, family, practice improvement, the highest level of patient care, contributing meaningful research and/or teaching, and even getting some homemade muffins or a bottle of cherry wine from patients on occasion.

Why would someone in this situation feel so dissatisfied to …

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How doctors should organize

Physician
July 22, 2022

Eric Topol wrote an excellent op-ed in the New Yorker titled “Why Doctors Should Organize.” I’m going to spell out exactly how they should organize.

Doctors should form a nationwide class-action lawsuit against the major EHR companies for cognitive repetitive-strain injury. They can easily prove lost wages and mental strain from technical debt in the software interfaces they are being forced to use.

They should demand …

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A cancer patient’s last wish

Physician
July 22, 2022

It’s not a good feeling when you cannot do too much for your patient as a doctor. That’s how I felt when I walked into the room to see Valerie for the first time.

She was in her 60’s. She was flanked by her two adult granddaughters, who were very close to their grandma. You could tell that at some point in her life when she was younger, she may have …

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Fibromyalgia is not a trash can diagnosis [PODCAST]

Podcast
July 21, 2022
YouTube video

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“How would you like to see your career slip away from you as you gradually become less and less able to sleep, to rest, to feel awake, to feel like your memory is failing you, to be taking pills every night on call …

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Nothing is sacred: Changing CPR algorithms can be a rude awakening

Conditions
July 21, 2022

It always makes my heart sink when the CPR guidelines change.

In 1980 I became a provider of advanced cardiovascular life support (ACLS) as certified by the American Heart Association.  This was a great move.  Through my internship and the many years that followed, it proved comforting to know that  I would act decisively and with confidence in the setting of a cardiorespiratory arrest.  The ACLS course dictated dogmatic protocols – …

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How our sickest patients mirror the political divisions of our country

Policy
July 21, 2022

I was on service as the attending physician recently, and it struck me how closely our sickest patients in the intensive care setting mirror the political mires of our country.

Usually, when I’m on service, it’s an all-consuming matter, with little time for media and external affairs. However, this time it was different: history in the making with a Supreme Court decision that eviscerated a woman’s right to choose, to care …

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A child psychiatrist on Sarah Silverman’s The Bedwetter

Physician
July 21, 2022

As a child psychiatrist, it was such a pleasure to see a play about a child who suffers psychologically and finds a way to heal that does not require an epic quest, a magical ability,  becoming a princess, or even fixing the problem itself.

Sarah Silverman’s delightfully witty, dirty, and wordy musical, The Bedwetter, which ends its run today, features a spunky and irreverent 10-year-old girl with typical tween issues. A …

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Don’t give up on intermittent fasting just yet [PODCAST]

Podcast
July 20, 2022
YouTube video

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“So don’t give up your eating window just yet! The good question I am hoping researchers will answer next: who loses the most weight? Is it the human who eats three meals and no snacks that include protein, fiber, and healthy fats, or …

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The claims data dilemma: 4 things to consider

Policy
July 20, 2022

I recently met with leaders of provider organizations representing a range of specialties and geographies. One of the themes that came through loud and clear was their ongoing struggle to obtain claims data from their payers. As providers continue their efforts to navigate alternative payment models (APM), their need for global claims data becomes a more pressing issue.

Why claims data is important to providers

Many providers are still in a position …

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Why doctors are increasingly investing in real estate

Finance
July 20, 2022

With many health care systems around the world an elaborate mess, real estate can be an efficient strategy for doctors to ensure their financial future after retirement. They can benefit from long-term appreciation and tax breaks by investing in real estate.

As economies and technologies continue to evolve, many physicians have started buying real estate for investment purposes. Some doctors choose to invest their money in real estate to diversify their …

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A bullied medical assistant’s tragic story [PODCAST]

Podcast
July 19, 2022
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“Today, I’d like to tell you the story of one who was exemplary. He was never late to work. He never came in and insisted on finishing his breakfast at his desk before rooming our first patient. He was so personable that they …

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It’s time to invest in trauma-informed ACEs interventions

Policy
July 19, 2022

Last year, I witnessed the extreme consequences of untreated childhood trauma as a medical trainee rotating through multiple safety-net hospitals in Los Angeles County.

I helped care for children who arrived in our emergency departments after multiple suicide attempts due to trouble in the home. Some children confided in me about their parents’ struggle with untreated substance use or mental illness and how witnessing these conditions deeply affected them.

Other children were …

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Why a nurse should not go to jail [PODCAST]

Podcast
July 18, 2022
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“From a place of personal accountability and commitment to system improvement, RaDonda Vaught’s conduct in the aftermath of this tragic event has been exemplary. She told what she knew, as soon as she knew it, to any stakeholder, for any purpose in hopes …

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Florence Nightingale. Clara Barton. Radonda Vaught?

Policy
July 18, 2022

Mistakes and errors are regrettable but inevitable risks of the job for any patient-facing role in health care. As nurses, we are trained to report mistakes and errors when they happen. The maintenance of transparency in this way is an important element of our profession, intended to inform improvements that will, in turn, reduce the likelihood of a recurrence of the error.

The context in which Radonda’s error occurred may be …

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My journey being gaslighted about obesity, skinny fat, and body type

Conditions
July 18, 2022

When I was eight years old, I was a star soccer player on a state championship team. During shirts-off practice and while down at the local pool, I noticed how different my body was compared to my peers. After I referenced my scientifically approved human body anatomy book, most of my peers’ bodies looked just like the standard human body image in the book, with all the muscles developed …

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He was more than a housekeeper

Conditions
July 18, 2022

Over 30 years ago, this man began working for our hospital system.

He was assigned to our ICU/CVICU units. Though some health care employees hadn’t even been born yet, Charles was a tried and true “lifer.”

He was our housekeeper. And he was our friend — our family.

He was a man with energy and stamina. He was a hard worker. Relentless. He could spin circles around a pack of 20-year-olds put together.

His …

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