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Working through a pandemic and watching the health care system crumble around me

Anonymous

Physician

December 27, 2022

The first dying patient I saw as a medical student was a man newly diagnosed with lung cancer, a chronic smoker with now oxygen-dependent COPD. In rounds, our medical team stopped outside his room, and the learned men and women pontificated about what to do next with the man. Chemo? Radiation? Both? I pretended to listen and rubbed my chin with feigned discernment, trying to understand the conversation like any …

A physician’s postpartum depression [PODCAST]

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Podcast

December 26, 2022

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“I may be practicing the art of repression and washing myself of any speck of contamination that would take me back to the state from which I have come very far. My suffering of the past, today, …

The time is ripe for virtual care solutions in COPD

Brian Gelbman, MD

Conditions

December 26, 2022

There’s a burgeoning crisis taking hold in the COPD management space; there are simply not enough pulmonologists, respiratory therapists, or pulmonary rehabilitation facilities to treat the growing number of COPD patients. This has left our field with an urgent window of opportunity to implement digital innovation into traditional treatment paradigms. Ironically enough, it was a respiratory disease that led to a global pandemic more than two years ago, which …

A physician shares his financial mistakes

Varun Verma, MD

Finance

December 26, 2022

Physicians often make mistakes when it comes to their personal finances and wealth-building strategy. We are human, after all. Private forums, blogs, and podcasts are filled with horror stories of physicians being scammed into buying expensive whole-life insurance, having disability insurance that didn’t include own-occupation coverage, and being steered toward high-fee investment vehicles by financial advisors. There are also countless situations, such as messy divorces, the risks of doing business …

The key to reversing the aging process

Michael Day, MD

Physician

December 26, 2022

There is no escape from our ultimate decline and death. The sooner we accept and embrace that reality, the freer we are to live life to the fullest now. So when I speak of reversing the aging process, I’m really referring to reversing the acceleration. If you recall the Newtonian physics from your high school physics class, acceleration is the velocity …

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The key to reversing the aging process

Building individual health equity [PODCAST]

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Podcast

December 25, 2022

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“Building individual health equity starts with a commitment to price transparency. The current system favors a broader, value-based model that does not require individual fees for services. Resources are allocated based on outcomes and are dependent on …

What’s the sense of having a living will if it’s not honored?

Althea Halchuck, EJD

Conditions

December 25, 2022

‘This victory ensures that advance planning documents are legally enforceable and will be respected by doctors; if they are not, individuals can hold providers accountable for violating their health care decisions.”
– Greenberg decision, 2022

Dr. Gerald Greenberg was a New York dentist when in 2010, he was diagnosed with early-onset dementia. In 2011, he executed a living will stating the medical staff was to provide comfort measures only and no medical …

The vampire, phlebotomy, and advocating for my care

Emily Raffensberger

Conditions

December 25, 2022

Every five weeks, I see a different vampire from the phlebotomy and give this collective of blood-suckers consent to take my blood. The crimson-filled, turquoise-capped vacutainer is destined for analysis to see how fast my blood coagulates. If the vampires read my chart, they would see the graph showing values dating back to 2015, marking my third open-heart surgery when I got my mechanical aortic valve. My lab testing is …

Can Medicare advance directives be simple?

Kevin Haselhorst, MD

Physician

December 25, 2022

Consider Medicare enrollment with the end in mind. In case of emergency, do seniors prefer medical care or holistic care? Might they designate a medical power of attorney or a merciful power of attorney? Do they oblige CPR or sign a DNR order?

The JAMA Network just published Death and End-of-Life Care in Emergency Departments in the U.S. This retrospective cohort study concludes that,

Robust systems of emergency care …

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Can Medicare advance directives be simple?

Being a physician and a son at the same time [PODCAST]

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Podcast

December 24, 2022

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“As we continue this journey as a family in what will likely be an even more challenging six months ahead, the last six months have provided lifelong lessons. Equipped with these learnings, a new exciting professional opportunity …

The solution to America’s primary care shortage is direct primary care

Sara Pastoor, MD

Physician

December 24, 2022

Primary care in the United States is on the brink of collapse. Primary care providers suffer existential burnout, are the lowest compensated among all medical specialties, and there is a crisis-level shortage of primary care physicians, especially in health professional shortage areas. Despite strong evidence linking primary care (unlike any other medical specialty) to a better quality of life, longer life expectancy, better patient experience, and lower total …

When contentment falls short

Claire Unis, MD

Physician

December 24, 2022

Sliding toward another solstice, I feel myself yearning. I want the daylight to stay a little longer, soft like this, gentle warmth and lovely shadows, lazy breezes, the illusion of contentment.

But I am not content. Or perhaps I am, but whereas I once thought contentment was the goal, the sentiment makes me uneasy now.

“Nothing gold can stay,” Robert Frost wrote. To stay content would be to embrace the shift in …

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When contentment falls short

What consumers want from telehealth

Lyle Berkowitz, MD

Tech

December 24, 2022

After becoming more familiar with telehealth during the COVID-19 pandemic, a growing number of consumers today are realizing the value and convenience of virtual visits for minor urgent issues, chronic disease management, and mental health services.

At the same time, an overwhelming majority of consumers believe it is important that both their regular doctor and their telehealth provider have access to their health records for sharing critical data such as current …

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What consumers want from telehealth

26 hours in a day: the impossible math of providing quality care [PODCAST]

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Podcast

December 23, 2022

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“Until I have dedicated time during the week to tend to administrative tasks, I must work 12 to 14 hours most days just to stay afloat. If I fail to work at least 12 hours per day, my in-basket …

A medical student’s greatest mistake

Emily Kahoud

Education

December 23, 2022

I made a mistake.

I almost failed out of undergrad as a premed. Yet this wasn’t the greatest mistake, the one that’s only now dawning on me as I stand at a crossroads in considerable decision-making despair.

Growing up in a loving yet highly dysfunctional home, I turned down a full presidential scholarship to attend a highly coveted college to make my parents, who grew up impoverished, proud. Yet the lingering trauma …

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A medical student’s greatest mistake

Who’s holding space for you?

Faryal Michaud, DO

Physician

December 23, 2022

The first time I saw someone die was when I volunteered in the ER as an undergraduate student.

That day I was helping in the trauma bay, and my job was to quickly run STAT or urgent blood specimens to the lab.

The year was 1994. It was winter time, and the tension of the people sitting in the waiting room was palpable to me every time I would go through those …

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Who’s holding space for you?

How accelerated learning platforms are pushing surgical education forward

Ruchi Thanawala, MD

Tech

December 23, 2022

Surgical training has long been confined to traditional models of Halstedian apprenticeship, where trainees are guided—but also potentially limited—by their superiors. Within this dynamic, the transfer of knowledge from expert to learner is dependent on individual educators, which can then be easily affected by personal circumstances and potential unconscious biases.

Physicians are often busy and rightly focused on patient care, but this can lead to uncaptured and delayed feedback for …

Coaching or mentorship: What is the solution for physicians? [PODCAST]

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Podcast

December 22, 2022

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“Over the years, I have mentored a lot of trainees. After discovering coaching and seeing my career transform after I started working with a coach, I have become a coach myself. I definitely use coaching techniques with …

Psychic numbing: Why we would prefer to save a single dog instead of thousands of humans

Brian Angus and Recha Bergstrom, MD

Physician

December 22, 2022

In 2002 a fire broke out on an oil tanker hundreds of miles south of Hawaii. All eight of the crew members were successfully rescued, but, as it was later realized, the captain’s dog, Hokget, was left behind. The two-year-old terrier was alone on the tanker, floating around in the Pacific Ocean.

The lost dog story made headlines, and people donated thousands of dollars to the Hawaiian Humane Society to save …

The promise of patient-centered biotechnology

James Geraghty, JD

Meds

December 22, 2022

An excerpt from Inside The Orphan Drug Revolution: The Promise of Patient-Centered Biotechnology.

Pre-revolutionary stirrings

Every revolution rises up against an order in need of reform. For the orphan drug revolution, that order was the pharmaceutical industry of the 1970s. Most pharma companies had been founded by entrepreneurial chemists or pharmacists decades …

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