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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 …
Building individual health equity [PODCAST]
‘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 …
What’s the sense of having a living will if it’s not honored?
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 …
The vampire, phlebotomy, and advocating for my care
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 …
Can Medicare advance directives be simple?
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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 …
Being a physician and a son at the same time [PODCAST]
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 …
The solution to America’s primary care shortage is direct primary care
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 …
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 …
What consumers want from telehealth
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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 …
26 hours in a day: the impossible math of providing quality care [PODCAST]
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 …
A medical student’s greatest mistake
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 …
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 …
How accelerated learning platforms are pushing surgical education forward
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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 …
Coaching or mentorship: What is the solution for physicians? [PODCAST]
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 …
Psychic numbing: Why we would prefer to save a single dog instead of thousands of humans
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 …
The promise of patient-centered biotechnology
Physician suicide rates are unacceptably high at baseline and go even higher during the holidays. The holiday increase in suicide rates is not unique to physicians, though. According to the National Alliance on Mental Illness (NAMI), A 2021 survey showed that 3 in 5 Americans feel their mental health is negatively impacted by the holidays.
And suicide is a problem that goes beyond the …
The holidays can open up a range of emotions
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“This last doctor was also the happiest doctor I have ever met. He was not a youngster but had a wonderful following of patients and was loved by the entire hospital staff. And he had a very …
Wisdom from 50 years a doctor [PODCAST]
We hear it all the time.
Practice gratitude. Be thankful for what you have.
The evidence is clear. Being grateful does offer numerous scientifically proven benefits.
It makes sense why gratitude is good for you, from improved relationships to decreased physical pain to better sleep to increased happiness and self-esteem.
In fact, it’s one of the keys to leading an abundant life full of what you desire and deserve.
But gratitude is not just …
Don’t make this mistake with gratitude
For me, the cheerful musical sounds of the holiday season invariably give way to a somber song: Gil Scott-Heron’s “Winter in America.” Dubbed the “Godfather of Rap,” Gil Scott-Heron (1949-2011) embraced diverse musical styles alternating between jazz, blues, soul, and hip-hop. He wasn’t known for delivering good tidings as much as he was for sermonizing and engaging in “Small Talk at …
Gil Scott-Heron’s “Winter in America” is upon us
Suicide isn’t beautiful. It’s not glamorous. It’s not Virginia Woolf, with pockets full of stones walking calmly into the water surrounded by trees and dappled sunlight with string music playing in the background as you slowly sink under the water.
Suicide is blood and vomit pouring out of your nose. It’s losing control of your bladder and bowels and soiling yourself. It’s blood all over the bathroom floor. Or, it’s bits …
Suicide isn’t painless for those left behind
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