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“If you did not have a colonoscopy, I would still recommend that you do it in a conventional way and get that IV sedation. But if you are an adventurer as I am, I would highly recommend …
Meet the doctor who had a colonoscopy without anesthesia [PODCAST]
The precipitous decline in the mental health of U.S. children and adolescents has been meticulously cataloged in newspaper articles, books, and documentaries. In our own pediatrics clinic, the numbers have skyrocketed — a baseball player unable to get out of his car for practice, a teenager with aggressive behavior masking underlying depression and anxiety, and another 9-year-old unable to attend school due to daily panic attacks. Every day now, we …
Digital philosophy: a critical tool for the mental health of children
The question of addressing physicians by name has been addressed again. Yet the question about names has not been addressed.
Before addressing the name question, I will talk about how I have evolved with time.
In India, I have been used to formally addressing everyone as either “Sir” or “Madam” during in-person meetings and in virtual communications when I have known them — “Sir/Madam” or rarely …
Why we should end gendered titles
I saved a baby’s life today.
I say that not to impress anyone or to make myself out to be some kind of deity but because it is simply true.
A three-week-old baby arrived at my office, gray and limp, with agonal respirations and oxygen saturation of 67 percent. My team of dedicated office staff worked with me rapidly and seamlessly, providing oxygen, bag-mask ventilation, and emergency medical services (EMS) activation. Together, …
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“Suppose you’re getting ready to send your young adult off to college for the first time. In that case, you’ve likely been spending the summer getting college dorm and apartment essentials lined up: bedding, storage cubes, first …
Why you should add advance directives to your college freshman’s checklist [PODCAST]
To paraphrase Fat Man’s Law Number Three, “At a code, the first pulse you take is your own.”
Enduring advice, as true today as it was in the early ’70s when Roy G. Basch, MD, and his gang of hapless interns roamed the airless wards of The House of God, the mythical hospital in the infamous novel by Samuel Shem, although almost everything else about practicing medicine seems …
More than a million Americans have died since the late 1990s from drug overdoses, with the vast majority dying from an opioid overdose. This trend started with the heavy marketing of opioids to physicians as nonaddictive and effective. The number of deaths from overdose has escalated significantly in the past few years. Although many of the recent opioid-related deaths are from fentanyl, substance abuse treatment providers report that …
It’s time for a reckoning in pain medicine
My first COVID vacation last year was spectacular, except that I barely remember three days because I was drinking to the point of amnesia.
I am a physician from a multigenerational family of alcoholics, and I never wanted to struggle with alcohol use disorder. Instead, I discovered that I could avoid feelings of discomfort by overworking, achieving, and staying perpetually busy. Workaholism became my drug of choice. As an adult, I …
The story of a physician, after a year sober
Sandy was sent to me by her primary care physician for evaluation of anemia. As I reviewed her chart, I explained to the medical student that the blood work showed a lifelong benign condition called alpha thalassemia trait that she was born with. It had no potential to harm her. This would be a quick consult, meaning we would have some extra time to enjoy our lunch.
Read more…
My 5-minute conversation with a suicide hotline expert
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“Not too long ago, a circumstance occurred. I have experienced similar circumstances several times in my career. However, this time, my response was different. It was like a switch in my brain flipped. I was ready to …
What it means to leave clinical medicine [PODCAST]
The American Cancer Society released its annual report on cancer statistics, showing that we have made clear and significant progress in treating numerous forms of cancer. The overall rate of death has declined steadily since 1991, translating to over 3 million lives saved.
Despite this progress, I still see room for improvement in a care model where patients too often slip through the cracks.
The National Cancer Institute identified that …
Integrated care is the key to optimizing cancer outcomes
Risk adjustment is a statistical method used by health plans to predict an individual’s use of health care services and the associated cost of care. Unlike traditional fee-for-service Medicare, Medicare Advantage (MA) plans receive a flat monthly payment for the individual beneficiary’s cost of care, with payments partially based on risk score.
Higher risk scores mean higher payments, and plans have financial incentives linked to more thorough documentation (coding) of their …
Let’s focus more on caring, rather than coding
Compared to the Silicon Valley world of moving fast and breaking things, health care change often happens slowly. Some of the reasons for the inertia of our industry make sense. Change impacting patients requires a vetting process to ensure we are creating net benefit.
But this inertia also exists partly because many believe our field is so uniquely complicated that it cannot be improved using lessons from other industries. But the …
Design thinking in health care: Physicians already have the training to be innovators
Similar to most financial topics, benefit elections are not a one-size-fits-all recommendation. Open enrollment occurs at the end of each year and remains open for a month and a half. During this time, you can sign up for health insurance, flexible spending accounts (FSA) for health care and/or dependent care, health savings accounts (HSA), retirement plans, as well as other benefits. Be aware that employers often use the open enrollment …
Common open enrollment considerations for doctors
This article is sponsored by Novavax.
In this special sponsored episode. I’m joined by Dr. Filip Dubovsky, chief medical officer at Novavax, to discuss topics like COVID-19 and influenza in the fall and winter seasons, the importance of education to understand your vaccine …
Preparing for fall and winter: Importance of COVID-19 vaccination during the flu season [PODCAST]
How can you be an example of what’s possible for your patients on their weight loss journey? I got this question recently in a doctor’s social media group I like. The answer is simpler than you think. As their doctor, you aspire to perfection in your medical care for them, but you can be an example of what’s possible in weight loss as a plain regular human being. Sharing …
Be a shining example for your weight loss patients
Every day, patients with the same story walk into my office. Young people in their teens, 20s or 30s are exasperated and seeking help for constant painful boils that drain the pus in underarms, groin, and around breasts — a condition called hidradenitis suppurativa (HS). This disease often makes their lives a nightmare. Despite being a more common condition than once thought, many patients see providers for 7 to 10 …
Why does it take 10 years to diagnose this common disease?
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“Without a strong rural health care system, our nation’s ability to expand and contract with surges in demand will become very limited. When hospitals work together, they can better ensure that no community is left without a …
Keeping rural hospitals in the game [PODCAST]
The superior doctor prevents sickness. The mediocre doctor attends to impending sickness. The inferior doctor treats actual sickness.”
– Chinese Proverb
The management of diabetes today requires an understanding of the concept of the circular economy in eliminating waste and pollution, circulating products and materials at their highest level, and regenerating nature.
Today, we saw a 64-year-old woman for her follow-up visit to the diabetes clinic. She is our typical Oklahoma patient with …
The environmental impact of the diabetes epidemic
The goal of making a hospital pediatric program a greater presence in the community hinges upon two areas, building community and alliance with local pediatricians and creating more visibility in the public arena. Both are not mutually exclusive, and each affects the other. The goal is to create a positive experience for both areas that will enhance each individually as they connect with one another.
Unfortunately, if not done correctly, negative …
If growing a hospital pediatric program was only this easy
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