The confusing policy surrounding the buprenorphine X-waiver

Meds
March 18, 2021

In the waning days of the Trump administration, a surprising announcement came down from the Department of Health and Human Services (HHS) that the barrier required to write buprenorphine prescriptions for opioid use disorder would be lifted via reform of the so-called “X-waiver.”

The X-waiver is a rare regulation in American medicine that requires an 8-hour training and documented DEA permission before a medical doctor can prescribe Suboxone to …

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The world needs more hope-givers. Be that person.

Physician
March 18, 2021

He stood silently. His eyes fixed on us, immaculately dressed in a dark three-piece suit adorned with a gold watch and chain, hair meticulously groomed, a brightly colored bow tie centered perfectly on a freshly starched white shirt, wire collar stays in place, black wing-tip shoes glistening. Gold cuff links and military-like, sharply creased pants, with just a subtle break of the cuff on the shoe tops, completed the picture. …

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Life in a rural emergency department during COVID [PODCAST]

Podcast
March 17, 2021
YouTube video

“I am grateful that I work in a small rural hospital that is like a family. I am grateful that my organization has done everything in its power to protect us… but I hope we can do better. I hope medical workers have enough left within them to give their all …

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When the teen with depression and anxiety is yours

Conditions
March 17, 2021

Every week, I see a teen with depression and/or anxiety. Sometimes that teen is mine.

And while I can certainly opine over the lack of mental health resources for our children and teens — you have to be a certain age, you have to have certain insurances, if you’re uninsured or underinsured, you can see a community health professional but only for eight sessions — what I really get frustrated with …

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PCPs could counter virtual plans by increasing telehealth visits

Policy
March 17, 2021

Primary care physicians already have a lot of competition from retail clinics, urgent care clinics and telehealth services that cater to consumers. Now they’re facing a new threat from the “virtual primary care plans” that insurance companies have launched recently. These are health plans that prioritize virtual visits with doctors hired by telehealth services over in-person visits to primary care doctors.

For years, some insurance companies have been offering online urgent …

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An ode to the differential diagnosis

Physician
March 17, 2021

The differential diagnosis is a cornerstone of the profession of medicine which epitomizes physicians’ critical thinking skills. It is not an antiquated tradition of by-gone eras. The practice of medicine has been positively impacted in the past century by revolutionary scientific advancements, standardization of medical education, and transformative societal changes. Its overlap has provoked some unfavorable changes in the practice of medicine with the business of health care. The differential …

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Weight stigma in children and teens [PODCAST]

Podcast
March 16, 2021
YouTube video

“Let’s meet in the middle and listen to what’s happening in communities. All across U.S. communities, there are pockets of promise and programs focused on family interventions, behavior change, and health disparities, but there are many obstacles to true change. Currently, the work relies on visionary champions within a community, but …

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Reflections on a year of COVID

Conditions
March 16, 2021

One year ago, on March 14, I worked my first of many COVID shifts as a hospitalist at a large academic teaching institution in Chicago.  In the beginning, I think most of us on the front lines felt a strange combination of duty, fear, and exhilaration. There was this novel virus, the world was shutting down because of it, and while the rest of society was stocking up on toilet …

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Medical school interview secrets [PODCAST]

Podcast
March 15, 2021
YouTube video

“When you’re applying to medical school, it’s remarkable how much four years or more of intense work can come down to one single day. The medical school interview is high stakes: studies have found that interview performance is the most important factor in admissions decisions.

While your MCAT score and your GPA …

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One year into the COVID-19 pandemic

Conditions
March 15, 2021

“Come to triage right now, and wear your N95. A patient going straight to OR and she’s having fever and chills.”

I was summoned to the triage area of labor and delivery for a patient brought in from the ultrasound clinic and found to have absent fetal heart tones. One of my colleagues started an IV, and I ran to the OR to set up for emergency general anesthesia. The patient …

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Reimagining diet: Why cheating brings the win

Conditions
March 15, 2021

Keto, Mediterranean, Paleo, intermittent fasting. How many times have you or your patients been sucked into the latest diet trend only to crash and burn just a few weeks later? I have tried every diet in the books and every single time, draw the same conclusion: extreme dietary restrictions are not sustainable. So many of us lose weight with the newest trending diet only to gain it back months later …

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A physician deals with uncertainty during the pandemic [PODCAST]

Podcast
March 14, 2021
YouTube video

“Despite forces not within our control, namely the thoughts and actions of others, headway has been made in my local practice area:  the decline in mortality, the advances in clinical knowledge about the pathophysiology, more efficient testing, more PPE, an uprooting and great revealing of the need for prioritization of health …

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Debunking the myth of the doctor car

Finance
March 14, 2021

Everyone knows about the doctor car. Doctors know about it. Non-doctors know about it. Other than the doctor house, it is the symbol of medicinal consumerism.

But today, my friends, I am going to completely debunk the doctor car myth!

What is the doctor car myth?

This car myth states that a doctor must have a fancy car to legitimize herself or himself as a physician.

To drive a fancy car is to show that …

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End the draconian hospital visitation policies during COVID-19 [PODCAST]

Podcast
March 13, 2021
YouTube video

“At the start of the pandemic when hospitals were overrun, testing and PPE were scarce, and unknowns about COVID-19 transmission abound, such restrictions were reasonable, perhaps even essential. But we have made progress since then; most hospitals test most if not all admitted patients for COVID-19; most Americans own a mask, …

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My Shot! A COVID vaccine adaptation

Video
March 13, 2021

Vax’n 8, a group of physicians from Northern California working in a variety of specialties in medicine, are proud to present “My Shot!”, a song adapted from the hit Broadway show Hamilton.

“My Shot” addresses the social, scientific, and political issues currently affecting the decision to receive the vaccine against the virus SARS-CoV-2, or COVID-19.

While we completely respect everyone’s freedom of choice, we as a group of physicians support …

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What this physician says to vaccine-doubters [PODCAST]

Podcast
March 12, 2021
YouTube video

“A scientific achievement can never have success on its own unless if it has acceptance in the social context by the masses. I think that the concerns brought forward by the vaccine-doubters cannot be dismissed as ignorance, and it is hard to convince people. As a physician, it is not uncommon that I see a patient become indecisive and anxious about various treatment decisions facing them. I don’t …

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Could a glass of wine diagnose long COVID?

Conditions
March 12, 2021

Acute COVID-19 infection ranges from no symptoms (asymptomatic) to life-threatening.  What about long COVID (the symptoms occurring more than three weeks after infection, also known as post-acute COVID syndrome)?  Could there be thousands of people with “mild” long COVID who don’t know it? Could there be legions of people with new low-energy levels being misdiagnosed as depressed, stressed, having a sleep disorder, or being labeled “lazy”?  The inability to tolerate …

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