Avoiding the pitfalls of integrating primary care into community-based mental health centers

Physician
April 12, 2021

Providing primary care to patients with mental illness is a challenging task that requires highly skilled and experienced practitioners comfortable with the full array of biopsychosocial problems with which these patients present. For example, understanding the side-effect profiles of psychiatric medications and their impact on problems such as diabetes and other complex endocrinopathies requires highly evolved clinical skills.

Optimally, the successful care of these patients is best provided in close collaboration …

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In gratitude to our nation’s residents [PODCAST]

Podcast
April 11, 2021
YouTube video

“Most residents are young, often in their mid to late 20s, having spent years ensconced in libraries, research labs, and classrooms learning pathophysiology and pharmacology. Upon graduation from medical school, they are now drafted to the front lines of a generational pandemic, working long hours, often in cities where they are …

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Don’t yell at me. I’m trying to help.

Conditions
April 11, 2021

For many years, I have treated individuals with substance use disorders. I have found this work to be both gratifying and frustrating. Part of the frustration stems from interactions with governmental agencies and families.

The families are, of course, fearful and frustrated. They are watching their loved ones “die” before their eyes and want someone to fix it. It is difficult to understand that their loved one’s brain has changed, that …

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COVID-vaccine induced thrombosis as explained by a hematologist

Conditions
April 11, 2021

VIPIT is the medical term given to the phenomenon of developing clots in various parts of the body after certain (not all) COVID-19 vaccines. VIPIT stands for vaccine-induced prothrombotic immune thrombocytopenia, a complicated term explained simply as clotting of the thrombocytes or platelet cells in the blood vessels after receiving the COVID vaccine.

Clearly, understanding this newly evolving condition is very limited, but what we know so far is extremely concerning. …

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12 tax deductions physicians overlook

Finance
April 11, 2021

Recently, I was talking on the phone to a physician client of mine about the COVID-19 vaccine and how thrilled I was that everyone over the age of 30 is now eligible in New York, which meant I could now schedule my own appointment.

We discussed the current market, and just when I was about to end the call by wishing him a happy National Doctor’s Day, his younger son, who …

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How to find sparks of joy [PODCAST]

Podcast
April 10, 2021
YouTube video

“Keep it Simple is a bumper sticker slogan. Life during a pandemic has been anything but simple, and the holiday season presents (not the gift kind) its own special challenges. So does living alone and trying to stay humanized. In his book Together: The Healing Power of Human Connection in a …

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How to be a “good girl”: confessions of an (im)perfectionist

Physician
April 10, 2021

Indian parents are perfectionists. This is what I had come to understand and believe, even before I had the vocabulary to define it. Perfection was the expectation. Not excellent, not superb, but perfection, and only perfection. After years of reflection, I don’t take issue with the expectation of perfection, but, rather, how I perceived it to be defined for me — a well-behaved, beautiful and academically successful girl who does …

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Tears from heaven: a nurse’s tribute to Dr. Robert Lesslie

Conditions
April 10, 2021

Recently, a former NFL football player, Phillip Adams, murdered Dr. Robert Lesslie, his wife, his two grandchildren ages 5 and 9, an air conditioning appliance man, and critically injured a second man. The NFL player had gunned down these innocent people. And then, he left and went to his parent’s house (who lived on the same road), and after hours of the SWAT team begging this man to surrender, he …

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Exclusivity and exclusion: disability discrimination in medical education

Education
April 10, 2021

In my medical school admissions essay, I wrote about helping at-risk kids like myself. I wanted to be a child and adolescent psychiatrist, but that wasn’t the main reason for applying. The real reason I applied was for my own personal survival. I needed to learn how to talk to doctors about my symptoms and get an appropriate level of care.

For years, my doctors told me that my illnesses and …

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What physicians should know before they’re interviewed by the media [PODCAST]

Podcast
April 9, 2021
YouTube video

“Lights, camera, action!

You get a call from your hospital’s public relations office asking you to speak to the local news. Even though this isn’t your first time, your heart is pounding, with a mix of nerves and excitement. You start doubting whether you have anything valuable to say about the topic, …

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Why medical students should be taught the business side of medicine [PODCAST]

Podcast
April 8, 2021
YouTube video

“Ultimately, patient care is at the center of medicine and is the main reason many physicians chose to go into the field. A good understanding of the business side of medicine and personal finance can help future physicians focus on just that. There are plenty of options when it comes to how …

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“Use the force”: How do we teach in the operating room?

Education
April 8, 2021

As I embark on my chief year in general surgery, I look forward to most is taking junior residents through operations. I am grateful to have had excellent teachers over the past five years, and I appreciate the opportunity to pay forward this mentorship. But taking what you have learned and teaching someone else turns out to be a very different challenge than learning itself! Suddenly, you realize your attendings …

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A medical student finds a reason to dance

Education
April 8, 2021

Today I attempt to walk a new path in life, a path that sparkles from the sun above to guide my every move.

Step by step, I embrace the light and escape the dark shadow behind me. Slowly, I start to run as I crave harder to escape my unburdening. With the weight of sorrow on my back, I let it go and reach in front for the chamber in my …

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End medical school grades [PODCAST]

Podcast
April 7, 2021
YouTube video

“There should be no grades in medical school. Forty-something percent of applicants get accepted to one or more medical schools. To even apply to medical school, one needs to have not only graduated or be on track to graduate college, but also needs to have passed the MCAT and have the support …

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A physician colleague’s gratitude

Physician
April 7, 2021

There are endless life lessons to learn from people around us. Our friends’ opinions on what they think about a product, a certain cuisine, or how they view life not only gives us a glimpse of who they are, but also can impact our own views. As a doctor, it is always fascinating to me how two patients with the same oncologic diagnosis can have such different views of life: …

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A doctor’s life is absurd, but can it still be worth living?

Physician
April 7, 2021

I will speak for myself to say that I completely identified with, and fully agree with, all the sentiments shared by Dr. Klingberg in “A breakup with primary care.” Still, from my own life experiences, and a 30-year career in primary care solo practice, I have been forced to believe that these sentiments are ultimately narcissistic and self-destructive.

Yes, primary care medicine has become thankless, oppressive, cruel, …

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A physician applies to law school. Here is her application essay.

Physician
April 7, 2021

I have been a physician for 26 years. I have been a fierce patient advocate throughout my entire career. It never occurred to me that physicians do not have the same rights of citizenship that the very patients I fight for do. I always thought I lived in a democracy. Medicine is not what it used to be. Articles relentlessly speak of physician burnout as though we are responsible for …

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Film and television continue to depict psychiatrists as heartless swindlers [PODCAST]

Podcast
April 6, 2021
YouTube video

“Have you ever watched a movie, television show, or read a book where the villain is a medical doctor? If you are a psychiatrist, you will be alarmed by how many times the villain in these stories turns out to be a psychiatrist. In all fairness, psychiatry has had its share …

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After all the years of medical training, I learned how to treat ugly on my own

Conditions
April 6, 2021

We first met about two years ago when she came to see me in my clinic as a new patient. I glanced through her chart and reviewed her scans and pathology reports. She had one of the worst possible kinds of lung cancers, called small cell lung cancer, that had spread to both of her lungs. Her disease was incurable, but I could give her chemotherapy to improve her symptoms …

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Attention mid-career physicians: Let’s find our ikigai

Physician
April 6, 2021

As a physician who helps administer and analyze our medical staff’s wellness data, I have been puzzled by one consistent finding from our semi-annual physician wellness survey – the group of physicians with the highest level of distress are the mid-career physicians, those who, like me, graduated from medical school 15 to 24 years ago.

Our hospital, a community-based, semi-academic hospital, utilizes a nine-question survey to track physician’s well-being.  Some of …

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