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“Picture this. A patient in a hospital or rehab facility has just finished exercising with therapy. He is thirsty, and he thinks he might as well ask for a snack now because he will be hungry in 30 minutes. …
Time constraints in physical therapy [PODCAST]
We get what we incentivize.
This is a basic rule. I’d love to say it’s a basic rule of humanity, but unfortunately, I have a background in psychology, so I know it goes a lot deeper than that—it’s a basic rule of every living creature. Humans are, in many ways, just very big pigeons. We reliably prioritize certain rewards. We prefer smaller sooner rewards to larger later rewards; we push the …
Historically, students’ three-digit scores on the United States Medical Licensing Exam (USMLE) Step 1 were a main factor in determining competitiveness for residency programs. In February 2020, the world of medical education shifted drastically when it was announced that the USMLE Step 1 would transition to a pass/fail scoring system. One of the main factors driving this change was that medical students and residency programs were attributing too much …
The immediate impact of the transition to a pass/fail Step 1 exam
After a great game of doubles tennis, a good friend brought up a recent visit with his primary care physician while sitting with friends, trying to cool down. He expressed appreciation for his position but complained about the need to see his doctor every three or six months, all the while acknowledging various medical problems being addressed.
This led to general comments by several non-physician friends about how they feel that …
Why even doctors need regular doctor visits
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“Empathy, intelligence, and commitment are crucial traits every doctor must have to succeed. However, there is one trait that stands above the rest. One of the most important aspects of an effective doctor is the desire to …
Effective doctors need to be challenged [PODCAST]
Psychedelic-assisted therapy (PAT) represents one of the most promising developments in psychiatry in decades. The treatment typically involves the infusion of a compound such as LSD, psilocybin, or MDMA during an extended therapy session with licensed professionals.
Although it lacks widespread regulatory approval or clinical use, significant advances have been made in the study of PAT in the past decade, with a pronounced increase in recent years. Recently, a Read more…
Prudence and promise in psychedelic-assisted therapy
Last evening I crumbled in the arms of my patient and wept. This was unknown territory to me, an unexpected role reversal. For three weeks after my Mom’s death, I maintained a stoic distance as patients offered their condolences, as they asked about my mother, and empathized. We doctors have been trained to do this, to face death, to keep our emotions at arm’s length. But this patient, who has …
Dear Dr. El-Dalati,
I am sorry that we will not be able to publish your recent letter to the editor regarding the Chowdhury article of 16-Sep-2021. The space available for correspondence is very limited, and we must use our judgment to present a representative selection of the material received. Many worthwhile communications must be declined for lack of space.
The response from The New England Journal of Medicine (NEJM) seemed simple and …
When your letter to the editor is rejected or ignored
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“During addiction, the brain becomes ‘hijacked,’ which then ‘exaggerates the need for the drug and minimizes the dangers associated with the use of the drug.’ This is so affirming because the chemicals in my brain told me …
Let doctors in recovery be able to recover their careers [PODCAST]
This article is sponsored by the Nuance Dragon Ambient eXperience. AI-driven ambient clinical intelligence (ACI) promises to help by revolutionizing patient and provider experiences with clinical documentation that writes itself.
What is cognitive load?
Cognitive load is a psychological theory that deals with how the human brain uses its working memory, how …
What is cognitive load? How can we help clinicians manage it?
Although the holidays are typically associated with feelings of joy and thankfulness, it is imperative that people should not automatically assume these emotions are commonly shared. Three percent of all individuals are impacted by seasonal affective disorder (SAD) during the holidays – a statistic many people are unaware of. The media promotes an unrealistic expectation that everybody should be happy during this time, but this is not the case …
5 tips for treating seasonal depression during the holidays
I’ve always been curious about the top 0.1 percent.
Their mindsets, backgrounds, upbringing, perceptions, skills, and behavioral traits that got them there.
After living through the Dot-com bubble, 9/11, Enron-WorldCom, the 2008 financial crisis, the meteoric rise of technology (search, e-commerce, social media, sharing economy), and the rise of a new class of billionaires, I intuitively sensed that there was a disconnect between what was going on in the real world, and …
The most valuable health care companies of tomorrow will be technology companies
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“My own burnout episode forced me into some heavy-duty soul-searching and serious reflection. I got lost in the world of seeing as many patients as possible, battling for more operating room time, and keeping up procedure volumes, …
A physician’s remedy for stress, anxiety, depression, and burnout [PODCAST]
I became a self-involved status and achievement “junkie” in order to tune out unbearable inner voices that repeated, “You are worthless … you’re a fraud … you’re a failure.” I was obsessed with grandiosity: I owned a penthouse apartment with a landscaped terrace, a closet full of Brooks Brothers suits, a family crest ring, engraved stationery from Tiffany & Co., monogrammed dress shirts from Charvet in Paris, and towels from …
The transformative power of EMDR
“You have the good cancer.”
These are the most common words that spill out of providers’ mouths to patients just being diagnosed with papillary thyroid cancer. However, this statement does not make this diagnosis any easier to comprehend and digest the life-altering news that has been received by the patient. The survivability rate for this cancer is a high percentage; that is good news, but not good cancer. An issue at …
Stop calling it the good cancer
I’ve moved recently, and in the process of moving, invariably, one discovers old items. This had gotten shelved in the fracas of those years, work changed overnight, changing employers, moving. However, in a discussion with a close friend today, this resurfaced as she’s grappling with patients and family who are not seeing what she’s seeing.
Summer 2020
It’s another Sunday night family dinner. Conversation centers around catching up on the latest family …
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“I experienced many deaths when I was a nurse, from babies, kids, young adults, the elderly, and my own family. It was always heartbreaking, but I found that staying with the dying and the family and supporting …
What anticipatory grief feels like [PODCAST]
From the halls of ancient Greece to the heights of television screens, the myth that the physician is more god than mortal has stood the test of time. As such, we are held to moral and superhuman standards no matter how tough things get. And thanks to our friend Hippocrates, we are oath-bound in our virtues to help anyone in need; while putting OUR personal needs aside, of course. Many …
Doctors treat people in all types of situations. Life or death. Sometimes both. Babies die, children die, and teenagers die. Women die. Men die. Sometimes you even have the misfortune of delivering a stillborn. Everyone experiences death, but for doctors, it’s part of our daily norm. Day after day, for decades throughout their career, we have to experience death and the pain of others. Beyond being knowledgeable and competent in …
It’s called crying and it’s normal
Time of death: unknown.
It was around 6 p.m. on April 21, 2013.
My mom saw my grandfather dying slowly in the hospital bed.
She had pressed the nurse call button frantically over the last 20 minutes.
She rushed to the nurse station only to find out nobody was there.
She went back to my grandfather and spent the last three minutes with him.
She was the one who saw my grandfather’s bpm (beats per minute) …
Don’t lie about medical errors. Apologize.
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