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“I was first diagnosed with stage 1 breast cancer, DCIS (ductal carcinoma in situ), on May 15, 2015, at 41 years old. I had my annual exam with my gynecologist and told him I felt a small, …
A breast cancer story from an Asian perspective [PODCAST]
“You’re my last hope.”
The words come from a patient I have no prayer of helping. He has had decades of back pain. He has had several surgeries, injections, hardware in, hardware out, but nothing has helped. He is unable to work. His struggle with back pain has ruined relationships, ruined his financial stability, ruined his mental health. His goals and mine are aligned. We both want to make his life …
The patient I cannot help and a gun
While cancer has been around for decades, the fight for survival and treatment options are still very top of mind. Treatment is simply playing catch up. We continue to try and get rid of the disease that has already infiltrated one’s body rather than catching it before it develops. We need to shift the focus from therapeutics that fight the disease to ways we can catch it before the deterioration …
Cancer of the future: diagnosis, treatment, and impact on the health care system and patients
What they want is power, control, and to take all the credit. In short, they want what you have.
Vision. Even more so, the ability to manifest a vison. Even more so, they want your energy. Your passion.
“Candy Everybody Wants” by 10,000 Maniacs is an epic song. I know every word.
Hey hey give ‘em what they want
If lust and hate is the candy
If blood and love taste so sweet
Then we give …
What it takes to build a pediatric weight management program
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“Automation and technologies can enable adherence, but true change happens when physicians and pharmacists work together in collaborative teams to achieve common goals: Better managed chronic conditions, fewer complications, and improved experience for patients and physicians.”
Tony Willoughby is …
How to improve medication adherence [PODCAST]
As a physician’s attorney focusing on physician contract review, I spend all of my professional life reviewing and negotiating physician employment agreements. In my experience, women physicians have several issues that need special attention when negotiating their physician employment agreements.
Any physician needs to be familiar with appropriate compensation through benchmarking data such as that published by the Medical Group Management Association (MGMA). However, while this may be one of several …
Special contractual issues for female physicians
As we continue through the summer months, medical students are putting the finishing touches on their elective rotations for their fourth year.
These rotations, also known as audition rotations or sub-internships, enable students to “showcase” their talents, meet faculty and residents and put their best foot forward prior to submitting their electronic application.
A 2016 study showed that rotating improved a student’s chance of matching at that program by a factor of …
What makes up the ideal residency program for you?
I left practice 25 years ago when I saw portents of clinical practice as it exists today: impersonal, with electronic records and assembly-line labor heralding the movement to institutional employment over private practice.
But it was also my genuine interest in population health and pharmaceutical medicine that propelled me into a nonclinical career. The jobs I chose in this millennium were with health insurance and pharmaceutical companies, …
If you don’t practice, don’t move, or you’ll probably lose your license
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“I cry often enough that my kids almost gleefully expect it, checking me for tears during movies or shows, shaking their heads in mock dismay when they see that their prediction is correct. I’ve cried many times at home, watching screens, reading books, …
What this physician mom learned about shame [PODCAST]
In the unending ocean of choice and complexity of medical insurance, sailing your own ship is harder than it looks. Especially when you get a new job, age into Medicare, or turn 26 and thus can’t stay on your parent’s coverage. Every ship captain needs a helmsman—brokers are a major help for picking a health plan, but they are best used as an insurance translator rather than your personal shopper. …
Make your health insurance broker a translator, not a shopper
An excerpt from Determined: How Burned Out Doctors Can Thrive in a Broken Medical System.
Let’s address the elephant in the room. The word “burnout” has come under fire recently (pun intended). The reason is that burnout, which was first coined by German psychologist Herbert Freudenberger in the 1970s, implies to …
The word “resiliency” has been lauded, applauded, and buzzed about in talks about physician burnout.
When I hear it, I tune out.
My stomach churns. I feel sick.
Why?
Because physicians are resilient.
We are, in fact, the walking, talking, breathing personification of the word.
We cannot manage to get through medical school, residency, and boards, without being resilient.
And remember, we do this by choice.
Lots of schooling and academic demands.
Inhumane hours.
Little sleep.
Extraordinary amounts of information to …
Less resiliency may heal burnout
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“In early 2018 when I started full-time telemedicine, I was quite reluctant about losing the physical hands-on evaluation, especially the palpation, percussion, and auscultation components in the physical exam, and the holding hands, hugs, and handshakes of in-person visits.
But thankfully, I remembered one …
A physician mom’s take on telemedicine [PODCAST]
My first patient of residency was Mr. John. He endured life-threatening injuries that left him without speech or the ability to move his limbs. Every day had obstacles, and I met most of his family over time. Mr. John was a family man who looked after others first before himself. A self-made man. He was a man who was physically strong and dedicated to every project and goal he set …
Doctors need to advocate more for their patients
Five years ago, I met a patient that changed my view on practicing traditional medicine, especially when it comes to rheumatology. For years, I was proud to be in a booming field that provided patients with a new therapy every few years. As a physician and scientist, I believe that targeted therapy offers tools to treat patients like never before, but I have noticed that results vary over time.
Daniel was …
The role of nutrition in rheumatology patients
Do not become a doctor. This was the piece of advice my parents gave me when I initially shared my desire to do so.
No, neither parent is in the medical field. As I’m finishing medical training today, I fear this will be the advice I will give my daughter one day. Once wide-eyed, I now look in the mirror and barely recognize myself. Seven years into post-medical school training, I …
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“While you may not know exactly what your transition period will look like ahead of time, you can do your best to prepare for this change. By having a plan in place, you can make sure you are ready for the time between …
Transition planning: financial moves for medical residents and fellows [PODCAST]
A hungry college student was on a plane flying to Italy. She was alone, as her parents had bought her a ticket to join them on the trip, but their own flight had been sold out. About an hour after take-off, the flight attendants came down the aisle with their carts to serve dinner. She chose the chicken and quickly ate the entire meal. It was Indian-style cuisine, an odd …
A nut allergy nightmare at 35,000 feet
That health care in the United States is wildly expensive is beyond debate — but the actual numbers are almost beyond belief. In 2010, for example, health care costs amounted to $2.6-trillion. By 2020, those costs had risen to $4 trillion — an increase of more than 50%. Worse, such increases show no signs of slowing.
Health insurance premiums, out-of-pocket expenses, and direct government expenses all add up to a nearly …
Denying essential medical care doesn’t save money — or lives
When I started my internal medicine practice in 1996, the medical arena was vastly different than it is today. Back then, having an MD after my name actually meant something.
A letter from me to an insurance company would get a needed medication covered for a patient––a time before preauthorization existed. Dr. Google was not yet born. “Provider” exclusively belonged to the insurance industry.
My patients called me “doctor” and referred to …
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