I spent a year as a UCSF postdoc with the leaked tobacco documents. And this article is taken directly from the tobacco-control playbook. In the tobacco wars, we learned that: when a disease is caused by a for-profit industry, the only successful approach is regulation first, followed by treatment.
Here is exactly how and why doctors should regulate EHR and regain control of their cognitive …
How doctors can regain control of their software
I didn’t know her name until it was over, much too late. What I knew was she was thirteen and that on this winter day, someone in her family had been pulling her behind their car on a sled. No doubt laughing and looking in the rear-view mirror, the person driving had whipsawed around a corner, and the young girl — probably screaming (fear? delight?) — held onto the sled …
I didn’t know her name until it was over
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. His therapist sets him up in his wheelchair (brakes locked), tray table with all necessities positioned in front of him, with his call bell within reach. As she approaches the door …
A pervasive culture of time constraints in health care
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“Five days before this story begins, where everything is upside down, and the end is the beginning.
Me, standing in my PICU, slowly approaching that cradle, then removing the medication, one by one, turning off the syringe pumps. …
Preserving humanity in the ICU [PODCAST]
I’m standing outside the exam room, reviewing Marcus, my 16-year-old patient’s growth chart, specifically his BMI. It’s up again, and my heart sinks. I feel that all too common rush of frustration and disappointment and, “Why am I here and what is the point?”
“Am I just here to document weight gain in my patients?”
Marcus has been coming to my pediatric weight management clinic for over two years and has high …
Our Shakespearean love affair with BMI
“It’s just part of getting older.”
“Welcome to being a woman.”
“I hear this all the time from women. You just need to learn to deal with it.”
“Here’s a pill. See you in six months.”
“I have run all the labs I can think of. They are all normal. There’s nothing wrong. I’m sure it’s just stress.”
“It’s probably in your head.”
“There’s nothing I can do for you.”
Every doctor visit was the same. Each …
Breast implant illness: It’s not all in your head
I am a second-year medical student at the University of Texas Medical Branch (UTMB) in Galveston, Texas. In 2018, I graduated from Westwood High School in Austin, Texas. My experience at Westwood was harder than my first year of medical school at UTMB. I wrote this piece to provide some context to students like myself who struggled or are struggling with public school in Texas.
When I was 17 years old, …
My high school was harder than my first year of medical school
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“Ehlers-Danlos syndrome patients take an average of 10 years to be diagnosed.
In that time, the pain from microtrauma and joint instability can become unbearable. “Just exercising more” can backfire, causing injury and disability and creating a cycle of added …
What a lifetime of gaslighting by other doctors feels like [PODCAST]
Would you expect the chef at a restaurant to be told that they are not only required to prepare the food in the kitchen but also deliver it to each of the tables and manage the billing? What about sorting out the restaurant’s finances or understanding the number of patrons that need to flow through per night to optimize income? If this sounds unreasonable, how did we end up asking …
Misaligned expectations lead to conflict, burnout, and disillusioned physician leaders
You may never have created a budget. Not everyone does. For many of us in medicine, our saving so completely dwarfs our spending that we’ve never needed to use a budget. We just wing it. Why do some physicians spend so little?
Spending money is hard for many people, including physicians. After years of frugality in education and training, then funneling money into investments, planning for the future, building life for …
When can physicians start spending money?
An excerpt from The Evening Hero.
This was apparently not to be a Yungman-only meeting. It was in their conference room, same one where had their monthly morbidity and mortality conferences, and it was packed with doctors. In fact, there was just one chair open, and Yungmans best friend Ken the …
When a hospital unexpectedly closes
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“Dying and introspection happening at the same time were a dual reality that I found impossible to ignore when Bill was not doing well. As Bill’s poor prognosis and impending death began to reflect on our life, …
A caregiver’s love story [PODCAST]
Jumping on the recent TikTok trend of medical professionals sharing the things they would never do given their knowledge and expertise, I am sharing the five things I would never do as a board-certified allergist-immunologist.
1. I would never rely on a Primatene mist inhaler to treat my asthma or breathing symptoms alone. Primatene mist is a controversial over-the-counter epinephrine inhaler that can be used for mild intermittent asthma. This inhaler …
5 things I would never do as an allergy and immune system expert
Lawsuits are conventional in medical practice.
An unhappy patient hires a malpractice attorney, who hires a medical expert, who interprets the standards of care and generalizes a departure from the standards of care and proximate cause. The preponderance of evidence is 50% certainty plus an ill-defined scintilla, which needs to be only 0.01% to be good enough.
The lawyer sues the doctor, who notifies the malpractice carrier, hires a defense counsel, and …
Breaking the vicious cycle of medical malpractice lawsuits
I always think of the beginning of July as the New Year in medicine. It’s when medical students become interns, interns become residents, and residents become newly minted attendings. With each change is an increase in responsibility.
I remember paying even more attention to the history and physical each time I crossed that threshold. With an increased sense of purpose and responsibility. This was true in the office and during admissions …
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“Work dread. Even if you didn’t know it had a name, you know the feeling. It is that sensation in the pit of your stomach when you realize that the start of your workday or workweek is fast approaching, …
A physician’s work dread and what he did about it [PODCAST]
An excerpt from Boundaries For Women Physicians: Love Your Life And Career In Medicine.
My story is similar to that of countless other women who have chosen careers in medicine. I am a pediatric hematologist/oncologist. A few years ago, I was driving home one afternoon after having spent several hours with …
Boundaries for women physicians
The majority of people who donate money don’t research or compare charitable organizations. Only 1 in 3 research before giving, according to one of the biggest charity ratings websites, Charity Navigator. Giving 2.0 author Laura Arrillaga-Andreessen says only about three percent compare charitable organizations.
These numbers were both surprising and not surprising to me. I have done most of my donating with no more than a cursory …
Comparing charity evaluation websites: What do those ratings mean?
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 aid kit, extension cords, dry erase board and other room necessities. But have you thought about what could happen should they get ensnarled in a health crisis away from home?
It’s a hard …
Why you should add advance directives to your college freshman’s college checklist
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“This is an important time to rise up, come together, and understand that it is our time to remove the confusing veil put on us. We are not delirious. We are not psychotic. We are physicians. We are the …
I’m a physician, not a provider [PODCAST]
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