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“Address the patient’s chief complaint first. In this case, the other symptoms were only side effects of the main problem.
Pay attention to lab work. In this case, the elevated white blood count and the related blood culture …
Teen dies when blood culture protocol botched [PODCAST]
It’s hard to concisely put into words how frustrated physicians are right now. How many other professional groups out there have to fight to not have their compensation cut multiple times a year? Recently, CMS released its proposed physician fee schedule for Medicare for 2023, which reduces the conversion factor by 4.42%. This compounds upon additional cuts such as the resumption …
CMS Medicare fee cuts: The altruism of physicians is used against them
Medical mistakes are as old as the practice of medicine itself, but it wasn’t until 1999 that the United States started paying more attention to them.
Over twenty years later, we may be reducing medical errors — a recent study published in the Journal of the American Medical Association found significant decreases in mistakes in cases of pneumonia, acute myocardial infarction, heart …
We’re reacting to medical errors the wrong way
Primum non nocere. First, do no harm.
All doctors are familiar with this credo. From ancient precepts such as the Hippocratic Oath promising to abstain from doing harm to the modern bioethics principle of nonmaleficence, the calling of physicians involves striving to help alleviate suffering and avoid making it worse. In our increasingly complex health care and data environment, avoiding inadvertent harm can be more difficult than one might expect.
Opioid-free orthopedic surgery: Why (and how) my patients go opioid free after surgery
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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, …
Less resiliency may heal burnout [PODCAST]
In the mid-1980s, with the AIDS epidemic on the horizon, austere conservative Margaret Thatcher sanctioned the first needle exchanges in the U.K. to prevent the budgetary burden that HIV might otherwise have become on the National Health Service. Nearly forty years later, New York City opened its first supervised injection sites in November of 2021, where intravenous drug users inject their substances of choice under the watchful eye …
Fear. It means something different to each person, but collectively we can all agree that fear can be something that drives us to succeed (fearing failure), causes us to take care of ourselves (fear of poor health), and can even promote experiences that wouldn’t otherwise be pursued (fear of missing out, affectionately known by the acronym FOMO). This isn’t the kind of fear I had this past Sunday sitting in …
As we live in fear, there is still hope
I started my hospitalist shift like any other day. I arrived at 5:30 a.m. for shift hand-off at 7 a.m. A full hospitalist load and endless administrative tasks to complete, the duality of both roles punctured me like a venomous snake bite. I had two full-time jobs to complete in 12 hours. Impossible! Or was it? I added one and one-half hours to my shift at the beginning–time hidden behind …
My “dig deep button” is officially out of service
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“Amazing pediatricians are back where I was years ago, with their C-suite asking for business plans for the medical side of their adolescent bariatric surgery programs. The reality is corporate health care has infiltrated pediatric health systems, …
What it takes to build a pediatric weight management program [PODCAST]
“Nerves ablaze, my voice cracked as I ended my remarks outlining the need for equitable data collection. I leaned towards the screen, adjusted my eyeline to make eye contact, and asked Representative Thomas Suozzi to support The Equitable Data Collection and Disclosure on COVID-19 Act. Representative Suozzi paused for a second, appeared to think over, or perhaps through the points of my argument–and then responded resolutely with, ‘I will cosign …
Student advocacy through the Student Osteopathic Medical Association (SOMA)
Get off the field.
Go back to the dugout and rally your team.
Create your rules of engagement.
The structure and hierarchy of medicine teach doctors to compete with one another. From the beginning, we’re told there are a finite number of acceptance letters sent to aspiring physicians. In medical school, we compete for one of a limited number of slots in highly selective and competitive training programs. And as attendings, we have …
Physician success is a team sport, so why are you on the field alone?
It’s been two and a half years post-pandemic, and I still don’t feel normal.
There’s a dark veil hanging over my life. I feel oppressed, unable to practice the way I want, unable to live and think in ways other than this abnormal new biological pseudoscience I’m not expected to question so that I’m more inclusive.
There’s a sense of lost purpose like I no longer work to feel fulfilled. Instead, I …
Why doctors should write poetry
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“Nearly three-quarters of consumers say they prefer texting with a business if an actual human is the returning texts — no bots need reply.
But the rise of artificial intelligence has led to further advances in smart texting, …
Patient-initiated collaborative texting [PODCAST]
Imagine that you are a brand-new attending in a hospital. You have your new starched white coat and stethoscope around your neck. Before you enter your patient’s room, the nurse says, “Whew! Good luck! The patient’s dad is really angry! He’s been yelling for the last ten minutes!”
Are you prepared? Do you know what to do?
The boundaries of unacceptable behavior have eroded in the past few years. Politicians, law enforcement, …
People behaving badly: 4 steps to de-escalate hostile people
A recent JAMA article showed that starting salaries for female physicians were lower than that of their male counterparts in most subspecialties.
New physicians are not expected to have many differentiating factors besides gender, yet the starting salaries differ. It is important to note that specialties with a higher percentage of women also have lower salaries for bother men and women. As the percentage of women physicians in a given …
We are all responsible for women physicians’ pay discrepancy
I lay on an examination table while a plastic surgeon surveyed my skin to determine if a suspicious mole should be excised. I joked with him that I had once considered plastic surgery as a career. I knew he still worked at the hospital and fired a rhetorical question at him, enquiring if the hospital was still as busy as it was two years ago when I had worked there? …
The New Zealand health system in crisis: We need to look after our clinicians
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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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