Inhaler nonadherence and social determinants of health

Policy
February 26, 2022

Cities and urban environments tend to have large gaps in health care accessibility and correspondent health care disparities. Despite the existence of localized public health infrastructure, such infrastructure tends to be fragmented and cannot fully encompass the level of nuance within its patient population as a result. As such, health care inequities are cyclically perpetuated in part through discontinuous health systems. Smarter, patient-centric approaches are needed to move the needle …

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Opportunities from the coding changes in primary care [PODCAST]

Podcast
February 25, 2022
YouTube video

“There’s a new best practice emerging, one that lets you deliver a high standard of care today but that well-prepares you for a shift to value. We’ve been talking about it throughout this article series in terms of doing more with less and making the system work for you: it’s …

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Is it time to find a new mental health provider?

Conditions
February 25, 2022

The stress and hardship of the ongoing pandemic caused an increase in the number of adults, teens, and children who have sought mental health care recently. More than 23 million American adults received mental health care last year and the American Academy of Pediatrics, the Children’s Hospital Association, and the American Academy of Child and Adolescent Psychiatry warned of a mental health crisis among children and adolescents.

Of course, the need …

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How physicians can restore themselves on vacation

Physician
February 25, 2022

As the latest pandemic wave seems to be easing, I am again thinking about traveling. I love to travel on vacation. A staycation can be nice, especially if there’s a lot to do around the home, whether that’s working on my home (decluttering and organizing anyone?) or just getting all the little things done that I usually don’t make time for. A break from working, but still at home.

Those homestay …

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Pandemic behaviors, dog poop, and the social contract [PODCAST]

Podcast
February 24, 2022
YouTube video

“It is hard to understand and communicate the uncertainty that comes with evolving science, the changing recommendations as we learn more, the vaccine that didn’t do all that was initially promised. It has become even harder with the erosion of trust and civility.

Back to the poop. It stinks. It’s not …

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Are hospital CEOs responding to the realities of health care?

Policy
February 24, 2022

On December 14th, 2021, hospital CEOs met under the guise of The Transformative CEO Healthcare Summit to brainstorm novel ideas in health care and to create “a new world ecosystem.” Themes included how to utilize medical data, how technology can transform health care and expanding at-home delivery systems of care.

Leaders in health care met just weeks before hospital admissions skyrocketed to an all-time high of Read more…

A soul that never loses faith

Conditions
February 24, 2022

I am so tired. Not in the usual “hard day at work,” but in a “deep-in-my-soul” tired. I am exhausted.

I am heading into my third year as system medical director, where I lead a system-wide palliative medicine program in rural health.

As in many rural systems, we have issues with broad geographic spread coupled with lower population density and limited resources.

But for those of us working in rural health, there is …

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How do we explain the end-of-life rally?

Conditions
February 24, 2022

Granny Rachel, my husband’s mother, was an old country soul. She was a simple lady who loved the Lord.

She accepted me with open arms when my own parents turned their backs on me.

Granny Rachel made the best sweet tea and the best homemade vegetable soup with cornbread and gave unconditional love to all.

She totaled two of her cars twice. Her son would check on her and found multiple candles lit …

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Managing expectations in the face of COVID-19

Physician
February 24, 2022

After working a 10-hour Monday, I came home and wanted to collapse on the couch. It was a typical day of dealing with more needs and demands than what was humanly possible to meet. Specifically, I was chewing on what happened at the end of the day regarding a patient’s unrealistic demands juxtaposed up against a medical system that cannot meet the physical and psychological demands of the latest wave …

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A PSA from a neurologist to the medical community [PODCAST]

Podcast
February 23, 2022
YouTube video

“Have you ever been to a new city and realized you’d been pronouncing a street or a town name all wrong? Have you ever been from one of those cities and has it broken your heart to hear someone call Copley Square Cope-ly? Or pronounce the Schuylkill River or Worcester …

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When primary care helps a psychiatrist

Physician
February 23, 2022

“Do you plan to cut down on your hours?”

This was what my primary care doctor asked me after she found me complaining about multiple somatic symptoms.

As a psychiatrist, I always took pride in how I prioritized my family’s needs and found a work-life balance. I had decided to work part-time as soon as I graduated from my training. I belong to a dual physician household. Going part-time was the best …

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Break the rules of health care with technology

Tech
February 23, 2022

In the 21st century, all but one U.S. industry has used information technology (IT) to cut costs, increase access to products and services, and improve quality.

Health care is the lone exception. For decades, medical costs have risen faster than inflation — with spending now above $4 trillion annually. For patients, accessing medical care is both time-consuming and burdensome. Meanwhile, U.S. health …

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Multi-system inflammatory syndrome in children: a pediatric hospitalist’s conversation

Conditions
February 23, 2022

Them: “I have never heard of this.”

Me: “That’s OK, let me explain what is going on. Your child has a condition called multi-system inflammatory syndrome in children, which we call MIS-C. We see this condition after a COVID infection where the whole body becomes inflamed, causing fevers. You get inflammation in the small blood vessels of your eyes and skin, which is why your son has red eyes and a …

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The orphans of COVID: Who will care for them now?

Conditions
February 23, 2022

The 911 call came too late. Her daughter was 32 years old and usually quite healthy. But she refused the COVID vaccinations. She said she took her vitamins and was healthy and that “God is my pilot” and “I don’t want toxins in my body.”

Her mother knew she was running a high fever. She knew she was short of breath frequently … until…

Her 10-year-old grandson couldn’t wake his momma up …

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Finding a pathway to hope: reflections from a psychiatrist

Physician
February 23, 2022

You may be feeling hopeless. That wouldn’t be shocking, under the current circumstances. Reading the headlines, one can’t help but remember the beginning of the pandemic, when we were reading about “flattening the curve” and overrun, understaffed hospitals.
Additionally, the dark days of winter can be a difficult time for many, even under the best of circumstances. Losses from the year become highlighted, family dynamics are under strain, and we may …

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I am an ICU nurse. We are drowning. [PODCAST]

Podcast
February 22, 2022
YouTube video

“Tears and sweat drown my face as I try to rip off my PPE and exit the room. I didn’t want to leave him, but I couldn’t bear another second in that reality. A whirlwind of emotions crash over me, and my knees weaken. I thought, “If I can …

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COVID-19 and a call for unity

Conditions
February 22, 2022

It’s 2022. COVID-19 is still here, and there is little evidence that it’s going away. Coronaviruses have been here longer than us and will be here after us. For centuries, we have co-existed with viruses, and our God-given immune systems have evolved, perfecting our macrophages which fight the nasty microbes. Cytokines or killer chemicals usually put many viruses at bay during our lifecycle, without us even realizing their magnificent work. …

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Medication management and how consultant pharmacists can help

Meds
February 22, 2022

Management of medications is sometimes handled sub-optimally, at least in the United States. At the extreme, physicians who prescribe multiple medications prescribe some medications that treat the side effects of other medications. This could be considered physician negligence in extreme cases.

An example was given in a class I took at UCSF (the University of California at San Francisco). UCSF physicians jointly provided remote advice for a physician treating a developmentally …

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Keep healthy boundaries and not define yourself by your profession

Physician
February 22, 2022

The COVID-19 pandemic helped bring out people’s true colors. After two years of the unrelenting pressures of the pandemic, people’s true colors came out, and I will have a frank about this truth. As physicians, we often put our patient’s comfort before ours, but at what point does one have to stop and reflect on this.

As physicians, we are often put on a pedestal and have unrealistic expectations. We want …

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