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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“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]
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