I’m sorry, but I can’t “clear” your patient

Physician
January 21, 2022

Every primary care provider has been there. A patient comes in requesting a pre-operative evaluation or places a phone call or EMR message expressing the need for “clearance” before having a surgical procedure. Sometimes, we even get a request from the surgeon’s office with paperwork for “clearance.” Time is always, seemingly, of the essence regarding these evaluations, and either the patient or the operating surgeon requests this be done expediently …

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6 tips for success in medical school

Education
January 21, 2022

Medical school is like a tennis match—a series of short sprints and challenges that, when put together, tell a larger story. Unlike tennis, however, everyone can win. Being “successful” in med school has multiple meanings—from caring for your rural hometown, working with your institution to implement a racism in medicine curriculum, and matching into orthopedic surgery. No matter how you define “success,” there will be bumps and potholes along the …

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The pandemic has me angry, infuriated, demoralized, and scared

Conditions
January 21, 2022

I would love to say 2021 outshone 2020. But I think sometime around mid-fall of last year, we realized the joke was, sadly, on humanity, and that was not going to happen.

Yes, we finally had vaccines (thank God and bless those involved forever), but the life purpose of a virus is to replicate, somehow, someway — and Delta was born.

The tragedy of the preceding winter still haunted all of us …

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Doctors have had it with tall tales (and those who tell them)

Physician
January 21, 2022

The majority of my coaching clients are physicians. It isn’t easy for them these days. For the most part, doctors are rational types who believe in science, data, and facts. They have trouble understanding why so many of their patients seem to have signed on as extras in the unreality show of a skilled Pied Piper with a large and devoted following. How sad that so many people have followed …

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Unrequited: love in the time of COVID-19

Physician
January 21, 2022

If you knew we are like the “Two Fridas,”
that our hearts are connected,
would you change your mind?
Would you stop
as you are about to cut
the artery feeding your heart and mine?
If you knew that when you cry because of your loneliness,
because of your longing for your family,
that I cry, too, (though behind your back,
after I have comforted you)
would you change your mind?
If you knew that your isolation,
with the tubes and gadgets
coming …

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How advanced analytics can help social determinants of health [PODCAST]

Podcast
January 20, 2022
YouTube video

“Advanced analytics can provide the insights needed to understand social determinants and help develop interventions that assist patients in overcoming some of the challenges and adverse environmental and social factors that are barriers to healthier behavior. Moreover, analytics are needed to support the team-based approach to care delivery. With advanced …

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A shout out to small hospitals

Physician
January 20, 2022

I’m a small-time doc in a small town, and I work at a small hospital in the Midwest, and I’m proud of it. The huge university hospitals (like Cleveland Clinic) get all the glory (especially in society and in the press), but small hospitals like mine drive this country.

It has been really weird working at a small hospital, where it seems like …

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I go on because I must: for my patients and for my children

Physician
January 20, 2022

I stare at the sharply rising line in front of me, its stark outline harshly highlighting the data–data that shows that we are in the midst of yet another surge. That graph haunts me, intruding upon my thoughts, hovering at the edges of my life. I hold my breath, not knowing when this sly encroacher will become an intruder that will disrupt the normalcy of these last few months, …

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Breaking down the real cost of the opioid epidemic

Physician
January 20, 2022

I have been writing of late about recent developments in the opioid saga. My first piece talked about a fresh decision in California’s seven-year-old The People vs. opioid pharma case. The next one focused on how the middle-man, distributors, contributed to the epidemic’s picture.

Now, I wanted to write an overarching piece hitting some astounding highlights that summarize the opioid crisis through its decades-long lifespan. …

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What I learned about medicine in the House of Pain [PODCAST]

Podcast
January 19, 2022
YouTube video

“Guiding kindly illustrates mentorship, whether it be in the dojo or in an academic medical setting. Regardless of one’s stage in medical training, certain errors in patient management will be made … this is part of the learning process. It is the role of the mentor (i.e., attending physician to …

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COVID vaccination: If not for yourself, then for the rest of us

Conditions
January 19, 2022

“It’s my right not to be vaccinated. It’s my body.”

So goes the argument for the COVID anti-vaxxers, emphasizing personal freedom taking precedence over everything else. Unfortunately, and perhaps unfairly, we health care providers do not have that same freedom; our profession requires us to perform our duties despite the risks to us. We place ourselves in jeopardy each day we come to work, and we cannot simply refuse care for …

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How to combat imposter syndrome in medical school

Education
January 19, 2022

When I was about to take my first quiz in medical school, I was convinced I would fail while everyone else felt prepared and would score perfectly. While I floundered to believe in my mastery of the material, my peers had seemed confident and secure. This couldn’t be farther from the truth: I was indeed prepared and ready to succeed in my academics as an M1, and many others were …

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Can patients just say no to treatment?

Physician
January 19, 2022

When can a patient say “yes” or “no” to a recommended colonoscopy? A blood transfusion? A COVID vaccine?

As 2022 opens, health officials predict a tsunami of new coronavirus cases worldwide due to the Omicron and Delta variants. For more than a year, official messaging has been that vaccination is the way out of the pandemic.

But ongoing vaccine hesitancy has hindered progress. The Centers for …

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A message to physician job recruiters: First impressions count

Physician
January 19, 2022

More than half of all physicians in the United States are employed by health care organizations, and the numbers have been trending upward since 2019. Recruiters who work for health systems are tasked with finding the best physicians available, and their roles have become more important than ever. In-house job recruiters, and recruiters contracted with health systems, represent the face of the organization. They are often …

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Culinary medicine and why clinicians should garden [PODCAST]

Podcast
January 18, 2022
YouTube video

“For too long have gardeners allowed our food supply to be dependent on mysterious logistics. We have criminally allowed our own food growing capacity to be displaced. Growing something you eat and trading with people who grow what you don’t are ways to be less reliant on Big Food and …

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It’s time to rethink board recertification

Physician
January 18, 2022

Doctors are reporting an alarming rate of dissatisfaction and burnout, with some leaving the practice of medicine altogether. Administrators and insurance companies are often blamed; however, our own professional organizations impose a significant portion of the problem.

Several years ago, Danielle Ofri wrote an op-ed in the New York Times about how doctors’ precious time was being wasted on recertification exams. That year (2014), I took my first …

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The real value of high-value care

Policy
January 18, 2022

When newly admitted medical students enroll in their respective programs, they participate in the cherished White Coat Ceremony, in which they eagerly vow to stop at nothing to help patients—to go above and beyond to provide the highest quality care to any and every individual who needs it. Though this aspiration is not overtly naïve, it is, perhaps, exceedingly optimistic. As training progresses, many students come to realize that the …

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The painful anniversary of Dr. Susan Moore

Conditions
January 18, 2022

“You have to show proof that you have something wrong with you in order for you to get the medicine. I put forth, and I maintain that if I was white, I wouldn’t have to go through that.”
– Dr. Susan Moore.

In a 7-minute-and-22-second Facebook video documenting her treatment at a suburban hospital in Indiana, Dr. Susan Moore, a Black woman physician, articulated the collective desperation and frustration that was a …

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How do we embrace the plot twists in our life?

Physician
January 18, 2022

The most memorable books have twists, turns, and surprises. A plot twist is a literary technique involving a radical change in an expected outcome. It involves withholding critical information until the time is right, changing our perception of preceding or current events. There are often hints along the way, foreshadowing what is to come, but realization does not come until the twist happens, and often only appreciated in retrospect. Red …

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Analyzing the deficit of African-Americans in academic medicine [PODCAST]

Podcast
January 17, 2022
YouTube video

“The lack of diversity in academic medicine is a significant issue that can compromise our patients’ health and the education of our training clinicians. There is a vicious cycle in which there are few black academic physicians, leading to seemingly fewer available mentors for black students, which in turn leads …

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