A friend called me for medical advice two weeks ago. He’s single, in his 30s and generally healthy, but he’d developed a dry cough with mild congestion. After a self-administered COVID-19 test turned up negative results, he remained suspicious he could be infected.
He was set to fly west in a couple of days for a conference and dreaded the thought of infecting other passengers. I recommended a PCR test if …
Get ready for a COVID culture shock
Mental health disorders are by far the largest cause of disability in the world. More money is spent on mental health than either diabetes or cardiovascular disease. About 45 million people in the U.S. have a mental illness. Almost every American will, at some point or another, face a mental health challenge. It may be related to depression, anxiety, suicidal thoughts, substance abuse or maybe something more circumstantial like grief …
How to fix the psychiatrist shortage in the U.S.
“Teaching medical students entrepreneurial and business skills is invaluable as the need for leadership in medicine grows in every single sector. Many physicians already engage in managerial and entrepreneurial-like practices without labeling these skills. By formalizing these skills into medical education, physicians will be able to take their ambitions and ideas …
Physicians need to be trained as entrepreneurs and encouraged to innovate [PODCAST]
Every primary care doctor knows what we are up against. The obstacles are many: payers, licensing boards, MOC, CME requirements, coding for billing, access issues, and the changing clinical field.
Sometimes these cause real harm.
Fifty miles north of where I-95 ends in Maine, winters there are long. My friend Dr. J did locums and spent a winter there. He tries new things wherever he goes, like spearfishing on Maui. So he …
Boards should protect the public, not destroy doctors
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. Saying out loud the number of milliliters passed, where that line is trapped, that little division between the professional and me, the person.
Where I stopped being a doctor and became a woman holding …
There are many topics on which I cannot claim to be an expert. I cannot solve the issue of gun violence, I don’t know what will “fix” the current societal crises, and I have no idea what will happen in the future regarding climate change.
There is one topic that seems to be coming up with more frequency and regularity, and I am qualified to speak on that. The shortage of …
Why is there a shortage of mental health professionals?
“Stigma surrounding mental illness often prevents patients from seeking the mental health care they need, delaying care and prolonging suffering. Fear, embarrassment, and impaired quality of life are a reality for many patients suffering from skin disorders like severe cases of psoriasis, hair loss, or acne. In these cases, assistance from …
Want your skin to look better? Then consider your mental health. [PODCAST]
If the U.S. medical system is a chessboard, and providers are the game pieces, America is playing those pieces with one column, row, and role instead of using the whole space. Several journals, economists, and medical professionals forecast physician supply to be dangerously low in 10 to 20-plus years. They’re 100% correct that supply won’t meet demand (as things stand now), but the reasons are flawed. Alarmists have been complaining …
America trains enough doctors: Redefining medical supply and demand
Imagine that you hired a teenager to sell hotdogs at the local fair, but the teenager started telling customers that hotdogs were really not very healthy, that the price was ridiculously high, and that they could find healthier, cheaper options just around the corner. Is he wrong? From a business perspective, he’s a nightmare, but from a human perspective, he’s absolutely correct.
Where does your current work setting fall …
As an emergency medicine physician, I see firsthand the consequences of being a patient in America without health insurance. While the Biden administration previously addressed a key gap in insurance coverage known as the family glitch, other gaps remain, including Medicaid postpartum coverage. Additionally, recent attacks on reproductive rights in this country have left many concerned about the future of health care for people who choose to, …
Medicaid expansion for postpartum support
“We owe it to our patients to do better. Every time I picture the couple leaving the pharmacy unvaccinated, I am reminded that true health care requires accountability and a willingness to challenge the status quo. That means challenging a “no” or “that’s too much work” rather than accepting it passively. …
My experience as a teenage health care worker during the COVID-19 pandemic [PODCAST]
He was a tall, healthy psychiatric technician, experienced in his line of work. He was a CNA but wanted more. He wanted to help heal the troubled, forgotten, and neglected — behavioral health was his niche.
He would lead the way with therapy sessions in this group every day. This was Intensive management: the intermittent home for the paranoid schizophrenics, bipolar, and MDD.
They came in all shapes and sizes — wealthy, …
Game over for behavioral health
It’s been five days since I’ve been able to sleep. My two-month-old daughter coos softly in her bassinet. My husband sleeps soundly next to me. But I lay awake, hijacked by thoughts that I am a bad mother, wife, and doctor. This unwanted torment consumed me. All I wanted was to remain still and make this stop.
I lay awake; time stands still.
I am swept by flash currents beyond my control.
I …
A physician’s struggle with postpartum depression
Starting a new job can be nerve-wracking and exciting. Along with negotiating salary and benefits, you should also ask about a few other factors to know what you are getting into. Here are eight questions to ask before you join a new medical practice.
1. Why are you hiring? Some practices are hiring because they are growing. Other practices are hiring because people are quitting. What is the case at this …
8 questions to ask before you join a new practice
“Diabetes uniquely requires patients be experts in their own care and demands 24/7/365 vigilance. Close communication with a health care team eases the burden and improves outcomes.
Glucose management revolves around numbers. Unfortunately, numbers are just noise unless translated into actions. Innovations, such as color for people with low numeracy, are essential …
Combining personalized education and digital technology to improve glucose monitors [PODCAST]
In a published statement in JAMA Network on May 24/31, 2022, the U.S. Preventive Services Task Force found that there was insufficient evidence for screening for primary open-angle glaucoma in adults. They could not find a way to balance harms versus benefits for screening in general. But is this reasoning faulty?
It is well known that Black and Hispanic populations suffer a greater incidence and severity of glaucoma, …
Open-angle glaucoma: To screen or not to screen?
“I am so sorry …”
My apology diffused as I stood adjacent to the IV pole, triangulated between Ms. S, her husband, and her daughter. Ms. S, who was congenitally deaf and capable of lip-reading save for my N95, nevertheless immediately caught the sadness in my eyes. My pulse raced, and my heart sank as her face fell. She knew that her transplant – for which her family had paused their …
Every intern encounters moments of patient care that become poignant memories
One day, working as a floater PT, I walked into the rehab gym, and every single therapist looked at me with the same pitying expression. The rehab manager took me into her office.
“I’m so sorry to put you in this position. One of your new patients today is a really large man. His BMI is 103. It took 12 people to move him from the stretcher into the bed last …
Confronting weight bias in health care
“Lifestyle medicine is part of regular medicine but stands apart in that it is health care that directly benefits patients through the restoration of vitality and health, primarily by lifestyle interventions.
And its healing capacity does not stop there. Because it unlocks the door to health and well-being, its effects reach …
Healthy patients and healthy physicians: Is it possible? [PODCAST]
Most physicians choose medicine to care for others. The essential premise balances this selfless, optimistic objective that the physician is healthy and happy with enough knowledge, experience, and abundance to heal their patients.
Unfortunately, our health care system thwarts us at every turn, with continual devaluation and reduction in reimbursements, paralyzing insurance and government regulations, and demoralizing lack of control.
Ballooning student debt and declining reimbursements, and the perception of greater stability …
Private practice is the best defense for burnout
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