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“Nineteen children were killed in a mass shooting in Texas. I have barely escaped the pandemonium of the pediatric emergency department to scarf down a bowl of pasta when I hear the announcement on the breakroom TV. My stomach drops. Again? How is …
Guns and public health advocacy [PODCAST]
Today, I propose a new kind of metric in medicine.
I know. I know. (I hear the uncomfortable clearing of your throats.)
On one side of the room: Of course we are human, are we not?
On the other: Here we go again, Doctor Touchy-Feely. Let’s get on with it. I’ve got work to do.
But what if …
We rewarded a “chief complaint,” written as a patient concern or a family observation, features fleshed …
A new kind of metric in medicine
If guilt were an Olympic sport, mothers would win every medal. We worry we should have prevented our children’s problems or might have even caused them. Mothers tiptoe through a minefield of complex personal, family, and societal expectations that no one escapes unscathed.
As an OB/GYN resident, I sought extra training to care for mothers experiencing miscarriage and stillbirth. Miscarriage occurs in 1 in 4 pregnancies due to early genetic Read more…
Post-Roe, miscarriage is more dangerous
In an exciting recent study, researchers found that for adults with obesity, weight loss through bariatric surgery lowered their risk of cancer by 35% and reduced their risk of cancer-related death by 43%. This was true of both gastric bypass and gastric sleeve surgeries, and the results were observed ten years after patients’ procedures.
This is great news for people who have seen weight-loss success through bariatric surgery. The study …
A gastric bypass might help some people bypass cancer
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“Communication is both the sending and receiving of information. Data is as difficult to receive and act upon as the ingredients of a meal because much work is left to be done. Information is palatable, actionable, and leads to measurable results in the …
Patient platforms should be intuitive in design and execution [PODCAST]
Not a week goes by that I don’t have a conversation with an amazingly successful women physician who states: “I’m thinking of quitting.” They are succeeding in all their goals: leadership, family, practice improvement, the highest level of patient care, contributing meaningful research and/or teaching, and even getting some homemade muffins or a bottle of cherry wine from patients on occasion.
Why would someone in this situation feel so dissatisfied to …
Why are women leaving medicine? Gaslighting.
Eric Topol wrote an excellent op-ed in the New Yorker titled “Why Doctors Should Organize.” I’m going to spell out exactly how they should organize.
Doctors should form a nationwide class-action lawsuit against the major EHR companies for cognitive repetitive-strain injury. They can easily prove lost wages and mental strain from technical debt in the software interfaces they are being forced to use.
They should demand …
It’s not a good feeling when you cannot do too much for your patient as a doctor. That’s how I felt when I walked into the room to see Valerie for the first time.
She was in her 60’s. She was flanked by her two adult granddaughters, who were very close to their grandma. You could tell that at some point in her life when she was younger, she may have …
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“How would you like to see your career slip away from you as you gradually become less and less able to sleep, to rest, to feel awake, to feel like your memory is failing you, to be taking pills every night on call …
Fibromyalgia is not a trash can diagnosis [PODCAST]
It always makes my heart sink when the CPR guidelines change.
In 1980 I became a provider of advanced cardiovascular life support (ACLS) as certified by the American Heart Association. This was a great move. Through my internship and the many years that followed, it proved comforting to know that I would act decisively and with confidence in the setting of a cardiorespiratory arrest. The ACLS course dictated dogmatic protocols – …
Nothing is sacred: Changing CPR algorithms can be a rude awakening
I was on service as the attending physician recently, and it struck me how closely our sickest patients in the intensive care setting mirror the political mires of our country.
Usually, when I’m on service, it’s an all-consuming matter, with little time for media and external affairs. However, this time it was different: history in the making with a Supreme Court decision that eviscerated a woman’s right to choose, to care …
How our sickest patients mirror the political divisions of our country
An excerpt from Finding Purpose: A Neurosurgeon’s Journey of Hope and Healing.
Each year, almost 400 physicians die by suicide. Reading that sentence should be enough to give anyone who has dedicated their life to helping and saving others cause for concern.
From the perspective of …
Destigmatize burnout and let those facing pain in silence know they are not alone
As a child psychiatrist, it was such a pleasure to see a play about a child who suffers psychologically and finds a way to heal that does not require an epic quest, a magical ability, becoming a princess, or even fixing the problem itself.
Sarah Silverman’s delightfully witty, dirty, and wordy musical, The Bedwetter, which ends its run today, features a spunky and irreverent 10-year-old girl with typical tween issues. A …
A child psychiatrist on Sarah Silverman’s The Bedwetter
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“So don’t give up your eating window just yet! The good question I am hoping researchers will answer next: who loses the most weight? Is it the human who eats three meals and no snacks that include protein, fiber, and healthy fats, or …
Don’t give up on intermittent fasting just yet [PODCAST]
An excerpt from Soul in the Game: The Art of a Meaningful Life.
A rental car counter clerk had the audacity to tell me that the SUV I ordered was not available and I could only have a minivan. (I know, I can feel your blood boiling, too.) In …
An event, judgment, and reaction framework
I recently met with leaders of provider organizations representing a range of specialties and geographies. One of the themes that came through loud and clear was their ongoing struggle to obtain claims data from their payers. As providers continue their efforts to navigate alternative payment models (APM), their need for global claims data becomes a more pressing issue.
Why claims data is important to providers
Many providers are still in a position …
The claims data dilemma: 4 things to consider
With many health care systems around the world an elaborate mess, real estate can be an efficient strategy for doctors to ensure their financial future after retirement. They can benefit from long-term appreciation and tax breaks by investing in real estate.
As economies and technologies continue to evolve, many physicians have started buying real estate for investment purposes. Some doctors choose to invest their money in real estate to diversify their …
Why doctors are increasingly investing in real estate
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“Today, I’d like to tell you the story of one who was exemplary. He was never late to work. He never came in and insisted on finishing his breakfast at his desk before rooming our first patient. He was so personable that they …
A bullied medical assistant’s tragic story [PODCAST]
For years, scholars have thought the perfect surgery consult was impossible. Comedic ophthalmologist Will Flanary, a.k.a. Dr. Glaucomflecken, characterizes the golden consult as one in which the surgeon is not consulted too soon — because the patient is not sick enough to require his or her services — and one in which the surgeon is not consulted too late, or else …
The “golden consult” revisited
Last year, I witnessed the extreme consequences of untreated childhood trauma as a medical trainee rotating through multiple safety-net hospitals in Los Angeles County.
I helped care for children who arrived in our emergency departments after multiple suicide attempts due to trouble in the home. Some children confided in me about their parents’ struggle with untreated substance use or mental illness and how witnessing these conditions deeply affected them.
Other children were …
It’s time to invest in trauma-informed ACEs interventions
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