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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
An excerpt from Reality Check: In Pursuit of the Right Questions.
I was on the floor of the International Meeting on Simulation in Healthcare conference when I heard screaming in the near distance. I turned toward it and saw some people gathering and others running. It sounded like an …
Chaos and order: the simulated context
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“From a place of personal accountability and commitment to system improvement, RaDonda Vaught’s conduct in the aftermath of this tragic event has been exemplary. She told what she knew, as soon as she knew it, to any stakeholder, for any purpose in hopes …
Why a nurse should not go to jail [PODCAST]
Mistakes and errors are regrettable but inevitable risks of the job for any patient-facing role in health care. As nurses, we are trained to report mistakes and errors when they happen. The maintenance of transparency in this way is an important element of our profession, intended to inform improvements that will, in turn, reduce the likelihood of a recurrence of the error.
The context in which Radonda’s error occurred may be …
Florence Nightingale. Clara Barton. Radonda Vaught?
When I was eight years old, I was a star soccer player on a state championship team. During shirts-off practice and while down at the local pool, I noticed how different my body was compared to my peers. After I referenced my scientifically approved human body anatomy book, most of my peers’ bodies looked just like the standard human body image in the book, with all the muscles developed …
My journey being gaslighted about obesity, skinny fat, and body type
Over 30 years ago, this man began working for our hospital system.
He was assigned to our ICU/CVICU units. Though some health care employees hadn’t even been born yet, Charles was a tried and true “lifer.”
He was our housekeeper. And he was our friend — our family.
He was a man with energy and stamina. He was a hard worker. Relentless. He could spin circles around a pack of 20-year-olds put together.
His …
He was more than a housekeeper
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“When most health care professionals hear the word ‘malpractice,’ they want to run the other way. This is understandable—but also a missed opportunity. We can leverage malpractice data to target and drive investment in patient safety efforts. Malpractice data shows us that good …
Malpractice may be negative, but its data can generate positive results [PODCAST]
I see your comments on social media, and I wonder: Why are you upset? How do the negative comments towards physician colleagues serve you?
This is not an attack (that would be hypocritical). Rather, I invite you to genuinely ask yourself these questions as I sense something familiar — a projection of frustration and pain, perhaps? And I wonder how we may stop projecting and, instead, indeed start healing together?
While I’ll …
Stop bashing physician-entrepreneurs
Recently, I was sitting in the DFW airport after my son’s soccer tournament witnessing multiple flight cancellations. Travelers became upset because their plans were ruined due to “staff shortages.” I felt lucky as my flight was just delayed, and I had patients scheduled the next day. I needed to be there for them. Because of the increasing frequency of cancellations noted in the news, I had plans to rent a …
Health care’s band of brothers and sisters
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