“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
I wondered if this post needs a trigger warning. Maybe it does. I don’t know now. What feelings stir up inside us when we hear of a child’s death?
My first experience with a child dying in front of me was soon after medical school graduation. I was an inexperienced 24-year-old working in a government hospital in Bangalore. I don’t remember many details, but I remember his face and his father’s …
What feelings stir up inside us when we hear of a child’s death?
On June 4, 2022, CNN.com published an Opinion piece written by Carolyn Chen: “Why ‘do what you love’ is the worst graduation advice.” As a mother of a recent college graduate, with two others close behind, I read it to garner insights into which encouraging words to use with my own babies entering the adult workforce. The target audience is college graduates, narrowing the relevance to those privileged to …
Who do we become when we love work more than we love ourselves?
“The bottom line is that while you can’t predict exactly which MMI prompt you’ll be given, you can absolutely start preparing for the MMI. Become familiar with the format, practice your delivery, start reading about issues in health care, and start thinking about major points to discuss around these issues. While …
Strategies to help you prepare for multiple mini interviews (MMIs) [PODCAST]
Since writing a cathartic post about being burned out, I’ve received supportive messages as well as concerned calls from friends and former colleagues. Some were worried about my well-being. Others agreed with the sentiments.
One note in particular resonated. It named cognitive dissonance as part of the problem. This dissonance is pervasive in society. The gap between what we say we stand for and what we actually do …
Cognitive dissonance in the medical profession
When it comes to developing healthy habits, there’s no one-size-fits-all approach. However, certain habits are particularly effective when working as a physician. These are what we refer to as high-performance habits.
Being a physician is one of the most challenging jobs out there. I know this because I am one. It takes many years of schooling to become a physician. But, it takes even more than that. It takes …
7 high performance habits for physicians
An excerpt from The Paper Tiger Syndrome: How to Liberate Yourself from the Illusion of Fear.
Your Original Blueprint is the part of you that knows abundance is your natural state. It’s the inner voice, which says, I am full. I am satiated. I am content. I am peaceful. …
The body is the gateway to the Original Blueprint
“The tech giants of Silicon Valley – love them or hate them – have put incredible personal technology tools into homes and pockets of our patients and their caregivers. Now, we must activate those instruments for our own sustainability, and for our patients’ benefit.
If the neighborly primary care practice is going …
Primary care’s inevitable reboot [PODCAST]
An excerpt from Cutthroat: A Surgeon’s Fight against Big Government, Corrupt Businessmen, and a Broken Healthcare System.
The media, the business world, insurance companies, and even the government have done an amazing job of portraying doctors as the culprits for the exorbitant costs of health care.
They’ve been able to …
Why does one person respond favorably to lung cancer treatment while another does not?
The answer lies in their DNA.
Just 20 years ago, lung cancer was broadly categorized into two groups: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Relatively recently, the treatment of NSCLC shifted from chemotherapy as a single treatment option to treatment with precision medicine, which is positively impacting survival rates.
Precision medicine: the rifle vs. shotgun approach to cancer treatment
So-called “evidence-based guidelines” are slowly destroying the practice of medicine, and companies that develop these proprietary guidelines are guilty of conspiring with payers to deny individuals necessary medical treatment.
Guideline developers, health plans, and their benefit managers contend that utilization management (UM) programs based on medically proven guidelines will reduce unwarranted clinical practice variation and improve care quality and cost. But real-world evidence paints an entirely different picture. A recent Read more…
Utilization management is medicine’s great conspiracy theory
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