I’m angry. The sound cut out again, for the fifth time in the last hour. “Why can’t I get through one telemedicine visit without some technical problem?” I ask myself. I can feel the chest discomfort, my shoulders tense, I start to flush, tell-tale signs of frustration and anger bubbling up. I did not go to medical school to become tech support. After 12 patients, it’s finally time for lunch. …
Telemedicine exhaustion is real
“There is nothing like staying at home for real comfort,” says James Austen. So, instead of traveling and waiting for hours by standing in a queue, what if health care is provided to you at home? That’s why home hospital care (HHC) is a viable solution for physicians and patients. HHC is an innovative, technologically advanced, and effective care model in which certain patients receive hospital-level care at their homes …
Is home hospital care the way forward?
Pediatric cardiac anesthesiologist, woman, mother, wife, friend, mentor. I can’t remember a time when I wasn’t trying to “work smarter, not harder” to get it all done and feel good about myself, only to begin climbing the mountain with a fresh list the next day. My goals were simple: peace of mind and a sense that I was in control of my life and doing a good job for all …
The new rules of time management
“For me, my own personal stories of opioid patients come to mind, including one who keyed my car when I stopped prescribing his opioid after an acute injury. I think of some local opioid overdose deaths in my community. I would love to hear what other doctors and clinicians have …
Coal mining culture and the opioid crisis [PODCAST]
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 …
I’m sorry, but I can’t “clear” your patient
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 …
6 tips for success in medical school
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 …
The pandemic has me angry, infuriated, demoralized, and scared
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 …
Doctors have had it with tall tales (and those who tell them)
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 …
Unrequited: love in the time of COVID-19
“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 …
How advanced analytics can help social determinants of health [PODCAST]
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 …
A shout out to small hospitals
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, …
I go on because I must: for my patients and for my children
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. …
Breaking down the real cost of the opioid epidemic
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“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 …
What I learned about medicine in the House of Pain [PODCAST]
“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 …
COVID vaccination: If not for yourself, then for the rest of us
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 …
How to combat imposter syndrome in medical school
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 …
Can patients just say no to treatment?
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 …
A message to physician job recruiters: First impressions count
“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 …
Culinary medicine and why clinicians should garden [PODCAST]
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 …
It’s time to rethink board recertification
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