Seattle is at risk for explosive coronavirus growth

Conditions
March 4, 2020

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The coronavirus outbreak in the Seattle area is at a critical juncture and could see explosive growth in cases much like Wuhan, China, if public officials don’t take immediate, forceful measures, according to a new analysis of genetic data. The author of the analysis, a computational biologist named Trevor Bedford, said there are likely already at …

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Why does Generation Z require so many workplace accommodations?

Conditions
March 3, 2020

Recently the Wall Street Journal reported on how many young people are now seeking “accommodations” at work for their anxiety, PTSD, depression, and other mental conditions.

The article provoked a lively discussion split largely on age lines. While older people accuse Gen Z members of being “emotional hemophiliacs,” Gen Z members often say they have real, palpable “mental illnesses” and need extra time to complete their …

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Our seniors deserve better. It’s time we all paid more attention.

Conditions
March 2, 2020

Most Canadians are familiar with nursing homes or long-term care facilities that provide 24-hour care to seniors who are no longer able to care for themselves independently – but we don’t spend a lot of time thinking about them. Given our rapidly aging population, and the likelihood that someone we love, or maybe even ourselves, will be living there one day, maybe we should.

What might surprise …

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What it’s like to take a MPH gap year

Education
March 2, 2020

It has been nearly seven months since I made the decision to take a year off from medical school to pursue a master’s of public health (MPH) degree in Baltimore and nearly eleven months since I last saw a patient. From attending a Public Citizen workshop on access to pharmaceuticals to competing in my first business case competition to meeting several members of Congress to brushing up on my gym …

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What can a doctor do to build confidence?

Physician
March 1, 2020

The journey in medicine is a journey of goal setting. Doctors set goals all the time. We set the goal to become a doctor and then strive to achieve it. Once we decide on the chosen specialty, we set the goal for the residency training program we hope to match into, and we strive to achieve that. Match Day can be a day of great celebration for some, while it’s …

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Should nurse practitioners complete medical residencies?

Physician
March 1, 2020

About three months ago, something awful happened. The oncology nurse practitioner (NP) whom I trained for the past two years in my subspecialty decided to seek employment elsewhere in order to have a more flexible work schedule.

My team and I lamented we had a going-away dinner to say thank you for her work. And for the next three months, I trudged through my days in a busy oncology clinic, seeing …

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A peek behind that 8-minute $300 doctor visit

Physician
February 29, 2020

If you or a loved one has ever been hospitalized, by day two or three of your hospital stay, you likely remember the doctor visiting you every day but not staying more than seven or eight minutes or 10 to 15 minutes max.

It may have felt like he or she was just “dropping by and laying eyes on you.” A month or two later, you get a bill with the …

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I struggle with my pride in the profession and fear of the health care system

Physician
February 29, 2020

I believe in the practice of medicine and enjoy teaching others this amazing art.  However, after experiencing nine months of interactions through medicine as the daughter of a sick patient, I struggle with my pride in the profession and fear of the health care system.

My mother would proudly tell all her physicians that her daughter was a doctor. I knew she was proud, but I didn’t believe in using my …

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Core values were key to reclaiming my physician identity

Physician
February 28, 2020

My identity crisis attempted its first appearance five years ago. I had decided to leave my job as a psychiatrist in an outpatient, community-based practice. My professional role had become incongruent with the doctor I had envisioned becoming. In my misalignment, I had lost clarity in my identity as a physician. I was frustrated and felt ineffective and disconnected from my work.

I suspected that some of my colleagues were struggling …

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Everyone needs rudimentary statistical training

Physician
February 27, 2020

Every day we get bombarded in the news with health statistics. Coffee causes cancer! Coffee cures cancer! And so on. Many of these are meant to grab headlines (and, these days, web page clicks), and the articles they accompany are often very poor at telling the reader what they mean. They often have statistics, and health statistics can be complicated. Sad to say, even many physicians are pretty poor and …

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Working as a digital nomad physician practicing telemedicine while travelling the world

Physician
February 27, 2020

This is not the career path I set out to practice when I left medical school; in fact, it’s a career path that didn’t even exist. But after making a number of lifestyle choices this is where I find myself today. I am sitting writing this article from the hot, tropical lowlands of Colombia, on the site of Pablo Escobar’s Hacienda where, in a few hours, I will …

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How to find your squad in residency

Physician
February 26, 2020

At nearly every stage in our education and training, we find “our people.”  Maybe it’s your table-mate in kindergarten, or the kid with the really cool light-up sneakers in preschool who becomes your best friend.  Maybe it’s your next-door neighbor who you play with after school or a coworker from your first job in high school.  These people become part of our squad — even if their membership is only …

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Confessions of a bed-sharing pediatrician mom

Conditions
February 26, 2020

I remember lying in my bed after my second delivery in severe pain. With my first delivery, I had already endured a C-section. Four years later, I wanted to experience a “natural” delivery. I opted for a vaginal delivery after C-section (VBAC).

The VBAC quickly turned into an emergency where the maternal-fetal medicine (MFM) physician gave me two options: Get this baby out now or emergent C-section.

My mind flashed back to …

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The art of diagnosis is like a riddle

Physician
February 26, 2020

“I have a riddle,” Paul says, as the dining room falls silent.

“You’re at the bottom of the stairs. And on the wall, there are three light switches labeled one, two, and three. There’s a room upstairs with three lamps, labeled X, Y, and Z.

You can turn on and off as many switches as you want while you’re downstairs, but you can only go upstairs once. And once you’re upstairs, you …

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Here’s why you should get a chaplain for your patient

Education
February 26, 2020

It was my first week of internal medicine rotation. A newly-minted third-year, I was rotating on the wards back in the spring, when I met a 90-something-year-old gentleman. He had come in for confusion after a fall.

There were no relatives or friends in the waiting room.

I was assigned to follow him. During his stay, his words were few; it was often difficult to engage him in conversation. Whenever I pre-rounded, …

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Welcome to prior-authorization hell

Physician
February 25, 2020

“What diagnosis do you want to use for those ear drops you sent on Mr. Johnson,” Jenn texted me. “ICD-L21.8 for seborrheic dermatitis?”

Sigh. Welcome to prior-authorization hell.

These are generic ear drops I ordered for presumed fungal infection of the external ear. The cash price for the drops is $15 for a 10-milliliter bottle (I checked before prescribing them). “No,” I responded, “it would be ICD-B36.9 for otomycosis.” (translation: ear fungus)

Jenn …

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