“Too often in medicine, health care providers assume what patients want or need. Like the crocodile, we may assume all patients would want a tire removed in order to help extend their life – even if the cure meant losing the only thing that made their unique life worth living. …
Help patients recognize how important their opinions are [PODCAST]
At some point, most of us will take on the role of caregiver. You may be caring for your parent or older family member, a spouse or partner, or a close friend. As the population ages, the number of people in the U.S. who are caregivers is growing significantly. Caregiving in the U.S. 2020, a report from The National Alliance for Caregiving, found that the number of …
How to prepare to be an effective caregiver
In 2017, the CDC rolled out a “solution” to the opioid crisis. The recommendations, which were never intended to become laws, were mostly level of evidence three or below.
To put it another way, they were not robust, nor were they based on research in any way that matters. There was also no input from the pain medicine associations.
The premise was that we would solve the problem using what those of …
I see so much of this in pain management
One of the difficulties faced by those of us who are chronically ill (which includes chronic pain) is that others don’t understand what we’re going through. Our culture does a poor job of educating people about health challenges even though they’re a natural part of the human condition.
We wish with all our hearts that others understood these four things.
1. When you’re chronically ill, you’re likely to look fine. When I …
4 things the chronically ill wish others understood
“I am ashamed of the callous, avoidant goodbyes that have been made in my name, and I regret the distress caused by this widely accepted standard. The determined patients will figure it out anyway, and the less-resourceful ones are left confused, hurt, and more likely to avoid important medical …
When a doctor leaves a practice, who tells the patients? [PODCAST]
Doctors have already proven their worth. We have succeeded beyond what most of the population will achieve. And yet, there are certain goals we cannot seem to achieve. And the worst part is that we know we could do it, and the person getting in our way is someone we know well. We look at her in the mirror every day.
You want to lose weight, but it doesn’t last past …
How to stop sabotaging yourself
A little over two years ago, my elderly mother was admitted to the hospital. Almost 90, she’d been short of breath for days — uncomfortable, perspiring, unable to sleep properly.
Blood tests, a chest X-ray, and an echocardiogram followed, whereupon her doctor pronounced: “You have congestive heart failure, Mrs. Les.”
I arrived on the scene the next morning to find her lying in bed, iPad open to Dr. Google, earnestly exploring the …
It’s not your heart that’s failing. It’s our medical jargon.
The U.S. government took an important step forward to help address the high incidence of health care professionals’ burnout, depression, and suicides. On March 18, 2022, President Biden signed the Dr. Lorna Breen Health Care Provider Protection Act into law. The law outlines several requirements for the Department of Health and Human Services (HHS). Key among them are to:
New legislation addresses health care professionals’ mental health needs
“It turns out that living beings are less like bags of sloshing water, as I imagined in grade school, and more like a stew. While water makes up most of it, water alone is thin and empty of the organic molecules from which organisms are built—the stew thickeners. Water …
Hidden wonders of human anatomy [PODCAST]
These last two years have been extremely challenging for most health care professionals. Watching society challenge essential health and science principles that we have known to be fact has been difficult to bear. Being villainized, health care workers went from being hailed “health care heroes” to being the target of hate, violence, and disregard.
These past few years have been a year of reckoning in many ways. The COVID-19 pandemic has …
We are the voice of reason, the scientific experts, and the advocates for our patients
There is no denying that we live and work in some extraordinarily trying times. Cast your eyes in the direction of any streaming news source, and another breaking story that describes the catastrophic dumpster fire of the current state of the U.S. health care industry will jump out at you.
The weight of this downward spiral, coupled with staggering workloads, makes it almost impossible for those struggling in the front lines …
In the coming months, no one can predict with certainty what will happen with the war in Ukraine. But there’s one thing we do know for sure. The United States will soon reach an unthinkable milestone: One million Americans will have died of COVID-19. Over the last month, while many people were celebrating the rollback of mask mandates and other pandemic restrictions, over 1,000 Americans continued to quietly succumb to …
We’re losing the war. No, not that one.
“Unconscious bias in health care describes associations or attitudes that reflexively alter our perceptions, thereby unintentionally affecting behavior, interactions, and decision-making. Health care organizations need to be actively discussing this subject at the highest level to find gaps and learn where to dedicate resources for improvement, even if it …
Acknowledging and mitigating unconscious bias in health care [PODCAST]
It’s been a year since I retired from almost 40 years as a pediatrician (most of that time as a pediatric hospitalist). What have I learned? What surprised me?
1. I have finally caught up on my sleep. I have been convinced that I still had a cumulative sleep deficit dating back to med school. After one solid year of sleeping 8-9 hours a night and waking up without an alarm …
A physician’s personal great resignation
Pneumonia is the deadliest of all hospital-acquired infections in the United States, costs 3 billion dollars per year and is the leading cause of new antibiotic initiation in hospitals. Hospital-acquired pneumonia is classified as either ventilator-associated pneumonia (VAP) or non-ventilator hospital-acquired pneumonia (NVHAP). For the past 15 years, VAP has dominated our attention, resulting in the wide implementation of evidence-based prevention strategies that have …
It’s time to focus on non-ventilator hospital-acquired pneumonia
I gasped at the guilty verdict that halted my indifferent scroll through the newsfeed.
In the course of her duties, a nurse who had accidentally administered the wrong drug, self-reported her mistake, and remorsefully admitted her error to a body of her peers was turned into a criminal.
If that standard was applied across the board to medical mishaps, health care as we know it would not exist. We will all be …
“We need to address the underlying preventable factors that cause more Black Americans to die of heart attacks and strokes and suffer from high blood pressure and diabetes complications than white Americans instead of focusing on non-existent biological differences. I would like to see the scientific disciplines unite to …
Remove race from clinical guidelines [PODCAST]
Recently, colleagues asked me how I solve burnout with communication. From the tone of their voice, they thought I was in over my head, and this was never going to work. I thought, wow, this is a great opportunity for me to share.
I came into the field of burnout through bullying. I’ve been the victim, and I’ve been the bystander-more times than I can count. I’ve been a locums physician …
The relationship between communication and burnout
The Great Resignation. I doubt there is a medical practice out there that has not been affected by it. And experts predict we are just at the beginning. The U.S. Bureau of Labor Statistics’ early data from 2022 shows that health care is among the top three industries increasing in monthly “quit rate,” second only to accommodation and food services. 2.6 million health care workers quit their jobs from May …
COVID-19 and the Great Resignation: a catalyst, not the cause
For practicing physicians, inclusivity proves critical.
Not because of HR mandates. Not because it’s a good thing to do.
Inclusivity improves your patients’ care. It enables you to be a better doctor.
Rising complexity, rapid change, and treating far-flung patients mean physicians need information from all angles of care.
Physicians need to know that everyone participating in your patients’ care can tell you vital information. They must feel safe and comfortable communicating with you …
A surprising way to create safer, more efficient patient care
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