“If we want a more effective health care system, it needs to be re-engineered to revolve around the true center of gravity – the patient. We must involve patients early and often in the design of health policy, health technology, and health care ecosystems. We must reinvent health care payment …
Primary care should be the center of gravity in health care [PODCAST]
FDA and Health Canada recently approved Paxlovid as an oral treatment option for mild-to-moderate COVID-19 who are at high risk of progression to severe COVID-19. It is a combination drug containing nirmatrelvir/ritonavir. Nirmatrelvir works by binding to SARS-CoV-2 3CL protease to ultimately stop viral replication. Ritonavir does not have any antiviral activity against COVID-19 but increases concentrations of nirmatrelvir by decreasing its metabolism by CYP3A4 enzyme. Ritonavir is …
Before taking Paxlovid, consider these drug interactions
My credit card hovered over the card reader at the pharmacy as I contemplated whether I should pay. Two hundred and eighty dollars and some change. For two EpiPens, each with 0.3 mg of epinephrine that could potentially save my life if I accidentally ate something with sesame seeds. At that moment, I realized that even I, as someone with good employer-based family health insurance, was being forced to make …
Will Biden’s State of the Union remarks revive prescription drug reform?
Tutoring is the most selfish thing I do. This probably sounds counterintuitive, but let me explain.
To state the obvious, medical school is hard. You spend four years pushing yourself to the limit of your comfort zone. For two years, you cram more information into your brain than it can hold (and most of it leaks back out). Then for the next two years, you chameleon your way from one clinical …
Why this medical student tutors
“I do not hesitate to share what I endured. I recognize that there is a code of silence that must be broken when one is involved in legal action. It is imperative that we speak out to patients, legislators, and other physicians against these types of injustices. The sense of …
How a legal injustice changed this physician’s career [PODCAST]
It was not too long ago, but it seems like decades when traveling for a CME conference was a routine part of being a physician as looking up articles on UpToDate or giving patients bad news. But like so many other things in life, the reality of CME conferences has changed.
Most training programs give allowance to physicians for CME conferences on a yearly basis. After training, you have to keep …
Bring back CME conferences to exotic locations
When most people think of physicians, they think of the class nerds or the smart kids who got all As and took honors classes and were on the debate and math teams, did the science Olympiad or won the spelling bee. They think of us as brighter and more intelligent than most of society.
But we are also just human beings who have the same flawed brains and make the same …
10 mistakes smart doctors make
“What does it mean to be neighbors in the trenches?” I began a recent staff meeting at our medical group.
We’d just read a passage about the Christmas Truce between the Germans and the British in World War I. The troops found themselves so close together they could smell each other’s food, hear each other’s music. It was impossible not to pause the violence in a moment filled with so much …
Is there such a thing as too much empathy?
“Now more than ever, our profession needs to move toward racial healing. There is an urgent need for nursing to acknowledge its history of racism, boldly confront racism wherever it shows up, and address the racism that nurses witness when delivering care to those they serve. This will not happen …
Nurses are in need of racial healing [PODCAST]
Health care is a complex machine. With each passing year, it appears to get even more complicated. There’s an ever-increasing need to balance quality and cost between technology and humanity. These are competing needs, which are usually critical to health care delivery, as care professionals are faced with the often overwhelming paperwork and the need for hands-on patient-centered care.
There can be challenges in prioritizing one condition at the expense of …
The need for physician leaders for a better health care system
“If you don’t let us go home because of the vomiting, his time is running out … I don’t want him to be at a point where there is nothing else to do, and I don’t want him to go home at that point,” said J’s mom.
“Am I crazy to want to see this naturopathic doctor? He promised us he would cure our son of his cancer …”
“It is not …
Palliative care: Most doctors do not know how to talk to their patients
I came across an article a few weeks ago with the heading, “Biden administration denies funding handing out crack pipes to addicts to improve ‘racial equity.'” As similar articles came out across the United States and the United Kingdom, I was immediately bombarded with questions from friends and family members who were in disbelief that the government would do something as ludicrous as giving out crack pipes. …
How stigma and online trolls stopped an intervention that could save lives
“What exactly is my obligation to medicine? Am I supposed to practice medicine forever? Is it my duty? Do I have to continue serving my patients, the hospital, and society because of these expectations?
The answer is simple: You get to decide. Most physicians I know love practicing medicine. It …
Physicians and the weight of expectations [PODCAST]
This article is satire.
The DSM-5-TR came out in March with some shocking omissions. Here submitted are a few new conditions the next version might include:
Animaculism: the state of joy that comes from the care and companionship of nonverbal creatures, with subtypes for canine, feline, bovine, avian, piscine, exotic, and even serpentine.
Hyperfurrification: being covered in exogenous pet hair
Itchymaskanosis: an acquired hallucination, the sense of an invisible nose tickle as if from …
Stunning new medical conditions overlooked!
At birth, our rudimentary brains have very few developed circuits. Through everyday experiences, we slowly develop simple circuits before the more complex circuits form. Our interactions with caregivers teach us words and shape our concepts, and we ultimately string concepts together into thoughts.
We have tens of thousands of thoughts every day, but many go unnoticed. Our brain utilizes an autopilot mode so that each day isn’t a completely new experience. …
Mitigating perfectionism through self-compassion
During my pathology rotation as a third-year medical student, I had the opportunity to examine many patients’ slides under the microscope. This allowed me to study and understand diseases in ways different from how I had often done during my previous rotations. I appreciated the various architectural patterns of cells, blood vessels, and tissues strewn across slides as I directed the microscope into focus. I often thought about how these …
Simultaneously being a medical student and patient
“Deeming individuals ‘non-decisional’ for misinformed beliefs that are not representative of a psychiatric illness is inappropriate, unfairly medicalizes the narrative and incurs a risk of further public distrust of the health care system.
It is not the province of psychiatry to adjudicate uncomfortable social discourse so much as to elicit …
Can patients just say no to treatment? [PODCAST]
Why should doctors become involved in social media? I asked myself this same question a few years ago. My answer was, “I don’t know.” I saw no redeeming reason to get involved with social media as a physician. At the time, I just saw it as a social platform for posting cute family photos, funny pet videos, jokes, inspirational quotes, and links to entertaining stories. Sure, a lot of that …
They didn’t teach social media in medical school
He was sick-sick but he had broken his hip, and if you put a broken bone and an orthopedist together, you have an operation. It wasn’t as far afield as the classic ortho-anesthesia video where ortho calls for an OR for a dead patient, but believe me, all kinds of badness can occur that turns sick to dead.
A good sign was that the patient was ornery. He didn’t so much …
The sick-sick patient and the anesthesiologist
I’ve come across several articles recently highlighting the Dr. Lorna Breen Healthcare Provider Protection Act. The primary stated intent of this is “to improve mental health among health care workers. It is named in honor of an emergency physician who died by suicide during the height of the COVID pandemic.
Although my very first thought was, “oh, thank God … they are finally listening,” that was quickly replaced with a sick …
Stop telling physicians to be more resilient
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