I don’t think I became a whole person until my mid-30s. When you spend the majority of your life in school, training, and building a practice, everything else goes on hold, or autopilot. There are very few things that I made conscious decisions about. Becoming a doctor was something I decided in childhood, and then it was a mission that I felt I needed to achieve. Every action in my …
A physician was bullied and fired by the bully
It is no surprise that burnout is surging along with this latest pandemic wave. Exhaustion—both physical and moral—is the ashen heart of burnout. Even as the flood of patients recedes in some areas, health care operations are hardly back to normal as many systems struggle with staffing shortages. In the hospital where I work, nurses have carried up to double their normal patient load, while the remaining phlebotomists on staff …
Those with the power to reform our system have little incentive to act
I’ve been as guilty as anyone of leaving my patient out on a limb. As a practicing primary care physician, I’ve had patients with diabetes who observe Ramadan, but I had no idea how to support them during their fast. I’ve had transgender patients yet didn’t have the right language to talk about their health, and nothing in the electronic health record (EHR) seemed designed to support them. I’ve sent …
The center of gravity in health care and the role of primary care
“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 …
A physician’s new rules of time management [PODCAST]
The magical number for one full-time equivalent (1-FTE) professional is 2,080 work hours annually — 40 work hours per week for 52 weeks in a year.
Professionals can work extra hours during non-vacation weeks to make up for opportunities lost during vacation weeks. For example, 1-FTE can work 52 work hours per week for 40 weeks in a year to accrue a 12-week annual vacation, while 0.5-FTE will need to work …
A full-time equivalent is 2,080 work hours annually
Listen up, ladies. All of you strong, brilliant, and deserving women in medicine. The physicians, NPs, PAs, nurses, and other women currently in or thinking about future leadership roles in health care.
Listen. Up.
Are you aware that male physicians make up to $2 million more than female physicians over their medical career? If not, I suggest you read more here: “Women Earn $2 Million Less Than Men in …
Gender disparities in medical leadership and entrepreneurship
Today medical records are developed for a single encounter (an outpatient visit or hospital stay). The medical records for an encounter are signed off at the end of the encounter and cannot be changed. An addendum medical record can be added later to correct misinformation in the encounter medical records, but this is seldom done.
This process enables medical documents to be legal recordings of what happened during each encounter. But …
A critique of interoperability, big data, and AI in medicine
“Knowing that an important number of Latinx are not yet fully vaccinated and understanding the health care gaps and social disparities that affect this group, it is reasonable to assume that the Latinx community will be disproportionately affected by the pain and sorrow of the new wave of the …
Health care and the Latinx experience [PODCAST]
They are the foundation of the CDC’s 2016 opioid guidelines, resulting in legislation limiting opioid prescribing in 36 states. Morphine milligram equivalents, or MMEs, are used to set arbitrary prescribing limits for opioids by physicians since many state legislators fail to understand — and translate into policy and law — the ’16 guidelines. If we had all known the history of MMEs, perhaps we would not have been so eager …
The true story of morphine milligram equivalents
“Doctor, why don’t you remember when I was last hospitalized? I told you about that two months ago. You obviously don’t care if you can’t remember. Is all of psychiatry like this? Maybe I need to see someone else. Why won’t you prescribe Ambien for my insomnia during pregnancy along with all the other medications I am on? My last doctor had no problem giving me Ambien during pregnancy.”
This was …
In most professions, the pecking order is clear, even when there’s no formal designation.
Take pro football. Although nothing in the rulebook grants status or authority to certain players, everyone knows the starting quarterback is the most valuable person on the field. That’s because no other player can do more to win (or lose) a game.
You might assume the same type of logic applies to medicine. If saving …
Restoring the value of primary care
“Sickle cell disease (SCD) affects about 100,000 Americans as an inherited genetic disorder with intermittent exacerbations requiring hospitalization. SCD is also a painful and complicated disease with no single physician specialist that can provide pain relief. While SCD pain is similar in severity to cancer pain, patients struggle to find …
Patients need palliative care to manage the pain of sickle cell disease [PODCAST]
I was truly gutted when watching the recent Saturday Night Live that joked about nut allergies. My son Joshua, who is 16 years old, has an anaphylactic peanut allergy. I found the segment to be insensitive to the millions of people globally who live each day with food allergies, an invisible but potentially fatal disease.
How do I explain to my son that it is OK to make …
Food allergies are a growing public health concern, not a joke
If you have never heard the term “financial infidelity,” it doesn’t mean you don’t know what it is. In fact, according to a recent creditcards.com survey, 32 percent of respondents have financially cheated on their partners. Both finances and cheating can be complex subjects to discuss, even with and, sometimes especially with, those closest to you. Not surprisingly, this topic is pertinent to physicians and dentists because they tend to …
Financial infidelity: It’s not about the money, it’s about trust
I love generic brand products. I will fight to the last breath for my Shoppers’ Choice Adhesive Bandages rather than pay an extra $0.49 for Band-Aids. So why, then, have I been paying up to $395 every month for brand-name medication for the last two years instead of getting the generic version for $7.56? After all, aren’t generic drugs the same as their brand-name counterparts?
Let’s go back to November 2019, …
Concerns about the generic formulations of ADHD medications
“We know regulators can move quickly to confront a health crisis because we have seen it in action. During COVID, the nation eased regulatory burdens at all levels of government to help health systems and doctors leverage technology and change the way they deliver care and to drive vaccine …
We’re failing people with opioid use disorder [PODCAST]
Throughout history, ancient tribes practiced cannibalism with the intent of bolstering their own courage or energy by consuming their defeated enemies. They wanted to be what they ate: full of courage and vigor. They would even eat their enemies to vanquish their energetic spirits before they ascended to the afterlife.
Christian Communion also practices the consumption of the figurative blood and body of Christ. It serves as a remembrance …
We are not defined by what we eat
Arguably one of the most overlooked yet incredibly important aspects of your malpractice insurance policy is the Consent to Settle Provision. You’re paying thousands of dollars a year for your malpractice insurance; you should have a say in how your claims are handled, don’t you think? Today we’re going to talk about the consent to settle provision – why it’s important, how carriers can limit you, and what you can …
Understanding consent-to-settle in your malpractice insurance policy
An excerpt from The Empathy Academy.
It might be tempting to choose an easier path, Monty thought, but amid the stress, pain, and tragedy, there were also triumphs: A patient’s seizures stop. A CT scan is clear. He remembered resuscitating Mrs. Caldwell and feeling a wave of relief upon …
Human beings are more than their genes
“Their absence makes me feel sad,
I look around at my peers, envious and curious,
Obsessing over when they will show up.
When they do, they never seem to live up to expectations,
Too small, too uneven, but what’s sure is it’s a sign I’m no longer a child.
It adds to my wardrobe …
A body part that fills me with a roller coaster of emotion [PODCAST]
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