“American medicine is facing an identity crisis. The COVID-19 pandemic brought renewed attention to socioeconomic health disparities and turned up the heat on the question of whether health care is a right or a privilege. The financial strain on hospitals resulting from the temporary postponement of scheduled surgeries exposed a vulnerability caused …
Before I walk into clinic, I already know their response if I submitted my resignation letter today.
I hear it monthly from multiple patients who have no reason to believe I’m leaving: “You aren’t going to leave too, are you?” “It took us years to get here after the last doctor left.” “Please promise me if you move on, you will let me know where you go.”
They have baseline trauma from …
“Before COVID-19, clinical research was a little-known part of health care. Despite this process being responsible for determining the safety and efficacy of all the drugs, medical devices, vaccines, and other medical therapies available, less than 5 percent of the U.S. population actually participates in clinical research.
One reason why clinical research has …
Own it.
People sometimes say, “Own it.” Own your mistake. We use it less frequently to say own reactions or actions instead of blaming others and external forces for our actions. Life coaches call it being in a state of “emotional childhood.” It means that instead of saying you are responsible for your thoughts, feelings, and actions, you blame others for these.
“The situation is bad.”
“I am angry because it is not …
I am sitting in hot springs deep in the dark and crisp air woods – naked. It has been a day of lectures and workshops at a retreat with my fellow physicians. We are all naked in the effervescent, warm bubbles of the springs. In the dark, I can recognize who people are by the fluorescent necklace each wears. You know, the kind that you crunch and shake to activate …
“I have a form of genetic primary immunodeficiency and several heart issues, among other things. I know that I need to be far more vigilant than someone with a fully armed and operational immune system, so I try to take as much responsibility for that as I can.
First tactic: Not going out …
When plastic surgeon Dr. Robert Pearl published his Los Angeles Times op-ed, “How Doctor Culture Sinks U.S. Healthcare,” a polemic essay critical of primary care physicians like me, he set off a firestorm. While he made some valid points, Dr. Pearl also blamed many of the preventative health failures in the U.S. squarely on the shoulders of primary care physicians without acknowledging that our health care …
My phone rings.
“Namaskar! My cough is really bothering me. What should I do?” says a middle-aged man.
“Namaskar! I am Astha Prasai. I am here to help you. Please bear with me while I ask you your problem in detail,” I answer.
Mr. Kafle from Kathmandu is worried about this nagging cough he has, and it has been a month since he has tested positive for COVID- 19. After talking to him …
“For thousands of generations, parents, relatives, and the extended community raised and prepared children to become successful adults, to acquire knowledge, and strengthen the abilities needed to meet the challenges of their time. How did they do it? Until relatively recent times in human history there were no schools or organized institutions, …
“When I was diagnosed as gene-positive for HD, just over ten years ago, there wasn’t anything promising on the horizon in terms of a cure. It has only been since new clinical trials were announced in the past few years that I have allowed myself to feel a tiny bit of …
Even though I completed residency almost 15 years ago, it is easy to remember the dread I experienced before taking hospital call. The sinking feeling in my stomach as the call date loomed near, the hypervigilance and terror every time my beeper went off in the middle of the night, the fear of imagined catastrophes that would by necessity be my fault.
My anticipation of call was usually worse than reality. …
July 1 is a day that marks the new era when student truly becomes doctor, where hundreds of residency programs start day one of the three-year or longer residency, a life-changing rite of passage. Where the initial hours start the tens of thousands of hours of experiential full immersion training. Looking back, intern year was one of the hardest years of my training and definitely one of the hardest years …
Value-based care (VBC) continues to be a popular expression across the health care landscape, but the challenges and opportunities it offers are quite different across specialties. Behavioral health (BH) providers are an important case in point. The opioid epidemic combined with increased recognition and prevalence of mental illness secondary to the pandemic has brought behavioral health to the forefront, but for BH providers, the transition to VBC continues to present …
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“I’ve been semi-retired in clinical medicine for almost four years now. Initially, I found myself coaching burned out physicians: Helping them recover, finding careers they love, and even starting their own businesses outside the box. However, as I listened to my inner voice, I was led back to my healing roots, and …
I’m not an organizational leader, a member of the C-suite, a department chair, or a VP of anything. I’m a coach who guides physicians as they try to provide exceptional care and actually have a life. But I know a lot about setting goals, executing on priorities, and inspiring through vision statements.
Here’s the thing. This is not a successful long-term strategy:
I am a first-generation Chinese American. And amidst the complexity of the pieces that form my identity (mom, wife, daughter, woman, doctor), it is the piece I have often prized the least.
In one of my earliest memories, I am riding a crowded bus in Beijing. My aunt and cousin are pointing out the American tourists as we pass, commenting on their high nose bridges and round eyes and how these …
“This plea for help is on behalf of every hospital worker who has been on the front lines of the COVID-19 pandemic — from the environmental services staff and medical assistants who are often not recognized, to the social workers and chaplains who are surrounded by distress, to the physicians and …
Most physicians have been defendants in lawsuits. Plaintiff experts almost always have a feeding frenzy. In truth, expert witnesses are held to codes of conduct about remaining objective and avoiding partisanship or advocacy. Yet, should the verdict favor defendants, these experts, except for deserving the term “hired guns,” are rarely, if ever, held accountable for their feeding frenzy, which conflicts with their ethical obligations.
I want to share my experience. I independently …
The Food and Drug Administration (FDA) negated the recommendation of its expert panel and approved Aduhelm to treat Alzheimer’s dementia (AD), contending that the possible benefit trumped the lack of evidence of efficacy. The FDA was inexcusably in error in making this decision. Aside from the likely lack of benefit, the use of this drug can result in many negative consequences that make its use ethically questionable.
The manufacturer submitted two …
“The right choice of words, at the right time, can lift a person out of despair and literally save a person’s life, while an ill-chosen word, or worse, a purposely harsh one, can scar a person. The entire field of narrative medicine is formed around the principle of reviving empathy in doctors …
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