I spent the past year and a half of this pandemic getting a degree in quality, safety, and leadership. Though there were days, nights, and weeks where I simply did not know how I could finish the work or go on, I never realized how much I needed the work to help me process what is happening around us. To help me navigate my rage at the state of our …
We have been forced into a mass casualty scenario
“Crowdfunding models of paying for health care maximize the probability that all members’ eligible bills will be paid in full each month. These models come without the burdens of skyrocketing premiums and deductibles. Unlike traditional models, members aren’t chained to yearly contracts and have more flexibility and autonomy with …
Crowdfunding to pay health bills [PODCAST]
Stories of overworked and burned out, front line health care workers have been in the news since early in the pandemic. Job vacancies in health care and social assistance are at a record high, according to Statistics Canada data published in March of 2021.
At the same time, COVID has highlighted the persistent health disparities between white and Black, Indigenous and People of Color (BIPOC) …
I’m a burned out family doctor and racism is part of the problem
Despite protests from the medical community contained in multiple amicus curiae briefs, the Pennsylvania Superior Court recently ruled that the term “cause of death” on death certificates is ambiguous and should include any physician errors that contributed to the death — they were correct.
What they failed to consider was that, without an autopsy, the listed cause of death is often wrong, so using it to determine precipitating …
Do we really know why they died? The inaccuracy on death certificates.
March 2020. Administrators informed us that primary care physicians would be deployed to the “front lines” – either the emergency department or the COVID-19 wards. When I shared my news with my 21-year-old daughter, she cried and hugged me and said, “I don’t want you to die.”
Fate intervened, and I didn’t get deployed. By the time I was up, the numbers improved, and it was time to return to my …
What this primary care physician learned from her COVID-19 infection
My patient balanced precariously in the bustling hallway as she carefully removed her boots and slipped into lightweight sandals. My medical assistant offered to hold her purse and jacket as my patient held her breath and stepped onto the scale. Squinting at the numbers, my patient sagged in frustration. “Same as last year. Nothing I do ever works.”
By the time I met her in the exam room, the patient had …
Why you should not use BMI for your New Year’s resolution
There is value in reflecting on the most difficult experiences, as it affords an opportunity to examine how we act, react and change in response to the forces around us. The most difficult experiences in medicine are often not discussed, as there is typically not a space in which to begin such stories. So, without further preamble or justification, here is my worst experience in medicine, one which I’ve never …
“Virtually everyone understands the importance of major medical insurance as it relates to unexpected high-dollar care for severe injuries and significant medical conditions, but the value equation for health insurance is quite different when applied to coverage for primary care services.
The full potential cost for primary care services is neither …
Is direct primary care the answer to insurance-based problems? [PODCAST]
This article is sponsored by Masterworks, the art investment platform.
Jeff Bezos has been doing a lot of buying and selling lately.
In fact, he recently sold billions in Amazon stock to buy $70 million worth of this asset. And he isn’t the only billionaire accessing this $1.7 trillion …
I failed my Step 1 medical school board exam by 1 point. This was very hard for me to process, and I consistently wondered if I would have passed if I had just waited an additional week. This new challenge led me to reach out to a new resource: the disability office.
Never before had I considered my medical diagnosis of endometriosis and anxiety as a “disability.” I had obviously done …
Requesting disability accommodations in medical school
As I write this, a rapidly spreading COVID-19 variant called Omicron is the uninvited guest this holiday season. I’d hoped that the vaccine would have had more widespread acceptance, and we wouldn’t be in this situation, but this is our unfortunate reality now. In addition, COVID-19 has metastasized the already inherent bureaucratic cruelty of the U.S. medical system into death by a thousand slashes of red tape. I will explain why …
The bureaucratic cruelty that is modern medicine
“The data are remarkable and promising, though beyond the numbers is a bigger picture. Each data point represents a life – a mother, uncle, grandparent, loved one, friend. Technological advances in image guidance and therapeutic delivery are allowing us to extend life – and quality of life – for …
How MRI-guided radiation therapy is changing the paradigm in pancreatic cancer [PODCAST]
One of my favorite passages from sacred writings is the story of Moses, still tending his father-in-law’s sheep, an ordinary day in an ordinary place, suddenly encountering God, the ground he stood on now consecrated into holy ground, admonished to “Take off your sandals, for the place you are standing is holy ground.” All of the world’s religions speak of holy ground. For Muslims, even the simplest prayer rug in …
You are standing on holy ground
Nurse: “I need help with the computer; patient transfer needs to be completed.”
Me: “Ma’am, the patient’s medications are on ‘MAR HOLD,’ which means Medication Administration Record Hold. Therefore, we cannot administer medication unless an attending physician releases this hold. Can we get the physician on the phone for him to reconcile the meds?”
Nurse: Reluctant to call the physician, insists on completing the transfer at the unit manager screen. Finally, she …
Physician informatics demystified
I just wanted to tell you that I had a wonderful patient as a consult today. She had a pretty bad prognosis and was a recently diagnosed hepatobiliary cancer patient. Pretty aggressive disease with wild metastasis. From her time of diagnosis to my consult was less than two weeks. But her cancer was advancing at a remarkable pace, and the oncologist was recommending no further chemotherapy if she remained this …
The price of love is loss. But still we pay.
“The unvaccinated patient is the addicted person, the overweight patient, the smoker in the waiting room. Our antipathy toward them endangers their health, maybe their lives. The unvaccinated will not be convinced with stigma. They will be convinced with integrity, sincerity, and love.
Stigmatization has never been an effective health intervention. And that’s exactly what …
Anger toward the unvaccinated will only cause more harm [PODCAST]
In 2017, I read an article called “I Don’t Know How to Explain to You that You Should Care About Other People.”
I don’t remember the details of the article; the name was enough.
As we enter our third year of a global pandemic, I think about that often.
I don’t know how to explain to you that COVID is real.
I don’t know how to talk to the ex who …
I can’t make you care. But you should.
With apologies to the late Yankees slugger Yogi Berra, for pandemic-weary Americans, it’s like “déjà vu all over again,” as new lockdowns and mandatory mask mandates are being imposed across the globe.
The latest threat, the Omicron COVID-19 variant, has been a major source of breakthrough infections, including among those who have been fully vaccinated and boosted, such as United States Senators Elizabeth Warren and Cory Booker.
Pfizer, Moderna, Johnson & Johnson, …
Covaxin: Doomed to the dugout or ready to join the field of vaccine options?
I opened my email recently and blurted out a heartbroken expletive that I can’t print here. Another member of our health care family had died by suicide. I didn’t know them well, nor had I known our colleague who died from suicide just a few months before, but I felt as though I had been punched in the gut. An image came again that has been arising in my head, …
We must start looking for drowning colleagues
“Physicians, nurses, advanced practice providers, medical assistants, and other health care workers are a finite resource. They don’t grow on trees. And, though we all seem to deny it, they are human.
The physicians I coach often wonder what they are doing wrong that their lives feel impossible. They are …
Hello, health care organization leader, are you listening? [PODCAST]
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