Once again, at 1 a.m., I was knee-deep in patient charts and the cacophony of messages that our “user-friendly” EHR employs to allow various staff members to reach us. One of these was about a simple, inexpensive radiologic test I had ordered which the insurance company denied for my patient. Not surprisingly, I was exhausted, and I lost it.
With some minor edits, I wrote the following in response to this …
A physician’s rant. Written but not sent.
This article is satire.
As an orthopedic surgeon, it has always been clear that our specialties benefit from a somewhat symbiotic relationship. We feed you patients, and you often return the favor by providing us with the needed confirmation to operate. However, I feel as though there is a deepening rift between our two specialties. It has been developing gradually, almost imperceptibly, over time. Perhaps it is perpetuated by the belief …
An open letter to radiologists from a jilted orthopedic surgeon
If you are a frequent flyer in an airlines program, this is often a benefit. If you are a “frequent flyer” in a health care setting, this is not. It means you may have a chronic illness and are often seen in a health care setting, treated, sent home, and quickly return because the care approach was not to prevent recurrence by implementing lifestyle changes.
This is why lifestyle medicine is …
It’s a lifestyle: Adopting a behavioral approach to health care is urgent
I’ve been struggling to find the right way to highlight how relentlessly misinformation is killing us. I could say that another World War II would only be 60 percent as deadly for Americans as this misinformation-fueled pandemic. I could say that if the deceased victims of COVID-19 were their own state, they’d have a larger population than Wyoming, Vermont, or Alaska.
But these examples fall short in two important ways.
First, they …
A dark corner of Reddit shines light on how misinformation kills
In Catholic elementary school, we sat at our school desks, and the nuns had us pray for the lost souls in purgatory every day.
If we prayed hard enough, we would pray them out of purgatory and lift them into heaven.
Before I clock in, I say my anti-assault prayers to the gods. I pray for safety. I pray for the next 12 hours to be uneventful.
I thought I would give ICU …
“I believe there is a formula that can reduce the risk of burnout and save primary care, rooted in one key objective: Remove work from primary care doctors and nursing staff’s plates immediately.
Easier said than done. And that’s where technology and clinical navigation must be leveraged — to assist, facilitate, …
How can technology innovation save primary care? [PODCAST]
This article is sponsored by Altus Assessments, data insights for health care education.
As diversity, equity, and inclusion (DE&I) initiatives in medical education work towards improving the heterogeneity of learners, the weaknesses of an educational system with uniform instruction will become more apparent. Uniform instruction does not take into account the complex mechanisms underlying each individual’s learning goals or …
Personalized, precise, and data-driven: Precision Medical Education is here
There are several major transitions in a person’s medical career. The first occurs when you leave behind undergraduate life for medical school. The first term as a medical student will test your resiliency and confirm whether you are prepared to make the necessary sacrifices to be a physician. The next transition occurs as you leave the academic portion of medical training and enter clinical rotations. This process culminates with the …
Free association on lessons learned as a new attending psychiatrist
Most of the people who debate COVID-19 vaccination are not physicians. Of those who are, not all have treated COVID-19 patients. I have.
As soon as COVID-19 vaccines became available, my entire practice was vaccinated. One elderly patient was not because he was hospitalized in another state. He acquired COVID-19 there and died.
With the availability of testing and treatment, I have routinely tested patients who were symptomatic or exposed to the …
A message from a physician treating COVID patients
“My brain is still struggling to comprehend the battle for the status quo a physician faces each day; one who must, by default, be cognizant of the lurking dangers of an opioid prescription, while also helping the patient on their swiftest way to recovery, led by the very same guidelines. …
A new approach to orthopedic post-operative pain [PODCAST]
It was a Monday two years ago. I was still fresh from coming back from having been out of school from a COVID break. I was no older than 22, and I was in my pediatrics clerkship. I was greener than a freshly watered lawn, and I felt every bit of it. It was one day into this rotation that I met Adam.
He was a 7-year-old boy the size of …
A story of medicine’s stolen children
“I am a woman of history who stands up and tells the truth, irrespective of what other people say. I remember the words of the late Representative John Lewis, ‘Do not get lost in a sea of despair. Be hopeful, be optimistic. Our struggle is not the struggle of a …
Black female physicians and the bias against them [PODCAST]
I am definitely getting my daughter vaccinated, and I acknowledge a minimal risk. Here is my reasoning, and perhaps this can help your family decide to get the vaccine for the kids in your family, too.
Coronavirus is going to be with us for a long time — years, decades, probably for the rest of our lives like influenza. It is even widespread in deer now, another reservoir …
Why you should vaccinate your kids
“I am exhausted and sad and disappointed and discouraged.
I am losing faith in humanity. Where is the ‘love your neighbor as yourself’? Where is the willingness to help each other? Where is the solidarity of those first days? Physicians have gone from being heroes to being villains. We have dedicated …
Physicians have gone from being heroes to villains [PODCAST]
In a 1968 episode of Star Trek, Captain Kirk is kidnapped by humanoid aliens, tortured unrelentingly, and shackled to the ceiling by his wrists. Science officer Spock and Dr. McCoy find him disheveled and minimally responsive. They release him from the chains and set him on a nearby table for examination. Dr. McCoy urgently takes out his medical tricorder, a device that can check organ function and …
The exciting future of our physical exam with point-of-care ultrasound
How did we Americans allow health insurers to dictate how physicians practice good medicine? The hypocritic oath says, “Do no harm.” We should not allow insurance company profits to prevent proper care for patients.
Our insurer is now telling our young adult son, a Crohn’s patient (Crohn’s is not yet a curable disease), who has been in remission since he began taking Remicade over 11 years ago to switch to a …
How did we let insurers run health care?
How do you learn to deliver the worst news anyone will ever hear?
And equally important, how do you find the resilience to go on when difficult conversations don’t go well?
My profession for the past 15 years has been to train the next generation of physicians as an inpatient clinician-educator. A key piece of my work revolves around communication with patients and their families. On each new resident team, I coach, …
Letting your resident break the bad news
“The truth is, we were all drowning, alone, and hiding behind the image of perfection. Clearly, each of us secretly thought that the others had it all figured out. We were so afraid of admitting weakness or asking for help, so we kept it to ourselves and muddled through, burnt …
Doctors are humans, not heroes [PODCAST]
I truly believe we’re at the beginning of something great in terms of fundamentally changing how we approach pancreatic cancer, the third leading cause of cancer death in the United States. With a mortality rate of roughly 80 percent, it’s been referred to as a medical emergency, yet minimal progress has been made in its treatment over the past few decades.
In the world of radiation oncology, …
How MRI-guided radiation therapy is changing the paradigm in pancreatic cancer
On Monday, November 1, an Orange County California Superior Court Judge said, in a tentative decision, that the opioid pharmaceutical companies were not responsible for the opioid crisis.
This particular case, going by the name of “The People of the State of California v. Purdue Pharma,” started in 2014. The judge’s ruling noted that neither party requested a trial by jury. The trial took place before the judge between April 19, …
The people vs. opioid pharma: Pharma wins again
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