“We created a core team of individuals from different levels and functions who met daily. This team’s purpose was to receive and synthesize department-wide information and transform it into new ways of working for our doctors, nurses, ancillary, and support staff. We had a compelling vision which was shared with our …
Bridging business principles with emergency medicine [PODCAST]
Health care systems in the United States are beginning to emerge from the devastation of the pandemic. Since the existential threat of COVID-19 first hit in March of 2020 and the waves kept rolling across the country, doctors, nurses, and other clinicians put themselves and their families at risk to save others.
Clinicians were thrown into situations for which neither they nor their institutions were prepared. Like combat, the pandemic created …
Caring for caregivers post-pandemic
Doctors have a few dirty little secrets. We have the highest rates of suicide amongst all professions and are in desperate need of mental health reform.
For those who don’t know what it’s like to work in this area, it can be difficult to understand the pressures that doctors face daily.
Doctors live their lives balancing an intense workload with long hours, often without any time for themselves or their families. Many …
“Where do we go from here? Conventional wisdom suggests that we can only transform ourselves. This is why I propose that we attempt to recognize the Trump that lies within each of us and to heal him. We are plagued not just by the pandemic but by the human condition—and no …
Bridging the political divide [PODCAST]
May is Celiac Disease Awareness Month. Physicians and others in the medical community need to be more aware of celiac disease. Celiac disease is an autoimmune disease triggered by the ingestion of gluten that affects approximately 1 percent of the U.S. population. However, most physicians didn’t learn much about it in medical school or during training. As a result, physicians don’t include celiac disease in their differential diagnoses and …
Raising the awareness of celiac disease in the medical community
One of my clinic patients recently asked me to administer his intramuscular medication injection. I appreciated the vote of confidence but had to tell him he was mistaken in thinking that my skill would surpass that of our nurses’.
“Trust me,” I told him. “You’re in better hands with them.”
It reminded me of the time, some years back, when I inadvertently found myself “impersonating” a nurse for a school field trip. …
I was a doctor. Could I also be a nurse?
“Social connectedness is the remedy to the COVID fatigue that is running rampant in the United States. We need to stay connected to those we love. At the same time, we must also recognize that life is going on in the age of COVID-19, which means what happened to Mariana is occurring …
Social connectedness, volunteerism, and the remedy for COVID fatigue [PODCAST]
When I’m working in the hospital, I always find it interesting talking to patients about their medical history and experiences with outpatient physicians. I recently wrote about our broken primary care system. In fact, I’ll be stronger than that: Our primary care system is a tragedy, and it’s reflected in the comments I receive from patients. This is despite the best efforts of an amazingly dedicated number of doctors, …
3 reasons why patients are unhappy
The 2020-2021 residency application cycle was profoundly altered as a result of coronavirus disease 2019 (COVID-19) in the United States which led to a completely virtual season for nearly all specialties. At the time of this publication, pediatrics, obstetrics and gynecology, and ophthalmology have announced virtual interviews for the upcoming 2021-2022 cycle. Using lessons from the inaugural “virtual” cycle, many residency …
#PedsMatch22 and the social media imperative
“As I leaned against the pristine wall, my vision suddenly dimmed. Everything turned gray. I gulped for air. My arms and legs went numb. I felt that drowning sensation I’d had in third grade when a nun pushed my head between my legs to keep me from fainting in church on a …
A panic attack brought on by the stress of medical school [PODCAST]
Summer marks a flood of young new attendings hitting hospitals all over the country. There will also be many doctors whose first contract is coming to an end, and they are moving to a new position. Both of these scenarios create an opportunity to make a first impression at a new job. The effects of that first impression will linger for years to come.
What lingering effects do you want to …
Here’s the secret to establishing a great physician reputation
I began this journey in 2010. It began as a fresh-smelling breeze after a year and a half of anxiety, depression, and uncertainty. I did not think I would be a surgeon. I thought maybe family medicine, psychiatry — at worst, I would like gynecology. I outgrew the fear of the stereotypes and chose surgery for myself, despite what my now-husband warned me. He thought it would change me, depress …
Lessons learned from a general surgery chief resident
Words can be misleading. Medical terms work really well when shared between clinicians. But we can’t assume our patients speak the same language we do. If we “run with” whatever keywords we pick up from our patient’s chief complaint, we can easily get lost chasing the wrong target.
Where I work, along the Canadian border, “Valley French” expressions tripped me up when I first arrived. The flu, or in French, le …
When words mislead in the exam room
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“Clinicians want specific things from a pathology consultation. They want a short turnaround time and a clear and coherent report, which can be discussed with the patient and correlates with the clinical findings. Unfortunately, this does not always come to pass, particularly with some smaller or disrupted specimens, resulting from minimally invasive …
Go behind the scenes with a pathologist [PODCAST]
My friends and I spent Thanksgiving 2018 attending surf school in Jacó, Costa Rica. We spent that week fully immersed in twice-daily surf sessions interspersed with conditioning, balance exercises, and of course, downtime to explore the town and rainforests of Jacó. Having been on a surfboard only a handful of times previously, this was a new experience for me. Our surf instructors quickly got us out on the water, and …
Feel the musicality: A surgeon explores how he learns
As the pandemic grew in Southern California, intubating COVID patients became increasingly dangerous. Initially, any patient with signs of respiratory distress was intubated, then sent to the ICU immediately. My physician colleagues and I all thought we were doing the right thing — until we saw all the complications of mechanical ventilation.
Instead of immediate intubation, we tried placing patients on high-flow nasal cannula (HFNC), a special nasal oxygen device that …
My most dangerous COVID intubation
The beer bottle that cracked over Christian Pean’s head unleashed rivulets of blood that ran down his face and seeped into the soil in which Harold and Paloma Pean were growing their three boys. At the time, Christian was a confident high school student, a football player in the suburbs of McAllen, Texas, a border city at the state’s southern tip where teenage boys — Hispanic, Black, white — sung …
A police shooting in a hospital forces a family to rethink American justice
“Yoga therapy differs from contemporary yoga in that the profession has a defined scope of practice based on educational standards and accreditation requirements for training schools and yoga therapists. In dealing with pain conditions, certified yoga therapists possess understanding and knowledge of pain theories and pain physiology and may collaborate with …
What to consider when recommending yoga to patients [PODCAST]
Last summer, Anna Ramsey suffered a flare-up of juvenile dermatomyositis, a rare autoimmune condition, posing a terrifying prospect for the Los Angeles resident: She might have to undergo chemotherapy, further compromising her immune system during a pandemic.
After an agonizing three-day wait, the results of a blood test came back in her online patient portal — but she didn’t understand them. As hours passed, Ramsey bit …
Doctors now must provide patients their health data, online and on demand
With about a year’s worth of experience practicing medicine, I can say with certainty that I’ve got a lot left to learn. I’m a medical student in my final year. In Estonia, we cover all subjects by the 5th year — and in the 6th year, we practice.
I applied for a medical license back home in Finland that allows me to practice medicine with a designated consultant. Having a consultant …
3 lessons I’m learning about practicing medicine
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