Today I helped a family friend in a medical crisis. My friend’s elderly mom had been admitted to the hospital after a series of falls. In hospital medicine, this is a tale as old as time. Falls often herald the beginning of a downhill trajectory.
Experienced docs know to look for urinary tract infections, electrolyte abnormalities, dehydration, constipation, over-medication and more. We know that delirium (an alteration in mental status that …
We tell ourselves documentation is for patient safety. For continuity. For protection. But let’s be honest. It’s for billing. And once you see that clearly, it is hard to unsee.
In training, I was taught that the note reflects the thinking of the physician. That it should tell the story of the patient and the rationale for each decision. But in practice, it does not. It is a tool for revenue …
Tough and tender at the same time, Linda is a woman with a broad smile, the kind who likes to “fish all weekend at the lake, a place where I don’t think about anything. Or, anyone.” I often smelled cigarette smoke on her, and she has the raspy voice that comes from a lifetime of stepping outside on the porch to light up. She embodies the physical strength that comes …
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Professional development practitioner and veteran emergency nurse Kristen Cline discusses her article, “America’s ER crisis: Why the system is collapsing from within.” Using the TV drama “The Pitt” as …
Imagine a dedicated physician, after years of rigorous training and countless lives saved, facing a medical board complaint over a minor issue—perhaps a clerical error in documentation or a subjective interpretation of a clinical decision. What should be a straightforward matter escalates into a career-threatening ordeal. State medical boards, endowed with significant authority, often wield it with little accountability. Armed with prosecutors who prioritize winning over truth, boards can distort …
“Doctor, it’s not my portion. I don’t have hypertension,” she said confidently, shifting her wrapper and returning my gaze like I had just accused her of something terrible.
The blood pressure monitor read 170/120 mmHg. I had just measured it myself twice, yet here I was, facing a patient who flat-out refused to believe her numbers.
She was a middle-aged woman who came in complaining of a headache and body weakness. She …
Health care is in the middle of a technological reckoning. AI and IT innovations promise efficiency, predictive analytics, and system-wide transformation. Yet inside hospitals, clinics, and virtual care platforms, the psychological fallout tells a different story, one that leadership must reckon with before the cost becomes irreversible.
The silent resistance: Psychological transition vs. technical adoption
Most health care executives measure success by how fast they implement new systems. But psychological readiness is …
Imagine a family physician who works 12-hour days packed with complex cases and endless paperwork. They may skip meals, miss their child’s recital, and stay late to finish charting. Patient care feels rushed, and the physician begins to feel emotionally numb and irritable. Driving home exhausted, the doctor wonders if medicine was the right career choice! A physician’s role is considered a calling, and when it starts to feel like …
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Family physician Jonathan Bushman discusses his article, “The hidden moral injury behind value-based health care.” He shares the story of a young physician who was told to remove her most complex patients …
Come sit down and I will start
To tell a tale of Harvy heart,
And how his feud with Brian brain
Flushed their friendship down the drain.
Brian brain and Harvy heart
Were never very far apart.
Harvy fast and Brian slow,
They worked together, don’t you know?
Then one day they had a spat
Over whom to point their loving at.
Harvy thought that he should lead
Since hearts are much like trusty steeds!
Brian brain thought he was best
Since loving …
It is a question that has stopped more than a few of my physician clients in their tracks: Who are you outside of the white coat?
I do not mean your hobbies, though yes, of course those matter. I mean your identity. Your core sense of self when you strip away the pager, the patient lists, the provider ID, and even the deeply ingrained instincts to care, to fix, to achieve. …
Medical errors happen every day, and patients are being harmed in hospitals. Despite years of tracking and reporting outcome-based quality measures, preventable harm remains widespread, prompting the Centers for Medicare & Medicaid Services (CMS) to launch the Patient Safety Structural Measure (PSSM). This measure, released in August 2024, focuses on structural and cultural root causes of harm rather than just retrospective results of quality improvement initiatives.
In our consultancy practice, we’re …
A physician’s financial journey isn’t always linear, and the journey can’t always be predicted in a how-to book. While the hospital-employed physician normally gravitates toward a path filled with benefits and retirement plans, the equity owner physician, or physician practice owner—both terms used interchangeably—has a much different pathway. Let’s dive into the equity owner physician a bit further.
Why choose ownership?
Like the term “business owner,” equity ownership physician is a generic …
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Anesthesiologist and clinical mental health counselor Maire Daugharty discusses her article, “Why peer support can save lives in high-pressure medical careers.” Drawing from her personal experience of losing three colleagues to suicide …
We’ve all seen the hype.
AI will revolutionize health care. It will cut documentation time. Improve diagnoses. Save lives. Maybe even replace doctors.
But here’s what I know after 11 years as a hospitalist: Hype without evidence is dangerous. And AI—especially in medicine—isn’t just software. It’s treatment.
If we’re going to let AI influence life-or-death decisions, it needs to meet the same standard as any clinical intervention. That means rigorous trials, transparent design, …
For decades, you were told that whole milk was the devil in a glass. Doctors (including me), dietitians, and public health agencies told you to toss the red cap and grab the blue — skim, 1 percent, or 2 percent milk. Why? Because whole milk had fat. And fat, particularly saturated fat, was supposed to clog your arteries like grease in a kitchen drain.
Except we were wrong.
The fat in whole …
In today’s interconnected society, individual health shapes the well-being of communities. This is evident in the role of pain clinics, which have evolved beyond their traditional mandate of managing chronic pain. A recent peer-reviewed research publication in the SVOA Medical Research journal highlights how pain clinics are contributing to societal safety by addressing risks that extend beyond the clinical setting; promoting safer roads, stronger families, and healthier workplaces.
The clinical …
About a month ago, I developed a very sudden and alarming skin condition—clusters of painful, itchy bumps that quickly spread across my arms, legs, and chest. At first, I was not overly worried. I made an appointment with my primary care physician, expecting answers. But the exam was brief—she took a cursory glance and speculated it was an allergic reaction. To her credit, she didn’t jump to conclusions. She snapped …
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Physician and public health advocate Judith Eguzoikpe discusses her article, “Hope is the lifeline: a deeper look into transplant care.” She pulls back the curtain on the kidney transplant process, revealing that …
Many health care providers are still coming to terms with the opioid epidemic. The development of drugs such as Oxy opened a door for widespread opioid use, and the aftermath of this failure has led to rampant addiction in our country’s most vulnerable. As the system gradually regulated legal opioids, dangerous alternatives like heroin and fentanyl increased in prevalence. Other nonopiate medications like amphetamines have also become common in communities. …
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