“What if I had access to real solutions? What if I had resources to provide to a person to help them overcome their problem? As a primary care provider with over 20 years of experience, I know viscerally that I will never “fix” anyone. I can teach, I can guide, …
Why it’s important for physicians to change the system [PODCAST]
I remember the second I received my first phone call from admissions to a medical school. I was sitting at an airport, after having finished another interview. After putting down the phone, I started to cry. All of those years of hard work had been recognized, and I was finally welcomed into the profession of my dreams. I never thought that I accomplished something less meaningful because it was a …
DO and MD: If perceptions matter, which one matters most?
Some pediatric practices refuse to provide care for children with vaccine-hesitant parents.
Those pediatricians are quick to offer rationalizations for this decision. Many of their reasons are compelling. I’m confident you yourself are thinking of some right now. This piece isn’t intended to be a deep dive into those reasons. No justification for refusing care to certain children changes the outcomes.
We assume that these families end up at organizations like mine: …
The non-acceptance of vaccine-hesitant families is a problem in pediatrics
A public health expert and a web developer have created a new digital communication tool to get more COVID-19 shots into arms — a vaccine emoji.
Social media users have been using the syringe, microbe, or mask emoji in their posts to talk about the pandemic. The new vaccine emoji, however, will display a flexing bicep patched up with a Band-Aid, representing an …
A new vaccine emoji to get more COVID-19 shots into arms
Increased prevalence of ophthalmic diseases due to continued population growth and aging requires an increase in the number of ophthalmologists nationwide. Multiple sources, including the National Eye Institute (NEI) and the American Academy of Ophthalmology (AAO), report that the number of people with the most common eye diseases will double between 2010 and 2050. This includes the elderly suffering from long-term eye diseases such as cataracts, age-related macular degeneration (AMD), …
The need for ophthalmologists is greater than ever
“I think doctors are just wired that way. We are productive. We get things done. It is expected. We are supposed to do more, do it all, and be all the things to all the people. We come to a point where we try to satisfy this, and then we …
Why doctors can’t rest [PODCAST]
“How many lives did you save today, Dad?”
That is what my kids would ask me, rather sarcastically, many years ago, when they were young and when I arrived home late, missing our game of backyard basketball. They knew I was a neurologist. And, of course, they knew I didn’t exactly save lives since, as I had explained to them many times, my job consisted of giving folks lots of medications …
Where does the joy and meaning in medicine dwell?
“It’s rare for anyone to try and tally the precise cost of unnecessary care. But when they do, the estimates are staggering. The Washington Health Alliance, a nonprofit dedicated to making care safe and affordable, analyzed insurance claims from 1.3 million patients who received one of 47 tests or services …
Marshall Allen on how to contest hospital bills and avoid treatment you don’t need [PODCAST]
In June, the FDA approved aducanumab (Aduhelm) to treat patients with Alzheimer’s disease using the agency’s accelerated approval pathway, despite significant concerns about the evidence regarding the drug’s safety and effectiveness. The agency’s approval decision contradicted the recommendations of its own advisory committee, which voted overwhelmingly against the evidence presented in support of the drug. Soon after approval, three members of the committee resigned in protest. …
Should Medicare pay for Aduhelm?
“A sad truth is this: Most everywhere, health care is a low-margin industry that lacks resources to invest in leadership development. Although our business’s central, sacred function is caring for our fellow human beings, many who move up in the health care hierarchy do so without possessing the so-called ‘soft …
How physicians can be better medical leaders [PODCAST]
Life is full of hierarchies — whether you are the older brother in the family, the supervisor in a company, a chief resident in medicine. There is always a hierarchy. It is a pecking order that keeps our society organized. You know where to look for guidance. Who is the person above your title that can help you with a challenge you are facing?
Even within surgical specialties, there is a …
Let’s talk about hierarchy and priorities in medicine
He was in his ICU bed without movement or brain stem involvement. His weight was down to 90 pounds.
His six-foot frame and skeletal body made me gasp.
After countless sessions with the patient’s daughter to make her 92-year-old dad “comfort care,” the intensivist sadly hung his head down low.
The daughter insisted on doing everything for her daddy.
It was my night shift, and I knew what was to be expected. Another endless …
The horror of keeping a loved one alive at all costs
You are more likely to be struck by lightning than be born with cri du chat syndrome and OCD. The chances of becoming a performer with these diagnoses are even smaller, and yet, what a show Tanner performed.
His performance is meticulously planned out. Pump soap dispenser twice. Rub hands three times. Wash quickly. Create bubble! As the first bubble emerges, the kids take notice.
Pushing her wheelchair forward, Maria pops the …
Advocating for people with disabilities: People First Language
Earlier this year, a federal rule that requires clinical information such as doctors’ notes and lab and imaging results to be made immediately available to patients took effect. A little more than three months out from implementation, there are mixed reviews as to how well the so-called “Open Notes” rule is actually improving patient care.
Patient advocates and even many physicians have supported the concept of electronic health information …
Is Open Notes as good in practice as it is in theory?
One of the leading reasons for provider frustration is prior authorizations. The insurance companies initially created prior authorization (prior auth) to keep down the cost of care when a service fee was the primary payment method for payers. However, it has become a hindrance for providers and staff as they spend hours waiting for authorization to provide medical care.
In the past, hospital organizations needed approval (prior authorization) from an insurance …
Prior authorization reform for health care coverage takes center stage
“During my medical school clerkships, an attending recognized a truth within me that I’d hidden for many years. Just a few hours into my pediatrics rotation, the attending asked me, ‘You had a rough childhood, didn’t you?’
I was astonished. How had he known? I asked him, needing to know …
How a homeless teen became a physician [PODCAST]
Singing during the years around menopause can bring unforeseen challenges for some women. To Elaine, a 56-year-old professional singer and voice teacher, her voice has felt like a mystery for the last few years. Her vibrato was wider than it used to be, her usual songs didn’t feel good anymore, and her flexibility and agility had decreased.
On top of that, the vocal transition, or break, between her high and low …
Menopause changes women’s singing voices
Daily cries from parents, pediatricians, the press, and the public to reopen schools in the fall are certainly well-intentioned, but they are overlooking a critical opportunity to advance adolescent physical and mental health long after the COVID-19 pandemic is over. Delaying school start times for teens by an hour, or even two, could optimize a teen’s sleep and their ability to learn throughout the day.
Sleep is critical for teen health …
Teens need later school start times
“Embrace dialectical thinking, stupid!”
That’s the mantra I repeat when I catch myself getting worked up about a deep-seated belief, idea, or cause. Understanding the flip side of the equation helps me to neutralize powerful negative feelings like righteous indignation, bitter disappointment, and utter disgust with the incompetence of fill-in-the-blank.
Dialectical thinking is the ability to view an issue from multiple perspectives. Embracing it helps us recognize that it’s almost always possible …
Why it’s important to embrace dialectical thinking
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