Primary care is dying: Why that should scare every large employer

Policy
July 6, 2020

Primary care is on life support. COVID-19’s toll on American health care extends beyond the hospitals and medical workers besieged by infection. An equally insidious but less-visible crisis is engulfing primary care, the long-neglected foundation of our health care system. Given the role of America’s largest corporations in providing health care benefits, the C-suite should be on high alert.

As growing numbers of patients postpone appointments over concerns about …

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What happens when patient capacity and autonomy diverge?

Physician
July 6, 2020

“I can’t take this, doc. It’s gonna kill me. I can’t. I just can’t,” exclaims my patient with persistent refusal of his medication. My frustration is met with my patient care team’s hesitation to give him the medication with fear of further conflict and possible escalation to violence.  But who’s at fault? Any of us? All of us?

My second patient, lying on the MRI table, shaking his head swiftly in …

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The view from an infectious disease physician in Texas [PODCAST]

Podcast
July 5, 2020
YouTube video

“Death is not meant to be rushed. Saying goodbye shouldn’t be rushed. Celebrating a life once lived cannot be rushed. And yet, we must. Taking a moment, a minute, an hour, maybe a day to feel something that normally takes far longer. Because we must. And in our hearts, the grief remains. Frozen in time in this state of mourning that …

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The emotional side of being a doctor during the COVID-19 pandemic

Physician
July 5, 2020

It was a Thursday. It was supposed to be one of those “regular” evening shifts. Then, at 6:15 p.m., my first page went off: Bed 11, Mrs. R., Dr. H. needs to talk to you. The page came from the COVID section of the emergency department.

I immediately called back. It saddened me when I learned that our patient was a young woman health care worker in her early 50s. She …

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9 tips for new pediatric residents

Physician
July 5, 2020

It’s that wonderful time of year when new interns take their first steps into hospitals as practicing physicians One of us has just completed her intern year and the other quite a while back (but recently enough to still remember some of it), so we wanted to share some tips for the pediatric interns about to start this wonderful adventure.

1. Don’t be overly anxious (as a little anxiety is expected). …

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I don’t care what your cardiologist says

Physician
July 5, 2020

Yeah.

I said it.

As an anesthesiologist, especially as a cardiothoracic anesthesiologist, there are few things I am more interested in than how well or how poorly your heart functions and why.  And a cardiologist can help me obtain a lot of vital information in that regard.  But there several things a cardiologist cannot, and I argue, should not do, when it comes to the perioperative care of patients.

First, a cardiologist’s assessment …

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A public health update on COVID-19 [PODCAST]

Podcast
July 5, 2020
YouTube video

“Over the last 100 years, the U.S. has had to respond to five avian flu pandemics. The most severe was the 1918 avian influenza infecting 1/3 of the world’s population and killing 650,000 Americans. It was also the last time wide-spread containment, mitigation, and isolation strategies were used in the U.S. Seldom mentioned about the 1918 pandemic are the three ‘waves’ …

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Pandemic behavioral health tips from a psychiatrist [PODCAST]

Podcast
July 4, 2020
YouTube video

“The unparalleled and pervasive nature of the evolving COVID-19 pandemic has touched all of us in some way. There is limited, albeit growing, research on the mental health effects of disasters.  A recent review article pointed out the potentially negative consequences of prolonged quarantine, while other research from Wuhan, China, highlighted the impact of COVID-19, particularly amongst healthcare personnel. Psychiatrists and mental health professionals will play a …

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A graduation speech to a residency class

Physician
July 4, 2020

I feet truly honored to have been asked to speak at your graduation and to have a chance to share on this day with all of you. We are experiencing a truly singular moment, and I imagine you are hoping that I might say something that would be comforting or inspiring, and I really can’t think what that could possibly be.

For the last half of your third year of residency, …

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COVID-19 is a grim reminder of my roots

Physician
July 4, 2020

Ever since the COVID-19 pandemic gripped New York City, I have come to dread calling home to my parents. Every conversation ultimately leads to the question: “Is everyone okay?” This is always followed by a pause as my parents consider how much to tell me. Over the past few months, I learned on an almost weekly basis of a new family member, family friend, or neighbor who was hospitalized, transferred …

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This is a time for national unity, not sensationalism [PODCAST]

Podcast
July 3, 2020
YouTube video

“Recent articles have accused some physicians of hoarding medications for themselves during our international medical crisis. Authors such as these should be ashamed of their coverage and wasted ability on sensationalism when they could be spending their time informing the public about the dangers of COVID-19 and the actions communities, hospitals, physicians, businesses, and public servants are taking on a daily …

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Spare older anesthesiologists COVID-19 coronavirus risk [PODCAST]

Podcast
July 2, 2020
YouTube video

“This pandemic presents a unique opportunity for senior anesthesiologists to see the benefit of accommodating the health care needs of our workforce. Just as I tried to avoid the teratogenic effects of certain cases when pregnant, we should consider the most effective ways to protect senior anesthesiologists from a life-threatening infection. When the pandemic has passed, anesthesiologists of all ages can …

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Who should be the first responders to mental health crises?

Policy
July 2, 2020

First and foremost, a mental health crisis is a medical emergency well within the sector of public health. Therefore, the question of who should respond to mental health emergencies is one in which physicians and all medical providers should have a say. Medical providers should not only be aware of the systems in place to respond to mental health crisis but must advocate for patient safety as a measurable outcome …

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How writing inspires this physician [PODCAST]

Podcast
July 1, 2020
YouTube video

“Being present is a wonderful thing. It relieves stress caused by focusing on failures of the past and worries of the future. Both realms are unreachable, largely unchangeable. But at the same time, they both entice and tease our minds such that we often find ourselves everywhere, but at the moment as we focus on changing what has already passed or …

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Marriage and parenting tips in the year 2020 [PODCAST]

Podcast
June 30, 2020
YouTube video

“Recently, I realized that something needed to change in my family life. With three busy daughters at three different schools who participate in multiple activities along with my full-time job as an anesthesiologist, my life depended on accurate and concise communication. However, this was the third time in a week that a ball had been dropped between my husband and me.

This …

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We should communicate like we are in a code blue 

Physician
June 30, 2020

The alarm goes off! Code blue! Code blue! The code blue team rushes to the scene. The patient is unresponsive. There is no pulse. The leader of the code team looks at the monitor and takes charge. The patient is in ventricular fibrillation (cardiac arrest) and would very well flat-line if prompt action is not taken. The leader gives clear instructions: Start chest compression. Fred, you will handle the defibrillator. …

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Telemedicine pitfalls and direct primary care in the year 2020 [PODCAST]

Podcast
June 29, 2020
YouTube video

“All too often, physicians and other health care providers have tried to do the right things for our patients to ultimately have had our hand slapped.

So pause for a second, get the questions answered, know what future implications are for today’s actions. Make the right choice for your patient, and for yourself, especially if it means amending your contract before you …

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Advice for new interns: How to earn respect the right way

Physician
June 29, 2020

July is a very special time of year in the medical community. We welcome thousands of newly minted physicians donning their spotless white coats and nervous smiles as they begin what will be one of the most difficult but also most rewarding and exciting times of their lives. Reflecting back on that first day as a brand new intern, I can’t help but think of how nervous I was over …

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What’s to blame for the obesity epidemic? [PODCAST]

Podcast
June 28, 2020
YouTube video

“Obesity is a topic that literally hits home for me.  For the past two years, the website WalletHub has voted the McAllen-Edinburg-Mission TX metroplex as the ‘fattest city in America.’  As a health care provider, this is deeply disturbing because it puts my community at high risk for a wide variety of health problems, including but not limited to coronary artery disease, …

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