“If PCPs want to meet the new competition from virtual primary care plans, I suggest that they gradually increase the percentage of their visits that they do through telehealth. Now that payers are reimbursing those visits at the same level as in-person visits, they have nothing to lose financially. Of course, there …
PCPs could counter virtual plans by increasing telehealth visits [PODCAST]
I have seen great leadership and bad leadership. As a leader, I have also made my share of mistakes, and I am sure I will make more. When I do, I will immediately take ownership of it, learn from it, and do all I can not to make the same mistake. However, there will be times I may not recognize my failure, as can happen with any leader. This points …
My 10 Commandments of a Servant Leader
“Looking back on these words at the end of my rotation, I understand what I had felt, and I feel confident naming it: the futility of medicine. We can comfort and treat patients, but there’s nothing more we can do after a certain point. As a bright-eyed medical student who wrote …
My first end-of-life conversation [PODCAST]
A letter of recommendation is a document written about the applicant by a previous employer, professor, or anyone working in close contact with the applicant. This one document is supposed to describe you, your qualities, and your abilities — all in less than a few paragraphs. It can be an enormous determining factor in getting the job position, being accepted to a university, or matching your number one residency program. …
Are letters of recommendation effective or burdensome?
An excerpt from The Big Lie: How One Doctor’s Medical Fraud Launched Today’s Deadly Anti-Vax Movement.
Inside the Royal Free Hospital in London, scores of reporters, physicians, and hangers-on packed the Atrium conference room, waiting for a press briefing to begin for five medical specialists who would deliver what would prove to be a historic—and dangerous—announcement.
It was February …
How one doctor’s medical fraud launched today’s deadly anti-vax movement
“Motherhood has been the biggest gamble of my adult life thus far. How was I going to operate for 12-plus hours while 39-weeks pregnant? Where would I be when I went into labor? How would was I going to return after three weeks? How would I pump during and in between OR …
Advice to pregnant surgical residents [PODCAST]
I’ve been speaking with women physicians about the top challenges they face today. I’ve learned there are many—which honestly didn’t surprise me, given that 48 percent of women physicians report burnout symptoms (compared with 37 percent of their male counterparts).
Several have mentioned the challenge of breastfeeding while working—rather ironic considering what is known about the health benefits for mother and infant. Maybe their colleagues and …
Institute policies to proactively support physicians who are breastfeeding
It was past midnight in the ED, and she was writhing on the bed, palms clutched over her abdomen. I pulled up a stool, notebook, and pen in hand. I was ready to listen to Mrs. Walker’s story. But I also felt a sense of dread rising: From a quick chart review, I knew that Mrs. Walker had 23 negative CT scans for abdominal pain within the last 18 months. …
“Difficult” patients: Is it them or is it us?
“COVID-19 disproportionately impacts those with pre-existing conditions, and our health care system leaves one in five Americans with a pre-existing condition uninsured. Further, with multiple COVID-19 vaccines already in early but slow distribution, attaining universal coverage is critical, particularly in light of uninsurance having an inverse relationship with vaccination rates.
President Biden …
President Biden’s quest for a public option [PODCAST]
It is not a secret that being a physician can be exhausting and time-consuming, but do most nonphysicians really know what it’s like to be one? The answer is a resounding no. Television glamorizes the role of the physician and hides the tedious everyday realities. Spouses and partners of physicians know too well the frustration of having a partner that seems to be “always working and not shutting work off.”
Being …
The soul-sucking, energy-draining life of a physician
When I sat down to write this article, my thoughts immediately went to the tragic loss of one of my best clients, a physician who recently passed away after battling COVID-19. I remember him not only as an excellent physician but even more so as a great person.
Unlike many physicians I speak to in the course of my work, this client had the foresight to do some careful estate planning. …
8 estate planning mistakes for physicians to avoid
“The patient knocking on your door is not your enemy. They’re sick. They’re scared. They’re in pain. They don’t know why, and they’re hoping for an answer. If you can’t find the source of a problem quickly, it doesn’t mean it’s not there.”
Denise Reich is a patient advocate.
She shares her story and …
Patients don’t need quick diagnoses. They need accurate ones. [PODCAST]
Before you jump on the diet bandwagon with your brother-in-law (who’s crowing about shedding all that weight with so little effort), think about the potential downside.
The problem with an ill-thought-out diet:
Fad diets are designed to take off weight as quickly as possible. They often ignore the long-term effects that might occur regarding both the brain and spine. Someone embarking on a radical weight loss …
Think about your brain and spine before you start that new fad diet
Many who know me might be shocked by this: I shot my first pistol when I was 8 or 9, taught by my father, a physician, aiming at targets in our basement. At summer camp, I loved riflery the way some kids loved art. Staring through the sight, down the barrel, I proved an excellent shot, gathering ever more advanced medals from the National Rifle Association. As a reward, for …
I was a teenage rifle owner, then an ER doctor
Four months into the largest U.S. vaccine rollout in decades, it’s become clear that the messaging surrounding COVID-19 vaccination efforts is as important as the science behind them.
That was true when the first COVID vaccines were introduced in December at hospitals and nursing homes and even more so after the federal government on Tuesday paused the Johnson & Johnson vaccine after reports of extremely rare but very serious — in …
The J&J COVID vaccine pause: What the experts are saying
“I can tell you what I don’t want to do. I don’t want to mill through 50 patients a day, mindlessly clicking through EMR checkboxes so an insurance auditor five states away will deem that I’ve done my job and deserve reimbursement. That’s a high volume, high overhead game, and I …
Meet the orthopedic surgeon who stopped taking insurance and does house calls [PODCAST]
What is this potential side effect of the J&J vaccine for COVID-19?
The potential side effect is a blood clot in the veins that drain blood from the brain. This is called central venous sinus thrombosis. In the vaccine-associated cases of this, platelets in blood, which are important for making clots, have been lower than normal. While …
Johnson & Johnson vaccine suspension: What this means for you
“Humanities can be seen as part of the fabric, society, and culture of human experience. In many ways, they might be seen as the disciplines that make us human and make life meaningful. They broadly encompass ancient and modern languages, literature, philosophy, religion, visual and performing arts, such as music and theater. …
Harness the power of the humanities to counteract burnout [PODCAST]
I sat in a crowded auditorium listening to an attending at a renowned medical institution give a lecture. I didn’t know the answers, and shrouded in imposter syndrome, I avoided eye contact. The visiting medical student from Mexico answered the question, and the attending moved on. Another question came. Again, the medical student from Mexico answered. The attending chuckled and said, “OK, Cinco de Mayo,” an exaggerated emphasis on the …
The daily micro- and macroaggressions of being an underrepresented minority in medicine
Providing primary care to patients with mental illness is a challenging task that requires highly skilled and experienced practitioners comfortable with the full array of biopsychosocial problems with which these patients present. For example, understanding the side-effect profiles of psychiatric medications and their impact on problems such as diabetes and other complex endocrinopathies requires highly evolved clinical skills.
Optimally, the successful care of these patients is best provided in close collaboration …
Avoiding the pitfalls of integrating primary care into community-based mental health centers
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