I am a psychiatrist who volunteers his time on the clinical faculty of the local medical school. This is a role I have valued over the years that has allowed me to give back and mentor young residents as my senior colleagues did for me during my training.
Recently, I had a chilling experience that has caused concern and pause. I was supervising a first-year resident who was presenting a patient …
When an attending was canceled by a resident
In the face of genetically engineered therapies for many cancers and the incredibly rapid development of effective vaccines for COVID-19, it’s easy to lose sight of the breadth and depth of unsolved puzzles in medical science. Many of these remaining mysteries may be at least partially resolved as we overcome the mind/body dichotomy. A fascinating example of this issue has emerged with recent evidence of the excessive prevalence of Type …
Type 1 diabetes in transgender children and adults
“As health professionals, we have the platform to enact change within our own institutions, as well as local and federal governments. We must elect leaders and officials who spearhead climate action. We must reduce the carbon footprint of healthcare. And we must educate our colleagues and our patients about the impact of …
What medical professionals can do to take climate action [PODCAST]
On Twitter @jpegjoshua recently posted about a staggering health care bill for going to the hospital for a life-threatening condition and then receiving an outrageous statement, which reminded me of a similar story that I had.
I also received a bill for nearly $40,000 but luckily managed to have it cleared through an unmentioned secret. For me, it all started the second …
A secret for my $40,000 health care bills
American medicine is facing an identity crisis. The COVID-19 pandemic brought renewed attention to socioeconomic health disparities and turned up the heat on the question of whether health care is a right or a privilege. The financial strain on hospitals resulting from the temporary postponement of scheduled surgeries exposed a vulnerability caused by an inherently flawed payment system.
The answer to the right versus privilege question has much more significant implications …
Health care as an uncommon good
About a year ago, I was referred to a sleep clinic and was diagnosed with “very mild obstructive sleep apnoea” (OSA). A continuous positive airway pressure (CPAP) device was recommended with a litany of disorders that would occur (heart disease, CVA, HTN, decreased mortality, motor vehicle accidents, etc.) if I did not use the apparatus consistently and properly.
I assiduously used it for two test periods. Though the physician reported improvement, …
A medical ethicist asks questions about CPAP
“Instead of focusing on one organ system, I want to know everything. The diagnostic challenge is to discern patterns of insults, symptoms, and lab tests that correlate with specific microbes, specific organ dysfunction, specific diet issues, and environmental exposures. We keep asking questions until we detect patterns in the chronically ill …
Our work as physicians and healers is to see the whole patient [PODCAST]
The 2021 residency match “capstoned” the inaugural virtual interview season. Interviews may likely continue to incorporate some virtual aspects given the realized efficiencies. But these efficiencies come at a cost: limiting the applicant’s ability to get a feel of the programs and adding virtual fatigue to the inevitable stress of interviews.
As two medical students who participated in this most recent interview season, here are a few best practices we encountered …
Best practices in virtual residency interviewing
I once spoke at a leadership forum on opioid abuse. I was asked to speak about the role of hospital systems in addressing this important issue. As I thought about what I would say, I realized there was very little I could add. The crisis is epidemic, and hospitals are ill-prepared to do anything proactive. It is that overwhelming. Leading medical missions, I learned an important lesson that …
A physician’s personal story with opioids
“Suicide is a path, whether fast or slow, that a person chooses to take because of their own reasons. We certainly can never predict suicide or truly understand it. But with that said, every time it happens, it is a tragic loss of life that time can and will never heal.
We must …
Physician suicide: We need safe spaces to talk about it [PODCAST]
In a previous post, I recognized lactation support for women physicians as an equity issue. Many of the women physicians I’ve interviewed have identified returning to work while breastfeeding as a major challenge and a major source of stress. Providing accommodations to ensure that these professionals have access to the resources they need to do their work is essential to creating an equitable workplace.
Soon after I published …
An organizational solution to lactation support for women physicians
COVID-19 is the first-ever “politicized pandemic” in human history. COVID-19 happened in an era of widespread social media which helped the general population to understand the disease better and faster. However, the public also formulated an opinion about it. The problem was that their opinions were distilled by the information they were exposed to. And a large chunk of the information available was not scrutinized or scientifically proven.
This is a …
Does your reaction to COVID reveal your political leaning?
The COVID-19 pandemic has brought to light the vital roles effective communication and reliable technology play in the patient journey, starting from the moment a patient is on the way to the emergency department (ED) through to discharge. There are many moving parts during an ED visit, and the process of keeping the patient, their family, and other departments within the hospital or health system informed is no small feat …
3 ways technology in the ER boosts the patient experience
This is a message to any medical doctor who is unhappy with their career. The individual reasons for this dissatisfaction will vary. Whatever the issue, it is important to ask, “Is the problem correctable?” If yes, then you must act and secure your happiness. If no, you must consider other options. One uncomplicated choice is to stay in medicine and practice somewhere else. However, you may also be unhappy in …
“Our relationship with Big Pharma is a dangerous, nasty, and abusive one, and it can prove to be fatal too. Benzos aren’t limited to a specific class, race, gender, creed, etc. Many stars have died from mixing benzodiazepines with opioids or illegal drugs.
It has been a little over a year that I have been …
My Klonopin withdrawal story [PODCAST]
This letter serves to provide my story for other women who may experience vanishing twin syndrome (VTS) and the providers that care for them, especially given how common VTS is and will continue to be.
For the folks who are either physicians or becoming care providers, I hope you choose to familiarize yourself with this odd yet common form of loss. I encourage you to respect a woman’s right to decide …
Let’s talk about vanishing twin syndrome
Joseph B. Fraiman is an emergency medicine physician currently practicing at Thibodaux Regional Medical Center and three other regional hospitals in Louisiana. This interview, conducted by journalist Martha Rosenberg, has been edited for clarity and length.
Rosenberg: Working at ERs in Louisiana hospitals that serve bayou communities, how seriously were you affected by COVID-19?
Fraiman: When COVID-19 began, as the only physician overnight, I was pronouncing or intubating patients two or three …
Research and censorship in an uncertain time
“Had I understood the nature of my struggles and felt permitted and supported in actively addressing them, I would have been more effective, a better learner, and more fulfilled. After trying out a few clinical settings, a lot of reading, and some much-needed coaching, I found my identity as a healthy, …
Focus medical education on training the whole person [PODCAST]
This article is sponsored by Eyevance Pharmaceuticals, developing innovative and impactful ophthalmic therapies for the ocular surface and anterior segment.
Allergic conjunctivitis (AC) is a common ocular condition. Worldwide, 15% to 20% of the population is affected by some form of allergic disease with ocular symptoms present …
Powerful prescription relief for ocular itch from allergic conjunctivitis
Medicine is very much like driving. As an emergency physician, when you see a patient, you ask the same questions, “What brought you in today? What’s bothering you?” and go through the normal flow of the history and physical. You order the same labs and imaging reflexively. When you’re driving to a location that you’ve been to many times before, when you get into your car again and turn the …
Medicine is very much like driving. But don’t be a passive driver.
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