An excerpt from Patients at Risk: The Rise of the Nurse Practitioner and Physician Assistant in Healthcare.
On a sunny Tuesday in March 2015, the steps of Capitol Hill were draped in white as nurse practitioners from across the United States descended on the nation’s capital. Their …
Proponents of independent non-physician practice make a dangerous assumption
“Like 9/11, we have a new reference point touching everyone on the planet: life before COVID-19 and life after. Regardless if you get it or don’t, the unknowns and secondary consequences are scary. Life before COVID was scary, too, minus the urgency.
Before COVID, we sensed the weight of living on a sick planet. We felt powerless to change the tide of …
A nontraditional approach to fear and stress [PODCAST]
“The inflammatory response elicited by the novel coronavirus can do great damage to the essential function of lungs. People with underlying lung disease are more vulnerable to this coronavirus, including people with asthma, emphysema, lung fibrosis, and even people with high exposure to air pollution. Smoking and vaping are perfectly preventable forms of high-intensity air pollution. We strongly urge city, county, …
A call for a moratorium on the sale of inhalable products [PODCAST]
I remember reading a post recently on a Facebook physician group that involved a cardiologist who asked for help on how to manage her finances after a divorce.
The pertinent aspects of this situation involves the physician being left with essentially nothing in retirement savings. She is mid-career with children and wants an option to reduce her schedule eventually to spend time with her children during the weeks she has custody. …
What to do financially when you’re a doctor getting a divorce
The symptoms of systemic discrimination and sweeping organizational problems are ubiquitous in the news and health care literature. Yet, medical students’ curricula focus on codes of professionalism, setting these issues, and the historical forces that created them to the side. While professionalism is undoubtedly an important aspect of being a physician, it is simply not enough to give students the background they need to recognize the historical contextualization of ethical …
Medical ethics and medical school: a student’s perspective
“Holding space means being physically, mentally, and emotionally present for someone. It means putting your focus on someone to support them as they feel their feelings. An important aspect of holding space is managing judgment while you are present.
Like when you tell a patient that they have stage IV pancreatic cancer and that it is nonsurgical and even with the best …
Palliative care and the importance of holding space [PODCAST]
If you are a doctor (or med student/health professional) and are human, you’ve probably made a medical mistake. You’ve probably not received emotional support for the mistake. Maybe you’ve never told anyone about a mistake that still haunts you today.
The truth is that almost all physicians have admitted to medical mistakes sometime in their careers. Depending on the patient outcome, many doctors carry the distress of medical errors for months, …
What not to do after a medical mistake
“The reality of being a medical practice owner is that we are small business owners and very vulnerable to the impact of COVID. Having previously worked in the telemedicine industry and because I am a psychiatrist, I initially felt that I was in a good position to adapt to this crisis – and this has been overall true, but the reality …
How to balance family and professional needs during the pandemic [PODCAST]
It’s good to have options, isn’t it?
So why isn’t there an option when it comes to taking your boards? In other words, can’t residents have a say with which board to become certified with once they’re done with their residency?
Well, there’s good news for you. The answer is yes. You definitely have options. There are other boards for your initial written exams. (And that also includes the oral exams for …
You have options when it comes to board certification
An excerpt from Universal Death Care.
Machine gun fire ripped me open—From Left to Right. There were too many bullets. No way could I feel each wound. They blended together like a single strike of lightning. I was paralyzed by pain. It had taken root in me. …
The trauma of a combat doctor in Iraq
Medical schools are increasingly emphasizing early clinical exposure for their medical students. While the traditional medical education format — in which the basic sciences are taught during the first two years, and clinical rotations are stressed during the latter two — are still generally followed, many schools provide their students with exposures to the hospital or clinical settings much earlier in their medical education. For example, just two months into …
The benefits of early clinical exposure in medical education
“To help the reader understand the issues better, I would like to relate some stories. A friend of mine was dying of pancreatic cancer. He had an implantable morphine pump and was on both hospice and palliative care. Still, he found that his suffering was unbearable and wanted to die sooner. Doctors told him that his only option to end his …
Medical aid in dying is not assisted suicide [PODCAST]
For thousands of years, bonesetters and doctors could not accurately diagnosis broken bones or differentiate such injuries from joint dislocations and torn ligaments. That changed with a chance discovery almost exactly 125 years ago. Subsequently, perhaps with equal parts of chagrin and enlightenment, doctors began using the new discovery to discount their previous assumptions and accurately diagnose skeletal diseases.
In his darkened laboratory on November 8, 1895, …
Orthopedic surgery enters the modern age on a chance observation
“There are some things that we are living through as a result of COVID-19 that I did not imagine in my fictional account. For example: the timeline. As we are now four full months into this pandemic in the U.S., some experts estimate that we are still early in the game. As one doctor put it, we are only at about …
Imagining a pandemic as a physician novelist [PODCAST]
“Aunty blew her brains out a few weeks ago!”
Words I shall never forget.
For weeks, she had been in my thoughts. But I never called her. I didn’t because of all the myriad reasons we often give ourselves for not checking up on each other.
In my case, they sounded like this; “I am 7 months pregnant, and it has been a difficult pregnancy.” “I am in an abusive marriage.” “My pediatric …
Female physician suicides: a silent pandemic
The transition from resident to doctor is overwhelming and can impact your personal life deeply, particularly within the context of your relationship. It is important to sit down and discuss with your partner or spouse and discuss your excitement and fear during this odd phase of life. Although the transition can make or break a relationship, if both you and your partner put forth the effort, you will surely be …
Moving forward in medicine with your significant other
“As our office begins to return to pre-COVID operations, it has been uplifting to have a relative sense of normalcy, even though morale seems to be reduced. It is difficult to promote team building and improve morale when everyone has to maintain social distancing. I would love to go out for a meal with my staff, hug my patients, and lecture …
Moral injury and practicing oncology during COVID-19 [PODCAST]
As a first-year medical student, the transition to an online curriculum has posed a unique set of challenges. I am often asked, “How exactly can you become a doctor without having seen a patient, without having put a stethoscope on another human being?” I’ve been told many times already by my professors that to listen to one of the four heart sounds, I should place the diaphragm of my stethoscope …
The pandemic has only further strengthened my passion to become a physician
“The duty of physician officials in the government exceeds that of other officials. As physicians, they have a unique moral obligation to do more than protect the constitution from enemies, foreign and domestic. They have a duty to be unambiguously truthful, to use their power to do good, and to avoid harm. If they fail in any of those regards, they …
Examining the duty of physician officials in the government [PODCAST]
“Growing up, my family sheltered and protected me with everything related to vitiligo. People never really asked me what happened to my skin. And, if I did get questions, I honestly did not know how to answer them, so I would say ‘oh, they’re just sunburn scars’ or some version of that story, and moved on. Thinking back, I probably was …
An Indian doctor with vitiligo shares his story [PODCAST]
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