I am an emergency medicine physician in an inner-city emergency department, and I would like to start by stating a simple truth: coronavirus is not going away any time soon. Cases are climbing in practically every state and show no signs of slowing down. From my personal perspective, things are getting worse. Every day I am treating more and more patients who are ill with COVID-19 …
If you don’t want to wear a mask, come to work with me
I have written, or more accurately ranted, about electronic medical records (EMR) systems throughout this blog. While the systems have clearly improved since their mandatory introduction into the medical universe, they have still not delivered on many of their promises.
Of course, EMR has brought tremendous advantages to the medical profession, and we are all grateful for the technology. But this progress has exacted a cost. Many of them are clumsy …
An EMR frustration that is still torturing us
“When doctors ignore the evidence showing that a support system doesn’t have to be traditional in order to be effective, that’s not a medical judgment. It’s a personal prejudice that puts singles at serious risk.
Classifying patients as married or unmarried when studying the effects of social support undoubtedly makes research easier, with groups determined by a simplistic either-or. But since social …
Patients without traditional support systems, and the doctors who stereotype them [PODCAST]
“Single payer is the solution. And the time for it is now.
A single-payer system would guarantee health care coverage immediately to every American. So whether a loved one gets sick from COVID, has a heart attack, or gets in a car accident, she will receive the care she needs without it causing financial hardship.
A single-payer system will eliminate employer health insurance …
Is now the time for single payer? [PODCAST]
Judging from the shortage of canning jars and lids in grocery stores recently, the COVID-19 pandemic has spurred fresh interest in home canning (a potentially dangerous practice that has declined since its peak in 1943); and because the public expects doctors to know everything about health, it may be educational for physicians to consider the tragic case of the unpeeled potato.
I recently read a Facebook post in a …
Food safety and the neglect of the unpeeled potato
During the COVID-19 pandemic, a glaring trend has emerged, one that has long helped forge the American religious cultural landscape, but has now blossomed in full force, particularly within many Christian fundamentalist circles. As a physician who is also an evangelical Christian, I constantly live with the tension of balancing the practice of my faith and the results of sound scientific investigation with the opinions of patients and others within …
Science and faith in the time of COVID-19
“Doctors are people, and people are capable of prejudice and discrimination. But, in medicine, there is no place for prejudice and discrimination because a patient’s life is at stake. Stereotyping a customer and assuming that they cannot afford a certain product is emotionally hurtful, but it is far less dangerous than stereotyping a patient and misdiagnosing a life-threatening condition.
The nature of …
Why cultural competency courses should be requisites for medical school [PODCAST]
Do you know how much your time is worth? Those of us who are 1099ers can easily tell you our hourly wage. Now, what about everyone else?
Well, there’s a quick trick. Take your yearly salary and divide it by 2,000. So if you make a salary of $200,000 per year, you are making roughly $100 per hour.
Now there are a few assumptions. To start off with, there are actually 2080 …
Don’t make the mistake of equating an hourly wage for the value of your time
I’m my breaking point! Frustrated, exhausted, caffeine-deprived, and surrounded by people who don’t listen to me, I’m not trained for this, and I am ready to tag out. OK, granted, it is only day two of distance learning for my third grader and kindergartener. However, this could also describe my first two days as a castaway on Survivor island.
It’s been about nine years since I was chosen to appear on …
A physician’s journey from Survivor to Shark Tank to quarantine
“My experience with recent knee surgery that left me significantly disabled for over a month brought this to my attention yet again. I was completely dependent on others for basic self-care since I was unable to get in and out of the tub/shower without help. I was only able to walk with significant pain on crutches and was completely incapable of navigating stairs. …
When physicians get sick: We are just as human as the patients we treat [PODCAST]
“With COVID-19, all of those memories have come flooding back. It is as if I am back in the NICU staring at that tiny infant and worried that she would get sick. Only now I have to pull myself out of that horrific daydream and stare at my teenager and pray that she will get through this. I am not alone …
COVID-19 is rattling the nerves of preemie parents [PODCAST]
Thinking, Fast and Slow is a well-known masterpiece of psychology by the formidable Daniel Kahneman. He diligently illuminates two different pathways of thought, which he arbitrarily titles System 1 and System 2. System 1 describes our quick thinking, our snap judgments, our gut feelings. System 2 encapsulates our deeper thoughts, the way we systematically review information, the analysis that requires time and mental effort. The work thoroughly lays out many …
A recent edition of Pediatrics has some disturbing research: “Trends in Capability of Hospitals to Provide Definitive Acute Care for Children: 2008 to 2016.” What the paper really does is document what many of us who work in referral hospitals have noted for some time: More and more community hospitals are transferring children who appear in their emergency departments to other, larger facilities instead of admitting them to …
Why are so many community hospitals transferring children to larger facilities?
“As a runner, my pulse rests around fifty, but the ICU team had worried when it dipped to thirty-five, and my blood pressure hovered around ninety over fifty. Understandably, bags of saline were hung, and steroids were added. My headache improved, but my ankles disappeared, and I was often short of breath. Upon discharge, I went into full diuresis mode and …
A palliative care physician’s brain bleed [PODCAST]
“I called the locum agency in the morning to air my concerns. To their credit, they admitted that the COVID-19 pandemic is an unprecedented event for which no one could have planned. They had developed a fund through which they could support health workers in need. If I took ill, I would have to call them for support. My health care …
COVID-19 reveals gaping holes in locum tenens contracts [PODCAST]
“COVID-19 is a tragedy that could have easily been prevented if our leaders cared more about the well-being of their citizens instead of economies, stock markets, and their political campaigns. To all those arguing about how the economy is more important, I ask, how will sick and dead people contribute to an economy? How will sick and dead health care workers …
Health care should be apolitical, but it isn’t [PODCAST]
I’m glad you’re looking at a career in medicine. I hope you will be happy with your choice forever. To help you out, these are a few myths I wish somebody told me about when I was in your shoes.
1. You’ll be rich. You likely won’t. After two decades or so of med school and residency, you’ll be paying back student loans with exorbitant interests for a few more decades …
So you want to be a doctor? Here are 10 myths debunked.
“I suppose those of us between zero and ninety-three are blessed in our own way as well. We are here, swirling in a jumble of the inconsequential and consequential. We’ve enjoyed some of the world’s beauty and reserve the potential to experience more. Some of us will have longer than others, but perhaps we should focus on savoring rather than quantitating …
Anesthesia touches nearly every area of medicine [PODCAST]
“There are roughly 221 million people — including 48 million kids — in states where marijuana has been named a medicine. These include patients who suffer from depression and could see their symptoms worsen. Mothers who could give birth to babies with low birth weights. Children who could face an increased risk of addiction, depression, and suicide.
We must allow our citizens …
Many medical marijuana program websites are silent about possible risks [PODCAST]
CC: “I feel like crap.”
HPI: 29-year old female internal medicine resident. Hasn’t seen sunlight in over three months due to 100 hour work weeks. Crying at work. Always exhausted and irritable. Isolated from friends and family. Feels guilty that she is not effective at work and home. States recent labs were normal.
ROS:
Gen: hypersomnia
HEENT: teeth grinding
CV: chest pressure, palpitations
GI: decreased appetite with weight loss
Neuro: headaches
Psych: apathetic, not suicidal
Meds: none
Social: alcohol on …
Call a consult: depression vs. burnout
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