How an insurance company auditor tried to destroy a physician’s career

Physician
February 6, 2019

It’s no secret that in today’s health care market, insurance companies are calling the shots. As a pediatrician in private practice for almost two decades, I’ve seen insurance companies transform into perhaps the single most powerful player in today’s health care landscape — final arbiters whose decisions about which procedures or medications to authorize effectively end up determining the course of patient care.

Decisions made by insurers, such as MassHealth, have …

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2 questions every physician should ask themselves

Physician
February 5, 2019

The numbers are in. Medscape National Physician Burnout, Depression & Suicide Report 2019 indicates that the rate of physician burnout is still at an all-time high. Forty-four percent of physicians reported feeling burnt out.

According to the report, 50 percent of women reported experiencing burnout versus 38 percent of men. Carol Bernstein, MD, a psychiatrist at NYU Langone Medical Center, states that the reasons for the difference …

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It’s time to update the stethoscope

Conditions
February 5, 2019

Perhaps the most important aspect of a physician’s role is our diagnostic capabilities. Truly, if we cannot identify and diagnose a patient’s pathology with reasonable accuracy, we cannot effectively treat them and may even cause greater harm.

Let’s look back. The year is 1816, and you are a physician evaluating a patient with shortness of breath. The common practice of the time was direct auscultation by placement of the practitioner’s ear …

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Why would any woman discourage a man’s advocacy or support?

Physician
February 4, 2019

A male interventional radiologist who is active in the #HeForShe campaign recently told me that he is being pressured to stop advocating for women. My first instinct was the biggest sigh and eyeroll of my life followed by thoughts of locker room peer pressure and boys’ club type discussions.

But the criticism did not just come from men; many women are asking him to stop. That they don’t need a knight …

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How physicians can use Marie Kondo’s KonMari Method

Physician
February 2, 2019

Marie Kondo, the best-selling guru of organization and “sparking joy” has established the foundation of getting a space organized and functional. Her do-it-all-once method, known as the KonMari Method, is considered healthy and life-altering for those seeking organization and productivity in their space. One of the ideal places to organize is the home office especially for doctors, nurses and medical professionals who have reading, studying and research to do. You …

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How to write a physician CV

Physician
February 2, 2019

This article is sponsored by Careers by KevinMD.com.

Academic and education environments tend to use the word curriculum vitae, or CV, more frequently than resume. But, a CV’s purpose is the same: to get you a job.

Although a CV generally contains more information than a standard resume, the keys to a successful CV are still brevity and …

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A physician’s addiction to social media

Social media
February 1, 2019

For Apple iPhone users, the release of iOS 12 included a new feature called “Screen Time.” Although a number of productivity apps that offered a similar snapshot of phone usage were available before this update, I was never interested in quantifying my usage. Now, on a weekly basis, I get a reminder of the exact percentage breakdown of how I’m using my phone.

In true millennial fashion, a review of my …

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Direct primary care physicians are not concierge doctors

Physician
February 1, 2019

I recently received a scathing email criticizing an article I wrote about the care of patients in underserved areas. “Should you really even get to write articles about poor, underserved populations when you run a concierge practice?” the author wrote. “This is called hypocrisy. You are what is wrong with the medical field.”

What the author of this email didn’t know was that I spent six years working for the underserved …

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How to talk with a struggling physician colleague

Physician
February 1, 2019

My friend, Lello Tesema, and I were sitting in a restaurant in Harvard Square. It was the first, feverish bit of spring when it seems like the entire city has emerged en masse from their winter dens. We were sitting outside under patio lights, wearing regular clothes instead of our usual scrubs. I should have been happy.

As often happened in those days, I asked Lello if things were ever going …

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Reflections after a medical student’s first code blue

Education
February 1, 2019

We were in the middle of the morning routine – sign out between mouthfuls of eggs and homefries – when the call came in overhead, “Code Blue, 9 West.  Code Blue, 9 West.”  Just like that, our team snapped into action, the continued banter only thinly concealing a change in demeanor: backs straight, jaws set, we walked with a sense of purpose.  There was a life on the line.

By the …

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The growing role of end-of-life activists

Conditions
January 31, 2019

Brittany Maynard was diagnosed with grade 2 astrocytoma, a form of brain cancer on January 1, 2014, her cancer also returned in April 2014, where her diagnosis was elevated to grade 4 astrocytoma, also known as glioblastoma, with a prognosis of just six months to live. She decided to take lethal drugs prescribed by her physician to end her life on November 1, 2014, at her home in Portland, Oregon. Under Oregon’s “Death …

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The problem with abbreviations in the medical record

Physician
January 28, 2019

Several patients seen in our practice recently were significantly and dramatically transformed by the electronic health record (EHR). And not in a good way.

Take, for instance, the patient whose outside chart was reviewed when she showed up in our office for a follow-up appointment after an emergency department visit.

The notes from the emergency department providers, including a scribe and the …

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Should residency programs review their applicants’ social media history?

Social media
January 28, 2019

By now, I’m sure most of you probably have heard about the Cleveland Clinic first-year resident who was fired last September when it became known that in 2012 she had tweeted she would “purposely give all the yahood [Jews] the wrong meds …”

The website Canary Mission documented numerous tweets expressing similar thoughts. She has apologized but will likely have great difficulty finding another job as a physician.

This …

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6 things learned from being rejected from medical school

Education
January 26, 2019

I have spent the greater portion of my 20s enduring a premature quarter-life crisis. Patterns of self-doubt and debilitating anxiety became my new normal.

I was rejected from medical school — again.

After taking time to process the reality that I would have to wait another year to re-apply, I fervently journeyed through a messy jungle of introspection that led me to these six lessons. Although I learned more than I could …

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The conflict between pharmacists and their corporate superiors

Meds
January 24, 2019

Pharmacists play an essential role in today’s ever-expanding health care system today. They check for drug interactions, watch for signs of opioid overprescribing and try to determine whether a drug for one condition prescribed by one doctor will negatively impact the patient because of another diagnosis the patient has. In hospital units, their roles have become yet more complex — often serving on various quality committees, managing daily dosages of …

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Treat your family like you treat your patients

Physician
January 24, 2019

Many times during difficult patient interactions — when I am not sure about the right thing to do — I let myself be guided by the question: “What would I do if it was my family member?” This internal dialogue usually cuts the clutter and lets me focus on the most important thing: the well-being of my patient. I can step away from the behavioral chaos and guide them in …

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This physician chose not to do a triathlon. Here’s why.

Physician
January 24, 2019

I posted on social media that in 2019, I would compete in Ironman. I wanted to hold myself accountable and was announcing “I could do this.” My primary reason, so I thought, was that “I wanted to grow mentally and physically.”

Since then, I have been training six hours per week on top of my usual daily routine. I have been mentally and physically challenged in ways I didn’t think possible. …

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