The fragile economics of America’s emergency departments

Conditions
April 2, 2020

On the front lines, America’s emergency departments (ED) are currently in at the center of a crisis treating patients with COVID-19.  Emergency physicians and other clinicians are placing themselves and their families at risk. Yet, there is also another important crisis facing hospital-based EDs: surprise billing legislation. Certain forms of surprise billing legislation have the potential have a substantial and negative impact on how America’s EDs are supported, and our …

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The fragile economics of America’s emergency departments

The doctor’s budget — remastered

Finance
April 2, 2020

About a decade ago, I had my first doctor-client. And part of what they wanted to discuss was budgeting in order to save more. They just got new jobs and wanted some general planning for the sake of making good decisions.

Software for budgeting and spending history didn’t exist the way it does now. I wanted to provide the best help I could on this topic, and I knew about budgeting, …

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The doctor’s budget — remastered

The world is a scary place right now, and that’s OK

Conditions
March 30, 2020

As a society, we are faced with levels of uncertainty that are unprecedented for our times. This tension and fear doesn’t discriminate and permeates every corner of the globe.

People might compare the magnitude of this pandemic to events like 9/11 or Hurricane Katrina, but that misses a key element. The disasters we have lived through in our lifetimes up until now were, of course, tragic and devastating in their own …

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The world is a scary place right now, and that’s OK

The ethics of being a doctor on board

Physician
March 30, 2020

It was Christmas Eve, and where most people are home with their families, residents are all too familiar with spending holidays inside the hospital. As such, I was traveling back to Austin for an early morning shift on hospital service, when I encountered an ethical dilemma that has stuck with me since.

A mere 20 minutes after the plane took off, I heard the dreaded words: “A passenger requires medical attention. …

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The ethics of being a doctor on board

Choose not what’s easy, but what is right

Conditions
March 28, 2020

“Dark times lie ahead of us, and there will be a time when we must choose between what is easy and what is right.”
– Albus Dumbledore

After Voldemort’s return in Harry Potter and The Goblet of Fire, the students of Hogwarts are faced with much fear and uncertainty. Suddenly a future that many had envisioned – progress through school, graduate, find a job – was no longer as straightforward as it …

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Choose not what’s easy, but what is right

Grieving the end of life experience from an ICU nurse

Conditions
March 28, 2020

The image of patients dying in the intensive care unit is changing. Over the phone, family members cry on the other end as I tell them that we are not allowing visitors due to “the coronavirus” at this time. They tell me, “but I help make his decisions for him.” These decisions now have to be made over the phone.

This is just what we have to do to keep society …

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Grieving the end of life experience from an ICU nurse

Relax documentation requirements during the COVID-19 pandemic

Conditions
March 27, 2020

The Centers for Medicare & Medicaid Services announced several measures guiding the care of patients during the current COVID-19 pandemic. Another important action that will immensely help the health care workers at the forefront is to reduce the documentation requirements for all patients. Health care workers should be unshackled from endless documentation, freeing up their time and resources to take care of the increasing number of …

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Relax documentation requirements during the COVID-19 pandemic

In the midst of COVID-19, triage is a four-letter word

Conditions
March 27, 2020

In my career as an outpatient family physician, triage is not something that I commonly do. But now, with the COVID-19 pandemic in full swing, it seems the large percentage of my day is spent in triaging patients. And I have to say, I don’t really care for it. (This is an understatement. I’m trying really hard not to use other four-letter words in describing how I truly feel.)

In my …

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In the midst of COVID-19, triage is a four-letter word

COVID-19 is rattling the nerves of preemie parents everywhere

Conditions
March 27, 2020

As I write this, hand sanitizers, disinfecting wipes, gloves, and masks are sold out everywhere in the panic over COVID-19. People are writing about increased anxiety, and mental health professionals cite a massive surge in requests for help.  Go anywhere, and it is not unusual to see people wearing personal protective equipment. Welcome to my world 16 years ago when my daughter was born prematurely at 30 weeks’ gestation …

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COVID-19 is rattling the nerves of preemie parents everywhere

Mental health and college students: What parents can do to support their children

Conditions
March 27, 2020

The percentage of U.S. college students who are living with mental health issues, including depression, anxiety, eating disorders, substance, and alcohol misuse, and self-harm are significant. Approximately 39% of college students experience a significant mental health issue. The 2018-2019 Healthy Minds study found that:

  • 36% of the random sample of students from colleges and universities across the U.S. who answered the study’s web-based questionnaire had experienced mild, moderate or major …

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Mental health and college students: What parents can do to support their children

5 things that should change in medicine after COVID-19

Conditions
March 26, 2020

As I sit here nervously reading the news and awaiting my next shift at the hospital tonight, I cannot help but wonder what the world will look like when the coronavirus pandemic passes. While I cannot predict when this will be, or how much more damage this outbreak will cause, I do know that medicine will never be the same. Here are some thoughts on what could change and the …

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5 things that should change in medicine after COVID-19

I’m a physician and I’m not a hero

Conditions
March 26, 2020

Upon walking through the revolving door that guards the hospital’s main entrance, I was ushered by security staff to join the queues of my peers, also seeking passage to their respective posts.

“The new policy,” the officer explained, examining my hospital ID to confirm that I am, indeed, an employee. Visitors are no longer allowed.

“Please sanitize your hands,” another instructed me, as he pointed to the neat rows of surgical masks …

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I’m a physician and I’m not a hero

Lack of professional and personal financial literacy is a primary driver of burnout

Physician
March 26, 2020

Physicians are, without a doubt, some of the most educated professionals around. You spend endless hours studying, taking tests, and jumping through academic hoops in the name of good grades and patient care. But is the education you are receiving truly preparing you for the practice of medicine today?

Health care is now considered almost exclusively a business term. And yet there is a lack of business taught in medical school. …

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Lack of professional and personal financial literacy is a primary driver of burnout

Physicians are disposable and are taken for granted

Conditions
March 25, 2020

Doctors are begging the public for basic protective equipment.  Us. The United States of America. Supposedly the most advanced, most privileged nation in the world.

We are in a pandemic dumpster fire. There has been no centralized movement to tackle this escalating threat.  Every hospital, city, county, and state has been left to flounder on its own. I’m not the only one who’s noticed we’re completely floundering, right?  Doctors …

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Physicians are disposable and are taken for granted

5 ways to manage anxiety during the coronavirus pandemic

Conditions
March 23, 2020

Since the coronavirus outbreak, reports of anxiety have increased, especially among physicians. Physicians face numerous stressors, including fears of contracting the coronavirus, concerns about potentially infecting loved ones, PPE shortages, testing delays, and frequently making quick decisions with limited information.

Common symptoms of anxiety are increased worrying about one’s self and/or loved ones, difficulty sleeping, difficulty eating, poor concentration, increased heart rate, hyperventilation, and struggling to control worrying.

Here are five ways …

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5 ways to manage anxiety during the coronavirus pandemic

Interested in locum tenens? Beware of fees.

Physician
March 22, 2020

Eighty-five percent of health care facilities used locum tenens temporary doctors in 2019 to address their staffing shortages or gaps in coverage.

Physicians are turning to locum tenens work to allow them more flexibility, extra income, the ability to travel, and exposure to new and evolving patient care environments. But what they are likely not aware of is the price tag on their heads if or when they decide to consider …

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Interested in locum tenens? Beware of fees.

Advice to employed physicians plunging into telemedicine

Conditions
March 21, 2020

As we have literally overnight plunged into the world of telemedicine, I wanted to caution everyone to stop and think about something.

As an avid telemedicine provider, I truly believe in helping support our patients and the public. However, if anyone is an employed physician or medical provider, please keep reading.

If your practice did include telemedicine before, this may be a non-issue. But if it didn’t, you need to ask these …

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Advice to employed physicians plunging into telemedicine

This doctor was called a bitch at work. Here’s what she did next.

Physician
March 21, 2020

As I hug my younger daughter’s little head at school drop-off, the calming aroma of her hair fills me with peace. She scurries across the schoolyard toward her 2nd-grade classroom, her big backpack bouncing up and down, seemingly with its own agenda and dwarfing her tiny frame. As soon as I leave the school, my focus switches.

I’m at the edge of my patient’s hospital bed, reviewing the day’s treatment goals. …

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This doctor was called a bitch at work. Here’s what she did next.

How death is a blessing and a burden

Education
March 21, 2020

Our goal in medical school is to learn how to preserve the quality of life. Yet, in order to better understand human life, we are immediately faced with death by means of anatomy lab.

From week one, we are tasked with removing the skin and fat from a cadaver’s thorax — desensitizing ourselves to death enough so we may cope with dissecting someone’s beloved mother or adored husband. It’s difficult not …

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How death is a blessing and a burden

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