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A paradigm shift in acute pain assessment and management

Myles Gart, MD

Meds

March 8, 2019

We have embarked upon a unique strategy to assess and manage pain. “Opioids Rarely Help Bodily Pain” is not a catchy phrase but a mnemonic related to educational learning which serves as the cornerstone of a new acute-pain management paradigm. As is known, the evaluation of pain is extremely difficult due to its subjective nature. However, this new evaluation not only accounts for the patients’ self-assessment but, for the first …

The commodification of health care is destroying the doctor-patient relationship

Jen Baker-Porazinski, MD

Physician

March 7, 2019

My elderly patients miss the days when, in an emergency, they could call their family doctor at home, and they’d be cared for. Retired doctors reminisce about the “good old days” when they were in charge of their own schedules and could prescribe whatever drug or test they felt necessary based on years of experience. While there was a strong doctor-patient relationship in those bygone days, it was not necessarily …

How self-awareness helps with patient interaction

Ton La, Jr., MD, JD

Education

March 7, 2019

What is self-awareness? A quick Google search says that it is “conscious knowledge of one’s own character, feelings, motives, and desires.” In other words, my worldview is different than yours. Hypothetically, I am a Republican, and you are a Democrat. You don’t believe in vaccinations, but I do. I believe in universal health care, but you disagree with my stance. You believe in stricter gun laws, and I don’t. That …

A key tip for premedical students: Ask for help

Sheindel Ifrah

Education

March 7, 2019

A simple Google search is all you need to do to gauge the difficulty individuals have with asking for help.

“How to ask to shadow someone.” 43.1 million results.

“How to ask for a letter of recommendation.” 66 million results.

“How to ask for help,” 3.73 billion results.

From the popularity of these topics, it is evident that people have a hard time reaching out and balancing coming across respectfully, but still receiving a …

To parents who have lost children: We never forget your children

Quinn Bensi, MD

Physician

March 7, 2019

Her name was Callie (identifying information changed). She was four years old. She loved glitter and princesses and anything sparkly. She was affectionate and silly, and I fell hard for her. She was a patient, my patient, on the pediatric oncology unit during my very first ward rotation intern year.

On my first day, I was as scared as any person can be, palms sweating, heart pounding, faced with these tiny, …

The most loving thing: end of life and saying goodbye

Jonathan Staloff, MD

Conditions

March 6, 2019

“Grandma fell and we’re in the emergency room. She’s very distressed and does not look good. I’m going to put the doctor on the phone.”

I could hear my mother’s voice strain on the other end of the phone line as I braced myself for my conversation with the emergency department physician.

The emergency physician told me that though the work-up was still developing, my grandmother was in respiratory distress, and that …

The reason so many physicians are retiring early

Valerie A. Jones, MD

Physician

March 6, 2019

There has been a disturbing shift in how medical professionals feel about their career. I almost cringe every time I’m at a party or social gathering now and tell people I retired early from my medical practice. I try not to bring it up.

I don’t cringe out of fear for how they will perceive me or whether they will look down upon me with condescending scorn about how I left …

Death by patient satisfaction

Rada Jones, MD

Physician

March 6, 2019

The new Holy Grail of business, Customer Satisfaction — CSAT to her close friends — is a measure of how products and services supplied by a company meet customer expectations. In a marketplace where businesses compete for customers, CSAT is a key element of strategy.

Why?

Money.

Satisfied customers buy. They come back and buy more. They tell their friends, who’ll buy too. If satisfied, they’ll return and buy more. That’s gold for …

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Death by patient satisfaction

How to help your doctor with diagnosis

Edward Hoffer, MD

Physician

March 5, 2019

To treat any condition, the doctor needs to know what it is. You would not expect to have your sore ankle treated with penicillin or to have an appendectomy recommended for your sore throat. While this may be self-evident, I know of at least one patient who had a normal appendix removed because the surgeon did not notice the few telltale blisters that were warning the careful observer that the …

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How to help your doctor with diagnosis

Physician Strong: a private practice journey

Talal Khan, MD

Physician

March 5, 2019

Being a primary care physician, I was afraid to start my own practice. There was discouragement from fellow physicians, hospital leaders, business colleagues, and even patients. Many said that the small practice model was not viable. With insurance mandates, mounting bureaucratic pressures from Medicare and Medicaid, increasing regulations by DEA, higher volumes of paperwork, and the health IT requirements, the task of setting up a private practice with primary care …

How physicians can develop their emotional intelligence

Carina Cezar Hopen, MD

Physician

March 4, 2019

If you’ve browsed the internet recently, you probably have noticed the #10YearChallenge social media trend that has taken over our news feeds. The phenomena have individuals comparing a current photo of themselves, to their former self ten years ago. As I thought about how well (or not) I’ve aged over time, it got me thinking about the two most important advice I would give my younger self (knowing what I …

What physicians can learn from anthropologists

Carolina Severiche Mena, MD and Matt Artz, MS, MBA

Tech

March 3, 2019

Since the passing of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009, it has been said that health tech would dramatically revolutionize health care and the patient experience. Advocates have claimed time and time again that it would advance disease diagnosis capabilities, improve patient outcomes, and increase patient satisfaction. Belief in this narrative can be seen in the sharp increase in health tech investments, with …

Physicians should talk about the F word: fertility

Melissa E. Parsons, MD

Physician

March 3, 2019

My fertility journey is not typical. I have not spent years “trying.” In fact, I have spent years trying not to get pregnant!

My husband has two daughters — and a vasectomy, so getting pregnant was a known challenge. Luckily, I like challenges. We went to an infertility specialist, who told us that reversal was not an option for us, and that IVF was our only option. A bunch of testing …

Non-medical transportation for postpartum moms is a necessity

Anirudh Prabu and Ishaan Shah

Policy

March 2, 2019

This past June, California’s Department of Healthcare Services went live with the implementation of its non-medical transportation (NMT) benefit. NMT is described by the National Health Law Program as “transportation provided to access medically necessary services, which is provided by ordinary forms of transportation (public transportation, taxi, or any other forms of public or private transportation).” While transportation as a benefit has long existed under California’s Medicaid program as …

5 tips for interns tackling a busy schedule

Abeer Arain, MD, MPH

Physician

March 1, 2019

The rotations on adult medicine and critical care are probably the most challenging ones for the residents doing internal medicine residency. No matter how much we try, we tend to feel overwhelmed, fatigued and swamped sometimes. As we progress into residency, we not only gain knowledge and clinical skills but also learn to tackle the challenges of a busy schedule. Below are some of the tips that might be helpful.

1. …

The tip of the iatrogenic benzodiazepine iceberg

Nicole Lamberson, PA

Meds

March 1, 2019

Life experience gives one an intimate appreciation for the meaning behind the saying “just the tip of the iceberg.” Everyone’s encountered something that turned out to be much larger and more complex than was initially understood. In my experience, medicine has yet to submerge its head underwater to discover the true depths of the sordid underside of what I’m calling the “iatrogenic benzodiazepine iceberg.” My own boat capsized on that …

A plastic surgeon explains the dangers of the Brazilian butt lift

Patrick Hsu, MD

Conditions

February 28, 2019

The Brazilian butt lift (BBL) is a procedure that enhances the buttocks through fat transfer. Excess fat is harvested from other areas of the body including the abdomen, hips, lower back and thighs through liposuction. BBL is a popular procedure for those seeking to enhance their bodies. However, with the recent reports of patient deaths from undergoing BBL, many have now labeled it as the most dangerous cosmetic procedure.

Dangers of …

Being a doctor and parent is hard: 10 ways to make it easier

Maria Perez-Johnson, DO

Physician

February 28, 2019

Being a doctor is hard; being a mother is just as hard — if not harder — and being both often seems impossible. Looking back at my medical career it is difficult to fathom not doing both. I was an older, non-traditional student when I came back to college to attempt to complete my prerequisites for entry to medical school. I had just had a baby a few months before …

A Xanax prescription that should have been rejected

Christy Huff, MD

Meds

February 27, 2019

In hindsight, I should have never accepted a Xanax prescription from my doctor. What followed was catastrophic — rapidly developing tolerance and physical dependence on the drug and a prolonged illness. Three-and-a-half years later, I am still slowly tapering off Valium (having transitioned to a longer-acting benzodiazepine to aid in tapering) and experiencing debilitating symptoms daily.

I was unprepared for what happened to me by my medical …

Physician negotiating: Go get what you’re worth

Barbara Hamilton, MD

Finance

February 27, 2019

Nearly five years into practice, I have negotiated my first contract, multiple pay increases, call compensation and independent contractor status. I prepared by researching my market value and reading about negotiation strategy. The following are some points I have learned along the way.

If you negotiate in medicine, you may feel like the only one.

Over the years, my mid-career colleagues confided that they have not received a single pay increase, only …