I swiped this editorial cartoon by Steve Sack from the redoubtable Dr. David Gorski’s blog, who goes by the nom-de-web of Orac. Recent epidemiology shows reducing the fraction of vaccinated children in the population rather promptly leads to a resurgence of the diseases vaccines protect against. This is the concept of community or herd immunity.
Epidemiologists debate the concept around …
The mythical unicorn of vaccine denialists
In Houston, all of my colleague’s offices are closed, and there is limited access to the Texas Medical Center due to Hurricane Harvey. As a virtual medical doctor, there was only one thought on my mind this entire weekend, “How can I help?”
As a Floridian, I have certainly faced my share of natural disasters beginning with Hurricane Andrew, a category 5 hurricane in 1992. Living through Hurricane Andrew gave me …
5 ways virtual doctors can help during a natural disaster
Recently, there have been many times when you may have gotten a news alert on your phone or checked the latest Twitter hashtag and wanted to scream. Or you were too busy to even check until later that day and did not know what to say other than to lurk and watch a train wreck in progress. You may have thought about saying something, but paused and wondered, “Is this …
Physicians: Use your voice to make the difference
A white coat ceremony address to the University of California, Riverside School of Medicine, August 4, 2017.
“It takes a village” is one of my favorite proverbs, an African proverb, that resonates with each of us on this monumental day. There is without a doubt that every one of you worked very hard to get into medical school. However, this difficult journey was supported by dozens of important individuals: teachers, …
The white coat symbolizes 2 important commitments
Reformers have expended considerable effort to change the way Medicare buys health care for millions of Americans, finding a wide range of support across the political spectrum. But Medicare’s current structure may doom these reforms. Some primary care doctors fear that the skewed incentives in Medicare’s pricing system will get built into any new system, whether it is “accountable,” “affordable,” or “value-based.” This fear is well-founded. If special interests buy …
Fix the pay imbalance between specialists and primary care physicians
When I finished my medical training almost sixty years ago, I was like many new graduates: I thought I knew it all.
I opened a private office in Los Angeles and paid courtesy calls on the local physicians to let them know my qualifications and my availability for consultation, as both an internist and a nephrologist. (The treatment of kidney disease was then in its infancy, and I was the area’s …
Good clinical care takes more than medical acumen
There is a definite finality to the decision of which specialty a physician pursues. The reasons are as vast as they are individual. Hopefully, the med student has done due diligence and has a solid grasp on what their future entails, at least for the future as far as anyone can confidently foresee. Here is my story.
1. Challenge. No day is quite like another, and life as an emergency medicine (EM) …
4 reasons to choose emergency medicine
“F*ck!”
I pried my eyes open and had the realization of exactly what time it was. I was going to be late — again. I jumped out of bed as fast as my stiff and weary body would allow, threw scrubs on I was mostly sure were clean, ran a brush through my hair so I didn’t look totally disheveled when I had to look like professional in a few minutes …
A surgeon makes a mistake, and couldn’t stop crying
An on-call weekend: 48 hours of being at any moment “on,” of being edgy, of being exhausted. This weekend included a full house of patients to see in the hospital, a patient list of three pages to be exact. As I went from patient to patient, room to room, each held its own unique story filled with the yin and yang of life. I realize too, this may be a …
48 hours in the life of an on-call gynecologist
“You find joy that people are doing better because of what you did for them.” #BornToHeal
Courtesy of the American Medical Association (AMA).
This resident’s childhood friend inspired him to help other children as a physician
Approximately 12 years ago, I hired my first physician in recovery. He had temporarily lost his license following a bout with alcohol. After a stint in a rehabilitation clinic, he was ultimately reinstated. My journey to hire this physician was arduous at best. During the interviewing process, I narrowed the field down to two candidates: one with a past and one without. I wrestled with the “in recovery” situation and …
Help me help doctors in recovery
Health care reform continues to make national headlines as Republican senators have failed to pass a bill in the Senate with enough support to repeal and replace the Affordable Care Act (ACA). How did we get here, and why do so many Republicans want to make the ACA go away badly? To answer this question, you have to first understand the history of health care reform in the United States …
A history of health care reform
Yesterday, we had a meeting about leakage.
No, it was not about urinary or fecal incontinence, but it was about care that could have been provided within our institution that ended up, for a multitude of reasons, happening with providers beyond the walls of our institution.
Representatives from our accountable care organization had requested a meeting to go over some issues they’ve been having with our practice, including low levels of usage …
Stop the patient leakage in primary care practices
I am an interventional pain physician. I spend most of my days doing spine injections with a fair amount of kyphoplasties and spinal cord stimulators thrown in as well. It seems to me that these are minor procedures that shouldn’t evoke anxiety in patients, but they do. Patients get nervous. They get anxious.
I am also a singer. I had the privilege of being classically trained through my college years. Like …
This doctor sings to her patients. And the results are beautiful.
I am a child psychiatrist who is also a patient, a mother of patients and the wife of a patient. I have lived all sides of health care and appreciate the complexity that is our American health care system. After a recent move to a different part of town, we decided to find a new pediatrician for our daughters.
I knew that we had several good options near our home. When …
A letter from a parent to her child’s pediatrician
The rise of the Internet has changed many things in the world of the customer. Now, in the age of the online consumer, a person can search for not only the exact item or service he or she wants, but read hundreds of reviews on that particular item or service. Thanks to Yelp and a host of other online rating sites, a person can find a reputable painter or contractor …
Online physician reviews: Patients are the ones who will suffer
As you look at the above image, please let me ask you a simple question: “What do you see?”
Do you see a sick man lying on a bed with a friendly looking doctor standing by his bedside?
Do you see only men in the picture and wonder, “Why not women?”
Do you see a clinical setting of an engaging sketch of a doctor and …
We look at the same picture but see different things
“He is the best physician who is the most ingenious inspirer of hope.”
– Samuel Taylor Coleridge
I was a third-year medical student on a Sunday morning when the reality of what I had chosen as my life career truly hit me in the gut. At that moment, I realized how intimate the practice of medicine was and that I would have to bring not only my brain and skills to work …
Doctors: Don’t emotionally detach
Hate your job? You may be in the right profession, but the wrong position for your personality. Want to love your life and career? Step one: discover whether you are an employee, a business owner or an entrepreneur.
Here’s how to figure it out:
Employees are risk averse and like to know the rules. They thrive on structure and predictability. They need clear instructions …
Doctors: Are you employees, business owners or entrepreneurs?
This is a tough post to write. I struggle with this issue daily. Is it OK for a physician to retire early? The obvious answer is: yes. Each individual should live their life as they see fit. But with a continued shortage of physicians (granted this is more in rural areas and not big metropolitan cities), and the time, money and resources required for training physicians, is it selfish to …
Is it OK for a physician to retire early?
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