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A retired physician wonders whether to rejoin the fray

Conditions and Diseases

March 26, 2020

Many moons ago, in the 1970’s era, when no imposition from physically brutal on-call schedules to laudable scut to demeaning attendings was outside the boundaries of the house staff training curriculum, our leaders informed us that we were being introduced to the worst-case medical environment. That familiarity with setting aside our own creature comforts would enable us to save patient lives when the circumstances demanded our resilience.

Not quite two years …

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

Meagan Vermeulen, MD

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. …

The many firsts of coronavirus

Simran Malhotra, MD

Conditions and Diseases

March 26, 2020

We are health care workers. We are doctors, advanced care practitioners, nurses, pharmacists, social workers, and so much more. We are on the frontlines. We are our parents’ children, and we are parents to our young children. For the first time, we are at an extremely high risk of being quarantined by the same beast we are trying to conquer. We are experiencing moral distress, guilt, and frustration, knowing our …

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The many firsts of coronavirus

COVID-19 and the power of prayer

Louis Profeta, MD

Conditions and Diseases

March 25, 2020

Prayer is a funny thing. I guess it’s like an N95 protective mask to guard you against COVID-19. You don’t realize how valuable and precious it is until you’re without it, and sadly we are all running low. For the past 25 years of my career as an emergency physician, I bet my partner Dr. Jaime Harper and I have passed by them on the droplet isolation precaution carts a …

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COVID-19 and the power of prayer

Now is not the time to vilify doctors

Jenny Hartsock, MD

Conditions and Diseases

March 25, 2020

Doctors used to be heroes. We used to be universally respected. Our opinions used to mean something. And now? Now the president of the United States goes on live TV and vilifies us. Pointing the finger, shifting the blame to us as the reason you can’t go to the bar and watch the game, or go to Disney World, or get drunk every day on spring break at the beach. …

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Now is not the time to vilify doctors

The next pandemic will be in mental health

Najma F. Hamdani, MD

Conditions and Diseases

March 25, 2020

I had my first full day of telemedicine today. Telemedicine is my happy place. For the last two years, I have provided telepsychiatry for a rural facility in my home state. I had the privilege of talking to my patients in their homes today. I was beyond humbled that my patients embraced the change with me and invited me into their homes. As I saw them in their homes …

How Ebola prepared me for the COVID-19 pandemic

Jeri Sumitani, PA-C

Conditions and Diseases

March 25, 2020

I decided to write this note because I am grieving. I am grieving for those infected and affected by the coronavirus pandemic, of course. But the deepest grief I feel right now is for my fellow healthcare workers who I know will be going through their toughest days in the next few months. I hate that so many of you will be forced to go through this experience, …

Physicians are disposable and are taken for granted

Anonymous

Conditions and Diseases

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 …

An urgent dispatch from the COVID-19 frontlines

Amy Cho, MD, MBA, Mark Pappadakis, DO, Theresa Tassey, MD, MPH, Sunny Jha, MD

Conditions and Diseases

March 25, 2020

We are physicians. We are experts at triaging and prioritizing action. Our decisions mean the difference between life and death. We regularly balance competing interests in the setting of constrained resources. We fight hard for our patients. Our job has been likened to “walking through minefields in clown shoes.” It breeds humility. If we make a bad decision, the unthinkable happens. And we are frequently reminded of the fragility of …

The pandemic is bringing us home

Anonymous

Conditions and Diseases

March 25, 2020

It began last week in our neighborhood, between the locals, who, out for a breath of fresh air, and dutifully in line with the new social distancing rules, began to shout back and forth through the crisp March air.

“Good morning! I hope you’re well!”

“Good morning! We’re well! I hope you are, too!”

Then goodwill took over the neighborhood email chain.

Who needs a casserole?

Just let us know! We’ll drop one off at …

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The pandemic is bringing us home

Who are truly non-essential during the coronavirus pandemic?

Lauren Das, MD

Conditions and Diseases

March 25, 2020

In light of the COVID-19 pandemic, people across the country are grappling with the question, “What and who is essential?” Instructions to reduce non-essential activity hit differently in crisis compared to our normal mindset that our day-planners are scheduled with only crucial tasks. When suddenly gyms, churches, and restaurants close their doors, one must reflect on what is truly indispensable.

This hits home in my field …

COVID-19 has urgently summoned telemedicine to the front lines

Ashwini Bapat, MD and Emeric F. Bojarski, MD

Conditions and Diseases

March 25, 2020

For thousands of years, medicine was an in-person enterprise. Patients with mysterious symptoms or requiring complex interventions traveled days to obtain an expert opinion. At times, Medicine appears to be nostalgic for these days now past; as society braces for the advent of 5G, many of us in medicine communicate via pager and landline telephones. The potential of telemedicine – the use of technology to remotely deliver patient care – …

Leading your medical practice through crisis

Amy Anderson, MBA

Conditions and Diseases

March 25, 2020

The conversations we’ve had with physicians this week confirmed that the primal fight-or-flight response has kicked in as physicians across the nation recognize the COVID-19 pandemic as an imminent threat to the survival of their practices. Some are reacting from a place of fear, while others are proactively evaluating options and making strategic moves.

In surgery, there exists a time-honored adage: all bleeding stops eventually. When a patient has unexpected severe …

The aftermath of a suicide attempt

Raymond Abbott

Conditions and Diseases

March 25, 2020

In November each year, I usually attend an all-day conference in Louisville on the subject of depression. Some of it can become a little grim, but there is an especially tasty free box-lunch that I appreciate.

Suicide is a big subject at depression conferences. One might expect this to be true. The focus is on suicide prevention, which is as it should be.

The discussion is usually led by university professors, and …

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The aftermath of a suicide attempt

In the midst of a pandemic, remember that physician practices are small businesses too

Nisha Mehta, MD

Conditions and Diseases

March 24, 2020

These days are getting harder.

Today I heard about physicians getting intubated. I heard about physicians having to make the decision to separate from their children indefinitely. I heard about health care workers who officially ran out of PPE. I heard of hospitals that are nearing capacity and many young patients who are intubated. The calls for help at the frontlines got more desperate.

Over the last few days, I’ve also heard …

Why toilet paper? A doctor tries to explain.

Rada Jones, MD

Conditions and Diseases

March 24, 2020

I roll in my bed, unable to sleep. I listen to BBC talk about the craziness that took over the world, preoccupied with this one question.

What question?

It’s not: “Why, Corona?” For that, I already have more answers than I want.

Scientists say that COVID-19 is an animal virus. It spread to humans from bats or pangolin due to close proximity in a seafood market, much like its older siblings SARS and …

It took a pandemic to realize the value of telemedicine

Hans Duvefelt, MD

Conditions and Diseases

March 24, 2020

It took a 125-nanometer virus only a few weeks to move American health care from the twentieth to the twenty-first century.

This had nothing to do with science or technology, and only to a small degree was it due to public interest or demand, which had both been present for decades. It happened this month for one simple reason: Medicare and Medicaid started paying for managing patient care without a face …

An anesthesiologist’s message to her community

Sasha K. Shillcutt, MD

Conditions and Diseases

March 24, 2020

I am an anesthesiologist who practices in Omaha, Nebraska at a large university. Our institution is preparing around the clock to care for our community in the midst of the COVID-19 virus. We are all coming together – doctors, scientists, nurses, technicians, administrators, therapists, and staff to develop plans. Leaders are not sleeping; they are working. We are all preparing. Reading. Staying up to date. Trying to learn from our …

My first question every time I see a new patient now is: Could this be COVID-19?

Nicholas Johnson, MD

Conditions and Diseases

March 24, 2020

Inside, as usual, patient beds are near capacity, and the emergency department is filled with not only the usual mix of patients with trauma, stroke, chest pain, and other concerns, but also dozens of people worried they might have COVID-19.

I am an emergency and critical care physician who cares for patients in the emergency department and intensive care units at Seattle’s Harborview Medical Center, a public hospital with 413 beds …

Health care workers are heroes

Suneel Dhand, MD

Conditions and Diseases

March 24, 2020

I spent the last week working in a large community hospital in a state with a soaring number of coronavirus cases. I previously had a few days off while this whole situation was escalating, and heard from colleagues that our hospital was taking huge measures to prepare for the onslaught. New protocols were being put in place, there was a scramble for personal protective equipment (PPE), and the hospital had …

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Health care workers are heroes

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