Alexa Karsdan’s medical bill for a sore throat reached over $28,000. NPR told her story recently, but I want you to know why I am actually glad this happened. Why is it good news that her charges were so exorbitant, and that her insurance paid over twenty-five thousand dollars for one laboratory test? This story is a brilliant illustration of fundamental flaws in our health care …
Why this physician supports Medicare for all
The words of the year as 2019 ends appear to be “OK Boomer” and “woke.” To this Boomer, it appears that the younger generation is blaming us for all the evil in the world, from their perch of “woke” moral superiority. They consider us to be out of touch and over the hill.
According to Merriam-Webster, “woke” means “aware of and actively attentive to important facts and issues (especially issues of racial …
Why generations need to talk to each other
In my recent post, “Why Gratitude Is A Superpower,” I told the story about a thank you note that my daughter, Maya, left me one morning for making her coffee. I was literally overcome with warmth and appreciation.
My reaction demonstrates the real impact we can have on another person’s emotional state when we express gratitude — either verbally or written — for something (gift, assistance, help, …
Gratitude collateral: A little thanks can go a long way
“Death comes for all of us. It is our fate as living, breathing, metabolizing organisms. Dealing with the fact of death is unsettling. Yet there is no other way to live.”
– Paul Kalanithi, MD
Recently, first-year students of the medical and physician’s assistant classes completed their seventh and final practical exam in clinical anatomy. Through fifteen weeks, 117 students learned the structures of the human body organized by region, working from …
Ironically, our first assigned patient encounter as medical students would be a corpse
Kahlil Gibran writes, “In friendship or in love, the two side by side raise hands together to find what one cannot reach alone.” What types of outcomes can physicians and patients achieve in healing, living, and life when Gibran’s message is incorporated into the physician-patient relationship? Can humanism in medicine become even more humanistic?
“Humanism in medicine” is characterized by the Arnold P. Gold Foundation as respectful …
Making humanism in medicine more humanistic
I’ve just discharged a kid with a cough, and there are no patients waiting to be seen. “I’ll be back,” I tell the nurse, as I slip away to the hospital kitchen and unlock the door. I steal two frozen grilled cheese sandwiches from the freezer and throw them into the microwave. Minutes later, I’m in the call room.
I take a couple of bites and can already feel acid rising …
Beyond red flags: Beware of black butterfly warnings
Consuming too many potato latkes and Christmas cookies has left its mark on our waistlines. Unfortunately for Americans and their medical care, the seasonal overeating seems to last all year. Indeed, the American Medical Association has declared that obesity is a disease.
It may be more accurate to describe obesity as a contributor to certain diseases. Obesity raises the risk of premature death, heart disease, high blood …
Obesity is America’s self-inflicted preexisting condition
Americans are not fans of socialized medicine. Sure, some people want socialized health care payment, including many people who are fans of Medicare for all. But even most Bernie Sanders supporters probably aren’t in favor of socializing the entire U.S. health care system, thereby making hospitals and medical clinics into government property. Americans are proud of the high quality of care offered by non-government providers, from their local community …
Does socialized medical care provide higher quality than private care?
Anita is 37 with blonde, wild, disheveled hair. She is overweight, has bad teeth, wears too much make-up, and is severely depressed — sometimes psychotic. She tells me she often hears voices. And she constantly complains that the medicine she gets from our clinic (and she gets a lot), does not take the edge off her feelings.
She has severe anger and is in an anger-management group at our offices. Each …
Preceding traumas lead to current ones
First, you have to call up your daughter to pick you up and take you to the lab. It’s hard for the nurse to find your vein. The pain from his fishing around in your arm is not nearly as bad as the pain you always have in your hip, and back, and shoulders, but it’s the straw that breaks the camel’s back, and you cry a little bit. The …
A quick CT scan for the frail and elderly
I knew Friday was not going to be a good day.
A leak in the ceiling of my family room. A pet who would need surgery. I was already stressed well before Friday.
But at work, the issues started on Thursday with an osteoporotic patient for whom I had recommended Forteo, six weeks earlier. It was denied by her insurer who wanted Tymlos instead. No big deal. We simply precerted Tymlos, but …
Are physicians allowed to be human?
One of the largest problems in our ER, it seems, is that there is a subset of patients who visit us on a routine basis. Commonly known as “the regulars,” these familiar faces are sprinkled throughout our day between all our other patient visits. Whether it be for chronic pain, for chronic illness, for companionship, simply to have a place to hang out for a few hours, or to get …
This is a real problem in our ER. This is a real problem nationwide.
I, along with some others, take Presidents Day as an opportunity to celebrate the lives and contributions of all U.S. presidents. Amid the praise, however, perhaps I alone feel compelled to describe their skeletal maladies. I have gleaned the following information from several websites and books that carefully detail the reported injuries, diseases, bad habits, and addictions experienced by U.S. chief executives throughout their lives, starting with George Washington’s …
An orthopedic surgeon analyzes presidents’ skeletal maladies
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“Aren’t you happy for me?” asks the patient smiling from the exam chair in my office. I say yes, but that’s not entirely true.
Happiness isn’t the right word. Conflicted might be it. How do I reconcile my feelings when this patient, who I am not sure is deserving, reports that he was awarded Social Security disability?
Sure, he has severe arthritis, wildly uncontrolled diabetes, and a massive skin breakdown of his …
As we embark upon this new decade, many of us are committed to improving our finances. We may have vowed to stick to a budget or have a general goal to live below our means. While these are noble goals, let’s challenge ourselves to do even more. Here’s my six step-money challenge for 2020:
1. Buy 1 or 2 finance books to read. There are many different ways to …
A physician’s 6-step money challenge for the New Year
Prostate cancer is the second most common type of cancer diagnosed in men in the U.S. According to statistics gathered by the American Cancer Society, approximately 191,930 new cases of prostate cancer will be diagnosed in this country in 2020, with one in nine men at risk of being diagnosed with this cancer during his lifetime. While advanced or aggressive disease can lead to death from prostate cancer, most men …
How to manage the side effects of prostate cancer treatment
Egotism is a common trait among doctors, although most of us keep it under adequate control when dealing with patients. The ideal doctor-parent encounter has been described as a collaboration among equals, each of which brings expertise to the exchange; the doctor knows medicine, the parent knows the child. This is the ideal, although sometimes the reality falls short of it. The way our medical system is now structured gives …
What to do if your doctor is excessively egotistical
My uncle died last year. As physicians, we are all too familiar with death. Even if we are practicing primary care, we are touched by death and the line between life and death. That patient who had what statistically should’ve been acid reflux, but who you found to have stomach cancer. That breastfeeding mom who thought a little lump was a clogged milk duct, when it actually turned out to …
Why sometimes you need to be your family’s doctor
Karen smiled nervously, her swollen belly peeking out from under her stretched silver tank top. Six months pregnant with her first child, the eighteen-year-old had come to the WIC (Women, Infants, and Children) office for help with getting enough to eat. As a medical student with a background in nutrition advocacy and a future in pediatrics, I had asked to observe the WIC enrollment process.
Karen and …
If you asked me five years ago what my career goals were, I may have said something about getting more grant funding and writing more manuscripts so I could eventually become an independently funded physician-scientist. But honestly, at that time, I had no concept of the nitty-gritty details and emotional support that it would take to accomplish those goals. My primary research mentor was a notable figure in our field …
The power of peer mentorship in medicine
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