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A physician got a DUI. The physician health program didn’t help.

Anonymous

Physician

December 11, 2019

A physician health program, PHP, is a state agency that is responsible for advocating, treatment referral and physician monitoring, residents and medical students who have substance abuse disorders, psychiatric disorders and/ or boundary issues. There are two ways of becoming a part of these programs, self-referral or be reported. Currently, 47 states have a PHP, and the issue is that there is no set guideline and several variables in the …

Medicare for all advocates are in for a rude awakening

Talal Khan, MD

Health Policy

December 11, 2019

Migrating to the U.S. as an international medical graduate, I was shocked by the health care culture of excess. Initially, it felt good to order a CT scan on everyone who had a fall or cardiac enzymes on anybody who had atypical chest pain. I felt powerful and light years ahead of the system I left behind, where you would have to very cautious about ordering diagnostic tests as, mostly, …

Acting as supreme commander is not leadership

Karyn P. Grant

Physician

December 11, 2019

Your medical training has failed you. When it comes to leadership, acting as the supreme commander — large and in charge — is not solving your problem.

You are racing from patient to patient, running as fast as you can to keep up. You see your income falling while your workload increases and the joy you used to derive in helping people to live healthier lives evaporating. How much longer can …

Taking food and drink away from doctors and nurses is just cruel

Edwin Leap, MD

Physician

December 10, 2019

It’s hard to explain what we do. And so maybe, it’s hard for others to sympathize with our situations. I mean, physicians, mid-levels, and nurses in emergency departments are tied to computers in often cramped work-spaces, even as they are required to be at the bedside almost constantly for the latest emergency or (in other cases) the latest bit of pseudo-emergency drama.

If you haven’t worked there, or haven’t for a …

A letter to a cancer patient in palliative care

Alison Vasa

Medical Education

December 10, 2019

I heard about you a few times before I ever met you in person. It was my first day on the palliative care service — a week that felt like a relaxing break from the sixteen-hour days I was used to on surgery. Many people don’t know what palliative care is. But I suspect these days if you are still living that you know it well.

I first heard of you …

Is there a link between readmission and a hospital’s non-profit status?

David Lozar, MD

Health Policy

December 10, 2019

It was the middle of winter in downtown Chicago in 1995, and I was sitting across from an apologetic alcoholic holding a slimy NG tube. Mr. Smith, an emaciated man in his sixties, had been on my service for three days with acute pancreatitis, and this was the fifth nasogastric tube that had “slipped” out of his nose.

Subsequently, his morning labs were just as bad as they had been on …

Negotiating lower drug prices in America: The tradeoffs are worth it.

Konye Ori

Health Policy

December 10, 2019

Negotiating lower drug prices in America could possibly stifle pharmacological innovation. But it would reduce health care cost for most Americans — and that should be all that matters.

If the United States began to regulate drug prices, medications would become cheaper, and Americans would have more access to drugs with lower health care costs. If bills like S.99 – Medicare Drug Price Negotiation Act (MDPNA) ever passes, it would permit …

The climbing rates of maternal mortality in Black women

Shani R. Scott, MD

Health Policy

December 9, 2019

To put it simply, I’m scared by news headlines and conversations about the climbing rates of maternal mortality among Black women. I’m not surprised, however. As an internist, I regularly marvel at the advances that have been made in Western medicine, yet I pause and wonder why, in our profession, we continually get this mortality issue wrong.

The conversation about the state of Black women’s health has reached a …

The gender imbalance in nursing

Cole Edmonson, DNP and Paulette Anest, RN

Health Policy

December 9, 2019

The gender imbalance in nursing, our nation’s largest profession, is a slow-to-change and complex problem steeped in stereotypes, economics, unconscious bias, power, and privilege in health care and society. Along with other diversity gaps in the nursing workforce, gender imbalance is another missing piece to achieving the highest quality patient care. Solving the gender imbalance could accelerate the profession in reaching its full potential.

Diversity improves quality

Addressing the gender gap represents …

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The gender imbalance in nursing

Aging out of being a physician

Kathryn Borgenicht, MD

Physician

December 9, 2019

My brother and I are both physicians. He is a pediatrician; I am a geriatrician and palliative medicine doctor. We are both getting older.

My brother has been a practicing pediatrician for almost 50 years. He had a remarkably successful solo practice in the city where he lived. He recently retired but continued to work at a free clinic several days a month. When it became time for him to renew …

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Aging out of being a physician

3 tips for physicians to become better leaders

Candace Good, MD

Physician

December 9, 2019

My 20-year medical school reunion was a time to reflect: Have we aged more gracefully than medicine? The Class of 1999 carried books and wore pagers while scrambling to gather paper charts for rounds. Residency did not prepare us for the explosion of managed care, EHRs, health systems, and allied health providers. What do I wish I knew then? The hardest part of medicine isn’t becoming …

How generations can learn a lot from each other

Michael Kirsch, MD

Physician

December 8, 2019

In our office, sometimes our secretaries listen to background music. A few days ago, while walking through the office, I heard an iconic song, written and performed by a songwriting legend. Even someone like me, who was never deep into the music scene, automatically recognized the song. I asked our receptionist, a young lady in her 20s, if she knew the song that was playing. She didn’t. I identified the …

Doctors: Fight for your role as our physicians

Michele Luckenbaugh

Patient

December 8, 2019

You are there to help bring a new life into the world, comforting and reassuring new parents.

You are there in the middle of the night to return a call to a distraught mom whose child is running a high fever and is panicked.

You are there to encourage and instruct a diabetic heart patient who wants to make changes in his life and who looks to you for guidance.

You are there …

Gun violence is a public health crisis

Ton La, Jr., MD, JD

Health Policy

December 8, 2019

Every day, 100 Americans are killed with guns. Forty-four percent of American adults report knowing someone who has been shot.

As a society, we have come to accept gun violence as commonplace and not something to take immediate action on. We hear about a new mass shooting on the television, on social media, on the radio or from a friend. We shake our heads in disbelief, ponder on how this is …

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Gun violence is a public health crisis

Sometimes, medicine isn’t elegant

Nana Dadzie Ghansah, MD

Physician

December 8, 2019

“The hospital room was as cold as dead skin, the hallway crowded with lost souls and reeking of illness.”
― Raquel Cepeda, “Bird of Paradise: How I Became Latina”

Once upon a time, I met a young lady who wanted to be a doctor. I could see the naked determination and resolve in her eyes. Her older sister, who was a friend, asked her to talk to me about her dream.

I asked …

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Sometimes, medicine isn’t elegant

How physicians can become self-actualized

Navpreet Sahsi, MD

Physician

December 7, 2019

What really makes a person complete?

What do we want in our lives, and what is it like to become our best, most fulfilled selves?

In the 1960s, psychologist Abraham Maslow tried to answer this question. This eventually led to his well-known hierarchy of needs. You might be familiar with the pyramid.

The premise of the theory is that once we fulfill our basic needs …

Why are we failing to solve burnout?

Baird Brightman, PhD

Health Policy

December 7, 2019

How would you make sense of the following vignette:

Over a 40-plus-year period, a disease (“X”) is diagnosed, its causes are defined, and effective treatments are prescribed
30-50+ percent of people working in your organization are currently suffering from X and cry out for relief
The stakeholders in your organization not only fail to apply best practices for preventing/curing X; they actually enable the drivers/vectors of the epidemic to intensify

As …

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Why are we failing to solve burnout?

When patient advocacy fails

Emily Gesner, DNP, RN-BC

Patient

December 7, 2019

Access to care, patient advocacy, health disparities: These are all buzzwords in health care now. We, as health care providers, understand that we must do the best for our patients in the hopes of providing a positive outcome. So, despite our perceptions that we may be doing a good job, we may find ourselves in a bad position. Or worse, causing significant pain to those we have vowed to protect.

I …

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When patient advocacy fails

MKSAP: 79-year-old man with progressive malaise and weakness

mksap

Conditions and Diseases

December 7, 2019

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 79-year-old man is evaluated for a 2-month history of progressive malaise and weakness, aching bilateral shoulders and hips, and stiffness for 2 hours in the morning and after immobility. He recently noted aching in his jaw when chewing. He also reports new left-sided headaches. Last week he had …

5 tax moves physicians should make before December 31st

Cory Fawcett, MD

Physician Finance

December 6, 2019

As physicians, we find ourselves in higher tax brackets than the majority of Americans. With the graduated tax system here in the U.S., the more we make, the higher the percentage of taxes we owe. That is not just because of the tax brackets, but also because many tax write-offs are phased out as income climbs, creating a compounding effect.

There are things we can do to decrease our tax burden. …

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