I’m being sarcastic, of course, but that’s often how it seems some days. Those are days when I’ve been busy at patients’ bedsides all day and then struggle to get my documentation done later, typically many hours later. I jot notes to myself as I go along, but it can be hard to recall at 5 p.m. just what I did and why at 8 a.m.
It used to be very much the …
Don’t let patient care interfere with documentation
The answer to physician burnout is purported to be resilience training. That’s like glorifying the natural ability of frogs to tolerate gradually heating and boiling water.
Unfortunately, health care today has some toxic ingredients, and physician burnout is directly related to them. Some forms of resilience training I have been exposed to are no more than mental escapes away from medicine, such as art, music, and personal relationships.
Those types of activities …
The answer to physician burnout isn’t resilience training
It seems that all day, every day, I care for patients who simply won’t take care of themselves. And I sometimes think that we in emergency medicine have caused more harm than we expected.
Now let me first say, I also take care of those who can’t care for themselves. There are those who, through age, infirmity, or poverty, simply have no means. The patient with a chronic condition who can’t …
What has emergency medicine wrought? Helplessness.
Dr. Wesley Boyd, an associate professor of psychiatry at Harvard, has spent years working with state programs that help doctors, nurses and other health care workers who have become addicted to opioids get back on their feet professionally.
He supports these non-disciplinary programs, in which doctors and nurses enroll for a number of years and are closely monitored by addiction specialists and state authorities as they seek to maintain or restore …
What’s the best way to treat doctors and nurses with drug addiction?
During one long ago very hot Washington, DC summer, at the suggestion of my parents, I enrolled in a typing course that was given at our elementary school.
This was the summer between sixth and seventh grades, and there were lots of things I would’ve preferred to have been doing, but my dad, who started out in advertising, felt that touch-typing …
The keyboard is the sworn enemy of physicians
The water continued to rise as the rain pounded Marsh Harbor, a town on Abaco, one of the 700 islands of the Bahamas archipelago. Hurricane Dorian plodded along, nearly slowing to a stop directly over their meager homes. The rain and wind continued to lash their wood and aluminum dwellings, but the real threat came from the sea. Changes in climate mean the ocean started higher than it did only …
A physician is on the scene in the Bahamas after hurricane Dorian
There is a haze lurking overhead clouding rational thinking. Thoughts wander back to times when my body was unencumbered, and I felt nothing was out of my grasp. Maybe that was an unrealistic thought, but it is how youth and inexperience protect one from the somewhat harsh realities of growing older.
Coming to terms with chronic health conditions is perplexing. There are days when everything goes just right. The sun is …
Doctors, do you really understand?
Having been an improvement advisor with many quality improvement initiatives and collaboratives, I have observed that stories about successful initiatives too often leave out major relational barriers that got in the way as well as the critical interventions necessary to overcome them.
That important details about relational challenges so often remain hidden is not a small problem. Evidence points to relational issues as a major cause of lack of expected success …
Here’s why health care innovations stay secret
I was in a discussion with a group of patients about how difficult it is for patients to get access to their own medical records. It was initiated after one of my patients was refused copies of her recent hospitalization. There is much confusion out there about who actually owns the record and how it is allowed to be accessed. Most people are aware of HIPAA, the regulation set into …
Who actually owns your medical records?
The bootleg medications were smuggled across the border and sold to mostly Latino immigrants in public spaces throughout Los Angeles — at swap meets, parks, beauty salons and makeshift stands outside mom-and-pop grocery stores.
The drugs were cheap, and the customers — mostly from Mexico and Central America — did not need prescriptions to buy them. Some of the products featured brand names and colorful packaging that immigrants knew well from …
Black market pharmaceuticals target immigrants
“The value of experience is not in seeing much, but in seeing wisely.”
– Osler, “Aequanimitas”
Recently, my family and I were leaving a restaurant, and in so doing, we crossed a large parking lot filled with a seemingly endless number of pebbles. My youngest daughter, whose hand I was holding, suddenly pulled away from me. I stopped short, about to reinforce with her the importance of holding hands in the parking …
In medicine, find the beauty in what is common
EMTALA is born
The machine beeps alarmingly as it breathes for your child. The various numbers on the monitor are foreign to you, but you know something isn’t right because the nurse briskly walks away from the stretcher to grab the doctor, who then orders more medication and makes adjustments to the machine. The beeping stops, and the anxiety eases from the staff.
The official in business clothes — standing next to …
An important health care safety net is at risk
A recent article in Modern Healthcare describes how private equity firms are starting to snatch up specialist physician groups that promise rich revenues, such as orthopedists, dermatologists, and ophthalmologists.
Naturally, this is about adding value, not adding to bank accounts. Because whether it’s physicians or hospitals, health insurers or drug companies, no one in health care ever does anything except in the best interest of patients.
The Modern Healthcare …
Your bone fracture, my cash flow: the consequences of private equity in health care
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In the early evenings after work, I thoroughly enjoy taking brisk walks. Walks are a great opportunity to exercise, of course, but I also cherish making time for myself to process the many thoughts that can occupy the mind of a busy physician. My walks are typically the only time of the day when I can quietly meditate, ruminate, prioritize concerns, or simply restore my soul.
As I walk, I get …
How emotional intelligence makes you a better physician
I was driving to work one morning, and as part of my new routine, I listen to The Moth podcast. If you do not know it, it’s a wonderful community of storytellers — compelling stories, told by people from every walk of life. I often find myself drawn into the program (like a moth …
When patients die, physicians mourn as well
About once or twice a day, everyone on our hospital’s computer network gets an emergency message that scrolls across the bottom of our screens, highlighted in the colors of danger and warning.
They include things like a notification that a particular data system is down and that a backup on paper will have to be used for documentation, or the hospital …
How pneumatic tubes symbolizes our health system
With August recess at a close, Congress has yet to find a solution to end balance (or “surprise”) billing, where patients are charged the remainder of their medical bill for out-of-network (OON) expenses not reimbursed by their health plan. About the only compromise for-profit health insurers, hospitals, and physician groups can agree on is that patients should be taken out of the middle, but they can’t agree on how.
Physician groups …
Let’s end surprise billing without a Trojan Horse
Artificial intelligence is incredibly buzzy in health care right now, and for a good reason. Other industries are already experiencing AI-enabled radical transformations, like real-time fraud monitoring and detection in banking and finance and instantaneous image recognition across the web and social media. Health care now stands similarly positioned to capitalize on the transformative power of machine learning, and the massive potential is driving levels of investment expected to Read more…
It’s time for AI-enabled solutions in health care to live up to their buzz
In his article, “Medical education needs to stop burning out students — now,” Augustine Choi suggests the culture of medical education is responsible for increasing numbers of depression and burnout among medical students, and suggests that more programs are needed to address self-care and wellness in order to build resilience.
While I agree that mental health treatment should be readily available and easily accessible to those in …
To extinguish burnout, bring back physician autonomy
Despite more than a dozen years in medical school admissions consulting, I still clearly recall a bright advisee who had improved her grades considerably throughout her college career. But I, unfortunately, had a less than stellar freshman transcript. After calculating her AMCAS GPA with me, she lamented, “I feel like my grades are a criminal record.” In a twisted way, she was right — she couldn’t erase the grades.
But she …
Made mistakes? How to spin them for your medical school applications.
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