An excerpt from Hindsight: Coming of age on the streets of Hollywood.
During my medical school clerkships, an attending recognized a truth within me that I’d hidden for many years. Just a few hours into my pediatrics rotation, the attending asked me, “You had a rough childhood, didn’t you?”
I was astonished. How had he known? I asked him, …
The story of how a homeless teen became a physician
As calls for radical health reform grow louder, many on the right, in the center and in the health care industry are arguing that proposals like “Medicare for all” would cause economic ruin, decimating a sector that represents nearly 20% of our economy.
While exploring a presidential run, former Starbucks chief Howard Schultz called Medicare for all “not American,” adding, “What industry are we going to abolish next — …
Medicare for all will kill jobs. But it may be necessary.
Recently I had the wonderful, yet solemn opportunity of attending my ninety-three-year-old paternal uncle’s funeral. I purposely choose the word “wonderful” to describe this experience because honoring the life of such a remarkable man, surrounded by my family who will continue to love him dearly, was such a special gift. Amid today’s increasingly complex world of business and “social” media, it is often a challenge to pause, to reflect, to …
Compassion is never a sign of weakness. It’s a sign of greatness.
Society gives short shrift to older age. This distinct phase of life doesn’t get the same attention that’s devoted to childhood. And the special characteristics of people in their 60s, 70s, 80s and beyond are poorly understood.
Medicine reflects this narrow-mindedness. In medical school, physicians learn that people in the prime of life are “normal” and scant time is spent studying aging. In practice, doctors too often fail to appreciate older …
Ageism in medicine is real. How can it be stopped?
You can save your baby for $2 million. Can you afford to do this? If you cannot, should we all pay?
Spinal muscular atrophy (SMA) is a rare genetic disease affecting the part of the nervous system that controls voluntary muscle movement. All types of SMA result from a single known cause, a deficiency of a protein called SMN, for “survival of motor neuron.” When SMA symptoms are present at birth …
You can save your baby for $2 million. Can we afford to do this?
An excerpt from Physician Suicide: Cases and Commentaries.
“Dear Richard and Yvonne,
I feel I have no choice but to end my life and am doing so in the hope that you will take this letter and employ it in the way that I suggest below. Please use what has happened to me as an example to help prevent the same tragedy happening to the patients of elderly physicians who …
A physician’s sudden, disastrous day. And its tragic consequences.
The future of our profession lies in our ability to come together with a unified voice. We must also recognize that the practice of osteopathic medicine, and the training of osteopathic physicians, has evolved significantly since A.T. Still, MD, DO, created osteopathy.
The AOA recognized this when its Board of Trustees announced that the AOA will start providing two pathways for board certification. DOs will be able to …
It’s time to rethink what it means to be a DO
As a surgeon who specializes in gynecologic cancer, I have performed thousands of operations over my two-decade career. But the ones my team and I have done since the beginning of this year have been the most fulfilling. The reason? A simple yet remarkable adjustment in how we prepare for surgery has forever changed the way we …
The power of an individual’s story reminds physicians why they got into medicine
The seeds of emotional turmoil inherent in medical education are planted early in the pursuit of becoming a doctor. It is the unspoken fear that medical students and residents experience each day on attending rounds. It is the worry of missing a vital piece of information from the history and physical exam of a patient. It’s the concern that despite reading and preparing for the cases, emerging physicians may find …
3 ways to change your mindset in continuing medical education
Who works for who?
How did we allow ourselves to let a system get built up around us that makes it so hard for us to take care of our patients?
Our job is to advocate for our patients, to help guide them towards their best health, to help them understand the difficult choices and to live healthy lifestyles, to give them …
How did we let insurance companies get so intimately involved with patient care?
Coming in to meet the students, house staff, and patients for the first day on service always excites me. This Monday was no exception. What awaited me? How many patients would I need to see? What lessons could I impart?
When I arrived, we had 11 patients, two new, and nine had arrived previously. Going through the list, while routine, always stimulated questions and teaching opportunities. Sometimes the team had questions …
When constipation pain was worse than cancer pain
3:30 a.m. – Wake up.
4:00 a.m. – Leave apartment.
4:15 a.m. – Arrive at hospital.
4:20 a.m. – Print out the patient list.
4:20 – 5:25 a.m. – Split the list of 50 patients with your partner, go to a computer and write down for every patient their 24-hr vital signs, any reported fevers and what was done, what post-op day it is, what day of antibiotics and indications, discharge criteria, etc.
5:29 a.m. …
A student finds his passion for medicine
It took me a long time to put a name to what I was feeling. Only recently had I started to read about imposter syndrome. I’ve had this feeling multiple times throughout my life, and it always had the potential to pull me backward instead of allowing me to propel forward towards my goals.
I had this feeling when I made it into college, then again in medical school. Even when …
How this physician fought imposter syndrome
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Financial planning is comprised of the six decisions people make with their money. Physicians need to make decisions as to how you earn, spend, save, borrow, give, and protect yours. Home buying typically touches on all of the six money decisions.
Home buying often begins with a mortgage, so you will have to make decisions about borrowing money. You also must earn money or at least have the potential to earn …
Home buying tips for physicians
Which statement fits your organization the best?
Option A: Our organizational strategies, incentives, goals, and mantras are driven by patient experience.
Option B: Our organizational strategies, incentives, goals, and mantras are driven by quality and safety.
It may be hard to say an organization can be one without the other since, after all, experience is a byproduct of quality. The two are so interrelated that there is often a cloud of confusion regarding …
Patient experience scores are being dragged down by process problems
A seizure in response to a fever, called a febrile seizure, is an extremely common event in childhood. They affect 2 to 5 percent of children between 6 months and five years of age and have a peak incidence between 12 and 18 months of age. They generally occur after a rapid rise in temperature; it appears the rate of rise is more important than the actual …
Disproving the false claims of febrile seizures after vaccines
I’ve delved into the issue of medical judgment more than once. I have argued that sound judgment is more important than medical knowledge. If one has a knowledge deficit, assuming he is aware of this, it is easily remedied. A judgment deficiency, per contra, is more difficult to fix.
For example, if a physician cannot recall if generalized itchiness can be a sign of serious liver disease, he can look this …
Medical judgment: Healing demands more than knowledge
How long does it take to diagnose guttate psoriasis versus pityriasis rosea? Swimmers ear versus a ruptured eardrum? A kidney stone? A urinary tract infection? An ankle sprain?
So why is the typical “cycle time,” the time it takes for a patient to get through a clinic such as mine for these kinds of problems, close to an hour?
Answer: Mandated screening activities that could actually be done in different ways and …
Physicians can’t do everything for everybody in every visit
Wealth accumulation can follow many trajectories, depending on discipline and external factors like stock market health or economic fluctuations. With a proper financial plan, doctors can stick to a game plan that should allow them to reach financial milestones rather predictably. The adage that wealth begets wealth certainly does hold true most of the time, but it doesn’t necessarily guarantee financial victory. One of the issues with wealth accumulation is …
Physicians and the risk of a plateauing net worth
I recently wrote an article giving 3 reasons why any patient may not have liked their doctor. They included the physician being visibly in a hurry, appearing to brush off concerns, or giving a general sense of not caring. While no doctor deliberately sets out to do any of these things, complaints like these are all too common, unfortunately.
The degree to which the practice of good medicine is …
3 reasons why your patients love you
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