Often a stay at home mom, like we have in our house, is not thought of as a contributor to wealth. Too often, only the person who “really” works and brings home an income is considered to be generating wealth. This is a case of incorrect thinking.
The non-working spouse is a very big factor in attaining wealth. In the book, The Millionaire Next Door, the spouse is considered one …
Your greatest financial asset? Your spouse.
Surviving suicide loss is difficult. And in some sense, the resulting grief is open-ended. I am a mother and doctor whose two sons died by suicide associated with psychotic bipolar disorder. My ever-present sensitivity to the fierce loss of death by suicide is again touched when I hear of death by suicide. The suicides of Anthony Bourdain and Kate Spade triggered in me a renewed feeling of grief. Like so …
After Kate Spade and Anthony Bourdain, it’s time to shift on suicide
It is a little after 9 a.m. I am about to start the second of a long list of endoscopy cases when my phone rings. I glance briefly at the caller ID to confirm it isn’t my office or the hospital calling about another patient, and am quickly overcome with dread as I see the screen reads, “daycare.”
Intuitively, I know why they are calling. My four-month-old must have a fever. …
Am I a doctor or a mother first?
Summer is upon us, and with it comes the end of the academic year, graduations and the arrival of the newest crop of interns. Soon these fresh-faced physicians will enter into one of the most remarkable educational experiences of their medical careers: residency. Many of these soon-to-be-interns are looking to attendings now for advice on how to excel during (or survive through) the arduous first year of training. Suggestions like …
Welcome to your intern year breakdown
In the context of human evolution, a vestigial organ is defined as one that has lost all or most of its original function through evolution. Charles Darwin provided a list of vestigial human organs in “The Descent of Man,” including the muscles of the ear, wisdom teeth, the appendix, the coccyx, body hair and the semilunar fold in the corner of the eye. If you had told me 19 years …
Is the stethoscope a vestigial organ?
You are a child of Thanos.
“Hear me and rejoice!”
“You have had the privilege of being saved by the American College of Cardiology and the American Heart Association. (Yeah, I know we said the same thing when we prescribed low-fat diets to decrease the risk of heart disease, but you gotta give us a pass on that one.”)
“Based on our research, we have found 100,000,000 of you are ill.”
“But we can …
How our health system is like the Marvel supervillain Thanos
I used to have a patient who was an undertaker. We had many conversations about philosophy and practicality, and it didn’t take long to realize the profound insights one must learn when engaged in such a unique business. As I was often fond of saying, when the undertaker speaks, you should really listen. This belief that our experiences can lead to new and different perspectives has pushed me to analyze not …
A hospice doctor gives investing advice
Signing the divorce papers was probably Charlie’s lowest point. His wife sitting by his side, occasionally she would swat at the air at some invisible fly buzzing around the room. There was no fly. Just the acrid smell of the nursing home, a horrifying mix of sweat, shit, and desperation. He tried to focus his aged eyes on the legal papers as the tears swirled past his nose and losing traction, fell …
This is what dying poor in America looks like
Those who follow my blog know I write about science and medicine and their complexities and challenges. Sometimes, I write about anesthesiology and what it’s like to be in the operating room. I write about gender issues and things I’ve noticed as a woman leader in medicine. I write about my children, being a mother, and all that it takes to have the best job in the world and feel …
A physician battles Frozen Car Disease
A new study confirms something we here at HealthNewsReview.org have been emphasizing for many years: Health news stories often overstate the evidence from a new study, inaccurately claiming that one thing causes another — as in drinking alcohol might help you live longer, facial exercises may keep your cheeks perky, and that diet soda might be a direct line to dementia.
The researchers looked at the 50 “most-shared academic articles and media articles covering them” in …
Health misinformation in the news: Where does it start?
It was 5:45 in the morning on a Monday after a full weekend of call. Thoroughly exhausted, I shuffled into the elevator and was met by the stench of stale clothing mixed with cigarette smoke. A painfully thin teenager exited, looking lost. I allowed him to wander out, grateful to be spared his odor. I was apathetic, overtaken by a weariness I vowed as a medical student never to have.
Morning …
Life as a doctor is selfless and selfish at the same time
When I hear pundits going on about the Medicaid work requirements, I think of my father.
He has worked in the United States for twenty-four years, taking on the role of a handyman, migrant farmer, truck driver, construction roofer, dialysis patient transporter, and elder transporter. His limited English and third-grade education land him in low-paying jobs with limited hours and an oversupply of workers — resulting in frequent periods of unemployment.
For …
A bipartisan solution for Medicaid work requirements
Wouldn’t it be cool if … ?
Wouldn’t it be better if … ?
Wouldn’t it be much easier when we see patients if … ?
How come we can’t … ?
It seems like every day, someone in our practice comes up with an idea for a way to do something better:
How did EHR designers get control of health care?
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Absent a last-minute, lifesaving intervention, after 20 years of reviewing and summarizing clinical practice guidelines in a continuously updated database, the Agency for Healthcare Research and Quality’s National Guideline Clearinghouse (NGC) will go offline on July 16th. Prior to its untimely death due to budget cuts, the NGC not only served as a one-of-a-kind online resource for clinicians, researchers, and educators, but raised the bar on guideline …
The National Guideline Clearinghouse will go offline. Patients will be worse off.
Primary care visits are never quick; we don’t give much advice over the phone or online; and we prioritize the government’s and insurance companies’ public health agenda over our own patients’ concerns.
Imagine health care as a retail customer experience for a few minutes:
Imagine you’re going to Walmart to buy a bag of dog food, a new coffee maker or to equip a small kitchen in your newly built mother-in-law apartment.
1. …
Fixing primary care’s broken business model
I have met, in the emergency department, some fierce individuals. Sometimes they can be terrifying. Their clothes, their manner, their demeanor, the way they pace, all suggest potential danger. They seem clearly capable of violence. They look at me with distrust, expecting to be disrespected, dismissed, treated harshly.
Sometimes, they are covered in piercings; a thing alien to me. Other times, the symbology on their clothes speaks volumes. My colleagues in …
A surprising way to connect with the most difficult individuals
Most physicians are increasingly forced to grapple with the problem of shortages in generic drugs. These are drugs for which the patent has expired and any company can make them. Certainly for those of us in the PICU it is a chronic problem because the majority of drugs we use are injectable medications that have been generic for many years. Hardly a week goes by I don’t receive a notification …
An innovative approach to fix the generic drug shortage
Recently, I had the honor of standing by one of my childhood best friends as she promised the love of her life that she’d stand by him forever. The wedding was beautiful, and at the reception, I played with another close friend’s 3-year-old daughter and talked with other friends about their work promotions and apartment searches. All I have to contribute to these conversations are anecdotes about medical school and …
Becoming a doctor is the epitome of delayed gratification
A new study found several senior academic surgeons had published papers in what used to be termed “predatory journals.” The newer, gentler term is “solicited publishing,” but it defines the same pay-to-play, low-quality publications.
Surgeons from the University of California, San Diego examined 110 emails sent to the senior author from 29 publishers during a six-week period and early 2017. Nearly all were requesting manuscript submissions. The 29 publishers represented 113 …
Why do physicians publish in predatory journals?
When we go to the deli, we expect to take a number and wait in line. Accomplishing any task at the department of motor vehicles can be an ordeal of waiting and then being herded out the door. This is part of life in American society. However, it should not be part of your health care.
Patients need personalized attention and they need a health care team that listens to them, …
5 ways assembly line medicine harms patients
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