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We cannot afford to lose more doctors to drug addiction

Mark Leeds, DO

Physician

March 1, 2018

It is a miracle that more doctors have not succumbed to substance use disorder at some point in their training or career. It is a fact that many have. The number of doctors and other healthcare providers who have struggled with substance-related issues is probably far greater than we can imagine. This is because of a culture of secrecy and implied threats. Doctors who need help think there is nowhere …

How psychiatrists became lesser physicians

Torie S. Sepah, MD

Physician

February 28, 2018

Recently, a form showed up on my desk to sign, approval for something or other. Not uncommon, given my role at the time as a chief psychiatrist, I signed dozens of such letters, memos, or forms, drafted by an administrative assistant. I signed so many; I never looked at the last line — at how my name had been typed out. Just once my eyes wandered to the end and …

Where is the love in medicine?

Errin Weisman, DO

Physician

February 28, 2018

Hippocrates is quoted to have said, “Where there is love of medicine, there is love of humankind.” But in today’s health care, is there still a love of medicine? Does our practice demonstrate a love of humankind? I must admit, as a physician I don’t see us always exhibiting a love of medicine. And if we do not love medicine, are we also failing to love humankind?

Walk into any hospital …

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Where is the love in medicine?

How to incentivize higher quality and lower cost in U.S. medical care

Samuel Falkson

Health Policy

February 28, 2018

U.S. health care costs are high – over $3 trillion annually and about 18 percent of our GDP. Estimates suggest that our costs are rising. Concomitantly, we are entering an era of extreme biomedical promise, where research breakthroughs are translating into unprecedented clinical benefit.

Luxturna from Spark therapeutics, for example, remarkably restores vision loss in patients with a specific eye disease. With amazing innovations, …

This is what’s missing from medical education today

Suhas Gondi

Medical Education

February 28, 2018

When my classmates and I returned to Boston to continue our first year of medical school early last month, we returned to a very different type, of course, called “Essentials of the Profession.” In it, we explored health policy, social medicine, ethics, and other topics outside the realm of traditional physiology and disease but just as important to our roles as physicians. In the health policy class, we learned about …

The unjust prosecution of physicians is not unique

David Markus, JD and Mona Markus, JD

Health Policy

February 28, 2018

Dr. Pramela Ganji had just finished her lunch when she was told that the appellate court had reversed and vacated her conviction. At first, she didn’t believe it.

After all, this whole experience had been surreal. Dr. Ganji, a 68-year-old well-respected medical doctor and married mother of 3 children, had practiced medicine for 40 years without incident. Her patients loved her, and she had dedicated her life to helping others. …

Patients lose when physicians burn out

Melissa Welby, MD

Physician

February 28, 2018

Despite loving my patients, I burned out. I chose my own quality of life over continuing to work with the chronically mentally ill population that I adored. This patient population is frequently shortchanged with their quality of care, and I have joined the ranks of people failing them.

This is my experience working in one mental health clinic in the United States. Every clinic runs differently, and there are fantastic systems …

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Patients lose when physicians burn out

A “stat” palliative care consult: cognitive dissonance meets cognitive ignorance

Michael A. Salvatore, MD

Physician

February 28, 2018

It was a perfectly comfortable morning when suddenly it was discomforted by a request for a stat palliative care consult. A stat consult is disquieting because “stat” is a dissonant adjective for the compound noun, “palliative care.”

“Stat” is the medical abbreviation for the Latin adverb “statim” meaning “immediately.” Stat orders always imply the necessity of an immediate response to an emergency: an inadequate blood pressure, an erratic hear rate, a …

Physicians don’t know everything, and that’s OK

Kristin Puhl, MD

Medical Education

February 27, 2018

Physicians face a host of challenges in practice, but the one that looms largest is often this — they don’t know everything.

It would be tempting to think that they do. As patients, we want them to. We want our doctors to tell us that they know what’s wrong and how to fix it. Medical mysteries are fun on television, but in our real lives, they’re profoundly unsettling and can have …

Teaching Health Centers: when there’s nowhere else to go

Laura Kahn, MD, MPH and Caitlin Farrell, DO, MPH

Physician

February 27, 2018

He’s a young guy: polite, well-dressed, easy to talk to. He works construction and is here because he’s been getting allergies to dust and pollen. He’s never had insurance, but it doesn’t really matter because he’s always been healthy. He’s the easy slot in my schedule; I ask him a few questions, look in his nose, we chat about the new Avengers movie, and I’m about to send him home …

A physician thinks about his future

Gil C. Grimes, MD

Physician

February 27, 2018

Lately, I have been seeing a lot of writing from Pamela Wible, MD. And today, I re-read her article about doctor suicides. As I read and reflected on how medicine has changed during my lifetime, I am struck by the degree to which the humanity scrubbed out of the system. I think about the times when I thought, “You know, it is not worth …

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A physician thinks about his future

Therapy and self-help strategies aren’t the answer to solving physician burnout

Matthew Hahn, MD

Physician

February 27, 2018

There is growing recognition that the broken American health care system is taking a toll, not just on patients and their families, but on health care professionals as well. Nearly half of all physicians in various surveys now report that they are burned out. Inevitably, the experts are lining up to further study the issue and to teach doctors better coping skills.

In terms of the need for further study, I am but a simple country doctor, but I think the …

A roller coaster of emotions at my community clinics

Avelina Sandoval, MD

Physician

February 27, 2018

I can’t help but wonder …

Every day I find myself driving against traffic to get to work. I am the kind of person that generally always worries about making it to work on time, so I tend to leave my home a few minutes early. Even at these early hours, I can already see a line of cars trying to merge on to the highway going the opposite direction as …

The case of Dr. Hadiza Bawa Garba is a tragedy

Dr. Sonia Henry

Physician

February 27, 2018

I was sitting in the tea room out the back of the country hospital where I occasionally work as an emergency doctor, and we started to discuss the case of Dr. Hadiza Bawa Garba. Dr. Garba is a pediatric registrar from the UK who has been all over the news after being struck from the medical register for doing almost exactly what any one of us would …

EHRs can advance good medicine: if doctors are aware of the risks

David Troxel, MD

Health Technology

February 27, 2018

Historically, the doctor-patient relationship has been at the heart of medical practice, with administrative tasks and record-keeping at the border.

Today, that critical balance is at risk. Nearly all hospitals and 80 percent of medical practices use electronic health records (EHRs), presumably to help improve access to health information and increase productivity. The problem is that none of these digital tools were designed specifically to advance the practice of good medicine.

Consider …

Medicine is fast becoming a field of editing for the sake of efficiency

Joe Andrie, MD

Physician

February 27, 2018

Have you ever written something that didn’t seem to come across the way you intended? Because I have, many times, almost every day. Not necessarily works of art, but text messages, emails, and pretty much every writing assignment I completed in high school and college. I happened to be thinking about this recently while reading through a story I had written about a patient experience during my residency.

My mind drifted …

When an anti-vaccination organization convinces a physician to join their ranks

Sean Gallagher, MD

Physician

February 26, 2018

It’s always a coup when an anti-vaccination organization can convince a physician to join their ranks. They act like it provides a thin veneer of legitimacy to their pseudoscientific cause. This was recently the case with an anti-vaccination organization in Ohio (my home state.) They recruited the former medical director of the Cleveland Clinic Wellness Institute. You may remember his infamous article in the Cleveland Plain Dealer in January 2017. …

We are all aging every day. But mostly we ignore, do not recognize, or deny it.

Stephen C. Schimpff, MD

Conditions and Diseases

February 26, 2018

Part of a series.

We are all aging every day, but mostly we ignore, do not recognize or deny it. Then all of a sudden, we look in the mirror and realize that older age has found us. Even then each person deals with aging differently. There is Dr. Seuss’ “Cat in the Hat” who sees nothing but adversity in aging. There are others who accept aging but …

Radical realism: A hospice doctor prepares for death

Shola Vaughn, MD

Physician

February 26, 2018

Bruce Wilson, MD, is a hospice doctor and former cardiologist who was diagnosed with pancreatic cancer in February of 2017. In the months that followed, he publicly discussed events as they unfolded on a CaringBridge blog. The irony of the situation was profound: a hospice doctor being handed what some consider a death sentence. A physician who dedicated his career to changing the conversation about end of life care now …

There’s more to the story of the fired patient

Anonymous

Physician

February 26, 2018

She could have been my charming tiny kindergarten teacher, sitting there nonchalantly in her wheelchair with neatly folded arms in her lap. The delicate, airy cloud of silvery blonde hair on her head resembled Queen Elizabeth’s style. I named her Ms. Elizabeth. A few moments ago, though, she looked like a young child who could not comprehend the meaning of her condition. Whenever she was spoken to, her mind seemed …

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