During a recent palliative conference, the discussion turned to the challenges of translating our work to the public and our colleagues. Despite the growth of our field and increasing access, there remains major confusion about palliative care and hospice. Much of the misunderstanding originates from within the medical profession. Having worked in the palliative care and hospice arena for nearly two decades, I have seen many examples of the confusion …
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Finishing up a consultation in the ICU, the nurses approached me to see how it went. “Did you get the DNR?” I explained that I enter these conversations without an agenda. My first goal is to develop rapport, reading the room to gauge how far I can take this conversation. What are they ready to hear? This phase of the consult is akin to preparing the soil for planting. The …
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As we continue our third year of the pandemic, there have been reports of hostile treatment directed at public health officials and medical personnel. This is escalating a crisis of burnout among health professionals, but there is an insidious, chronic hostility that lurks within hospitals between those who are supposed to be on the same team.
Bullying within health care has been a longstanding challenge. It is pervasive enough that the …
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My interest in the topic of physician wellness dates to my residency. We were required to do a project, and I opted to survey my colleagues about their health habits and concerns. I was not surprised to find that residents were unable to commit to the health recommendations we give our patients. For example, only 25 percent of respondents met the American Heart Association recommendations for physical activity. Access to …
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Recently, while visiting with a colleague in our doctor’s lounge, I blurted out, “I’m tired of the dying.” He looked at me quizzically, “But you’re the hospice doctor.” True, death comes with my work, but the recent volume of and the loss of younger patients have been especially difficult. It reminds me of an earlier time we faced a new virus.
As we endure this pandemic well into its second year, …
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As COVID-19 continues to surge across the country, with an anticipated death toll reaching 300,000 by the end of the year, the NFL season has just kicked off. Multiple professional and college sports programs have also returned to play. To prevent outbreaks among the athletes, they are tested frequently, sometimes daily, and with quicker results than our patients, health care providers, schools, and seniors, the population with the highest death …
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The school year is back in session, and our student health center is busy. As a college health doctor, I have been able to watch the rollout of the Affordable Care Act (ACA) among this population. Since its passage, more of our students are now insured, but many unique challenges still persist for this population.
Young adults have historically demonstrated high rates of un-insurance. An estimated 30 percent of those 19 …
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The call came in the middle of a busy office day; the radiologist had found a suspicious area on the mammogram. I had received similar calls many times in my primary care practice. This time was different; the patient was me.
My first thought “thank God I’m insured.” My second thought was for all those who are not. It was hard enough waiting the week, until further testing could be performed; …
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The Patient Protection and Affordable Care Act is in the process of being rolled out, however many questions remain.
Will it guarantee universal coverage? Will it stand up to the many court challenges? The private insurance industry will receive an estimated 400 billion in taxpayer money to subsidize the purchase of these plans. Is this the best way to spend our money?
Many of us in the health field remain skeptical …
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During the election season, the biggest loser appears to be civility. Anger, attack ads and name calling ruled the day. We are faced with enormous and complex challenges, issues not easily addressed in sound bites. Yet that is what we usually get from our representatives. I find myself asking are we not willing or able to do the hard work of examining the issues before us?
During the ongoing discussions over …
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I was enjoying lunch at a local café when I overheard one staffer say to another that she was facing her twenty fifth birthday soon. She went on to say, 25 is the last “real” birthday, after that “you’re just getting old”. I had to laugh, since I’m well past that age and holding up. Sure, there are some wrinkles and gray hair to contend with, that’s life.
I remember my …
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Back to school for many children means returning to the environment in which they are bullied.
Bullying is a form of abuse, defined as recurrent episodes of physical or psychological intimidation. It can take the form of taunting, name calling, threatening, stealing and physical assault. Other forms of bullying include the spreading of malicious rumors or gossip and the intentional exclusion of a child. The result is a victim who becomes …
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At a recent staff meeting, a colleague mentioned her client was at an “awkward age”.
I thought she was referring to a teenager, but she quickly clarified herself. She was referring to the age before someone is old enough for Medicare at sixty five, an awkward time indeed. Many people between the ages of fifty to sixty four find that relatively minor health problems make health insurance unaffordable. For those with …
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I recently finished reading In Their Own Words: 12,000 Physicians Reveal their Thoughts on Medical Practice in America. It is a summary of a 2008 survey from the Physicians Foundation. I vaguely remember filling out this survey. I was interested to see what my colleagues had to say.
Many physicians describe themselves as at the breaking point.
“I am so mired in this mess that I can’t see clearly enough to give …
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I often find, when I talk with patients and families about hospice care, there is a palpable sense of relief; relief that there is another option when facing a terminal diagnosis or end stage disease process.
Families who have participated in caring for their loved one at the end of life are grateful for the guidance provided in hospice care. Patients in turn are grateful to spend their last days at …
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As the oil continues to pour into the gulf from the BP oil rig, we are witnessing not only an environmental disaster but a potential health crisis too.
It is not just the water that has been impacted the crude can become airborne in tiny particles and carried inland with the breeze. Those working to clean up are particularly at risk, as are pregnant women and people with underlying respiratory illness.
Locals …
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I recently received a bulletin from one of the medical societies to which I belong: the topic was on promoting physician wellness.
My first reaction, “It’s about time “. Historically physicians have struggled with multiple health impacts from the demands of their work, with higher rates of depression, anxiety and suicide than in the general population. Physicians train under circumstances of extreme stress often resulting in unhealthy coping strategies; strategies frequently …
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Who hasn’t heard the story of a friend or acquaintance who retires only to become seriously ill or die soon after?
Are we working ourselves to death? For anyone who has ever wondered “is this worth it?” a move is afoot to question the concept of the American work ethic. We are currently the most overworked society on the globe. The United States has surpassed Japan as the nation with the …
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Jim called me late on a fall afternoon to report our mutual friend was in the local emergency room. “It looks like he had a stroke”. I immediately asked to speak to the ER doctor for the results of the CAT scan I knew would have been done. There were two metastatic tumors in the brain.
It has been over two years since my friend died. He was among the millions …
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It has been three months since I closed the door on my primary care office for the last time. It was with a heavy heart that I said goodbye to the many patients I cared for over the last six years. I am the fourth physician to leave the practice in as many years.
As the economy faltered, I found my private office practice had simply become unsustainable. With the popularity …
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