Arthur Lazarus is a former Doximity Fellow, a member of the editorial board of the American Association for Physician Leadership, and an adjunct professor of psychiatry at the Lewis Katz School of Medicine at Temple University in Philadelphia. He is the author of several books on narrative medicine and the fictional series Real Medicine, Unreal Stories. His latest book, a novel, is JAILBREAK: When Artificial Intelligence Breaks Medicine.
For me, the cheerful musical sounds of the holiday season invariably give way to a somber song: Gil Scott-Heron’s “Winter in America.” Dubbed the “Godfather of Rap,” Gil Scott-Heron (1949-2011) embraced diverse musical styles alternating between jazz, blues, soul, and hip-hop. He wasn’t known for delivering good tidings as much as he was for sermonizing and engaging in “Small Talk at …
Gil Scott-Heron’s “Winter in America” is upon us
Most experts recommend that premed students seek medically-related jobs to gain early proficiency and support their medical school application. There is nothing like valuable hands-on experience, they say, for students to demonstrate their passion and knowledge about the field of medicine. According to the article “25 Health Care Jobs To Get Before Medical School,” written by the Indeed Editorial Team, “students who fill their resumes with volunteer work, …
The jobs you hold prior to medical school are important, but not for the reason you think
Among the many definitions and meanings of the terms “woke” and “wokeism,” the two that capture the ideology best are contrasting meanings. The definitions are:
“The behavior and attitudes of people who are sensitive to social and political injustice” (Collins English Dictionary),
and:
“A system of thought and behavior characterized by intolerance, policing the speech of others and proving one’s own superiority by denouncing others” (Psychology Today).
The first implies a benevolent society that …
Is it really a woke nightmare for medical schools?
Dear Art:
On Friday, June 11, 1982, members of the faculty convened to discuss the performance of the psychiatric residents during the last six (6) months. The following is a summation of their comments as they apply to your performance.
The faculty’s reaction to your performance was uniformly excellent. There was some comment on your earlier fear of the psychotherapeutic role, but the consensus was that this has improved markedly and that …
The American Medical Association (AMA) would have you believe that the biggest threat to the medical profession is “scope creep” – the intrusion of advanced practice providers into medical practice.
The way I see it, this is no big deal; the movement will reach equilibrium, and everyone will play nicely in the sandbox.
In my opinion, the biggest threat to the medical profession is “political creep” – the increasing government …
Political creep: government intrusion in health care
Color is often used as a metaphor for personality and emotion. Terms like “red in the face,” “feeling blue,” and “green with envy” are etched in the vernacular. Great leadership requires emotional intelligence, and the best leaders lead in full color.
Colorful leadership is about seeing the whole picture, unfiltered by our own preferences and experiences. Colorful leaders have been depicted in books, movies, and songs. The “flower exercise” …
Medical leaders must show their true colors
I applaud the efforts of several states that have enacted legislation to make it easier for physicians to get mental health treatment without incurring the wrath of physician health programs (PHPs). PHPs, while well-intended, are notoriously disruptive to the lives and careers of physicians struggling with depression, substance use disorders, and other mental health conditions. PHPs have a reputation for implementing unreasonable requirements and being coercive, sometimes worsening …
Mental health is a slippery slope when it comes to physicians’ well-being
The callous and inhumane dislocation of migrants recently perpetrated by governors of the states of Florida and Texas reminded me of an equally disdainful and appalling tactic utilized by health care workers since the 1960s: “Greyhound therapy.”
Greyhound therapy refers to attempts by health care workers and administrators to remove undesirable patients from emergency rooms, hospitals, and other types of facilities by providing them one-way tickets on a Greyhound Lines …
Don’t let vindictiveness creep into medicine like it has in politics
Working remotely during the coronavirus pandemic has immersed physicians in technology, perhaps accelerating its integration with medical practice – but not necessarily its acceptance or authenticity.
I tend to doubt the veracity of much of what I read in electronic health care records. I also question reports based on data gleaned from large medical databases – for example, summaries about physician compensation and practice trends.
Many reports that profile physicians are generated …
Human touch and scientific veracity are missing in health care technology
I left practice 25 years ago when I saw portents of clinical practice as it exists today: impersonal, with electronic records and assembly-line labor heralding the movement to institutional employment over private practice.
But it was also my genuine interest in population health and pharmaceutical medicine that propelled me into a nonclinical career. The jobs I chose in this millennium were with health insurance and pharmaceutical companies, …
If you don’t practice, don’t move, or you’ll probably lose your license
Microaggressions are common, subtle, offending behaviors and attitudes that stem from implicit (unconscious) bias. Individuals targeted by microaggressions are different than us — different in their look, skin tone, gender, sexual preference, socioeconomic status, educational level and age.
Implicit bias refers to unconscious stereotypes, assumptions, and beliefs held about an individual’s group identity. They affect our understanding, actions, and decisions and increase Read more…
Do microaggressions persist after practice?
For years, scholars have thought the perfect surgery consult was impossible. Comedic ophthalmologist Will Flanary, a.k.a. Dr. Glaucomflecken, characterizes the golden consult as one in which the surgeon is not consulted too soon — because the patient is not sick enough to require his or her services — and one in which the surgeon is not consulted too late, or else …
The “golden consult” revisited
So-called “evidence-based guidelines” are slowly destroying the practice of medicine, and companies that develop these proprietary guidelines are guilty of conspiring with payers to deny individuals necessary medical treatment.
Guideline developers, health plans, and their benefit managers contend that utilization management (UM) programs based on medically proven guidelines will reduce unwarranted clinical practice variation and improve care quality and cost. But real-world evidence paints an entirely different picture. A recent Read more…
Utilization management is medicine’s great conspiracy theory
Iconic singer Naomi Judd died at age 76, one day before she was to be inducted into the Country Music Hall of Fame. Her daughters, Wynonna and Ashley Judd, shared a statement confirming her death: “Today [April 30, 2022] we sisters experienced a tragedy. We lost our beautiful mother to the disease of mental illness.” An exact cause of death was not disclosed, and no additional information was forthcoming. …
Why can’t we say the word, “suicide?”
This year, the National Resident Matching Program provided matching services to more than 42,000 applicants. A medical student’s choice of specialty is one of the most important decisions they will ever make. But deciding which medical specialty to enter can be difficult. The majority of medical students are indecisive about their intended area of practice. Over the course of medical school, only a quarter (26.1 percent) of …
Going mobile: an antidote for career regret
Will Smith’s Oscar smackdown of comedian Chris Rock proves one thing: violence should never be a response to insults – or any other inciting factors – in the heat of the moment. Will Smith knows it, and so do the millions of television viewers who witnessed the assault. Yet, despite Smith’s written apology to Rock, Smith may likely believe his actions were justified. Why do I say this? Because if …
What does Will Smith’s facial expression at the Oscars tell us about our patients?
It seems that each positive story I read about the benefits of artificial intelligence (AI) is countered by a negative story.
One internal medicine physician writes: “Someday, with enough computing power and artificial intelligence, we may be able to have systems that can do some basic medical advice and education about health care that could end up saving doctors a lot of time and …
Artificial intelligence is worse than the old boss
As 2021 passed into 2022, I was hoping new stories would emerge and dominate the medical landscape. So, I did a bit of crowdsourcing on social media and among colleagues. Here are five topics I’d like to read less about — if for no other reason than they’ve been discussed and vented ad nauseam with little likelihood of resolution unless words give way to meaningful action.
COVID-19
We’re rapidly approaching the three-year …
5 topics I don’t want to read about in 2022 (but I probably will anyway)
More than half of all physicians in the United States are employed by health care organizations, and the numbers have been trending upward since 2019. Recruiters who work for health systems are tasked with finding the best physicians available, and their roles have become more important than ever. In-house job recruiters, and recruiters contracted with health systems, represent the face of the organization. They are often …
A message to physician job recruiters: First impressions count
A colleague announces he is retiring.
Unknown at the time is the fact that there were a series of fires and suicides committed by patients at the psychiatric facility where he was chief medical officer during the year prior to his departure. State investigators condemned the incidents and found an array of policy failures and procedural errors compounded by staffing shortages due to the coronavirus pandemic.
Another colleague announces his retirement. Unknown …
When retirement is code for “You’re fired!”
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