An excerpt from Fallible: A Memoir of a Young Physician’s Struggle with Mental Illness.
Jason had an entire group of voices in his head that he called “the committee.” They talked nearly constantly, sometimes in a flat roar but often escalating to shouting. He described it as …
How your mind can turn against you
Why do we underestimate risk? This phenomenon isn’t unique to politics or natural disasters, and it contradicts our need to prepare for future events. It explains why it is hard to get healthy “millennial invincibles” to sign up for health insurance, why earthquake insurance policies skyrocket after an earthquake, and why people tend to underinvest for retirement. Two separate biases — availability and recency — explain why we make medical …
2 biases in medicine, and how to avoid them
Patient-centered care (PCC) seems to be a popular buzzword among policymakers and administrators in recent years. Indeed, many physicians see our health care system as payer-centric, many patients see it as physician-centric, and no one seems to see it as patient-centric. While putting the patient at the center of what we do as physicians is critical to improving the triple aim of better care, better health, and lower costs, it …
Patient-dictated vs. patient-centered care. What can physicians do?
Pamela Wible, MD, a family physician who is an expert in physician suicide prevention, recently asked other physicians why so many in the profession kill themselves. The answers were plentiful, tragic and not at all surprising.
One physician confessed to having post-traumatic stress disorder after medical school. Another cited constant sleep deprivation. Yet another mentioned the combination of a crushing workload, a difficult boss and payers who are more …
A physician’s story of mental illness
Nearly twelve years ago, Major League Baseball’s Cleveland Indians were losing to the Seattle Mariners 14-2 in the 6th inning. Cleveland, who were fighting off the resurgent Minnesota Twins and the pesky Chicago White Sox in a tight division race, were playing against a Mariners team that would finish the season tied for the most wins ever in a single season. Despite the seemingly insurmountable lead, Cleveland came back to win …
As residency begins, always remember there is hope in medicine
I recently heard from an aging and respected physician the old adage that “what is good for the doctor is good for the patient.” The room full of physicians of all ages and specialties nodded their heads in agreement. This saddened me, as it represents a physician-centric system that oftentimes leaves the patient’s needs and desires completely out of the equation.
An area of emerging importance in medicine, whose impact should …
Patients need to be involved in quality metrics
When I was traveling around the country interviewing for a residency spot in family medicine in the fall of 2008, I was eager to find a patient-centered medical home (PCMH). At every interview, I asked whether the program’s clinic was a certified PCMH or whether it was moving in that direction. “Well, we don’t yet know what that looks like” was the answer that I heard at nearly every destination. …
Care delivery transformation requires an upfront investment
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