An excerpt from Imposter Doctors: Patients at Risk.
On December 17, 2020, television network WGN America featured the book Patients at Risk: The Rise of the Nurse Practitioner and Physician Assistant in Healthcare in a news segment entitled, “Families sound alarm on medical transparency after deaths of their children.” …
Examining the changing definition of medicine in health care
I recently read an article about reducing physician burnout written by a health care consultant who proposed the creation of an enhanced medical scribe, or “team care assistant” (TCA). According to the article, the TCA obtains the patient’s medical history through “template-driven questions about the chief complaint.” After obtaining the history, the TCA then calls the physician into the exam room to present their findings. The article …
Adding more team members is the wrong answer to decreasing physician burnout
This health policy consultant may have never cried in a doctor’s office before (“My doctor made me cry. It summed up everything that’s wrong with health care“), but I can practically guarantee that her doctor has. I know this because throughout my 20 years as a primary care physician, I have cried many times in my office, and so have most of my colleagues. I’m not talking …
“My doctor made me cry”: Headlines that are examples of victim-blaming
I was scrolling through Facebook when it popped up. “Live! America’s Frontline Doctors address COVID-19.” A group of physicians in white coats stood before the Supreme Court, speaking into a microphone. As I stopped to watch, I was surprised to see several familiar faces—physicians I had interacted with on various social media physician groups.
I knew from reading previous posts on social media that these doctors were proponents of the drug …
It’s time to return civility to medical discourse
On July 8, 2019, the American Academy of Emergency Medicine wrote a letter to the American Medical Association, asking the organization to create a public campaign to support physician-led care.
Noting concerns over the recent media crusade to promote nurse practitioner care to patients, including the American Association of Nurse Practitioners “We Choose NPs” campaign, the letter asks the American Medical Association to combat the …
The April 18, 2019 CNN headline was a prime example of clickbait: “Feds charge doctors in 8 states in opioid bust, including ‘Rock Doc’ accused of trading pills for sex.”
The only problem with this headline? Of the 60 individuals charged, half were not physicians. More importantly, Jeffrey Young, the so-called “Rock Doc” who prescribed nearly 1.5 million pills of opioids and benzos often in exchange for …
Stop the anti-doctor media bias
I recently received a scathing email criticizing an article I wrote about the care of patients in underserved areas. “Should you really even get to write articles about poor, underserved populations when you run a concierge practice?” the author wrote. “This is called hypocrisy. You are what is wrong with the medical field.”
What the author of this email didn’t know was that I spent six years working for the underserved …
Direct primary care physicians are not concierge doctors
As more doctor pay is being tied to patient satisfaction and “outcomes,” a recent Forbes article argues that “It’s only a matter of time before physicians will see the bulk of their compensation tied to quality measures.” To prepare for this pay-for-performance apocalypse, the article cites Medical Group Management Association (MGMA) CEO Haylee Fischer-Wright, MD, who urges physicians to “build data analyses” and take …
Stop treating doctors like school children
Shortly after the publication of “Independent practice: Both nurse practitioners and physicians should be outraged,” the nurse practitioner (NP) leadership responded with a press release, denouncing the concerns that were cited, calling them “rhetoric.”
But in contrast to this criticism from the political end of the NP spectrum, I was inundated by emails from working NPs across the country in support …
Independent practice: Nurse practitioners respond
The United States is facing a looming physician shortage, and some groups see this as an opportunity to promote an agenda of replacing physicians with nurses.
The nurse-as-doctor concept appeared in the Institute of Medicine Future of Nursing 2011 report, which called for a radical change to the nursing structure in the United States, including a goal of …
Independent practice: Both nurse practitioners and physicians should be outraged
Physicians and patients are fighting a growing hypocrisy in American medicine. Examples abound, such as criticism that doctors are overprescribing antibiotics and contributing to resistance, while insurance companies simultaneously incentivize their members to use telemedicine programs or urgent cares instead of visiting their primary care physician.
My own insurance company, Cigna, recently sent me a letter notifying me that I will have a reduced co-pay if I …
This is the hypocrisy of American health care
Dear patients,
One year ago, I wrote to you about my concerns for the future of my practice in light of upcoming changes to the Medicare system. I explained my anxiety about the Medicare Access and CHIPS Reauthorization Act (MACRA), a change in fee structure from fee-for-service (I treat you in the office, submit the bill to Medicare, and they pay the bill), to “value-based” payment (I …
One year later: A physician’s letter to Medicare patients
With the latest data calculating physician burnout at greater than 50 percent, American medicine is at a tipping point. How to fix this crisis? Why, make physicians more resilient, of course!
Except physician resiliency is exactly what got us into this problem.
Let me explain. Doctors are notorious people pleasers. We spend years of our life at study, sacrificing the fun and freedom of youth, deferring childbearing, and delaying …
To prevent burnout, physicians need less resilience, not more
I recently saw the movie, Captain America: Civil War. If you haven’t seen it yet (no spoilers), the United Nations decides that because of civilian fatalities during previous Avenger battles, the world would be safer if all superheroes voluntarily subjugate themselves to the authority of an organized government body.
Sounds good to some of the Avengers; after all, innocent people have died, and maybe some form of supervision will minimize collateral …
America’s civil war on doctors
Like many physicians, I’m a people pleaser. On my medical school application, my personal statement was a literary cliché filled with my dreams of helping others, easing pain, soothing suffering — and I really meant it. What I didn’t know then was how difficult it would be to negotiate making patients happy while doing the right thing medically.
Medical school and residency didn’t adequately prepare me for the emotional strain of …
It’s time for physicians to stop being pushovers
I have a dream job.
I make my own hours, working three 12-hour shifts on Tuesday, Wednesday, and Thursday. I’m off Friday through Monday, and I don’t take any call. I take as much vacation as my budget will allow, and if I wake up with the flu, I call off from work without the usual feeling of guilt and anxiety.
It wasn’t always this way. Like all new doctors recently out …
How partnering with urgent care created a dream primary care job
Dear patients,
This is a hard letter to write, but it is important that you know about a major change that is coming for both of us in 2017, just a short year away.
As you recall, last year I left a large hospital group practice and opened my own office, and I want to thank you for your faithfulness in following me to my new location. With the newfound freedom of …
A physician’s open letter to Medicare patients
Studies show over and over again that empathy is the key to physician-patient communication and is directly related to patient satisfaction, adherence to medical treatment, lawsuits, and clinical outcomes. Yet despite its importance, many doctors still struggle with showing empathy.
The reality is that while most medical students start school with high levels of empathy, it doesn’t take long before that empathy is beaten out of us. Studies show …
Can you fake empathy until it becomes real?
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