A patient once told me, “I sit on the side of the road asking for change. People look right through me like I’m invisible. Food stamps aren’t enough. I can’t afford to exist and I want to die.” A man is dying of poverty — this is an emergency, but not one I have been trained to fix. I am an emergency medicine physician; I care for people on the …
Emergency departments need to claim their role in the social safety net
Deeply entrenched racism, rooted in the foundation of white supremacy, has had a stronghold in medicine for hundreds of years. Its legacy of harm against Black, Indigenous, and people of color (BIPOC) communities, particularly its atrocities against Black Americans, is undeniable. Yet significant change eludes us. For decades, these communities have borne the disproportionate burden of public health short-comings from police brutality, gun violence, infant and maternal mortality, and …
An open letter to the medical community at large regarding the termination of Dr. Princess Dennar
Health workers in Canada experience endemic levels of burnout directly related to understaffing and work overload. Leaves of absence from work for mental health and stress-related issues are 1.5 times higher among health workers than the rest of the population. Increasingly, health workers are significantly reducing their hours worked to cope or leaving their jobs altogether.
That was before the pandemic. With COVID-19, we are witnessing levels of stress, overload, and burnout …
The pandemic exposes critical gaps in Canada’s health workforce planning
All across the United States, elementary and secondary school teachers are refusing to go back to school. Before you join the growing lynch mob that’s going after these teachers, you may want to consider why they’re staying home.
For starters, many school boards make their decisions based not on what is best for students, teachers, or the community they’re supposed to serve, but on the vested interests of the …
Why teachers aren’t going back to school: a physician’s take
There is a strong push for health care to move towards greater value-based care (VBC) arrangements. The prospect of VBC holds the opportunity to re-create partnerships designed to increase health care sustainability by strategically improving processes, care delivery, and patient outcomes to achieve higher quality output at a decreased cost. Furthermore, the held potential will not be optimized until providers, payers, patients, and communities are connected in this common goal …
Why health care fails to deliver better value in patient care
As a foreign medical graduate and a multiple-time career changer — from being a doctor to a hospital process improvement and leadership coach to a business professor to a transformational career coach for female physicians — I have closely examined the U.S. health care industry from various lenses.
The one thing that stands out for me is the us vs. them attitude. Us being physicians and them being administrators.
I have seen …
Stop the us vs. them mentality in medicine
The Wall Street Journal’s decision to publish an attack on Dr. Jill Biden’s right to be called “doctor” has appropriately unleashed a firestorm. According to Joseph Epstein, the editorial’s author, Biden should drop the title because she isn’t what people often think of when they hear the word “doctor,” namely a physician. For Epstein, ‘Dr. Jill Biden’ sounds and feels fraudulent, not to …
There’s a doctor in the house, and maybe also a physician: a view from osteopathic medicine
This week at work, I had a patient in the hospital who had been through a pretty challenging illness, and he was going to have to be discharged to a skilled nursing facility (SNF) to rehab for a few weeks. Sadly, SNFs in my area do not currently allow any visitors due to the pandemic. The patient is very close to his daughter, who lives out of state, and she …
A real-life example of irrational health care spending
Sometimes structural racism surfaces in a way that even those of us who would like to be “color-blind” cannot help but see.
In the spring of 2020, the video-recorded death of George Floyd (who was Black) at the hands of a law enforcement officer (who was white) brought millions of witnesses to the kind of hostility that is all-too-familiar to individuals of color. Individuals, many non-white, took to our nation’s capital …
It is not enough to say we are anti-racist. We must address glaring disparities in treatment.
Disparities in rural health care have been well established with respect to socioeconomic status, race, and geography. COVID-19 brought these disparities to the surface within most rural communities in the United States, highlighting the limited access to health care specialists and subspecialists.
As an otolaryngologist, I have had the privilege and unique opportunity of serving two different communities: Chicago’s city dwellers and …
Why states need to develop rural health outreach programs
In recent years, the divide between rural and urban areas of the United States has become more pronounced, with sharply divergent views on both social and economic policies. The results of this latest election show starkly that the divide persists, and indicate that the institutions that shape our nation are not successfully representing all portions of society.
One of those institutions appears to be medicine. A sign of this is how the public …
Medicine is failing rural Americans
As communities of color continue to be disproportionately decimated by COVID-19 and the brutal impact of racism and other longstanding systemic inequalities, academic medicine finds itself at a critical inflection point in defining its role in addressing social injustices not only for its patients but also for its academic workforce. In the aftermath of George Floyd’s killing, many medical schools and teaching hospitals released statements condemning racial injustice and vowed …
A recent op-ed published by the Wall Street Journal, “Is There a Doctor in the White House? Not if You Need an M.D.,” has sparked a lot of controversy and immense backlash. The author Joseph Epstein, a former Northwestern University professor, first addresses the future First Lady as “kiddo” and continues with “’Dr. Jill Biden’ sounds and feels fraudulent, not to say a …
To Dr. Biden from an MD: Please keep using your deserved title
Starting on January 1, 2021, clinicians across the country can expect new Medicare rules on billing, documentation, and payment for evaluation and management (E/M) services — or common office/outpatient visits – to go into effect. These historic changes will give clinicians more flexibility in how they document visits in their patients’ medical record, reduce their paperwork burden and give them more time to spend with patients. With over 750,000 clinicians …
New Medicare documentation and payment changes starting next year that deliver relief for clinicians
Oh, Canada! Every presidential election cycle, my colleagues joke that if the election result is not to their liking, they will move to Canada. On election night 2016, “move to Canada” trended on Google, and the Canadian immigration website crashed. This election cycle America is having an existential crisis. What does America stand for? Who is American? What are American values? This time around, my colleagues …
Election anxiety? Here’s a guide to practicing medicine in Canada.
George Floyd’s murder magnified attention to police brutality and inspired collective activism leading to structural reforms and demands for abolition. His death provoked a national reckoning with the racism infecting all major American institutions, including American medicine. Health care providers (HCPs) have since called for diagnosing and treating systemic racism and promoting antiracism in …
Medical brutality, social media, and collective activism
The COVID-19 public health emergency has highlighted that government rules and regulations should not hinder providers from delivering high-quality care to patients. The Trump Administration exhibited an understanding of this principle long before the pandemic when it announced the Cut the Red Tape initiative in 2017. With a healthcare system marked by $200 billion in annual administrative costs that contributes to higher costs for patients and …
For many years and in disturbing frequency over the past few years, police brutality has been a big-ticket issue. The excessive use of force has led to innumerable acts of civil rights violation and, most tragically, the disproportionate death and destruction of innocent Black lives. There have been many debates on what to do to change law enforcement culture. But what has been weighing on my mind is …
Do police officers get jaded over time, just like a lot of physicians do?
I have been a doctor for twenty years, but I’m also a patient. We are all patients. This summer, my previously mild heart rhythm problem got a lot worse. By July, I was having frequent episodes of heart rates four times normal, causing me to almost lose consciousness. It was dangerous and scary. I consulted with a highly specialized doctor to fix this for good. He threaded four wires …
Why socialized health care is not right for America
A recent edition of Pediatrics has some disturbing research: “Trends in Capability of Hospitals to Provide Definitive Acute Care for Children: 2008 to 2016.” What the paper really does is document what many of us who work in referral hospitals have noted for some time: More and more community hospitals are transferring children who appear in their emergency departments to other, larger facilities instead of admitting them to …
Why are so many community hospitals transferring children to larger facilities?
Get free updates delivered free to your inbox.
