It is not unusual to see a patient for a timely transition of care visit after a hospital admission and within a minute of entering the exam room know with all the bones in your body that this person needs to go back into the hospital.
The funny thing is that when that happens, if the patient has Medicare, we may indirectly suffer financially from such “avoidable readmissions.” We belong to …
A patient readmission: Could it have been avoided?
You’ve probably heard this story before: a young physician, who has spent all of his or her life succeeding and building goals, stumbles into a career without meaning or enthusiasm. Indeed, my story about burnout is much like the rest.
Like so many before me, I entered into a career in medicine motivated and eager to change the world through the care of my patients. I grew up in a family …
Burnout during residency? Yep, and here’s what it taught me.
Looking at how incredibly expensive the last few months of life are for anyone in this country, I think most would be quite shocked. In 2014, there were approximately 2.6 million deaths in the U.S. According to a Keiser Permanente study, 2.1 million of those deaths were Medicare related. Medicare’s annual budget is right around $600 billion, and it has been revealed that one-third of that total is spent in …
Why we need a new approach to end of life care
Hospital email is supposed to be secure. This means that when you get an email with possible sensitive information, you receive a link to connect to a secure email product, requiring passwords, sign-ins and maybe even a bit of personal information.
Being what they are, hospitals tend to swap software products and we find some new “secure solution” that hits us, urging us to give email, make a password and possibly …
My hospital hacked my computer
Lori Wallace sits on a couch with her 11-year-old son and his new pet snake. It burrows under his armpit, as if afraid. Wallace is sure it’s not.
“If he was terrified, he would be balled up,” Wallace said. “See, that is why they are called ball pythons. When they are scared, they turn into a little ball.”
Wallace is dying of breast cancer, but a stranger wouldn’t know. She has a …
The painful side of positive health care marketing
As a cardiac anesthesiologist, there are times I care for patients who are faced with a tough decision: to take their chance on a very high-risk surgery, or let nature take its course. It is in these times I feel most humble and most human, as I may be the last one to hear the last words they speak.
Recently I was at a social event and introducing myself to some …
For an anesthesiologist, this is the hardest part of medicine
7 a.m. began as it always did; the overnight doc was threatening to quit while rubbing her bloodshot eyes and smearing mascara beneath them. Between heavy sighs, she listed the patients transferring into my care ending with Mr. Mandel.
“He’s eighty-something,” she explained, “hospice care. Cancer with metastases. Came in from home because family ran out of morphine and he was in a lot of pain. Anyway, he’s actively dying now, …
Here’s what death really sounds like
Countless times as a patient both at two hospitals in New York City, I have witnessed doctors arrogantly waltzing into an examination room and arriving not alone but with an entourage. Like Greeks bearing gifts, they arrived with something unwanted and threatening: medical students, interns, residents, and fellows. And not once, in all the many times that I have been subjected to this ignominious practice, was my consent ever obtained …
Is physician shadowing immoral?
It is early on a Saturday morning when I walk out of the elevator of Doan Hall looking for a nursing desk to call the fourth-year anesthesiology resident I am supposed to be shadowing. Instead, I am met with a set of double doors and a staff-only sign.
Before walking through the doors, I decided to read the placard placed on the wall next to them. As I begin to read, …
Medical students must have this mindset
Every patient eventually asks the same question: “How can I find the best hospitals and doctors?”
The solution might seem easy, since we live in a world where information is readily available on the Internet. In a few clicks we can shop for goods, review consumer products, market ourselves on social media, and complete financial transactions instantly. You would think that health care, which accounts for 17 percent of the GDP, …
Why quality reports for hospitals and doctors are interesting but flawed
Phnom Penh is changing at an incalculable rate. It is evolving so quickly that even from my last visit four years ago, I barely recognize the streets I once shuffled my well-worn sandals through. Now, the streets of my old neighborhood are proudly adorned with a new facade of artistic, stylish restaurants and a collection of boutique coffee shops. Bigger buildings and prime real estate positions are now occupied by …
I am the “same-same but different”
Health care in America and the practice of medicine has undergone a sea change over the last couple of decades. It used to be about Dr. Johnson’s office around the corner that would serve you and your whole family. Nowadays, it’s about mega-specialty groups and large health care conglomerates. It’s about mergers and hostile corporate takeovers. Statistics now suggest that over 50 percent of physicians are employed rather …
Why physicians should be their own brand
According to a recent publication by the Robert Graham Center, the number of family physicians practicing high-volume obstetrics (more than 50 deliveries per year) dropped by over one-half from 2.3 percent of practicing family physicians in 2003 to 1.1 percent in 2016.1 In small corners of the country, though, innovative training programs continue to foster these skills among learners and build supportive communities for family …
This doctor became her colleagues’ patient
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An excerpt from The Power of Moments: Why Certain Experiences Have Extraordinary Impact. Reprinted by permission of Simon & Schuster, Inc.
Defining moments shape our lives, but we don’t have to wait for them to happen. We can be the authors of them. What if a teacher could design a lesson …
How did this health care system add a personal touch?
Five years ago today I was at a memorial. Another suicide. Our third doctor in 18 months.
Everyone kept whispering, “Why?”
I was determined to find out.
So I started counting dead doctors. I left the service with a list of 10. Now I have 547.
Immediately, I began writing and speaking about suicide. So many distressed doctors (and med students) wrote and phoned …
What I’ve learned from 547 doctor suicides
The prevalence of burnout among physicians is estimated to be more than 50 percent and has grown in recent years. This alarming trend is largely due to changing patient demographics, increasing cost constraints, new federal and state regulations, and other external factors that have reshaped the daily work experience of physicians. Too often today, physicians spend more time on data entry than in direct …
Fix the system to address physician burnout
Empathy is a cryptic term. Those in the health care profession can certainly spout off a variety of phrases and metaphors that are typically used to describe the concept of empathy in the educational setting. Throughout my medical education thus far it has been described as “putting yourself in another’s shoes” or “sharing in another’s emotion.”
We are also taught early on what empathy is not. Empathy is not feeling sorry …
Empathy is better felt than defined
I was a chubby kid, but my parents still introduced me to lots of sports. Soccer, swimming, tennis, basketball; so many sports, when all I wanted to do was read and eat Doritos. I wasn’t particularly good at any of them, but some of my teams were better than good. We were champs. My swim team won the Cape Cod Summer League, my soccer team won its division one year, …
The key to health care is to have a great team
I walked into the ICU amidst a chaos of harried residents, chirping alarms, and the whir of the portable X-ray machine. Aromas ranging from old coffee down to vomit and stool mixed together in the usual fashion. In other words, it was a typical morning. I watched as my team gathered into a semicircle around me outside the first patient’s room and I got into my morning rounds stance: leaned …
Resist! The invasion of computers in health care
“Aren’t you cute,” he said as he smiled and squeezed her cheeks. On the start of a new rotation, a medical student walked into clinic and introduced herself to the attending physician.
With all of the news surrounding the Weinstein debacle, Alyssa Milano has urged women to share their stories of sexual harassment or abuse using the words “me too.” What has transpired is that a whole community of women from …
Women doctors: Speak up, because #MeToo
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