An excerpt from Preventing Physician Burnout: Curing the Chaos and Returning Joy to the Practice of Medicine.
Mark Linzer’s research identified workplace chaos as one of the key predictors of physician stress, burnout, and …
There is a direct connection between inefficiency and burnout
Since finishing my residency several years ago, I’ve worked in almost every type of hospital up and down the East Coast, from big urban academic medical centers to more rural community outposts. Although I primarily practice hospital medicine, working with both smaller private groups and being a hospital employee, I empathize a lot with my independent practice colleagues and brethren. I almost certainly would have gone down the route of …
Stop pushing doctors out of practice!
“I mean, ever since it happened, I just don’t feel safe anymore … they come out of nowhere … my heart will be pounding and pounding … they can get me at night, even if I’m in my mom’s house. I haven’t worked this whole month, and don’t know how I’ll go back.”
Ms. Smith is a young white woman who is presenting with panic attacks.
“Doctor, the pain is so bad …
Hope: Where can I fill a prescription for that?
I learned recently that the Massachusetts legislature passed the latest installment of the naturopathic licensing bill S.2335 in the final minutes of the 2016 legislative session. The bill is currently sitting on Governor Charlie Baker’s desk. He has a few days to sign the bill, which would make Massachusetts the 19th state to license naturopaths. If he does nothing, S.2335 will die from a pocket veto.
Senate Bill 2335 is asking a …
Massachusetts should reject naturopaths: A message to Governor Charlie Baker
U.S. life expectancy declined in 2015 for the first time in more than two decades, according to a National Center for Health Statistics study released last week. The decline of 0.1 percent was ever so slight ― life expectancy at birth was 78.8 years in 2015, compared to 78.9 years in 2014. However, this reversal of a long-time upward trend makes these results significant.
While many researchers are scratching …
Do primary care physicians increase life expectancy?
New Year’s resolutions have the potential to make our lives new and different and better than ever. But they also can do more harm than good. That’s because we put all our energy into setting the goal and don’t do the homework necessary to meet that goal. By the time February arrives, we’ve relapsed to our old habits and, what’s worse, we’ve given up hope of ever losing that weight …
Warning! New Year’s resolutions may be hazardous to your health
An excerpt from Physician—Time to Invest in Yourself: Work-Life Balance, the Needs of the Patient, and Medical-Legal Risk Management.
With advances in biotechnology, the average life expectancy is significantly longer today than in the past. As practicing cardiologists, we observe firsthand that even though there are artificial means to prolong our patients’ lives, they are still prematurely aging at an alarming rate. Many are sedentary, overweight, deconditioned, and apathetic. Consequently, they experience …
Mathew preferred using the more biblical term “shepherd.” After all, he labored his flock through pastoral pastures and meandering meadows. His parishioners, of course, were sheep and not people.
After years of leading them, he could discern subtle differences: the slope of a forehead, the stutter of a step or the variation in bleat. He had a distinct name for every animal in his flock of thousands.
Although Mathew preferred isolation, he …
We’re all shepherds helping others move through life
In medicine, our motto is first do no harm. Words matter. Choose them wisely. Here are 7 words that shame, blame, and injure people who need our help.
1. Don’t say COMMITTED suicide. Committed implies a crime. Committed rape, burglary, murder. Suicide is not a crime; it’s a medical condition that has been taboo for too long. Let’s come out of the dark …
Stop saying these 7 shaming words in medicine. Right now.
Transgenderism has been catapulted to the forefront in the media, and it is clear we are in the midst of a cultural shift towards greater acceptance of the transgender community. The January 2017 issue of National Geographic was recently released as a special issue entitled, “Gender Revolution,” featuring a nine-year old transgender girl on its cover. As the construct of fixed gender is challenged and the societal impact of this …
Policy changes in the transgender health care arena
Medicine is a paradox. To save, we cut with sharp knives. We ignore pain so that it will light the path to diagnosis. We give toxins to destroy toxic disease. We scold our neighbors when they neglect their health, even as we work ourselves to exhaustion, eat too much and evade exercise. We comfort the families of our patients while ignoring our own.
There is one contradiction, which, by its very …
Should doctors’ personal judgments affect their patients?
We are like a restaurant that charges handsomely for sit-down dinners but gives away food for free at the takeout window. And we only pay our providers for serving the dining room guests. If traffic gets backed up at the drive-through, we hold our providers responsible, even though we never planned for our ever increasing demand for takeout.
In simpler times, patients went to the doctor when they felt unwell, and …
This dirty secret keeps doctors from doing their job
We live in a world that is rapidly evolving and changing. The future is uncertain as policies change, as well as politicians. No one can predict what 2017 or future years will herald. We watch as dozens of news stories pour into our mobile apps every time we check in. And for those of us that practice medicine, health care research, and news coverage can change the way we approach …
What CME isn’t doing today to align and empower patient outcomes
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Anti-immigration policies are hazardous to the health of immigrant patients. In the last ten years, there have been over 1,500 anti-immigration laws adopted by states across the country. These laws have come with discriminatory, racist, and xenophobic undertones, which has created a hostile environment for immigrants and citizens perceived as immigrants.
Patients don’t need to be deported or detained to be harmed by these policies, laws, and language. Research shows an …
In a previous piece, I described the killer B’s of burnout in medicine, namely, bleakness, boredom, and bureaucracy. Both times I went through burnout, the cycle started with boredom. I found medicine so full of the mundane most days, after about five years in practice, I grew restless. There’s only so much time after your office is done, the kitchen is clean, and the kids are in …
Burnout left its mark on this physician
I both look forward to and despise Sunday mornings. I awake just before the sun and am on the road by 5:15 a.m. Although I dread being upright so early on the weekend, I rejoice because it is the only trip to work, all week, at a leisurely pace. I see the new admits at the nursing home, run by the hospital if necessary, and return just as my family …
Connecting the lines between father and child
We go to the doctor when we are sick. But what happens when doctors get sick? Who cares for them? All too often, physicians are threatened, harassed, even terminated for being ill. After reporting on a psychiatrist fired for having cancer and a pediatrician bullied for her brain tumor, I’ve heard from many more physicians who are now courageously stepping forward to tell the truth — in …
These doctors were shamed and bullied for being sick
Theresa Miller is one of the hardest working women I know. She doesn’t come into the office very often. She no longer needs my prescription for her heartburn medication, as it costs less for her to buy it over the counter these days.
Today I saw her for a preoperative clearance. She finally decided to get an operation for her chronically sore shoulder. She had injured it many years ago>. In …
Marking a melancholy anniversary
This is a story of two deaths. These patients’ stories intersected on the same morning, in the same building, in two adjacent rooms, has left me thinking about them.
I was surprised to see Mrs. Stevens’ name on my schedule today. She came to the office last week, and I felt sure that she’d be too weak for another visit. But I was glad she’d made it, as I’ve become quite …
Small moments have a big impact on patients’ lives
When I was in medical school, “real” doctors saved lives. Period.
Specialists who focused on a patient’s quality of life, (the plastic surgeons, bariatric surgeons, holistic practitioners, infertility experts, etc.) were considered sellouts. (We won’t even consider the med school status of future psychiatrists.)
We disparaged these doctors because they could be saving lives and chose not to, because they were often paid (God forbid) out-of-pocket by their patients, and because they …
Why doctors are rebelling against saving lives
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