Loss of autonomy, gaslighting, abuse, exploitation, and hypocrisy are all strong words. Just writing them brings to my mind the harsh reality of my experience and the collective experience of others who have dared to speak up. These words come to mind when I think about primary care in Canada. I recognize similar sentiments are heralded by my U.S. colleagues and those in the United Kingdom.
The system is failing. …
Patient volume has recovered across the country, and most medical offices are back to a steady state of care delivery—but ambulatory care has changed irrevocably. We’ve entered a phase shaped by crisis and marked by even more intense cost pressure and consolidation. What steps can independent medical practices take now to help ensure stability and prosperity moving forward?
Offer employees a more rewarding work experience.
The great resignation—unprecedented turnover in the labor …
Have you ever gone on a retreat?
I’m not talking about the Scouts of America kind, and I’m not talking about the one day the residents took off training to do team-building exercises and trust walks. Nope, family vacations do not count, as we all know that we need a vacation from our vacation when we get home.
Have you ever just gone away, disconnected from everything else, and connected to yourself?
Does …
In my recent TEDx Talk titled, Why Black Patients Don’t Trust the Healthcare System, I explored racially-based medical algorithms and their impact on health outcomes for Black patients. As a physician, I believe such algorithms have no place in the modern healthcare system, as they can affect how Black patients are diagnosed and the morbidity and mortality rates in the community.
A study published as recently …
The pandemic has brutalized health care such that the term “institutional betrayal” (IB) is becoming part of the physician vernacular. This cringe-worthy term is being used to point a finger of shame at health care leaders and systems who presumably are failing to support and protect their workers adequately.
Indeed, we depend on our employers for our safety and well-being. With staffing shortages, lack of supplies and lower revenue, employees bear …
Symptoms of burnout that are plaguing physicians and society include feelings of cynicism, apathy, depersonalization, and fatigue. These are associated with anxiety, depression, and suicide. In fact, more than 400 physicians each year die by suicide.
So much is written about the causes and what can be done to change these statistics. Whether it’s from the leadership standpoint, the autonomy of physicians, the burdens insurance places on physicians and their practices, …
Paula came to my office on a Monday afternoon, a few months after burying her husband. She and John had been inseparable. They were both my patients, so I knew John had spent the last six months battling lung cancer. They had been married forty-five years when John died. I sincerely offered Paula my condolences on that Monday afternoon. I could tell she was in pain and shared how she …
I shall translate.
This is her big day! She is meeting with her specialist for the first time, excited to finally hear that she will be cured from her annoying disease.
I am there to interpret back and forth between her and her doctor to eliminate the language barrier.
She has been suffering from this terrible disease affecting multiple organ systems in her frail body for a long time.
Today, she is done!
With her …
Ashley, one of my colleagues, and I discussed whether or not a doctor, nurse, or other providers of care should cry or show emotion with a patient or client. We’re not speaking of meltdowns or becoming so emotionally involved that it impairs our judgment or makes it difficult for us to render effective care, but simply being able to show a human response in the presence of your patient at …
When I was in high school, I read George Orwell’s 1984, a novel about a dystopian future where the government (a.k.a. Big Brother) monitors everything the citizenry says or thinks. Anyone deviating from government “doublespeak” is swiftly and severely punished. I recall my horror as the main character, Winston, a former government official who joins the anti-Big Brother underground, is arrested by the “thought police.” His mind is then reprogrammed …
I am not your provider.
There are days I loudly scream silently within the profundity of my soul, “Lord, please do not let them call me ‘provider’ one more time.”
I do not merely present to you to give you something you can use for your own personal subsistence.
Provider comes from the Latin verb “providere,” which means “to foresee.” Our beloved and storied profession’s effective and evidence-based practice does not merely imply …
If you are considering accepting an academic appointment, you need to be cognizant of the special issues involved in contracts in academia. You must know these things before signing an academic physician employment agreement.
An academic physician employment agreement is usually light on provisions.
Unlike most hospital physician employment agreements, an academic physician employment agreement tends to be very sparse on contractual provisions. Typically an academic physician employment agreement will just be …
From an Indian parable dated from before 500 BCE:
A group of blind men heard that a strange animal, called an elephant, had been brought to the town, but none of them were aware of its shape and form. Out of curiosity, they said: “We must inspect and know it by touch, of which we are capable.” So, they sought it out, and when they found it they groped about it. …
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Medical students are an odd bunch. At least in my day. Warning: The following may seem a little distasteful, violating the doctrine of proper decorum expected of medical professionals. I feel your anguish for those bent to the more sensitive side, but to sugar-coat a narrative only robs it of its essence.
I attended the Medical College of Wisconsin in the late 1980s, so what follows may not represent medical training. …
You must be thinking, what on Earth can the U.S. health care system learn from a poor, developing country like Nepal? Isn’t the U.S. known across the globe for its latest innovation and advanced procedures? Well, I was thinking the same thing. Until my seven-week trip this summer to rural Nepal. As a Nepali-American Emergency Medical Technician-Basic (EMT-B) studying medicine in the U.S., I learned more than I could imagine …
In recent months, three of the nation’s largest retailers have stirred up a frenzy on Wall Street with a string of high-profile health care deals.
Amazon bought primary-care company One Medical in early August for $3.9 billion. That was a month before CVS spent $8 billion to acquire Signify Health and its network of 10,000 clinicians who make home visits (both virtually and IRL). A day later, Walmart inked a 10-year …
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I was sitting in front of a panel of six people for my psychiatry training interview in Wellington, New Zealand. Two community members, two psychiatry consultants, and a senior psychiatry registrar, all of which were of Caucasian ethnicity.
I can recall talking about cultural differences in my upbringing and how that has helped me to connect to some of the most vulnerable people in our community. Samoan culture is adherently based …
As we continue our third year of the pandemic, there have been reports of hostile treatment directed at public health officials and medical personnel. This is escalating a crisis of burnout among health professionals, but there is an insidious, chronic hostility that lurks within hospitals between those who are supposed to be on the same team.
Bullying within health care has been a longstanding challenge. It is pervasive enough that the …
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You recently told me that I have the physician’s group’s highest patient satisfaction scores. This doesn’t surprise me. I know what makes me great: I take time. I let patients tell their stories. I listen, educate and collaborate. When I don’t know something, I find the answer. I am the poster woman for “AIDET.”
Recognizing that time is finite, I strive for efficiency. I delegate. I refer. I use order sets. …
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