Primary Care
Patients who are openly skeptical of a physician’s science-backed advice
I’ve just passed the 15-year milestone of practicing family medicine in a small farm town in the Midwest. Knowing my patients and their multi-generational families deeply and enjoying their trust is a major part of my job satisfaction.
Unfortunately, the last two years have put a serious dent in both the trust and the satisfaction.
No one ever takes all the advice their physician gives them, at least in my experience. Until …
Keep us safe: Stop the violence against health care workers
Violence against health care workers has escalated to unprecedented levels in the last decade. The pandemic seems to have accelerated outbursts against health care providers online, in print, and in person.
A man from Tulsa, Oklahoma, recently angry over back pain, killed his surgeon and other health care workers before ending his own life.
Many health care workers report they are used to working in environments that are …
Doctoring in the backwoods: challenges and rewards
I worked in rural Kentucky for 20 years, all of it in poverty clinics. I suspect I got to know my patients better than someone working in a specialty clinic in a big city. The challenges and rewards of doctoring are unique to each specialty. But these are the challenges and rewards I experienced in primary care in the backwoods.
I learned that doctoring is hard. People always come in complaining …
The true art of medicine
There have been countless references to the art and science of medicine over the years. I, for one, certainly have embraced both in my long career as a physician in internal medicine. However, I have always had a special connection to the art part.
My late mother was an artist, so I grew up with …
How privileged a physician’s knowledge is
I was warned about it before we walked into the room.
So when I did walk in, I made sure my eyes stayed focused on his eyes, my gaze high and attentive. I smiled, possibly more than normal, to make sure he felt comfortable. Like a puppeteer holding up his doll, I knew it wasn’t time for me to drop down my eyes yet.
The resident with me began the routine visit …
A physician’s work dread and what he did about it [PODCAST]
Boundaries for women physicians
An excerpt from Boundaries For Women Physicians: Love Your Life And Career In Medicine.
My story is similar to that of countless other women who have chosen careers in medicine. I am a pediatric hematologist/oncologist. A few years ago, I was driving home one afternoon after having spent several hours with …
Comparing charity evaluation websites: What do those ratings mean?
The majority of people who donate money don’t research or compare charitable organizations. Only 1 in 3 research before giving, according to one of the biggest charity ratings websites, Charity Navigator. Giving 2.0 author Laura Arrillaga-Andreessen says only about three percent compare charitable organizations.
These numbers were both surprising and not surprising to me. I have done most of my donating with no more than a cursory …
Why doctors should write poetry
It’s been two and a half years post-pandemic, and I still don’t feel normal.
There’s a dark veil hanging over my life. I feel oppressed, unable to practice the way I want, unable to live and think in ways other than this abnormal new biological pseudoscience I’m not expected to question so that I’m more inclusive.
There’s a sense of lost purpose like I no longer work to feel fulfilled. Instead, I …
We are all responsible for women physicians’ pay discrepancy
A recent JAMA article showed that starting salaries for female physicians were lower than that of their male counterparts in most subspecialties.
New physicians are not expected to have many differentiating factors besides gender, yet the starting salaries differ. It is important to note that specialties with a higher percentage of women also have lower salaries for bother men and women. As the percentage of women physicians in a given …
The New Zealand health system in crisis: We need to look after our clinicians
I lay on an examination table while a plastic surgeon surveyed my skin to determine if a suspicious mole should be excised. I joked with him that I had once considered plastic surgery as a career. I knew he still worked at the hospital and fired a rhetorical question at him, enquiring if the hospital was still as busy as it was two years ago when I had worked there? …
Please stop saying “provider”
When I started my internal medicine practice in 1996, the medical arena was vastly different than it is today. Back then, having an MD after my name actually meant something.
A letter from me to an insurance company would get a needed medication covered for a patient––a time before preauthorization existed. Dr. Google was not yet born. “Provider” exclusively belonged to the insurance industry.
My patients called me “doctor” and referred to …
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I’m a physician, not a provider
Your parents likely spent months searching through baby name books, polling the family, and looking through the photo albums of ancestors to pick the perfect name for you.
Maybe your parents had to see your face before they could pick the perfect one. Names have history, they have power, and they embody your personality.
My daughter was officially named Daniela, yet we called her Bimbi months before she was born. That is …
Health care takes its toll. Look for the moments that remind you why you’re in it.
Completing my second year as an attending during a pandemic has been, well, interesting. It has brought up a variety of emotions. It’s all you’ve dreamt about for the past 7+ years of training, finally making it — the ability to “call the shots.” It is exhilarating yet mortifying, all wrapped in one!
You have those occasional cases you have never been exposed to during training. You lean on colleagues for …
The importance of non-judgmental empathy
It has always been difficult for medical professionals to balance the time needed for personal care, both physical and emotional, against the overwhelming demands of their time. This is particularly true today, given the extraordinary pressures created by health challenges generated through external factors, such as the pandemic and those caused by genetics or lifestyle choices. However, focusing on this balance is critical for the welfare of both the doctors …
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A new kind of metric in medicine
Today, I propose a new kind of metric in medicine.
I know. I know. (I hear the uncomfortable clearing of your throats.)
On one side of the room: Of course we are human, are we not?
On the other: Here we go again, Doctor Touchy-Feely. Let’s get on with it. I’ve got work to do.
But what if …
We rewarded a “chief complaint,” written as a patient concern or a family observation, features fleshed …
Health care’s band of brothers and sisters
Recently, I was sitting in the DFW airport after my son’s soccer tournament witnessing multiple flight cancellations. Travelers became upset because their plans were ruined due to “staff shortages.” I felt lucky as my flight was just delayed, and I had patients scheduled the next day. I needed to be there for them. Because of the increasing frequency of cancellations noted in the news, I had plans to rent a …
What is the narrative that you hear when faced with uncertainty?
The first week of my big attending job, I saw a patient with fever, sore throat, no cough, and tonsillar exudates. Well-trained to manage septic shock, but having no idea how to practice in a primary care clinic, I crafted a vast array of infectious and inflammatory diagnoses. With a quick glance, my senior partner said, “You don’t know that this is strep?” Flushed and wanting to hide, I thought, …
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A hard lesson for new attending physicians
It is the time of the year in which freshly graduated residents and fellows finally enter the health care systems as an attending after years of hard work and training. A time of celebrating and reflection, and a time to stop and think of what you have done and what lies ahead of you. I am sorry, this may not be what you want to hear, but I am tired …
Past Week
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The silent crisis hurting pain patients and their doctors
-
How the CDC’s opioid rules created a crisis for chronic pain patients
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How to build a culture where physicians feel valued [PODCAST]
-
ADHD isn’t one-size-fits-all: Why nuance in diagnosis matters
-
Why vaccine access still fails America’s most vulnerable groups
-
From the other side of the table: a plea for empathy
-
Past 6 Months
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How trade wars could destroy the U.S. health care system
-
Cutting opioid use in half: a hospital’s pain management breakthrough
-
How hospitals are quietly taking control of physicians
-
The hidden bias young female physicians face every day
-
How the system hunts physicians who refuse to kneel
-
How to advocate for your transgender child’s health care
-
Recent Posts
-
Teaching by humiliation is still crushing future doctors
-
A philosophical shift: the doctor’s journey into the role of patient
-
What happened to real care in health care?
-
When saving lives leads to losing your own
-
A surgeon’s startling ketamine experience [PODCAST]
-
How doctors can thrive despite declining reimbursements
-
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Past Week
-
The silent crisis hurting pain patients and their doctors
-
How the CDC’s opioid rules created a crisis for chronic pain patients
-
How to build a culture where physicians feel valued [PODCAST]
-
ADHD isn’t one-size-fits-all: Why nuance in diagnosis matters
-
Why vaccine access still fails America’s most vulnerable groups
-
From the other side of the table: a plea for empathy
-
Past 6 Months
-
How trade wars could destroy the U.S. health care system
-
Cutting opioid use in half: a hospital’s pain management breakthrough
-
How hospitals are quietly taking control of physicians
-
The hidden bias young female physicians face every day
-
How the system hunts physicians who refuse to kneel
-
How to advocate for your transgender child’s health care
-
Recent Posts
-
Teaching by humiliation is still crushing future doctors
-
A philosophical shift: the doctor’s journey into the role of patient
-
What happened to real care in health care?
-
When saving lives leads to losing your own
-
A surgeon’s startling ketamine experience [PODCAST]
-
How doctors can thrive despite declining reimbursements
-
