An excerpt from No More Neckties: A Memoir in Essays.
The sign that welcomed visitors to Wakefield, Nebraska, said: “Pop. 1030.” The town’s size didn’t vary in all the years I lived there. It was a close-knit community linked by culture, economy, religion, and blood. The people knew each …
“I’m sad you are leaving! But I’m sure you had your loans forgiven by coming here! So I am happy for you!”
A colleague said this upon learning I was leaving to pursue a fellowship. Her comment stung. As a non-citizen with private student loans, I don’t qualify for federal loan repayment programs. I came to work in a Federally Qualified Health Center (FQHC) because I wanted to.
Each year, a very …
Doctors don’t get sick. Right?
We’re certainly not supposed to. Throughout our training, the consequences of illness are dire—if you have to miss a day, someone else, someone you know well and care about, will have to fill in. They will probably have to fill in on their one day off that week. You know they’ll be angry and sad. If you’re still a med student rather than a resident, the …
COVID-19 melted down the world at a very inopportune time in history. Just as medicine was getting a handle on previously intractable conditions, from sophisticated diabetes management to less invasive surgical procedures, a new threat that devastates our population with few good treatments overwhelms health care.
Medical workers come to the rescue, as we always do, though at a personal and communal price. Somebody else keeps our food available, allows our …
Bringing in the mail recently, I was pleased to see a thick 5-by-7-inch booklet among the catalogs and bills. The anticipation of reading a few Reader’s Digest short stories and “Humor in Uniform” made the evening seem pleasurable. But when I opened the 244-page Reader’s Digest-sized booklet, I found the “Senior’s Blue Book for Greater Boston.” Here was page after page of assisted living communities, retirement communities, skilled nursing facilities, …
On my second year-long round of burnout, I lay in bed at night as I festered in my negativity, thinking to myself, “What am I good at, what do I like to do, what am I supposed to be doing?” Little did I realize this was a spiritual crisis.
After almost 15 years as a urologist, I wondered, “What else can I do? What am I supposed to be doing because …
By this title, I mean whether it is a good idea or not to hire a scribe to enter data into the electronic medical record (EMR) system.
I favor having a scribe. I came of age with paper charts, and I found the transition to EMR tricky and time-consuming.
My chief argument favoring scribes is that scribes can save doctors a lot of time. And by saving time, scribes can also help …
“That is a very heteronormative lens.”
These words were uttered to me by a 23-year-old female patient as I explained i-PLEDGE and the steps she must complete to take oral isotretinoin.
The visit started as fairly routine. A young female presented with a complaint of acne. I quickly appraised the patient on entering. She was petite, with a blonde pixie cut. She wore clothes that …
I know most of us have started adapting to the new way of life in our practice. However, some of us are still skeptical. I’m hoping to reach out to the skeptical ones among us.
The reason I say that is I was in your shoes as I started my career in a brick-and-mortar practice. In 2017 when my twins were born and after a short parental leave, I returned to …
Many Americans will lose access to vital health care services in a few short months unless Congress passes bipartisan legislation already introduced in both the House and Senate.
Co-sponsored by Sens. Tom Carper (D-Del.) and Tim Scott (R-S.C.) and Reps. Earl Blumenauer (D-Ore) and Brad Wenstrup (R-Ohio), the Hospital Inpatient Services Modernization Act extends waivers allowing patients with acute illnesses to receive hospital-level care at home. The waivers are set to …
Over the years, I’ve had many medical office assistants. Most were good. Some were outstanding.
Today, I’d like to tell you the story of one who was exemplary. He was never late to work. He never came in and insisted on finishing his breakfast at his desk before rooming our first patient. He was so personable that they would pour their hearts out to him while rooming patients. They would tell …
It is one of the last days of September. The sun, pale and tired, is slowly surrendering the humdrum of earth to the grey, soulless air. My father and I walk to our very final medical appointment, hopeless, exhausted, and befuddled. My father’s labored breathing is the only sound that fills the silence on our trip. As we drift to the entrance, …
I was a nurse before I was a PA. As the mantra goes, once a nurse, always a nurse. I have lived on both sides of the toxic structure: the medical and nursing models. Nurses eat their young, then place an unrealistic and unsustainable standard of altruism onto their offspring. Many times, the worthiness of nurses is gauged by how much they are willing to give of themselves, work overtime, …
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Several months ago, I wrote a post on a Facebook community of over 17K Black physicians. The post asked them what they would do and how they would react if their child told them they were gay. The responses I received ranged from “I will love and accept them” to “Heaven forbid!” to “I will beat it out of him!”
When I got over my shock, I realized that even as …
“Then why did this patient come to the hospital? You haven’t done anything to help this patient,” the attending physician said angrily during our morning rounds, upset that the patient had not met their urination output goals during treatment for heart failure exacerbation.
A hot flush crept up my face. Tightness clenching my chest and stomach. What was this feeling I felt? Shame. The entire team attended morning rounds — the …
World events have me thinking about boundaries. Countries have boundaries. Often they are based on the land’s physical features, but not always. Boundaries are created over time and may need to change for various reasons. So too with our personal human boundaries.
When we speak of personal boundaries, we can mean the physical boundaries of our skin. Or we may mean the psychological or social boundaries that we live with and …
Primary care is a field that is both highly rewarding and highly challenging. Those who enter into it quickly find that they are rewarded with the satisfaction of knowing they are playing a vital role in the lives of their patients. However, they also soon realize the immense responsibility of the job. There are always more patients that need to be seen, more phone calls that need to be returned, …
Misinformation and public distrust of health care professionals are a daily hazard affecting the health of millions of people. So what can health care professionals do about it?
A new study shows 37% of millennials, or those ages 25 to 34 years old, do not trust their health care providers. The age groups from 35 to 54 years old show 34% distrust their health care providers. At 65 …
Our profession often sends the message that we are invincible heroes.
Here’s my vulnerable and honest admission: I lapped that up. There was something so seductive about denying pesky human requirements, like sleep, regular exercise, and time to decompress. I liked being needed more than I liked having needs.
I sublimated mine under my superhero cape right up until the time I hit a kryptonite wall. There …
The 2022 Medscape poll on physician burnout confirms what has been painfully obvious to doctors on the frontlines of COVID-19: Their burnout is intensifying.
According to the survey of 13,000 doctors, the nation’s most burned-out physicians are those in emergency medicine (60%) and critical care (56%). Medscape, a leading health care publication, describes burnout as “long-term, unresolvable job-related stress that leads to exhaustion, cynicism, and …
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